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Pilot dies mid-flight prompting emergency landing

<p dir="ltr">A Turkish Airlines pilot has tragically died in the middle of a flight from Seattle in the US to the Turkish city of Istanbul, prompting an emergency landing. </p> <p dir="ltr">Pilot İlçehin Pehlivan, 59, “lost consciousness” at some point after the flight took off, with the plane then landing in New York’s John F. Kennedy International Airport, almost five hours into the journey. </p> <p dir="ltr">The diversion came after initial medical intervention on board failed to revive the captain, with the second pilot and co-pilot making the landing in New York.</p> <p dir="ltr">Pehlivan was declared dead on arrival when the plane was met by authorities, and no cause of death has yet been released. </p> <p dir="ltr">Turkish Airlines spokesperson Yahya Üstün said the pilot, who worked for the airline since 2007, underwent a routine health check in March and “no health problem was detected that would prevent him from working”.</p> <p dir="ltr">He recalled the moment onboard, saying, "After the first medical evaluation to our captain on board was inconclusive, the cockpit crew ... decided to make an emergency landing, but our captain died before landing."</p> <p dir="ltr">“As Turkish Airlines, we deeply feel the loss of our captain and extend our sincerest condolences to his bereaved family, colleagues, and all his loved ones,” he added.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Trouble

Chilling vision of missing family emerges

<p>A video filmed in New Zealand's west coast is the first "credible" sighting of a father and his kids who went missing three years ago. </p> <p>Tom Phillips along with his daughter Jayda, now 11, son Maverick, 9 and daughter Ember, 8, disappeared from the New Zealand town of Marokopa in December 2021. </p> <p>There have been hundreds of sightings of Phillips reported to police since then, with many of them unverified, and the children nowhere in sight.</p> <p>But now, new footage shot on the evening of October 3, showed all four of them marching through a grass field in Marokopa, in a single file with camouflage gear and heavy backpacks.</p> <p>The video, filmed by pig hunters, was handed to police and has since prompted a large-scale search of farmland in the area this week, which unfortunately failed to locate Phillips and his children. </p> <p>In the footage, the family seemed unaware they were being filmed from afar, with one of the witnesses describing them as "equipped for the bush". </p> <p>The children's mother, Catherine, has seen the video and instantly recognised her kids. </p> <p>“I’m so happy that they’re all there," she told the <em>New Zealand Herald</em>. </p> <p>"I’m so relieved to see all three of my babies. They’re all alive."</p> <p>The pig hunters who filmed the footage recalled their short encounter with the children. </p> <p>“The children asked: ‘Who else knows we’re here?’ And then they just kept on walking. They were all packed up, they had big packs on. I think the father sort of kept them moving,” Farmer John McOviney told the New Zealand Herald.</p> <p>In another interview with radio station <em>Newstalk ZB</em>, McOviney said that Phillips was carrying a large rifle. </p> <p>NZ Police Detective Inspector Andrew Saunders has also confirmed the sighting was being treated as "credible". </p> <p>"While nothing further of significance was located, investigators will now assess information gathered to determine any next steps," he said. </p> <p>"This is the first time all three of the children have been sighted, which is positive information, and we know it will be reassuring for the children's wider family."</p> <p>While police remain tight-lipped about what their next steps are, they said : "Our focus is very much on the safe return of Jayda, Maverick and Ember to their whānau [the Maori word for family] and we are doing all that we can to make that happen.”</p> <p>Phillips and his three children first went missing on September 11, 2021, and an arrest warrant was issued for Phillips shortly after their disappearance. </p> <p>He does not have legal custody over his children is alleged to have breached a custody order by taking them. The children are believed to have had no education or contact with others since their disappearance. </p> <p>Members of the public have been warned not to approach Phillips if they spotted him, as he may be armed. </p> <p><em>Images: TVNZ/ Waikato Police</em></p>

Legal

Readers response: What’s your best advice for managing medications while travelling?

<p>When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. </p> <p>We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said. </p> <p><strong>Kristeen Bon</strong> - I put each days tablet into small ziplock bags and staple them at one corner. All that goes into one larger ziplock bag and into my toilet bag. I store all the outer packs flat into another ziplock bag and that stays in the zip pack with my first aid kit in the main suitcase. I travel long haul up to six times a year and this is the most manageable way I have found.</p> <p><strong>Diane Green</strong> - Firstly, take sufficient supply of all meds to last the time I'm away. I separate morning medications and evening medications. Then it depends on how long I'm away. I have one that needs to be refrigerated. Depending on where I travel, this can entail arranging overnight in the establishment fridge while taking a freezer pack for daytime travel.</p> <p><strong>Irene Varis</strong> - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble!</p> <p><strong>Helen Lunn</strong> - Just get the chemist to pack into Medipacks. I usually take an extra week. I alway put some of the packs in my partners baggage incase my bag goes missing and a pack and a doctor’s letter in my hand luggage.</p> <p><strong>Jancye Winter</strong> - Always pack in your carry on with prescriptions.</p> <p><strong>Jenny Gordon</strong> - Carry a letter from doc with all medications, leave in original packaging. Double check that it isn’t illegal to carry your medication as some countries have strict regulations for things like Codeine. Always carry in carry on as you don’t want them to get lost.</p> <p><strong>Nina Thomas Rogers</strong> - Be organised with all your medicines before you leave.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Tips

Drunk couple forces emergency landing after mid-air meltdown

<p>A Ryanair flight to Ibiza had to be diverted after a drunk couple allegedly assaulted cabin crew and other passengers. </p> <p>The plane, carrying holiday-makers from Manchester to Ibiza had to make an emergency landing in Toulouse, where police hauled the intoxicated passengers off the plane. </p> <p>A British traveller on the flight, who asked to remain anonymous, recalled the man "swigging duty free vodka" on the first hour of the flight, before he started arguing with a male cabin crew member and punched him in the face. </p> <p>As they tried to restrain him, the intoxicated man assaulted another passenger and spat at a woman, hurling verbal abuse at her. </p> <p>“He was kicking off with everyone, he was out of control,” the witness said.</p> <p>Flight attendants reportedly warned him that the flight would have to be diverted if he didn't calm down, but he replied: “I don’t give a f***.” </p> <p>The altercation lasted for about 40 minutes until Flight FR2626 had to land in Toulouse, and 12 police officers took him away in custody. </p> <p>Video of the attack showed the man shouting and swearing at the police, before assaulting another traveller as he was being escorted off the flight. </p> <p>After he left the plane, his partner started harassing another traveller, hitting him and calling him a "paedo". </p> <p>In another video, police were filmed physically restraining the woman, before removing her from the plane. </p> <p>The flight spent just over an hour and a half on the tarmac at the Toulouse-Blagnac Airport before continuing its journey to Ibiza.</p> <p>Just last week Ryanair chief executive Michael O’Leary called for flyers to be limited to two drinks at airports to crack down on disorderly behaviour on flights. </p> <p>“We don’t want to begrudge people having a drink," he said. </p> <p>“But we don’t allow people to drink-drive, yet we keep putting them up in aircraft at 33,000ft.</p> <p>“In the old days, people who drank too much would eventually fall over or fall asleep. But now those passengers are also on tablets and powder.</p> <p>“It’s the mix. You get much more aggressive behaviour that becomes very difficult to manage.”</p> <p>The airline has started carrying out hand luggage checks to stop passengers on flights to Ibiza and the Greek islands from smuggling duty-free alcohol on-board. </p> <p>A Ryanair spokesperson has apologised for the incident saying: “This flight from Manchester to Ibiza diverted to Toulouse after a small group of passengers became disruptive in-flight." </p> <p>“The crew called ahead for police assistance, who met the aircraft upon landing at Toulouse and offloaded two passengers before this flight continued to Ibiza.</p> <p>“We sincerely apologise to passengers for any inconvenience caused as a result of these unruly passengers’ behaviour, which was beyond Ryanair’s control. This is now a matter for local police.”</p> <p><em>Image: news.com.au</em></p>

Travel Trouble

WHO declares new global health emergency

<p>The World Health Organisation (WHO) has declared the spread of mpox a global public health emergency, after sounding the alarm following the dramatic rise of cases in Africa. </p> <p>Concerned about the increase in infections in the Democratic Republic of Congo, which has subsequently spread to at least 10 neighbouring countries, the WHO quickly convened a meeting of experts to study the outbreak.</p> <p>“Today, the emergency committee met and advised me that in its view, the situation constitutes a public health emergency of international concern. I have accepted that advice,” WHO chief Tedros Adhanom Ghebreyesus told a <a href="https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern" target="_self">press conference</a> on Wednesday. </p> <p>A PHEIC is the highest level of alarm under the International Health Regulations, which are legally binding in 196 countries.</p> <p>“The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” said Dr Tedros.</p> <p>“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives. This is something that should concern us all.”</p> <p>Since January 2022, 38,465 cases and 1456 deaths have been reported in Africa due to mpox, with cases surging 160 per cent and deaths 19 per cent in recent months compared to 2023. </p> <p>Dr Tedros said the more than 14,000 cases and 524 deaths reported so far this year in DR Congo had already exceeded last year’s total.</p> <p>“The emergence last year and rapid spread of clade 1b in DRC, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring DRC is especially concerning,” he said, citing Burundi, Kenya, Rwanda and Uganda.</p> <p>Maria Van Kerkhove, the WHO’s epidemic and pandemic preparedness and prevention director, insisted, “We can stop transmission of mpox with a concerted effort.”</p> <p>However, she said experts needed a “much better understanding of the epidemiology” and the transmission patterns of the virus, which would help make sure the limited number of vaccines could be deployed to best effect.</p> <p>Two vaccines for mpox are recommended by WHO immunisation experts.</p> <p>Formerly called monkeypox, the virus was first discovered in humans in 1970 in what is now the DRC.</p> <p>Mpox is an infectious disease caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.</p> <p>The disease causes fever, muscular aches and large boil-like skin lesions.</p> <p>A PHEIC has only been declared seven times previously since 2009, over H1N1 swine flu, poliovirus, Ebola, Zika virus, Ebola again, Covid-19 and mpox.</p> <p><em>Image credits: Manuel Romano/NurPhoto/Shutterstock Editorial </em></p>

Caring

Woman “bullied” on plane over budget seating trick

<p dir="ltr">A young woman has recalled a flight from hell when she was “bullied” by a couple who were trying to utilise a seating hack that went viral on TikTok. </p> <p dir="ltr">The solo traveller took to Reddit to recount the story and ask social media users if she was in the wrong for her action. </p> <p dir="ltr">The woman began by saying she usually pays more to select her plane seat ahead of time, but a medical emergency on another plane had her waiting on standby and left with no option other than to sit in a middle seat.</p> <p dir="ltr">When she was finally able to board, she was greeted by a couple who had purchased both the window and aisle seats in a bid to have more space, utilising a travel “trick” that has been popular on TikTok.</p> <p dir="ltr">The method, which has been dubbed the 'poor man's business class', usually leaves travellers with an empty middle seat and more space, and few travellers opt to pick a middle seat. </p> <p dir="ltr">“When I got to my row the man and woman were chatting and sharing a snack... it was obvious they were together. I mentioned to the man that I'm in the middle, and he got up to let me in,” the unsuspecting traveller wrote on Reddit. </p> <p dir="ltr">“I asked them if they would prefer to sit together, I said I was totally okay with that. The woman reacted rudely to this and said ‘you're not supposed to be sitting here anyway’.”</p> <p dir="ltr">After noticing how the plane was full, she offered to show the pair her new ticket with the correct seat number on it.</p> <p dir="ltr">“She flicked her hand at my ticket and made a disgusted sound. I offered again if they wanted to sit together to which she didn't reply, her partner said it's okay and... made some small talk,” she continued. </p> <p dir="ltr">The man’s girlfriend then interrupted their conversation to ask,”'Did you use one of those third party websites to book your flight? It's so frustrating when people cheap out to inconvenience others.”</p> <p dir="ltr">The American woman explained that she had booked her flight directly and she had been placed on standby like everyone else and didn't choose the middle seat - she was assigned it.</p> <p dir="ltr">She then tried to keep the peace by refusing to engage with the furious woman. </p> <p dir="ltr">“I was so done with her attitude, I put my headphones on and attempted to do my own thing,” she explained.</p> <p dir="ltr">But the “entitled” girlfriend wasn't letting it go, as the woman explained, “This woman kept reaching over me and tapping her partner and trying to talk to him in a way that was super intrusive.”</p> <p dir="ltr">“I could tell even her partner was trying to engage her less so that she would hopefully stop, but she didn't.”</p> <p dir="ltr">“I think they tried to pull that tactic where they don't sit together on purpose...hoping no one will sit between them. But on full flights it doesn't work. And even so - it's not the other person's fault.”</p> <p dir="ltr">The traveller's post was met with hundreds of comments slamming the girlfriend’s behaviour, as one person wrote, “It's like a toddler having a tantrum.”</p> <p dir="ltr">“She was disappointed and a total a**hole. Gross entitled people,” another added. </p> <p dir="ltr">Another person applauded the traveller’s level-headed behaviour, writing, “Wow! You are my hero for keeping it classy - I’m afraid I would not have been as kind as you.”</p> <p dir="ltr"><em>Image credits: Shutterstock </em></p>

Travel Trouble

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Migraine is many things, but one thing it’s not is “just a headache”.</p> <p>“Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided.</p> <p>Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function.</p> <p>Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health.</p> <h2>What’s happening in my brain?</h2> <p>The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply:</p> <p>The earliest phase is called the <strong>prodrome</strong>. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption><span class="caption">The hypothalamus is shown here in red.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></span></figcaption></figure> <p>Next is the <strong>aura phase</strong>, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands.</p> <p>In the <strong>headache phase</strong>, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache.</p> <p>Finally, the <strong>postdromal phase</strong> occurs after the headache resolves and commonly involves changes in mood and energy.</p> <h2>What can you do about the acute attack?</h2> <p>A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect.</p> <p><iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <p><strong>Aspirin</strong></p> <p>For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication.</p> <p><strong>Triptans</strong></p> <p>For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals.</p> <p>Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action.</p> <p>The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action).</p> <p>As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke.</p> <p><strong>Gepants</strong></p> <p>Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”.</p> <p>Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them.</p> <p>They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke.</p> <p><strong>Ditans</strong></p> <p>Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack.</p> <p>However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers.</p> <h2>What about preventing migraines?</h2> <p>The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol.</p> <p>Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives.</p> <p>Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include:</p> <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> <p>Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone.</p> <p>For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached.</p> <p>It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more.</p> <hr /> <p><iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe></p> <hr /> <h2>‘Nothing works for me!’</h2> <p>In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP.</p> <p>The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections.</p> <p>These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist.</p> <p>Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away.</p> <p>Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives.</p> <p>Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<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/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>.</em></p> </div>

Body

Wild conspiracy theory emerges over leaked horse cruelty video

<p>The equestrian world continues to reel after <a href="https://www.oversixty.co.nz/finance/legal/leaked-footage-shows-olympic-star-s-horrific-animal-abuse" target="_blank" rel="noopener">a controversial video surfaced</a> showing British dressage star Charlotte Dujardin whipping a horse 24 times, described by critics as "like a circus elephant".</p> <p>However, the timing of the video's release, just days before the Olympics, has led to allegations of sabotage from within the British dressage community.</p> <p>In a statement to members, British Dressage Chief Jason Brautigam condemned Dujardin's actions as "completely unacceptable" but expressed skepticism about the motives behind the leak. "I do find claims that this was done to 'save dressage' somewhat disingenuous, given that it was timed to cause maximum damage to our sport," Brautigam wrote. He urged members to be kind to Dujardin, acknowledging the human element in the controversy.</p> <p>Madeline Hall, a former dressage correspondent for <em>Horse & Hound</em> magazine, echoed Brautigam's sentiments. Speaking to <em>The Daily Mail</em>, Hall remarked, "The timing of this video days before the Olympics smells of sabotage. To me, it is suspect."</p> <p>The video's release has led to significant fallout for Dujardin, including the loss of sponsorships and a tarnished reputation, jeopardising her chance to become Britain's most decorated female Olympian.</p> <p>The identity of the individual who leaked the video remains unknown, though the complainant's lawyer, Stephan Wensing from the Netherlands, has refused to comment on the matter. Wensing's involvement has fuelled speculation, given the historic rivalry between the British and Dutch equestrian teams.</p> <p>The Dutch team, which Dujardin defeated at the Tokyo Olympics in 2021, have quickly distanced themselves from the incident. A spokesperson for the Netherlands team stated, "We regret the expulsion of our fellow athlete but also condemn the training method used by Dujardin in the video. This has no place in our equestrian sports, where the welfare of the horse comes first."</p> <p>As the dressage community grapples with the scandal, Brautigam reminded people of the need for a compassionate response. "Charlotte Dujardin has done the right thing by <a href="https://www.oversixty.co.nz/travel/travel-trouble/no-excuse-olympic-legend-quits-days-before-paris-games-commence" target="_blank" rel="noopener">accepting responsibility and expressing remorse</a>," he said. "While we do not condone her behaviour, we must remember that there is also a human element to this – and, regardless of what has happened, she still deserves our understanding."</p> <p>Dujardin, who was a favourite for a Damehood if she secured a medal in Paris, now faces an uncertain future in her sport. The dressage community continues to debate the ethical and competitive implications of the video, with calls for increased focus on the welfare of horses and the integrity of the sport.</p> <p><em>Images: Instagram / Good Morning Britain</em></p>

Legal

Rare footage captures secluded tribe emerging from the Amazon

<p>Remarkable new footage has captured one of the world's most secluded tribes, who have been known for firing arrows at outsiders who get too close, as they emerged from the Amazon rainforest in Peru. </p> <p>The tribe were spotted near several controversial logging sites that have been making clearings throughout the forest, decimating their home lands.</p> <p>According to the Indigenous rights advocacy group Survival International, members of the Mashco Piro tribe, believed to be the biggest group of indigenous people living with no outside contact, were spotted near the Las Piedras River a few kilometres from tree-cutting projects in Southeastern section of the country.</p> <p>“This is irrefutable evidence that many Mashco Piro live in this area, which the government has not only failed to protect, but actually sold off to logging companies,” local Indigenous organisation Fenamad’s President Alfredo Vargas Pio said.</p> <p>Near the remote villages of Monte Salvado and Puerto Nuevo, the tribe emerged in search of food, with President Pio voicing concerns that violent fights could break out between loggers and the Indigenous people.</p> <p>He also added that the outside loggers could potentially bring new diseases to the area, which could wipe out the tribe.</p> <p>According to Survival International, Indigenous advocates have urged authorities to pull the certifications from the logging companies to protect the tribes. </p> <p>Logging company Canales Tahuamanu has been granted permission to log on the jungle land since 2002 with its invasive activity now sprawled out over 193 square miles, <em><a href="https://www.washingtonpost.com/world/2024/07/17/mashco-piro-tribe-photos-peru/" target="_blank" rel="noopener">The Washington Post</a></em> reported.</p> <p>The publication also reported that the firm also has a history of clashing with local tribes, although in the past, the firm said its workers have never reported seeing any Mashco Piro people and has complied with laws in Peru, where it is illegal to contact the tribe.</p> <p>Despite the Mashco Piro tribe’s seclusion, they have had limited contact with outsiders, with most of their rare contact resulting in violence, as they have been known for fire arrows at tourists boats and park rangers as warnings not to approach the area. </p> <p><em>Image credits: Survival International </em></p>

International Travel

Taking too many medications can pose health risks. Here’s how to avoid them

<p><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a></em></p> <p>When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact?</p> <p>The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines).</p> <p>I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65.</p> <h2>Polypharmacy among older adults</h2> <p>Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics.</p> <p>Is it a good idea to take so many drugs?</p> <p>According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability.</p> <p>In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic.</p> <h2>The risks of polypharmacy: 5 points to consider</h2> <p>When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken.</p> <ol> <li> <p>Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments.</p> </li> <li> <p>A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses?</p> </li> <li> <p>The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences.</p> </li> <li> <p>The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death.</p> </li> <li> <p>Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks.</p> </li> </ol> <p>Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements.</p> <p>Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health.</p> <h2>3 tips to avoid the risks associated with polypharmacy</h2> <p>What can we do as a patient, or as a caregiver?</p> <ol> <li> <p>Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ?</p> </li> <li> <p>Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced?</p> </li> <li> <p>Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter.</p> </li> </ol> <h2>Benefits should outweigh the risks</h2> <p>Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion.</p> <p>Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<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/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>.</em></p>

Body

Asking ChatGPT a health-related question? Better keep it simple

<p>It’s tempting to <a href="https://cosmosmagazine.com/news/chatgpt-and-dr-google/">turn to search engines</a> to seek out health information, but with the rise of large language models, like ChatGPT, people are becoming more and more likely to depend on AI for answers too.</p> <div class="copy"> <p>Concerningly, an Australian study has now found that the more evidence given to <a href="https://cosmosmagazine.com/technology/chatgpt-an-intimate-companion/">ChatGPT</a> when asked a health-related question, the less reliable it becomes.</p> <p>Large language models (LLM) and artificial intelligence use in health care is still developing, creating a a critical gap when providing incorrect answers can have serious consequences for people’s health.</p> <p>To address this, scientists from Australia’s national science agency, CSIRO, and the University of Queensland (UQ) explored a hypothetical scenario: an average person asking ChatGPT if ‘X’ treatment has a positive effect on condition ‘Y’.</p> <p>They presented ChatGPT with 100 questions sourced from the <a href="https://trec-health-misinfo.github.io/" target="_blank" rel="noopener">TREC Health Misinformation track</a> – ranging from ‘Can zinc help treat the common cold?’ to ‘Will drinking vinegar dissolve a stuck fish bone?’</p> <p>Because queries to search engines are typically shorter, while prompts to a LLM can be far longer, they posed the questions in 2 different formats: the first as a simple question and the second as a question biased with supporting or contrary evidence.</p> <p>By comparing ChatGPT’s response to the known correct response based on existing medical knowledge, they found that ChatGPT was 80% accurate at giving accurate answers in a question-only format. However, when given an evidence-biased prompt, this accuracy reduced to 63%, which was reduced again to 28% when an “unsure” answer was allowed. </p> <p>“We’re not sure why this happens,” says CSIRO Principal Research Scientist and Associate Professor at UQ, Dr Bevan Koopman, who is co-author of the paper.</p> <p>“But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.”</p> <p>Study co-author Guido Zuccon, Director of AI for the Queensland Digital Health Centre at UQ says that major search engines are now integrating LLMs and search technologies in a process called Retrieval Augmented Generation.</p> <p>“We demonstrate that the interaction between the LLM and the search component is still poorly understood, resulting in the generation of inaccurate health information,” says Zuccon.</p> <p>Given the widespread popularity of using LLMs online for answers on people’s health, Koopman adds, we need continued research to inform the public about risks and to help them optimise the accuracy of their answers.</p> <p>“While LLMs have the potential to greatly improve the way people access information, we need more research to understand where they are effective and where they are not.”</p> <p><em>Image credits: Getty Images</em></p> <div> <p align="center"> </p> </div> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=301406&title=Asking+ChatGPT+a+health-related+question%3F+Better+keep+it+simple" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em><em><a href="https://cosmosmagazine.com/technology/ai/asking-chatgpt-a-health-related-question-better-keep-it-simple/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </em></div>

Caring

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 it’s a bad idea to mix alcohol with some medications

<p><em><a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Anyone who has drunk alcohol will be familiar with how easily it can lower your social inhibitions and let you do things you wouldn’t normally do.</p> <p>But you may not be aware that mixing certain medicines with alcohol can increase the effects and put you at risk.</p> <p>When you mix alcohol with medicines, whether prescription or over-the-counter, the medicines can increase the effects of the alcohol or the alcohol can increase the side-effects of the drug. Sometimes it can also result in all new side-effects.</p> <h2>How alcohol and medicines interact</h2> <p>The chemicals in your brain maintain a delicate balance between excitation and inhibition. Too much excitation can lead to <a href="https://www.medicalnewstoday.com/articles/324330">convulsions</a>. Too much inhibition and you will experience effects like sedation and depression.</p> <p><iframe id="JCh01" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/JCh01/1/" width="100%" height="400px" frameborder="0"></iframe></p> <p>Alcohol works by increasing the amount of inhibition in the brain. You might recognise this as a sense of relaxation and a lowering of social inhibitions when you’ve had a couple of alcoholic drinks.</p> <p>With even more alcohol, you will notice you can’t coordinate your muscles as well, you might slur your speech, become dizzy, forget things that have happened, and even fall asleep.</p> <p>Medications can interact with alcohol to <a href="https://awspntest.apa.org/record/2022-33281-033">produce different or increased effects</a>. Alcohol can interfere with the way a medicine works in the body, or it can interfere with the way a medicine is absorbed from the stomach. If your medicine has similar side-effects as being drunk, those <a href="https://www.drugs.com/article/medications-and-alcohol.html#:%7E:text=Additive%20effects%20of%20alcohol%20and,of%20drug%20in%20the%20bloodstream.">effects can be compounded</a>.</p> <p>Not all the side-effects need to be alcohol-like. Mixing alcohol with the ADHD medicine ritalin, for example, can <a href="https://www.healthline.com/health/adhd/ritalin-and-alcohol#side-effects">increase the drug’s effect on the heart</a>, increasing your heart rate and the risk of a heart attack.</p> <p>Combining alcohol with ibuprofen can lead to a higher risk of stomach upsets and stomach bleeds.</p> <p>Alcohol can increase the break-down of certain medicines, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763421005121?via%3Dihub">opioids, cannabis, seizures, and even ritalin</a>. This can make the medicine less effective. Alcohol can also alter the pathway of how a medicine is broken down, potentially creating toxic chemicals that can cause serious liver complications. This is a particular problem with <a href="https://australianprescriber.tg.org.au/articles/alcohol-and-paracetamol.html">paracetamol</a>.</p> <p>At its worst, the consequences of mixing alcohol and medicines can be fatal. Combining a medicine that acts on the brain with alcohol may make driving a car or operating heavy machinery difficult and lead to a serious accident.</p> <h2>Who is at most risk?</h2> <p>The effects of mixing alcohol and medicine are not the same for everyone. Those most at risk of an interaction are older people, women and people with a smaller body size.</p> <p>Older people do not break down medicines as quickly as younger people, and are often on <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over#:%7E:text=is%20this%20important%3F-,Polypharmacy%20is%20when%20people%20are%20using%20five%20or%20more%20medicines,take%20five%20or%20more%20medicines.">more than one medication</a>.</p> <p>Older people also are more sensitive to the effects of medications acting on the brain and will experience more side-effects, such as dizziness and falls.</p> <p>Women and people with smaller body size tend to have a higher blood alcohol concentration when they consume the same amount of alcohol as someone larger. This is because there is less water in their bodies that can mix with the alcohol.</p> <h2>What drugs can’t you mix with alcohol?</h2> <p>You’ll know if you can’t take alcohol because there will be a prominent warning on the box. Your pharmacist should also counsel you on your medicine when you pick up your script.</p> <p>The most common <a href="https://adf.org.au/insights/prescription-meds-alcohol/">alcohol-interacting prescription medicines</a> are benzodiazepines (for anxiety, insomnia, or seizures), opioids for pain, antidepressants, antipsychotics, and some antibiotics, like metronidazole and tinidazole.</p> <p>It’s not just prescription medicines that shouldn’t be mixed with alcohol. Some over-the-counter medicines that you shouldn’t combine with alcohol include medicines for sleeping, travel sickness, cold and flu, allergy, and pain.</p> <p>Next time you pick up a medicine from your pharmacist or buy one from the local supermarket, check the packaging and ask for advice about whether you can consume alcohol while taking it.</p> <p>If you do want to drink alcohol while being on medication, discuss it with your doctor or pharmacist first.<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/223293/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/nial-wheate-96839"><em>Nial Wheate</em></a><em>, Associate Professor of the School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jasmine-lee-1507733">Jasmine Lee</a>, Pharmacist and PhD Candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/kellie-charles-1309061">Kellie Charles</a>, Associate Professor in Pharmacology, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/tina-hinton-329706">Tina Hinton</a>, Associate Professor of Pharmacology, <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/why-its-a-bad-idea-to-mix-alcohol-with-some-medications-223293">original article</a>.</em></p>

Body

First photos of new royal baby emerge

<p>Grand Duchess Maria Teresa of Luxembourg is every bit the proud grandmother as she took to Instagram to share photos of the newest royal family member, Prince Balthasar Felix Karl. </p> <p>Prince Balthasar is the third child of Prince Felix and his wife Princess Claire, and the Grand Duchess' seventh grandchild. </p> <p>"What a great joy the arrival of Balthasar, our seventh grandchild, born on January 7 in Luxembourg," she captioned the series of photos. </p> <p>The Grand Duchess, 67, was pictured with a huge smile on her face as husband Grand Duke Henri, 68 cradled Prince Balthasar. </p> <p>In another photo, Prince Felix and Princess Claire are pictured with their older children Princess Amalia, 9, and Prince Liam, 7, with Prince Balthasar fast asleep in his mother's arms. </p> <p>The third photo shows Grand Duchess Maria and Princess Amalia posing on the hospital bed as the Grand Duchess cradles her grandson. </p> <p>The Grand Duchess ended the series of photos with two pictures of her grandkids holding their new baby brother.</p> <p>The birth of Prince Balthasar was announced on Monday in a statement which read: "The newborn Prince will be named Balthasar Felix Karl. He weighs 3.220 kg (7lbs 1 oz) and measures 50 cm.</p> <p>"Prince Balthasar and Princess Claire are in perfect health."</p> <p>The Grand Duke and Grand Duchess share five children – Hereditary Grand Duke Guillaume, Prince Felix, Prince Louis, Princess Alexandra and Prince Sebastien.</p> <p><em>Images: Instagram</em></p>

Family & Pets

"Bad news": Jimmy Barnes rushed into emergency open heart surgery

<p>Jimmy Barnes has shared a major health update with his fans, just hours before heading into an emergency surgery. </p> <p>The iconic musician took to Instagram to share that he is set to undergo open heart surgery, after a dangerous infection was unable to be controlled. </p> <p>The 67-year-old, who has only recently recovered from pneumonia, announced the news from his hospital bed on Wednesday. </p> <p>"Unfortunately I got some bad news yesterday….despite everyone's best efforts the bacterial infection I've been battling over the last fortnight has apparently now spread to my heart," Barnes wrote.</p> <p>"It's infected an otherwise healthy valve that was replaced some years ago due to a congenital defect, so l'll be getting open heart surgery over the next few hours to clear out this infection and put in a clean valve."</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/C0xKOuBhSpS/?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/C0xKOuBhSpS/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Jimmy Barnes (@jimmybarnesofficial)</a></p> </div> </blockquote> <p>After announcing the news himself on social media, Barnes' son David Campbell spoke about his father's condition on <em><a href="https://9now.nine.com.au/today/jimmy-barnes-undergoes-open-heart-surgery-after-bacterial-infection-spreads/f4c56d1e-cd25-4a2d-8b24-11b592a4aae8" target="_blank" rel="noopener">Today Extra</a></em>, saying his dad was more frustrated at letting his fans down than anything else.</p> <p>Just before being struck down with the infection, Barnes was due to headline the Rock the Boat 2023 cruise festival.</p> <p>"I am here to allay everyone's fears, he is in wonderful hands," Campbell said.</p> <p>"He loves to work and he is frustrated for the fans who have been booking tickets and coming to his shows, he is passionate about getting crews back up and running in Australia and performing with his band, but is grateful for the nurses and doctors and if he hadn't got bacterial pneumonia, he wouldn't have had this picked up."</p> <p>Campbell said the family were confident in the medical staff looking after his dad and said "it was a blessing" that the infection was picked up when it was. </p> <p>"He is in great hands and he will make a great recovery, so reach out to him on social media because all the love in the world will be good for him," he said.</p> <p><em>Image credits: Getty Images</em></p>

Caring

"More bad days than good": Sad new pics of Bruce Willis emerge

<p>Bruce Willis' family are "soaking up every moment" with the Hollywood legend, as his health is continuing to deteriorate. </p> <p>The 68-year-old's family have shared new heartbreaking photos of the actor, which show a steep decline in his appearance and capabilities since the onset of his health issues. </p> <p>Willis was diagnosed with frontotemporal dementia at the beginning of 2023, nearly one year after announcing his retirement from acting due to aphasia, which causes difficulties with speech.</p> <p>Since his diagnosis, his family have continued to share updates on the actor's condition.</p> <p>Now, a source close to the family has revealed that the star’s health has worsened in recent weeks, and now there are “more bad days” than good. </p> <p>“Bruce has good days and bad days, but in the last two months, there are many more bad days than good,” a source told <span id="U831940059013HOG"><em><a href="https://www.usmagazine.com/celebrity-news/news/how-bruce-willis-family-is-supporting-him-as-he-battles-dementia/">US Weekly</a></em>.</span></p> <p>“This experience has brought the whole family even closer together. No one knows how much time Bruce has left, so they’re soaking up every moment they get with him.”</p> <p>Another source added that the four-time Golden Globe winner “has around-the-clock care, but at least one family member is always with him.” </p> <p>The beloved Hollywood action star has been spending his days alongside his wife, Emma Heming, ex-wife Demi Moore, and their collective five children, who all care for him throughout his difficult health journey.</p> <p><em>Image credits: Getty Images / Instagram</em></p>

Caring

Madonna rushed to intensive care

<p dir="ltr">Madonna was rushed to a hospital in New York and admitted into the ICU on Saturday after being found unresponsive. She has since been treated for a serious bacterial infection.</p> <p dir="ltr">The <em>Material Girl </em>was intubated for at least one night but is now reportedly out of the ICU, alert and recovering, according to Page Six.</p> <p dir="ltr">The singer had her daughter, Lourdes Leon, by her side during the entire ordeal.</p> <p dir="ltr">Madonna’s longtime manager, Guy Oseary, has released a statement on Instagram regarding the incident.</p> <p dir="ltr">“On Saturday June 24, Madonna developed a serious bacterial infection which led to a several day stay in the ICU,” he started the post.</p> <p dir="ltr">“Her health is improving, however she is still under medical care. A full recovery is expected,” he added.</p> <p dir="ltr">Oseary also announced that all of the singer’s current commitments including her upcoming world tour have been “paused” due to the medical emergency, however further details will be provided with new dates for the tour “as soon as we have them”.</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/CuC6w1TPH_l/?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/CuC6w1TPH_l/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Guy Oseary (@guyoseary)</a></p> </div> </blockquote> <p dir="ltr">The “Celebration” tour highlighting her greatest hits and the 40th anniversary of her breakout single, <em>Holiday</em> was set to kick off on July 15 in Vancouver and wrapped up in Amsterdam on December 1.</p> <p dir="ltr">Fans and celebrities alike have sent their love and report for the recovering star in the comment section of Oseary’s post.</p> <p dir="ltr">“Hope she feels better very soon!” commented <em>New Girl</em> actor Zoey Deschanel.</p> <p dir="ltr">“Sending her so much love from us. ❤️❤️❤️” wrote Aussie actress Isla Fisher.</p> <p dir="ltr">“Omg sending her love and healing light! 🙏” commented Ariana Grande’s brother Frankie.</p> <p dir="ltr">“Please send her my love and support. I’ll be sending prayers for her healing ❤️❤️🙏🙏,” wrote one fan.</p> <p dir="ltr">“Health is everything. Take as much time as needed,” commented another.</p> <p dir="ltr"><em>Images: Getty</em></p>

Caring

"A night in hospital and a trip to the burns unit later”: Concerned mum's warning against popular fruit

<p><em><strong>Warning: This article contains images that some readers may find distressing.</strong></em></p> <p>An Aussie mum has taken to the internet and shared photos of her son’s severe burns that came as a result of him playing with a popular fruit. “A night in hospital and a trip to the burns unit later.” She began in her Facebook post.</p> <p>Her son Otis was playing happily outside with a lime in the sunshine, but the next day horror ensued.</p> <p>“It wasn’t until the next day that we noticed a rash appeared.” The mother said.</p> <p>The parents had assumed the rash must’ve been an allergic reaction to the lime juice, however, the rash quickly developed into a “horrific burn,” she added.</p> <p>The parents took Otis to the hospital where they were informed their son was suffering from a condition called phytophotodermatitis.</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/Cku5QH2thxE/?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/Cku5QH2thxE/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Tiny Hearts (@tinyheartseducation)</a></p> </div> </blockquote> <p>Phytophotodermatitis, more commonly known as margarita burn, is a little-known condition which causes burns to the skin when a chemical called furocoumarin reacts to sunlight.</p> <p>The chemical is found in limes, citrus fruit and some plants.</p> <p>“The small lime he had been innocently playing with - had now burnt his skin horrifically!“ The mum said. “If our story can help raise awareness into phytophotodermatitis at least something good has come out of our horrific experience!”</p> <p>The woman has urged parents to be on the lookout for this little-known skin condition.</p> <p>To minimise the risks of phytophotodermatitis, <a href="https://www.healthline.com/" target="_blank" rel="noopener">Healthline</a> suggests washing hands and other exposed parts of the skin immediately after being outdoors, wearing gloves when gardening, putting on sunscreen before going outdoors and wearing long-sleeved tops and pants in wooded areas.</p> <p>Photo credit: Getty</p>

Body

How to survive in 8 terrifying travel emergencies

<p>It’s every traveller’s worst nightmare to be caught in an emergency while on holiday overseas, and while it’s a rare occurrence, it’s still something everyone needs to be cautious of. So, we’ve got eight life-saving tips from the experts themselves, and trust us, you’ll want to commit them to memory.</p> <p><strong>1. Falling from a cruise ship</strong></p> <p>It’s estimated that just 20 people fall from cruise ships annually, but it’s still important to be prepared. “Everyone who falls unexpectedly into cold water wants to follow the same instinct, to swim hard and to fight the cold water,” explains ocean safety organisation RNLI. “But when people fight it, chances are, they lose. If you find yourself unexpectedly in the water, do as little as possible, and float.”</p> <p><strong>2. Avalanches</strong></p> <p>Snow lovers around the world dread the “A” word, but it is possible to survive one. If caught in the path of one, the Association of British Travel Agents advise skiing sideways to try and remain on the surface of the slide. Then, ditch the poles and “swim” in the direction of the slide and try to grab hold of a tree. Always carry a locator beacon with you to aid the efforts of search and rescue.</p> <p><strong>3. Quicksand</strong></p> <p>Quicksand is made up of waterlogged sand or clay which may appear solid but liquefies upon impact. Stay calm and avoid making any quick movements, as you could create air pockets which will only pull you deeper into the ground. Shed any extra weight (e.g. backpacks, hats), then lean backwards and spread out – more surface area means you’ll be lighter. From there, move sideways until you reach terra firma.</p> <p><strong>4. Rip currents</strong></p> <p>These are found on most surf beaches and can pull swimmers out to sea at a speed of up to 8km per hour. The RNLI advise against fighting the rip, instead treading water and conserving energy until the current grows weak enough for you to swim back to shore. Another option is following the current, which will take you in a semi-circle. Wait until you reach a weaker point, then swim back to shore.</p> <p><strong>5. Safari attacks</strong></p> <p>Stuck in the presence of a lion? Avoid the temptation to turn and run. Instead, make direct eye contact and back away very slowly. If it’s a leopard, do the opposite – avoid any eye contact and hope they lose interest. With elephants, simply stand your ground and try to look brave. Buffalos are almost impossible to outrun, so your best bet is to climb a tree.</p> <p><strong>6. Lost on a hike</strong></p> <p>Adventure blogger <a href="http://hikingdude.com/default.php" target="_blank" rel="noopener"><strong><span style="text-decoration: underline;">Hiking Dude</span></strong></a> recommends sticking by the acronym <strong>STOP</strong> when lost. <strong>Stop </strong>exactly where you are, <strong>think </strong>(try to retrace your steps, but do not move unless you’re sure you know where you’re going), <strong>observe </strong>how much daylight (and supplies) you have left and pay attention to any weather changes, then <strong>plan </strong>a route back to a safe place. Unless you’re absolutely confident, it’s best to stay put.</p> <p><strong>7. Snake bite</strong></p> <p>If you encounter a snake, back away very slowly and choose a different route. If it seems to be following you, stamp on the ground – the vibrations should drive it away. If bitten, ensure the affected area is moved lower than your heart (this will slow the spread of venom) and get to the closest hospital. If possible, try to remember (or even photograph) the snake – this will help doctors identify the required anti-venom.</p> <p><strong>8. Plane crash</strong></p> <p>If you’re unfortunate enough to be caught in a plane emergency, there are two immediate hurdles – surviving the impact of the crash, then surviving what follows – fire, smoke and drowning. Get the oxygen mask on immediately (20 seconds is enough to make you lose consciousness) and abandon your belongings. According to a simulation conducted using a Boeing 727, it’s actually safer to book a cheap seat at the back, as the front of the plane will bear the most impact.</p> <p><em>Image credits: Getty Images </em></p>

Travel Tips

People with long COVID continue to experience medical gaslighting more than 3 years into the pandemic

<p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a></em></p> <p>It’s increasingly clear that the <a href="https://www.worldometers.info/coronavirus/country/canada/">SARS-CoV-2 virus is not going away</a> any time soon. And for some patients, their symptoms haven’t gone away either.</p> <p>In January 2023, our team of researchers at the <a href="https://pipps.ca/">Pacific Institute on Pathogens, Pandemics and Society</a> published a <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">research brief</a> about how people seek out information about long COVID. The brief was based on a scoping review, a type of study that assesses and summarizes available research. Our interdisciplinary team aims to understand the experiences of people with long COVID in order to identify opportunities to support health care and access to information.</p> <h2>Lingering long COVID</h2> <p>Long COVID (also called <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html">Post COVID-19 condition</a>) is an illness that occurs after infection with COVID-19, lasting weeks to months, and even years. First coined by a <a href="https://doi.org/10.1016%2Fj.socscimed.2020.113426">patient on Twitter</a>, the term also represents a collective movement of people experiencing the long-term effects of COVID-19 and advocating for care. <a href="https://science.gc.ca/site/science/sites/default/files/attachments/2023/Post-Covid-Condition_Report-2022.pdf">Around 15 per cent</a> of adults who have had COVID still have symptoms after three months or more.</p> <p>Long COVID affects systems <a href="https://doi.org/10.1016/j.socscimed.2021.114619">throughout the body</a>. However, symptom fluctuations and limited diagnostic tools make it challenging for health-care providers to diagnose, especially with <a href="https://doi.org/10.1038/s41579-022-00846-2">over 200 symptoms</a> that may present in patients. Perhaps because long COVID presents itself in many different ways, the illness has <a href="https://doi.org/10.1016/j.socscimed.2021.114619">been contested</a> across the medical field.</p> <p>To identify opportunities to reduce barriers to long COVID care, our team has explored how patients and their caregivers access <a href="https://pipps.cdn.prismic.io/pipps/bd160219-3281-4c5d-b8be-57c301e7f99b_Long+Covid+Brief+Feb+2023.pdf">information about long COVID</a>. We have found that one of the most significant barriers faced by patients is <a href="https://doi.org/10.1177/20552076211059649">medical gaslighting</a> by the people they have turned to for help.</p> <h2>Lack of validation leads to stigma</h2> <p><a href="https://doi.org/10.1136/bmj.o1974">Medical gaslighting</a> occurs when health-care practitioners dismiss or falsely blame patients for their symptoms. While new information about long COVID has become more readily available, some patients continue to face gaslighting and feel that their symptoms are <a href="https://doi.org/10.1016%2Fj.ssmqr.2022.100177">treated less seriously</a> by some health-care professionals.</p> <p>This dismissal can <a href="https://doi.org/10.1111/hex.13602">erode trust</a> in the health-care system and can also lead to <a href="https://doi.org/10.1111/hex.13518">stigma and shame</a>.</p> <p>Preliminary findings from our ongoing study with long COVID patients indicate that, when medical practitioners do not validate a patient’s condition, this extends into community networks of family and friends who may also dismiss their symptoms, contributing to further stigmatization at home.</p> <p>Medical gaslighting can present additional barriers to treatment, such as not being referred to specialists or long COVID clinics. This can, in turn, compound other symptoms such as fatigue, and <a href="https://doi.org/10.1192/bjo.2022.38">exacerbate the psychological symptoms of long COVID</a>, such as depression and anxiety.</p> <p>Medical gaslighting isn’t new. It has been documented by patients with other chronic conditions, such as <a href="https://doi.org/10.5772/intechopen.107936">myalgic encephalomyelitis or chronic fatigue syndrome</a>. And while this is common for patients with <a href="https://doi.org/10.1001/amajethics.2021.512">non-visible illnesses</a>, medical gaslighting is more commonly experienced by <a href="https://doi.org/10.1111/1467-9566.13367">women and racialized people</a>.</p> <p>Long COVID patients also note gender biases, as women with prolonged symptoms feel they are not believed. This is particularly worrisome, as studies have found that <a href="https://doi.org/10.1001/jama.2020.17709">women are disproportionately more likely to experience long COVID</a>.</p> <h2>Where do we go from here?</h2> <p>While long COVID information is constantly shifting, it’s clear that patients face many barriers, the first of which is having their illness minimized or disregarded by others. To ensure that patients have access to compassionate care, we suggest:</p> <p><strong>1. Educating physicians on long COVID</strong></p> <p>Because definitions of long COVID, and its presentation, vary widely, primary care physicians need support to recognize and acknowledge the condition. General practitioners (GPs) must also provide patients with information to help manage their symptoms. This requires actively listening to patients, documenting symptoms and <a href="https://doi.org/10.1136/bmj.m3489">paying close attention to symptoms that need further attention</a>.</p> <p>Training physicians on the full range of symptoms and referring patients to available supports would reduce stigma and assist physicians by reducing their need to gather information themselves.</p> <p><strong>2. Raise awareness about long COVID</strong></p> <p>To increase awareness of long COVID and reduce stigma, public health and community-based organizations must work collaboratively. This may include a public awareness and information campaign about long COVID symptoms, and making support available. Doing so has the potential to foster community support for patients and improve the mental health of patients and their caregivers.</p> <p><strong>3. Ensure information is accessible</strong></p> <p>In many health systems, GPs are <a href="https://doi.org/10.1186/s12913-019-4419-0">gatekeepers to specialists</a> and are considered trusted information sources. However, without established diagnostic guidelines, patients are left to <a href="https://doi.org/10.2196/37984">self-advocate</a> and prove their condition exists.</p> <p>Because of negative encounters with health-care professionals, patients turn to social media platforms, including long COVID <a href="https://doi.org/10.7861%2Fclinmed.2020-0962">online communities</a> on Facebook. While these platforms allow patients to validate experiences and discuss management strategies, patients should not rely only on social media given the <a href="https://doi.org/10.3389/fpubh.2022.937100">potential for misinformation</a>. As a result, it is crucial to ensure information about long COVID is multi-lingual and available in a wide range of formats such as videos, online media and physical printouts.</p> <p>The <a href="https://science.gc.ca/site/science/en/office-chief-science-advisor/initiatives-covid-19/post-covid-19-condition-canada-what-we-know-what-we-dont-know-and-framework-action">recent recommendations of the Chief Science Advisor of Canada</a> to establish diagnostic criteria, care pathways and a research framework for long COVID are a positive development, but we know patients need support now. Improving long COVID education and awareness won’t resolve all of the issues faced by patients, but they’re foundational to compassionate and evidence-based care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/203744/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/simran-purewal-1405366">Simran Purewal</a>, Research Associate, Health Sciences, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kaylee-byers-766226">Kaylee Byers</a>, Regional Deputy Director, BC Node of the Canadian Wildlife Health Cooperative; Senior Scientist, Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/kayli-jamieson-1431392">Kayli Jamieson</a>, Master's Student in Communication, Research Assistant for Pacific Institute on Pathogens, Pandemics and Society, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>, and <a href="https://theconversation.com/profiles/neda-zolfaghari-1431577">Neda Zolfaghari</a>, Project Coordinator, Pacific Institute on Pathogens, Pandemics and Society, and the Pandemics & Borders Project, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser 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/people-with-long-covid-continue-to-experience-medical-gaslighting-more-than-3-years-into-the-pandemic-203744">original article</a>.</em></p>

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