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Why do I get so anxious after drinking? Here’s the science behind ‘hangxiety’

<a href="https://theconversation.com/profiles/blair-aitken-1510537">Blair Aitken</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rebecca-rothman-2231560">Rebecca Rothman</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> You had a great night out, but the next morning, anxiety hits: your heart races, and you replay every conversation from the night before in your head. This feeling, known as hangover anxiety or “<a href="https://adf.org.au/insights/what-is-hangxiety/">hangxiety</a>”, <a href="https://onlinelibrary.wiley.com/doi/10.1002/hup.2623">affects around 22%</a> of social drinkers. While for some people, it’s mild nerves, for others, it’s a wave of anxiety that feels impossible to ride out. The “Sunday scaries” may make you feel panicked, filled with dread and unable to relax. Hangover anxiety can make even simple tasks feel overwhelming. Here’s why it happens, and what you can do about it. <h2>What does alcohol do to our brains?</h2> A hangover is the body’s way of recovering after drinking alcohol, bringing with it a range of symptoms. <a href="https://www.mdpi.com/2077-0383/10/23/5691">Dehydration and disrupted sleep</a> play a large part in the pounding headaches and nausea many of us know too well after a big night out. But hangovers aren’t just physical – there’s a strong mental side too. Alcohol is a nervous system depressant, meaning it alters how certain chemical messengers (or neurotransmitters) behave in the brain. Alcohol relaxes you by increasing <a href="https://my.clevelandclinic.org/health/articles/22857-gamma-aminobutyric-acid-gaba">gamma-aminobutyric acid</a> (GABA), the neurotransmitter that makes you feel calm and lowers inhibitions. It decreases <a href="https://my.clevelandclinic.org/health/articles/22839-glutamate">glutamate</a> and this also slows down your thoughts and helps ease you into a more relaxed state. Together, this interaction affects your mood, emotions and alertness. This is why when we drink, we often feel more sociable, carefree and willing to let our guard down. As the effects of the alcohol wear off, your brain works to rebalance these chemicals by <a href="https://www.sciencedirect.com/science/article/pii/S0191886918305762">reducing GABA and increasing glutamate</a>. This shift has the opposite effect of the night before, causing your brain to become more excitable and overstimulated, which can lead to feelings of anxiety. So why do some people get hangxiety, while others don’t? There isn’t one clear answer to this question, as several factors can play a role in whether someone experiences hangover-related anxiety. <h2>Genes play a role</h2> For some, a hangover is simply a matter of how much they drank or how hydrated they are. But genetics may also play a significant role. <a href="https://onlinelibrary.wiley.com/doi/10.1111/add.12699">Research</a> shows your genes can explain almost half the reason why you wake up feeling hungover, while your friend might not. Because genes influence how your body processes alcohol, some people may experience more intense hangover symptoms, such as headaches or dehydration. These stronger physical effects can, in turn, <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/hup.2623">trigger anxiety during a hangover</a>, making you more susceptible to “hangxiety.” <h2>Do you remember what you said last night?</h2> But one of the most common culprits for feeling anxious the next day is often <a href="https://journals.sagepub.com/doi/pdf/10.1177/0091450915604988">what you do while drinking</a>. Let’s say you’ve had a big night out and you can’t quite recall a conversation you had or something you did. Maybe you acted in ways that you now regret or feel embarrassed about. You might fixate on these thoughts and get trapped in a cycle of worrying and rumination. This cycle can be hard to break and can make you feel more anxious. <a href="https://doi.org/10.1016/j.addbeh.2023.107619">Research</a> suggests people who already struggle with feelings of anxiety in their day-to-day lives are especially vulnerable to hangxiety. Some people drink alcohol to unwind after a stressful day or to make themselves feel more comfortable at social events. This often leads to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9756407">heavier consumption</a>, which can make hangover symptoms more severe. It can also begin a cycle of drinking to feel better, making hangxiety even harder to escape. <h2>Preventing hangover anxiety</h2> The best way to prevent hangxiety is to limit your alcohol consumption. The <a href="https://adf.org.au/reducing-risk/alcohol/alcohol-guidelines">Australian guidelines</a> recommend having no more than ten standard drinks per week and no more than four standard drinks on any one day. Generally, the more you drink, the more intense your hangover symptoms might be, and the worse you are likely to feel. Mixing other drugs with alcohol can also increase the risk of hangxiety. This is especially true for party drugs, such as ecstasy or MDMA, that give you a temporary high but can lead to anxiety as they wear off and you are <a href="https://adf.org.au/insights/drug-comedowns">coming down</a>. If you do wake up feeling anxious: <ul> <li> focus on the physical recovery to help ease the mental strain </li> <li> drink plenty of water, eat a light meal and allow yourself time to rest </li> <li> try <a href="https://www.headspace.com/mindfulness/mindfulness-101">mindfulness meditation</a> or deep breathing exercises, especially if anxiety keeps you awake or your mind races </li> <li> consider journalling. This can help re-frame anxious thoughts, put your feelings into perspective and encourage self-compassion </li> <li> talk to a close friend. This can provide a safe space to express concerns and feel less isolated. </li> </ul> Hangxiety is an unwelcome guest after a night out. Understanding why hangxiety happens – and how you can manage it – can make the morning after a little less daunting, and help keep those anxious thoughts at bay.<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/240991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/blair-aitken-1510537">Blair Aitken</a>, Postdoctoral Research Fellow in Psychopharmacology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rebecca-rothman-2231560">Rebecca Rothman</a>, PhD Candidate in Clinical Psychology, School of Health Sciences, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-get-so-anxious-after-drinking-heres-the-science-behind-hangxiety-240991">original article</a>.

Mind

Can you die from long COVID? The answer is not so simple

<a href="https://theconversation.com/profiles/rose-shiqi-luo-1477061">Rose (Shiqi) Luo</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/catherine-itsiopoulos-14246">Catherine Itsiopoulos</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/kate-anderson-1412897">Kate Anderson</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/magdalena-plebanski-1063786">Magdalena Plebanski</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/zhen-zheng-1321031">Zhen Zheng</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Nearly five years into the pandemic, COVID is feeling less central to our daily lives. But the virus, SARS-CoV-2, is still around, and for many people the effects of an infection can be long-lasting. When symptoms persist for more than three months after the initial COVID infection, this is generally referred to as <a href="https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition">long COVID</a>. In September, Grammy-winning Brazilian musician <a href="https://www.abc.net.au/news/2024-09-07/brazilian-musician-sergio-mendez-dies-at-83/104323360">Sérgio Mendes</a> died aged 83 after reportedly having long COVID. <a href="https://www.abs.gov.au/articles/covid-19-mortality-australia-deaths-registered-until-31-july-2023">Australian data</a> show 196 deaths were due to the long-term effects of COVID from the beginning of the pandemic up to the end of July 2023. In the United States, the Centers for Disease Control and Prevention reported 3,544 <a href="https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20221214.htm">long-COVID-related deaths</a> from the start of the pandemic up to the end of June 2022. The symptoms of <a href="https://www.healthdirect.gov.au/long-covid">long COVID</a> – such as fatigue, shortness of breath and “brain fog” – can be debilitating. But can you die from long COVID? The answer is not so simple. <h2>How could long COVID lead to death?</h2> There’s still a lot we don’t understand about what causes long COVID. A popular theory is that “zombie” <a href="https://www.pnas.org/doi/full/10.1073/pnas.2300644120">virus fragments</a> may linger in the body and cause inflammation even after the virus has gone, resulting in long-term health problems. Recent research suggests a reservoir of <a href="https://www.sciencedirect.com/science/article/abs/pii/S1198743X24004324?via%3Dihub">SARS-CoV-2 proteins</a> in the blood might explain why some people experience ongoing symptoms. We know a serious COVID infection can damage <a href="https://covid19.nih.gov/news-and-stories/long-term-effects-sars-cov-2-organs-and-energy#:%7E:text=What%20you%20need%20to%20know,main%20source%20of%20this%20damage">multiple organs</a>. For example, severe COVID can lead to <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19">permanent lung dysfunction</a>, persistent heart inflammation, neurological damage and long-term kidney disease. These issues can in some cases lead to death, either immediately or months or years down the track. But is death beyond the acute phase of infection from one of these causes the direct result of COVID, long COVID, or something else? Whether long COVID can directly cause death continues to be a topic of debate. Of the <a href="https://www.cdc.gov/nchs/data/vsrr/vsrr025.pdf">3,544 deaths</a> related to long COVID in the US up to June 2022, the most commonly recorded underlying cause was COVID itself (67.5%). This could mean they died as a result of one of the long-term effects of a COVID infection, such as those mentioned above. COVID infection was followed by heart disease (8.6%), cancer (2.9%), Alzheimer’s disease (2.7%), lung disease (2.5%), diabetes (2%) and stroke (1.8%). Adults aged 75–84 had the highest rate of death related to long COVID (28.8%). These findings suggest many of these people died “with” long COVID, rather than from the condition. In other words, long COVID may not be a direct driver of death, but rather a contributor, likely exacerbating existing conditions. <h2>‘Cause of death’ is difficult to define</h2> Long COVID is a relatively recent phenomenon, so mortality data for people with this condition are limited. However, we can draw some insights from the experiences of people with post-viral conditions that have been studied for longer, such as myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). Like long COVID, <a href="https://bmjopen.bmj.com/content/12/5/e058128">ME/CFS</a> is a complex condition which can have significant and varied effects on a person’s physical fitness, nutritional status, social engagement, mental health and quality of life. Some research indicates people with ME/CFS are at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218818/">increased risk</a> of dying from causes including heart conditions, infections and suicide, that may be triggered or compounded by the debilitating nature of the syndrome. So what is the emerging data on long COVID telling us about the potential increased risk of death? Research from 2023 has suggested adults in the US with long COVID were at <a href="https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802095">greater risk</a> of developing heart disease, stroke, lung disease and asthma. Research has also found <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9721155/">long COVID</a> is associated with a higher risk of <a href="https://www.tandfonline.com/doi/full/10.1080/21642850.2022.2164498#abstract">suicidal ideation</a> (thinking about or planning suicide). This may reflect common symptoms and consequences of long COVID such as sleep problems, fatigue, chronic pain and emotional distress. But long COVID is more likely to occur in people who have <a href="https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary">existing health conditions</a>. This makes it challenging to accurately determine how much long COVID contributes to a person’s death. Research has long revealed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302107/">reliability issues</a> in cause-of-death reporting, particularly for people with chronic illness. <h2>So what can we conclude?</h2> Ultimately, long COVID is a <a href="https://www.health.gov.au/topics/chronic-conditions/about-chronic-conditions">chronic condition</a> that can significantly affect quality of life, mental wellbeing and overall health. While long COVID is not usually immediately or directly life-threatening, it’s possible it could exacerbate existing conditions, and play a role in a person’s death in this way. Importantly, many people with long COVID around the world lack access to appropriate support. We need to develop <a href="https://www.mja.com.au/journal/2024/221/9/persistent-symptoms-after-covid-19-australian-stratified-random-health-survey">models of care</a> for the optimal management of people with long COVID with a focus on multidisciplinary care. Dr Natalie Jovanovski, Vice Chancellor’s Senior Research Fellow in the School of Health and Biomedical Sciences at RMIT University, contributed to this article.<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/239184/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rose-shiqi-luo-1477061">Rose (Shiqi) Luo</a>, Postdoctoral Research Fellow, School of Health and Biomedical Sciences, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/catherine-itsiopoulos-14246">Catherine Itsiopoulos</a>, Professor and Dean, School of Health and Biomedical Sciences, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/kate-anderson-1412897">Kate Anderson</a>, Vice Chancellor's Senior Research Fellow, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>; <a href="https://theconversation.com/profiles/magdalena-plebanski-1063786">Magdalena Plebanski</a>, Professor of Immunology, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a>, and <a href="https://theconversation.com/profiles/zhen-zheng-1321031">Zhen Zheng</a>, Associate Professor, STEM | Health and Biomedical Sciences, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/can-you-die-from-long-covid-the-answer-is-not-so-simple-239184">original article</a>.

Body

We know parents shape their children’s reading – but so can aunts, uncles and grandparents, by sharing beloved books

<a href="https://theconversation.com/profiles/emily-grace-baulch-1399683">Emily Grace Baulch</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> <a href="https://creative.gov.au/news/media-releases/revealing-reading-a-survey-of-australian-reading-habits/">Over 80%</a> of Australians with children encourage them to read. Children whose parents enjoy reading are <a href="https://www.booktrust.org.uk/news-and-features/news/news-2023/new-research-from-booktrust-reveals-the-impact-of-parental-reading-enjoyment-on-childrens-reading-habits/">20% more likely</a> to enjoy it too. My research has found parents aren’t the only family members who play an important role in developing a passion for reading – extended family, from grandparents to siblings, uncles and great-aunts, also influence readers’ connections to books. I surveyed 160 Australian readers about their home bookshelves and reading habits. More than 80% of them acknowledged the significant influence of family in what and how they read. Reading to children is often <a href="https://www.booktrust.org.uk/globalassets/resources/research/booktrust-family-survey-research-briefing-2-reading-influencers.pdf">the invisible workload of mothers</a>: 95% of mothers read to children, compared to 67% of fathers. Yet intriguingly, those I surveyed – whose ages ranged from their early 20s to their 70s – collectively talked about books being passed down across eight generations. Family members were associated with their most valued books – and their identities as readers. <h2>Treasured possessions</h2> Books passed down through generations often become treasured possessions, embodying a shared family history. One person discussed an old hardcover copy of <a href="https://www.harpercollins.com.au/9780732284350/blinky-bill/">Blinky Bill</a> by Dorothy Wall. Originally given to her father and his siblings by their great-aunt in 1961, the book’s pages are now discoloured and falling out. “Although I always think of my mother as having been my reading role model,” she wrote, “actually my father had an equally big impact, just in another way.” Her father is a central organising figure on her home bookshelf: she has dedicated a whole shelf to the books he liked. The story she tells about his old copy of Blinky Bill, however, crosses generations. The book’s battered state is a testament to its longevity and well-loved status. Its inscription to her family members makes the copy unique and irreplaceable. Another person remembered a set of Dickens’ novels, complete with margin notes and century-old newspaper clippings, carefully stored with her most special books. These volumes, initially owned by her great-great-grandmother and later gifted by her great-aunt, represent a reading bond passed down through generations. Such books can never be replaced, no matter how many copies might be in circulation. These books are closely associated with memories and experiences – they are invaluable for who they represent. A third person has her father’s “old” Anne McCaffrey’s <a href="https://www.goodreads.com/series/40323-dragonriders-of-pern">Dragonriders of Pern</a> series: he read it to her as a teenager, then passed it down. The book “sparked” her interest in science-fiction, and she now intends to pass it on to her own teenager. Her book, too, is “battered”, with “chunks falling out when you read it”. The cover is falling off. The deteriorating state of a book is part of the book’s legacy. It shows how loved it has been. Reading passions can be deliberately cultivated through family, but their value is less connected to reading comprehension or literacy than a sense of connection through sharing. Inherited, much-loved books bind families together. They can anchor absent family members to the present. These books can come to symbolise love, connection and loss. The family members who’ve passed down their books might not be physically present in children’s lives – they may not be reading aloud to them at bedtime – but through their books, they can have a strong presence in their loved ones’ memories. That indelible trace can be sustained into adulthood. <h2>Buying books for the next generation</h2> Another way relatives contribute to a family reading legacy is by buying new copies of much-loved books for the next generation. Theresa Sheen, from The Quick Brown Fox, a specialist children’s bookstore in Brisbane, notes that customers often ask for copies of books they had when they were younger. They may have read them to their children and now want them for their grandchildren. For example, <a href="https://www.goodreads.com/series/40767-the-baby-sitters-club">The Babysitters Club series</a> by Ann M. Martin was mentioned multiple times as a nostalgic favourite, now being sought after by grandparents. Readers’ habits of re-buying favourite books can affect the publishing industry. With older children’s classics still selling, publishers seek to update the text to reflect contemporary cultural mores. Enid Blyton is one author who endures through intergenerational love and nostalgia. However, her work is regularly <a href="https://www.news.com.au/entertainment/books-magazines/books/enid-blytons-famous-five-books-edited-to-remove-offensive-words/news-story/47a63bb79a5d870f19aed58b19469bb5">edited and bowdlerised</a> to update it. Books can be imbued with the voices and emotions of others. They are more than just physical objects – they are vessels of shared experiences that can be passed down, up and across generations. This enduring bond between family members does more than preserve individual stories. It actively shapes and sustains a vibrant reading culture.<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/232372/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-grace-baulch-1399683">Emily Grace Baulch</a>, Producer at Ludo Studio & Freelance Editor, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-know-parents-shape-their-childrens-reading-but-so-can-aunts-uncles-and-grandparents-by-sharing-beloved-books-232372">original article</a>.

Family & Pets

Why is pain so exhausting?

<a href="https://theconversation.com/profiles/michael-henry-1321395">Michael Henry</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> One of the most common feelings associated with persisting pain is fatigue and this fatigue can become overwhelming. People with chronic pain can report being drained of energy and motivation to engage with others or the world around them. In fact, a study from the United Kingdom on people with long-term health conditions found pain and fatigue are the <a href="https://weareundefeatable.co.uk/campaign-hub/latest-from-us/the-bridging-the-gap-report/">two biggest barriers</a> to an active and meaningful life. But why is long-term pain so exhausting? One clue is the nature of pain and its powerful effect on our thoughts and behaviours. <h2>Short-term pain can protect you</h2> Modern ways of thinking about pain emphasise its protective effect – the way it grabs your attention and compels you to change your behaviour to keep a body part safe. Try this. Slowly pinch your skin. As you increase the pressure, you’ll notice the feeling changes until, at some point, it becomes painful. It is the pain that stops you squeezing harder, right? In this way, pain protects us. When we are injured, tissue damage or inflammation makes our pain system become more sensitive. This pain stops us from mechanically loading the damaged tissue while it heals. For instance, the pain of a broken leg or a cut under our foot means we avoid walking on it. The concept that “pain protects us and promotes healing” is one of the most important things people who were in chronic pain tell us <a href="https://pubmed.ncbi.nlm.nih.gov/35934276/">they learned</a> that helped them recover. <h2>But long-term pain can overprotect you</h2> In the short term, pain does a terrific job of protecting us and the longer our pain system is active, the more protective it becomes. But persistent pain can overprotect us and <a href="https://onlinelibrary.wiley.com/doi/10.1111/jabr.12124">prevent recovery</a>. People in pain have called this “<a href="https://www.jpain.org/article/S1526-5900(22)00379-0/fulltext">pain system hypersensitivity</a>”. Think of this as your pain system being on red alert. And this is where exhaustion comes in. When pain becomes a daily experience, triggered or amplified by a widening range of activities, contexts and cues, it becomes a constant drain on one’s resources. Going about life with pain requires substantial and constant effort, and this makes us fatigued. <a href="https://www.aihw.gov.au/reports/chronic-disease/chronic-pain-in-australia/summary">About 80%</a> of us are lucky enough to not know what it is like to have pain, day in day out, for months or years. But take a moment to imagine what it would be like. Imagine having to concentrate hard, to muster energy and use distraction techniques, just to go about your everyday tasks, let alone to complete work, caring or other duties. Whenever you are in pain, you are faced with a choice of whether, and how, to act on it. Constantly making this choice requires thought, effort and strategy. Mentioning your pain, or explaining its impact on each moment, task or activity, is also tiring and difficult to get across when no-one else can see or feel your pain. For those who do listen, it can become tedious, draining or worrying. <h2>No wonder pain is exhausting</h2> In chronic pain, it’s not just the pain system on red alert. Increased inflammation throughout the body (the immune system on red alert), disrupted output of the hormone cortisol (the endocrine system on red alert), and stiff and guarded movements (the motor system on red alert) also go <a href="https://www.noigroup.com/product/explain-pain-supercharged/">hand in hand</a> with chronic pain. Each of these adds to fatigue and exhaustion. So learning how to manage and resolve chronic pain often includes learning how to best manage the over-activation of these systems. Loss of sleep is also a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9289983/">factor</a> in both fatigue and pain. Pain causes disruptions to sleep, and loss of sleep contributes to pain. In other words, chronic pain is seldom “just” pain. No wonder being in long-term pain can become all-consuming and exhausting. <h2>What actually works?</h2> People with chronic pain are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633893/">stigmatised, dismissed</a> and <a href="https://www.jpain.org/article/S1526-5900(13)01367-9/fulltext">misunderstood</a>, which can lead to them not getting the care they need. Ongoing pain may prevent people working, limit their socialising and impact their relationships. This can lead to a descending spiral of social, personal and economic disadvantage. So we need better access to evidence-based care, with high-quality education for people with chronic pain. There is good news here though. Modern care for chronic pain, which is grounded in first gaining a modern understanding of the underlying biology of chronic pain, <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/abstract">helps</a>. The key seems to be recognising, and accepting, that a hypersensitive pain system is a key player in chronic pain. This makes a quick fix highly unlikely but a program of gradual change – perhaps over months or even years – promising. Understanding how pain works, how persisting pain becomes overprotective, how our brains and bodies adapt to training, and then learning new skills and strategies to gradually retrain both brain and body, offers scientifically based hope; there’s strong <a href="https://jamanetwork.com/journals/jama/article-abstract/2794765">supportive evidence</a> from <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00441-5/abstract">clinical trials</a>. <h2>Every bit of support helps</h2> The best treatments we have for chronic pain take effort, patience, persistence, courage and often a good coach. All that is a pretty overwhelming proposition for someone already exhausted. So, if you are in the 80% of the population without chronic pain, spare a thought for what’s required and support your colleague, friend, partner, child or parent as they take on the journey. <hr /> More information about chronic pain is available from <a href="https://www.painrevolution.org/painfacts">Pain Revolution</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238417/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-henry-1321395">Michael Henry</a>, Physiotherapist and PhD candidate, Body in Mind Research Group, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-pain-so-exhausting-238417">original article</a>.

Body

The psychology of retirement: why do so many athletes struggle to call time?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sarah-tillott-1462234">Sarah Tillott</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/diarmuid-hurley-1462235">Diarmuid Hurley</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Think back to when you met someone for the first time. One of the first questions you asked, or were asked, was likely: “what do you do for work?” It’s a polite, innocuous and socially ingrained way of getting to know more about a person. But it also demonstrates the central role of our professional lives as part of our personal identities. For professional athletes, their careers, exploits and recognition can become the defining aspect of their identity. So what happens when sporting careers end? The transition to retirement, across professions and countries, can be extremely tough to navigate. It can be especially difficult for elite sportspeople, who can experience retirement as a <a href="https://www.sciencedirect.com/science/article/pii/S1469029221001679?casa_token=L4g3UTN8T78AAAAA:VHqcgJN7jIpW82cp32TXq9gIcKFzD2jtf6Jc_OX-3fjpHVnowlp0p8fcqE01BVF3Qjx0bmiRz4T1">loss of identity</a>, connected to their sense of achievement, meaning and control in life. <h2>How retirement impacts athletes</h2> A common saying with many sportspeople is “<a href="https://www.forbes.com/sites/jannfreed/2024/06/29/athletes-die-twice-retirement-as-a-death/">athletes die twice</a>” – once when they retire and again at their death. Former Wallaby Brendan Cannon <a href="https://www.impact.acu.edu.au/lifestyle/after-the-final-siren-helping-athletes-to-adapt-to-life-after-sport">has spoken of</a> this difficulty: <blockquote> [People] want to talk to you about what you used to be, and all you want to focus on is what you want to become. </blockquote> During the transition to retirement, elite athletes can be affected by how they got into their chosen sport, how long they stayed in the system and the variables that either accelerated or ended their careers. Other factors include whether they played a team or individual sport, male vs female pathways, whether their exit from sport was voluntary or involuntary and their age when retiring. My (Sarah) interviews with former professional athletes demonstrate the complexity of retiring from elite sport. To the public, William Zillman, former NRL star turned vet, seems to have it all together. But it didn’t come without hardship, pain and struggles in navigating the harsh terrain of retirement. When asked about his retirement, Zillman said: “[Being an NRL player was] all I knew.” <blockquote> I turned up to work each day, I was told what to do, how to do it and when to do it […] but when I left the system, I think I lost the ability to think for myself. I went from having all the help in the world to very little – it was tough. </blockquote> Retiring from high-performance sport can have profound effects on an athlete’s <a href="https://journals.lww.com/acsm-csmr/fulltext/2020/10000/the_psychological_burden_of_retirement_from_sport.11.aspx/1000">physical and mental health</a>, as well as their social and professional development. While “regular people” usually retire in their 60s or 70s, an athlete’s retirement often occurs earlier, coinciding with crucial phases of career development and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513329/">family planning</a>. Some have to adjust from being highly paid and highly managed to surviving on minimum wages with very little support. “It’s a recipe for disaster,” Ryan James, who considers himself one of the lucky ones, said. A former forward for the Gold Coast Titans, James has been working closely with the Rugby League Players Association (RLPA) with the aim to address some of the complex issues with the transition experience. James knows only too well the struggles some people in the system face as their careers begin to wind down: <blockquote> Many of our players come into the system from disadvantaged and vulnerable backgrounds and while we have made a start, there is more we can be doing. Financial literacy and management is just one avenue we need to tackle. I’ve known too many retired, vulnerable players who were homeless, sleeping in cars with their young families. It’s devastating. </blockquote> It took former English captain turned NRL superstar James Graham a good part of 18 months to re-configure his identity: <blockquote> You come out feeling so lost and alone. Most of your life is spent training, connecting with mates, having a lot of routine and structure to almost nothing. It’s strange and confronting. </blockquote> <h2>What are the major codes doing?</h2> Across various sporting codes there are programs that aim to assist athletes to prepare for retirement. For example, <a href="https://www.rlpa.com.au/past-player-and-transition-program">the RLPA has a program</a> to support athletes who are transitioning. Other major professional Australian codes have similar programs, including <a href="https://www.aflplayers.com.au/app/uploads/2021/10/Player-Retirement-Scheme_Booklet_A5_4.pdf">the AFL</a>, <a href="https://www.thepfa.com/players/union-support/pension-scheme">Professional Footballers Association</a> (soccer) and <a href="https://auscricket.com.au/programs-community/past-player-programs/">cricket</a>. However, whether or not athletes choose to participate in these programs is usually at the discretion of the players. <h2>The importance of planning, preparation and support</h2> One of the key factors influencing how an athlete transitions into life after sport is how much they have <a href="https://theconversation.com/its-not-just-retiring-athletes-who-need-mental-health-support-young-sportspeople-need-it-too-230296">prepared for it</a>. Research with elite athletes from <a href="https://elevateaus.com.au/wp-content/uploads/2021/09/The-end-of-a-professional-sport-career-ensuring-a-positive-transition.pdf">the AFL, NRL and A-League</a> shows those who planned and prepared for life after sport and who had goals, direction and identities beyond sport, experienced more acceptance, autonomy (control) and optimism about the future. On the other hand, those who were unprepared or did not plan ahead experienced negative emotional and psychological states, and struggled to move on. This negative effect is even more pronounced for those who were forced to <a href="https://journals.lww.com/acsm-csmr/fulltext/2020/10000/the_psychological_burden_of_retirement_from_sport.11.aspx/1000">end their career due to injury</a>. <hr /> <iframe id="lQixA" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/lQixA/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How to improve the situation</h2> A recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513329/">scoping review</a> explored the notion of retirement for professional athletes and their ability to adapt to life after sport. It summarised many areas that need more attention: Make athletes aware of what’s ahead Expect that when you leave, it may be hard. Reach out to your club, coach and support services and surround yourself with people who you can talk to and who may be able to help. Athletes should expect that it will take time to adjust, and this adjustment period is crucial for mitigating the adverse effects of retirement. This adjustment period can also significantly reduce the initial negative impacts on their mental and physical health. Tailored support programs Developing tailored support programs that address the specific needs of different sports and athlete sub-groups can help mitigate the challenges associated with retirement. These programs might include career counselling, mental health support and opportunities for continuous involvement in the sports community. A need for further research There is a pressing need for more research to identify effective support mechanisms for retiring athletes. Understanding the types of support that facilitate a smoother transition can help in designing programs and interventions tailored to the unique needs of elite athletes. Additionally, mapping out the factors that aid or hinder the transition across different sports and athlete sub-groups would provide valuable insights.<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/234559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-tillott-1462234">Sarah Tillott</a>, Senior Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/diarmuid-hurley-1462235">Diarmuid Hurley</a>, Lecturer, Faculty of Health, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-psychology-of-retirement-why-do-so-many-athletes-struggle-to-call-time-234559">original article</a>. </div>

Retirement Life

Why is it so hard to cancel subscriptions or end ‘free’ trials? Report shows how companies trap you into paying

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/katharine-kemp-402096">Katharine Kemp</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Many businesses are trapping Australian consumers in paid subscriptions by making them hard to cancel, hiding important details and offering “free” trials that auto-renew with hefty charges. We need law reform to tackle this continuing problem. <a href="https://cprc.org.au/report/let-me-out">A new report</a> shows 75% of Australian consumers have had negative experiences when trying to cancel a subscription, according to the Consumer Policy Research Centre (CPRC). It shows businesses use “<a href="https://www.wired.com/story/how-to-spot-avoid-dark-patterns/">dark patterns</a>”, which are designs that hinder consumers who try to act in their own best interests. Subscription traps are often called “<a href="https://www.ftc.gov/business-guidance/blog/2022/11/checking-out-ftcs-100-million-settlement-vonage">Hotel California</a>” techniques, referring to The Eagles’ famous lyric: “you can check out any time you want, but you can never leave”. In some of these cases, consumers may have remedies under our existing consumer law, including for misleading conduct. But we need law reform to capture other <a href="https://treasury.gov.au/consultation/c2023-430458">unfair practices</a>. In the meantime, the CPRC’s research also gives examples of businesses with fair, consumer-friendly subscription practices. These also benefit the business. <h2>Examples of unfair subscription traps</h2> <a href="https://www.forbes.com/councils/forbesbusinessdevelopmentcouncil/2022/09/12/the-evolution-of-the-subscription-model-and-whats-on-the-horizon/">Subscription business models</a> have become common – many products are now provided in the form of software, an app or access to a website. Some of these would once have been a physical book, newspaper, CD or exercise class. Most people who use online services have experienced the frustration of finding a credit card charge for an unwanted, unused subscription or spending excessive time trying to cancel a subscription. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?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/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=643&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=643&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=643&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=808&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=808&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615486/original/file-20240826-16-fp57es.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=808&fit=crop&dpr=3 2262w" alt="Infographic with a few statistics from the report." /></a><figcaption><a class="source" href="https://cprc.org.au/wp-content/uploads/2024/08/CPRC_LetMeOut_SubsTraps_Report_FINAL.pdf">CPRC, Let me out – Subscription trap practices in Australia, August 2024</a></figcaption></figure> Businesses can make it difficult for consumers to stop paying for unwanted subscriptions. Some do this by allowing consumers to start a subscription with a single click, but creating multiple obstacles if you want to end the subscription. This can include obscuring cancellation options in the app, requiring consumers to phone during business hours or making them navigate through multiple steps and offers before terminating. The report points out many of the last-ditch discounts offered in this process are only short term. One survey respondent said: <blockquote> I wasn’t able to cancel without having to call up and speak to someone. Their business hours meant I had to call up during my work day and it took some time to action. </blockquote> Other businesses badger consumers with frequent emails or messages after they cancel. One respondent said a business made “the cancellation process impossible by making you call and then judging your reason for cancellation”. <h2>What does consumer law say?</h2> Some subscription traps already fall foul of the Australian Consumer Law and warrant investigation by the <a href="https://www.accc.gov.au/media-release/accc-warns-consumers-to-beware-of-subscription-traps">Australian Competition & Consumer Commission</a> (ACCC). Consumers may have remedies where the business has engaged in misleading conduct or imposes an unfair contract term. For example, the ACCC is <a href="https://www.accc.gov.au/media-release/accc-court-action-against-eharmony-for-alleged-misleading-online-dating-membership-statements#:%7E:text=The%20ACCC%20has%20today%20commenced%20proceedings%20in%20the,the%20pricing%2C%20renewal%20and%20duration%20of%20its%20memberships.">suing dating site eHarmony</a> for its allegedly misleading subscription practices. In the United States, the Federal Trade Commission <a href="https://www.ftc.gov/news-events/news/press-releases/2024/06/ftc-takes-action-against-adobe-executives-hiding-fees-preventing-consumers-easily-cancelling">has filed a complaint against software company Adobe</a> for allegedly using dark patterns in its subscription practices. The Federal Trade Commission has alleged that “Adobe pushed consumers toward the ‘annual paid monthly’ subscription without adequately disclosing that cancelling the plan in the first year could cost hundreds of dollars”. Adobe <a href="https://news.adobe.com/news/news-details/2024/Adobes-Recent-Statement-Regarding-Updated-Federal-Trade-Commission-Complaint-/default.aspx">issued a statement</a> arguing the commission’s complaint “mischaracterises” its business. The litigation is ongoing. <h2>We need an unfair practices prohibition</h2> Some subscription traps would fall outside the existing consumer law. This is because they don’t meet the test for misleading conduct or unfair contract terms, but make it practically very difficult to cancel. The <a href="https://www.accc.gov.au/media-release/accc-welcomes-consultation-on-possible-unfair-trading-practices-regulatory-reforms">ACCC has advocated</a> for Australia to follow other countries such as the United Kingdom and the United States to enact an unfair practices prohibition to capture conduct like this. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?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/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=769&fit=crop&dpr=1 600w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=769&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=769&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=966&fit=crop&dpr=1 754w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=966&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/615487/original/file-20240826-16-2j23h7.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=966&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The shift businesses can make today. <a class="source" href="https://cprc.org.au/wp-content/uploads/2024/08/CPRC_LetMeOut_SubsTraps_Report_FINAL.pdf">CPRC, Let me out – Subscription trap practices in Australia, August 2024</a></figcaption></figure> <h2>Better practices benefit businesses too</h2> The CPRC report also revealed that 90% of Australians would likely purchase from the same organisation if cancelling a subscription process was quick and simple. Businesses focused on a short-sighted cash grab fail to realise that consumers might cancel but later return if treated well. The CPRC highlights businesses that are doing a good job. For instance, the habit change app Atoms (based on James Clear’s book Atomic Habits) has a genuinely free trial. It doesn’t require credit card details, doesn’t auto-renew, and lets consumers know how many trial days remain. The CPRC says the charity World Vision doesn’t auto-renew annual sponsorships, but reminds supporters about when the sponsorship will lapse. Importantly, some businesses – such as Netflix – use their data for good in this context. They notice when users are paying for the service without using it and help them unsubscribe. These practices should be applauded. But we need an unfair practices prohibition for businesses who don’t follow suit and recognise the long-term benefits of treating customers fairly.<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/237236/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katharine-kemp-402096">Katharine Kemp</a>, Associate Professor, Faculty of Law & Justice; Lead, UNSW Public Interest Law & Tech Initiative, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-is-it-so-hard-to-cancel-subscriptions-or-end-free-trials-report-shows-how-companies-trap-you-into-paying-237236">original article</a>. </div>

Money & Banking

No, your aches and pains don’t get worse in the cold. So why do we think they do?

<a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It’s cold and wet outside. As you get out of bed, you can feel it in your bones. Your right knee is flaring up again. That’ll make it harder for you to walk the dog or go to the gym. You think it must be because of the weather. It’s a common idea, but a myth. When we looked at the evidence, <a href="https://www.sciencedirect.com/science/article/pii/S0049017224000337">we found</a> no direct link between most common aches and pains and the weather. In the first study of its kind, we found no direct link between the temperature or humidity with most joint or muscle aches and pains. So why are so many of us convinced the weather’s to blame? Here’s what we think is really going on. <h2>Weather can be linked to your health</h2> The weather is often associated with the risk of new and ongoing health conditions. For example, cold temperatures <a href="https://pubmed.ncbi.nlm.nih.gov/27021573/">may worsen</a> asthma symptoms. Hot temperatures <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00117-6/fulltext">increase the risk</a> of heart problems, such as arrhythmia (irregular heartbeat), cardiac arrest and coronary heart disease. Many people are also convinced the weather is linked to their aches and pains. For example, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1479-8077.2004.00099.x?casa_token=jvpSbA4szqoAAAAA%3ATyHyGaqXmfevWyuJe6LW_3Pap3IPHC8HSMTl3RN63mFzNO0X7ozQjBb6Bi3yVFuPjqkrf-WlB-J5A1q1">two in every three</a> people with knee, hip or hand osteoarthritis <a href="https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-15-66">say</a> cold temperatures trigger their symptoms. Musculoskeletal conditions affect more than <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions-comorbidity-australia/summary">seven million Australians</a>. So we set out to find out whether weather is really the culprit behind winter flare-ups. <h2>What we did</h2> Very few studies have been specifically and appropriately designed to look for any direct link between weather changes and joint or muscle pain. And ours is the first to evaluate data from these particular studies. We looked at data from more than 15,000 people from around the world. Together, these people reported more than 28,000 episodes of pain, mostly back pain, knee or hip osteoarthritis. People with rheumatoid arthritis and gout were also included. We then compared the frequency of those pain reports between different types of weather: hot or cold, humid or dry, rainy, windy, as well as some combinations (for example, hot and humid versus cold and dry). <h2>What we found</h2> We found changes in air temperature, humidity, air pressure and rainfall do not increase the risk of knee, hip or lower back pain symptoms and are not associated with people seeking care for a new episode of arthritis. The results of this study suggest we do not experience joint or muscle pain flare-ups as a result of changes in the weather, and a cold day will not increase our risk of having knee or back pain. In order words, there is no direct link between the weather and back, knee or hip pain, nor will it give you arthritis. It is important to note, though, that very cold air temperatures (under 10°C) were rarely studied so we cannot make conclusions about worsening symptoms in more extreme changes in the weather. The only exception to our findings was for gout, an inflammatory type of arthritis that can come and go. Here, pain increased in warmer, dry conditions. Gout has a very different underlying biological mechanism to back pain or knee and hip osteoarthritis, which may explain our results. The combination of warm and dry weather may lead to increased dehydration and consequently increased concentration of uric acid in the blood, and deposition of uric acid crystals in the joint in people with gout, resulting in a flare-up. <h2>Why do people blame the weather?</h2> The weather can influence other factors and behaviours that consequently shape how we perceive and manage pain. For example, some people may change their physical activity routine during winter, choosing the couch over the gym. And we know <a href="https://pubmed.ncbi.nlm.nih.gov/28700451/">prolonged sitting</a>, for instance, is directly linked to worse back pain. Others may change their sleep routine or sleep less well when it is either too cold or too warm. Once again, a bad night’s sleep can trigger your <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. Likewise, changes in mood, often experienced in cold weather, trigger increases in both <a href="https://link.springer.com/article/10.1007/s00586-021-06730-6">back</a> and <a href="https://www.sciencedirect.com/science/article/pii/S1063458421007020">knee</a> pain. So these changes in behaviour over winter may contribute to more aches and pains, and not the weather itself. Believing our pain will feel worse in winter (even if this is not the case) may also make us feel worse in winter. This is known as the <a href="https://link.springer.com/article/10.1186/s12891-018-1943-8">nocebo effect</a>. <h2>What to do about winter aches and pains?</h2> It’s best to focus on risk factors for pain you can control and modify, rather than ones you can’t (such as the weather). You can: <ul> <li> become more physically active. This winter, and throughout the year, aim to walk more, or talk to your health-care provider about gentle exercises you can safely do at home, with a physiotherapist, personal trainer or at the pool </li> <li> lose weight if obese or overweight, as this is linked to <a href="https://jamanetwork.com/journals/jama/article-abstract/2799405">lower levels</a> of joint pain and better physical function </li> <li> keep your body warm in winter if you feel some muscle tension in uncomfortably cold conditions. Also ensure your bedroom is nice and warm as we tend to sleep <a href="https://www.sciencedirect.com/science/article/pii/S0033350623003359">less well</a> in cold rooms </li> <li> maintain a healthy diet and <a href="https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(23)00098-X/fulltext">avoid smoking</a> or drinking high levels of alcohol. These are among <a href="https://ard.bmj.com/content/annrheumdis/82/1/48.full.pdf">key lifestyle recommendations</a> to better manage many types of arthritis and musculoskeletal conditions. For people with back pain, for example, a healthy lifestyle is linked with <a href="https://pubmed.ncbi.nlm.nih.gov/36208321/">higher levels</a> of physical function.<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/235117/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/manuela-ferreira-161420">Manuela Ferreira</a>, Professor of Musculoskeletal Health, Head of Musculoskeletal Program, <a href="https://theconversation.com/institutions/george-institute-for-global-health-874">George Institute for Global Health</a> and <a href="https://theconversation.com/profiles/leticia-deveza-1550633">Leticia Deveza</a>, Rheumatologist and Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-your-aches-and-pains-dont-get-worse-in-the-cold-so-why-do-we-think-they-do-235117">original article</a>.

Body

It’s hard to reach out to old friends, but doing so may help alleviate loneliness

<a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a> Millions of <a href="https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=4510004801">Canadians are lonely</a>. This is worrisome because loneliness, defined by the World Health Organization as “<a href="https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection">the social pain of not feeling connected</a>,” predicts both lower mental and physical health. Research shows that lacking a sense of social connection can pose an <a href="https://doi.org/10.1177/1745691614568352">equivalent health risk to smoking 15 cigarettes per day</a>. To combat loneliness, people are commonly advised to seek out social connection. For many, this guidance brings to mind spending time with loved ones, such as close friends, family and romantic partners. But are there other people we can reach out to? In our research, recently published in Communications Psychology, we examined whether people have “old friends” — individuals that they care about but with whom they have lost touch — and <a href="https://doi.org/10.1038/s44271-024-00075-8">how easily these relationships can be rekindled</a>. We found that certain strategies can help people reconnect — and, in new research, we are getting a sense that certain values and personality traits may make it easier for people to stay in touch far into the future. <h2>Reconnecting with old friends</h2> Across a series of seven studies, we found the majority of people reported having an old friend. Yet, when we asked over 400 participants how willing they would be to reach out to an old friend right now, most said they were neutral or unwilling. In fact, in one study, people reported being no more willing to reach out to an old friend than they were to talk to a stranger or pick up trash. This reluctance was observable in behaviour too. We conducted two experiments in which more than 1,000 people were given several minutes to draft and send a message to an old friend. Only 30 per cent sent the message to their old friend. Given that reaching out to an old friend could boost <a href="https://www.forbes.com/sites/nextavenue/2018/08/19/the-power-and-joy-of-reconnecting-with-old-friends/">feelings of social connection and happiness</a>, we tried designing interventions to encourage reaching out. For instance, we reminded participants that reaching out to an old friend was an act of kindness and that the recipient would appreciate it more than they realize. We also tried telling participants not to overthink it — to just send their message. Unfortunately, neither prompt was effective at encouraging more people to reach out. <h2>Reluctance to reconnect</h2> Why are people reluctant to reach out to old friends? There may be a number of reasons, including the possibility that old friends feel like strangers after time has passed. In one study with over 500 participants we asked people to list between three to five old friends, and tell us how close each one felt to them right now. The more unfamiliar an old friend felt, the less willing people were to reach out. Research has found that when people <a href="https://doi.org/10.1016/j.jesp.2022.104356">practise talking to strangers for a week</a>, they become less anxious about it. If old friends can feel like strangers, might a similar strategy encourage people to reach out to old friends? To find out, we conducted an experiment in which we randomly assigned some people to complete a three-minute warm-up activity in which they messaged current family or friends. Other participants were randomly assigned to a control condition in which they simply browsed social media for three minutes instead. Afterward, all participants were given an opportunity to write and send a message to an old friend. While only 30 per cent of participants sent their message in the control condition, over 50 per cent did so after warming-up, suggesting that practising the behaviour that underlies reaching out may make this act easier. <h2>Personality traits</h2> We are extending this research in a number of new directions. For instance, in some newly conducted and unpublished research, we are examining whether people with certain personality traits or beliefs are more likely to send a message to an old friend. Responses from over 300 people suggest that people who are open to new experiences — <a href="https://www.psychologytoday.com/ca/basics/big-5-personality-traits">one of the five key personality traits studied by psychologists</a> — say they are willing to reach out to an old friend. Despite this inclination, our research found that highly open people do not necessarily communicate with old friends when given the chance. On the other hand, people’s values and beliefs may be important determinants of whether they stay in touch. Our preliminary work shows that people who see friendship as a bond that does not easily break may be more likely to reach out than others. We hope this work helps normalize the fact that friendships can fade and be hard to rekindle. That said, with some practice, people can overcome this reluctance and hit “send” to potentially open a path to connection and less loneliness.<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/234895/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-b-aknin-1365501">Lara B Aknin</a>, Distinguished Professor of Social Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a>; <a href="https://theconversation.com/profiles/gillian-sandstrom-1283157">Gillian Sandstrom</a>, Senior Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-sussex-1218">University of Sussex</a>, and <a href="https://theconversation.com/profiles/kristina-castaneto-1548733">Kristina Castaneto</a>, Master's Student, Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/its-hard-to-reach-out-to-old-friends-but-doing-so-may-help-alleviate-loneliness-234895">original article</a>.

Relationships

Why IBD is so hard to treat – and how scientists are making progress

<a href="https://theconversation.com/profiles/falk-hildebrand-1490022">Falk Hildebrand</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>; <a href="https://theconversation.com/profiles/katarzyna-sidorczuk-1490026">Katarzyna Sidorczuk</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>, and <a href="https://theconversation.com/profiles/wing-koon-1490274">Wing Koon</a>, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a> Inflammatory bowel disease (IBD) is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478758/">life altering</a> chronic illness that is <a href="https://bmjopen.bmj.com/content/13/3/e065186">rising dramatically globally</a>. It is stubbornly difficult to treat, and many people find the treatments we have just don’t work for them. Over the last 30 years, there has been almost a 50% increase in cases – now affecting around 5 million people. Not to be confused with irritable bowel syndrome (IBS) which is a condition that affects the digestive system, IBD is more serious. It is the term for two severe illnesses called <a href="https://www.nhs.uk/conditions/crohns-disease/">Crohn’s disease</a> and <a href="https://www.nhs.uk/conditions/ulcerative-colitis/">ulcerative colitis</a>. More women are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9958616/#:%7E:text=Male%20predominance%20in%20IBD.,%2C%202.32%3A1%20in%20CD.">diagnosed with Crohn’s disease</a> while more men are affected by ulcerative colitis. People with IBD can experience a variety of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106026/">symptoms</a>, ranging from diarrhoea and blood in the stool, to weight loss and belly aches. On paper, this may sound no worse than mild food poisoning, however, this is no normal stomach upset. Experiences are often extreme; people with IBD can suffer excruciating pain and in some cases, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9963331/">require surgery</a> to remove parts of the bowel. This is done by redirecting the bowel to a hole in the abdomen, where faeces are collected in a <a href="https://www.nhs.uk/conditions/colostomy/">colostomy bag</a>. However, we still don’t fully understand the cause of IBD. <h2>The impact of inflammation</h2> The main symptom of IBD is excessive and uncontrolled <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805548/">inflammation</a> – normally a sign of the body fighting off an infection. Although inflammation is an important aspect of our immune system, in IBD it is happening when the body is not under attack. Since we don’t know what causes this over-the-top reaction, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720971/">treatments</a> are limited to managing the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3964397/">derailed immune system</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8373857/">Inflammation is controlled</a> by cell signalling. Our cells detect bacteria using receptors that attach to parts of bacteria. This activates the receptor, causing it to send a signal to proteins, and each protein sends on more signals, creating a signal cascade. This is what tells the body it’s under attack. Many treatments follow the strategy of intercepting signals and preventing the signal cascade from starting. However, they are <a href="https://journals.lww.com/co-gastroenterology/abstract/2022/07000/management_of_refractory_inflammatory_bowel.6.aspx">not effective</a> for many people. Scientists are trying to target a different protein network, called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924159/">NOD2</a>, that often goes haywire in people with IBD but is not targeted by current treatments. A protein, called <a href="https://www.frontiersin.org/articles/10.3389/fphar.2021.650403/full">RIPK2</a>, seems like a promising target since it is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6939834/">only found</a> in this network. Researchers from the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10485824/">European Molecular Biology Laboratory</a> are investigating its structure to help scientists design a new medication that will block the signals from this protein. <h2>Importance of the microbiome</h2> Another inspiration for new treatments comes from the bacteria residing in our guts. This community of bacteria, called the gut microbiome, has been associated with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314516/">all sorts of health conditions</a> ranging from asthma to obesity. Gut bacteria work closely with our bodies and play a vital role in digesting food and managing our <a href="https://www.nature.com/articles/s41422-020-0332-7">immune system</a>. In a healthy person, there is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143175/">fine balance</a> between gut bacteria and the immune system. Disruption of this balance can lead to disease, starting from minor discomfort to more severe, long-term conditions. Scientists are trying to understand how our bodies interact with gut bacteria, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102608/">what changes</a> when people develop IBD. The gut microbiome is an ecosystem. Just like a forest has animals eating different things, microbes can form a <a href="https://www.frontiersin.org/articles/10.3389/fevo.2019.00153/full">food web</a>. Some bacteria will use up one type of food, while others feed off other foods. Some rely on the waste of other bacteria after they’ve eaten. It is now believed that disruption to the gut microbiome is a characteristic of IBD and contributes to its development and progression. It’s a chicken and egg situation. Is there a change in the bacteria and food web that alters our bodies? Or does something else in the body, like our immune system, change the food web, subsequently limiting which bacteria can grow? Scientists aren’t sure of the answer. Instead of trying to figure out what happens first, a team at the <a href="https://www.nature.com/articles/s41467-023-42112-w">Hudson Institute of Medical Research</a> in Australia have focused on investigating which interactions in the food web are the most affected in IBD. This could help scientists to prioritise certain gut bacteria, or their food source, to restore the balance in the microbiome and improve patients’ symptoms. Hopefully, this specialised targeting of the microbiome will lead to more effective and longer lasting treatments. Although we have a long way to go before these ideas for treatments can become a reality, it is a step in the right direction. Targeting a new signalling pathway will hopefully control the inflammation in more patients. And studying the microbiome may reveal how we can reverse changes associated with IBD. Since they are key features of IBD, these developments could allow doctors to stop the disease in the early stages and reduce complications.<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/218307/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/falk-hildebrand-1490022">Falk Hildebrand</a>, Researcher in Bioinformatician, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>; <a href="https://theconversation.com/profiles/katarzyna-sidorczuk-1490026">Katarzyna Sidorczuk</a>, Research Scientist in Metagenomics, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a>, and <a href="https://theconversation.com/profiles/wing-koon-1490274">Wing Koon</a>, PhD student in Bioinformatics, <a href="https://theconversation.com/institutions/quadram-institute-5557">Quadram Institute</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-ibd-is-so-hard-to-treat-and-how-scientists-are-making-progress-218307">original article</a>.

Body

So when should you book that flight? The truth on airline prices

<a href="https://theconversation.com/profiles/yuriy-gorodnichenko-144556">Yuriy Gorodnichenko</a>, <a href="https://theconversation.com/institutions/university-of-california-berkeley-754">University of California, Berkeley</a> and <a href="https://theconversation.com/profiles/volodymyr-bilotkach-145437">Volodymyr Bilotkach</a>, <a href="https://theconversation.com/institutions/newcastle-university-906">Newcastle University</a> How airlines price tickets is a source of many <a href="http://airtravel.about.com/od/travelindustrynews/a/mythticket.htm">myths</a> and urban legends. These include tips about the best day of the week to buy a ticket, last-minute discounts offered by the airlines, and the conspiracy theories suggesting that the carriers use cookies to increase prices for their passengers. None of these three statements is entirely true. Studies have suggested that prices can be higher or lower on a given day of the week – yet, there is no clear consensus on which day that is. Offered prices can in fact drop at any time before the flight, yet they are much more likely to increase than decrease over the last several weeks before the flight’s departure. Further, the airlines prefer to wait for the last-minute business traveler who’s likely to pay full fare rather than sell the seat prematurely to a price conscious traveler. And no, the airlines do not use cookies to manipulate fare quotes – adjusting their inventory for specific customers appears to be beyond their technical capabilities. What is true about pricing in the airline industry is that carriers use complex and sophisticated pricing systems. The airline’s per passenger cost is the lowest when the flight is full, so carriers have incentive to sell as many seats as possible. This is a race against time for an airline and, of course, no company wants to discount its product more than it has to. Hence, the airlines face two somewhat contradictory goals: to maximize revenue by flying full planes and to sell as many full-fare seats as possible. This a process known in the industry as yield or revenue management. <h2>Airlines and their bucket lists</h2> Here is how <a href="http://commons.erau.edu/cgi/viewcontent.cgi?article=1522&context=jaaer">yield management</a> works. For each flight or route (if we are talking about multi-segment itineraries), the airline has a set of available price levels – from the most expensive fully refundable fare to the cheapest deeply discounted non-refundable price. The industry jargon for these prices is “buckets.” Then, seats can be interpreted as balls that are allocated among these buckets. Initial allocation of seats between the price buckets is determined by historical data indicating how well a certain flight sells. For example, fewer deeply discounted seats will be offered on a flight on Thanksgiving week than on the same flight during the third week of February. As the seats on a flight sell, yield managers monitor and adjust the seat allocation. If, for instance, the sales are slower than expected, some of the seats might be moved to lower-priced buckets – this shows up as a price drop. As noted above, such price drops can occur at any time before the flight. However, the general trend of price quotes is upward starting from about two to three weeks before the flight departure date. Of course, an average traveler wants to know when he or she should buy the tickets for the next trip. Another important question is where to buy this ticket. Airlines distribute their inventory on their own websites and on several computer distribution systems, meaning that prices can sometimes differ depending on where one looks. We are not entirely sure what precipitates this phenomenon – likely explanations include differences in contracts between the airlines and the distribution systems/travel agents, implying that different travel agents may not have access to the airline’s entire inventory of available prices. <h2>When to book</h2> The airlines’ yield managers start looking at flight bookings about two months before the departure date. This implies that it generally does not pay to book more than two months in advance: studies show that initially the airlines leave the cheapest price buckets empty, and yield managers may move some seats into those buckets if a couple of months before the departure date the flight is emptier than expected. Between two months and about two to three weeks before the flight date, the fare quotes remain mostly flat, with a slight upward trend. However, and perhaps paradoxically, there is a good chance of a price drop during this period. We tend to monitor prices for several days – sometimes up to a week – hoping for a potentially lower quote. It does not always pay off, but sometimes we do manage to save a considerable amount of money. Two to three weeks before the flight date, the price quotes start increasing. This is the time when business travelers start booking. While price drops are still possible, a chance of a price increase is much higher if you wait to book within this time period. This is also the time when one can find significant differences between price quotes, depending on where one looks and what contract they have with the airlines. Thus, if we book a trip earlier than three weeks before the flight date, we tend not to delay the purchase. At the same time, we check quotes from multiple travel agents, or go directly to a site that allows for a quick comparison of prices (such as <a href="https://www.kayak.com">kayak.com</a> or <a href="http://www.skyscanner.net">skyscanner.net</a>). Or check the airline itself. As for answering the original question we posed, here are some simple tips. First, if you have to travel during a peak period, such as Thanksgiving week, it is generally best not to delay buying that ticket. Otherwise, it might pay to monitor the offered prices for some time before committing. The best strategy for booking within the last couple of weeks before the flight, however, is not to delay the purchase, but to try getting quotes from several agents, which is easy to do in the internet age.<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/34033/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yuriy-gorodnichenko-144556">Yuriy Gorodnichenko</a>, Associate Professor of Economics, <a href="https://theconversation.com/institutions/university-of-california-berkeley-754">University of California, Berkeley</a> and <a href="https://theconversation.com/profiles/volodymyr-bilotkach-145437">Volodymyr Bilotkach</a>, Senior Lecturer in Economics, <a href="https://theconversation.com/institutions/newcastle-university-906">Newcastle University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/so-when-should-you-book-that-flight-the-truth-on-airline-prices-34033">original article</a>.

Travel Tips

We know what to eat to stay healthy. So why is it so hard to make the right choices?

<a href="https://theconversation.com/profiles/nina-van-dyke-822557">Nina Van Dyke</a>, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> A healthy diet <a href="https://www.who.int/initiatives/behealthy/healthy-diet">protects us</a> against a number of chronic diseases, including heart disease, diabetes and cancer. From early childhood, we receive an abundance of <a href="https://cdn.who.int/media/docs/default-source/healthy-diet/healthy-diet-fact-sheet-394.pdf?sfvrsn=69f1f9a1_2&download=true">information</a> about how we <a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">should eat</a> to be healthy and reduce our risk of disease. And most people have a <a href="https://link.springer.com/content/pdf/10.1186/1479-5868-11-63.pdf">broad understanding</a> of what healthy eating looks like. But this knowledge <a href="https://www.sciencedirect.com/science/article/pii/S0001209216310584?casa_token=6CZgCmT1RMgAAAAA:sSRsj2o6swVfvoBxMIVrMTxqdczSAiFwfTCYzYQ8U3z4ey_WLQ6knpmk8WRH77zugAS3wEAQrA">doesn’t always result</a> in healthier eating. In our new research, we set out to <a href="https://link.springer.com/content/pdf/10.1186/s12889-024-18432-x.pdf">learn more</a> about why people eat the way they do – and what prevents them from eating better. Lack of time was a major <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.12472?casa_token=1D1mi-l0TR0AAAAA:dgebTQx-wgw7jbREfdawxZ5AZSDRztvrt8t1tuKyDy1x2mmXlyLDY8z9NbUf0v4hnh80HY_RbAk08Q">barrier</a> to cooking and eating healthier foods. <h2>How do you decide what to eat?</h2> We spoke with <a href="https://link.springer.com/content/pdf/10.1186/s12889-024-18432-x.pdf">17 adults</a> in a regional centre of Victoria. We chose a regional location because less research <a href="https://link.springer.com/content/pdf/10.1186/s40900-020-0179-6.pdf">has been done</a> with people living outside of metropolitan areas and because rates of obesity and other diet-related health issues are <a href="https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health">higher</a> in such areas in Australia. Participants included a mix of people, including some who said they were over their “most healthy weight” and some who had previously dieted to lose weight. But all participants were either: <ul> <li>young women aged 18–24 with no children</li> <li>women aged 35–45 with primary school aged children</li> <li>men aged 35–50 living with a partner and with pre- or primary-school aged children.</li> </ul> We selected these groups to target <a href="https://www.sciencedirect.com/science/article/pii/S0022318212803669">ages and life-stages</a> in which shifts in eating behaviours may occur. Previous research has found younger women <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1470-6431.2007.00642.x?casa_token=33QKWwhc2ogAAAAA:ZvJ6wfXiRC_6eoqvoxD121JOSKSPmIRHcrdiGl2uHzkq5pY6VVPL6WI2DhmxQ2q9i6bBGvLiFl8afQ">tend to</a> be particularly concerned about appearance rather than healthy eating, while women with children often shift their focus to providing for their family. Men <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/obr.12472?casa_token=KakMB6hAOQ0AAAAA:fLnpoxZQiiJIdEkg_TOcCq8hBwZef1iZETZKTiG5W6zW2x_PYzK0oLeOg5F9arKThq9RzMWEi4x4Xw">tend to be less interested</a> in what they eat. We asked participants about how they decided what food to eat, when, and how much, and what prevented them from making healthier choices. <h2>It’s not just about taste and healthiness</h2> We found that, although such decisions were determined in part by taste preferences and health considerations, they were heavily influenced by a host of other factors, many of which are outside the person’s control. These included other household members’ food preferences, family activities, workplace and time constraints, convenience and price. <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2767106">Healthy eating</a> means consuming a balanced diet rich in nutrients, including a variety of fruits, vegetables, whole grains, lean proteins and healthy fats, while limiting processed foods, added sugars and excessive salt. Healthy eating also includes how we eat and <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244292">how we think about</a> food and eating, such as having a positive relationship with food. One 35- to 45-year-old woman, for example, said that time constraints and family preferences made it difficult to prepare healthier food: <blockquote> I love the chance when I can actually get a recipe and get all of the ingredients and make it properly, but that doesn’t happen very often. It’s usually what’s there and what’s quick. And what everyone will eat. </blockquote> One of the 35- to 50-year-old men also noted the extent to which family activities and children’s food preferences dictated meal choices: <blockquote> Well, we have our set days where, like Wednesday nights, we have to have mackie cheese and nuggets, because that’s what the boys want after their swimming lesson. </blockquote> <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/joss.12649?casa_token=gsnU9O_G2GQAAAAA:mV2vtHlnEd0jqBGJPFkfml_ecLIDqwSlH5xksSwt4eQb_FP_UShyAKm9sLNnKy6Mkf2q9aKAlDEixA">Research shows</a> that children are often more receptive to new foods than their parents think. However, introducing new dishes takes additional time and planning. An 18- to 24-year-old woman discussed the role of time constraints, her partner’s activities, and price in influencing what and when she eats: <blockquote> My partner plays pool on a Monday and Wednesday night, so we always have tea a lot earlier then and cook the simple things that don’t take as long, so he can have dinner before he goes rather than buying pub meals which cost more money. </blockquote> Despite popular perceptions, healthy diets are not more expensive than unhealthy diets. A <a href="https://preventioncentre.org.au/wp-content/uploads/2017/03/1702_FB_LEE_4p_final_lr.pdf">study</a> comparing current (unhealthy) diets with what the <a href="https://www.health.gov.au/resources/publications/the-australian-dietary-guidelines">Australian Dietary Guidelines</a> recommend people should eat found that the healthy diet was 12–15% cheaper than unhealthy diets for a family of two adults and two children. However, learning and planning to prepare new types of meals <a href="https://www.mdpi.com/2072-6643/12/3/877">takes effort and time</a>. Simply educating people about what they should eat won’t necessarily result in healthier eating. People want to eat healthier, or at least know they should eat healthier, but other things <a href="https://link.springer.com/content/pdf/10.1007/s00394-017-1458-3.pdf">get in the way</a>. A key to improving people’s eating behaviours is to make it easy to eat more healthily. Policy changes to make healthy eating easier could include subsidising healthier foods such as fresh produce, providing incentives for retailers to offer healthy options, and ensuring access to nutritious meals in schools and workplaces. <h2>So how can you make healthier food choices easier?</h2> Here are five tips for making healthy choices easier in your household: <ol> <li> If certain days of the week are particularly busy, with little time to prepare fresh food, plan to cook in bulk on days when you have more time. Store the extra food in the fridge or freezer for quick preparation. </li> <li> If you’re often pressed for time during the day and just grab whatever food is handy, have healthy snacks readily available and accessible. This could mean a fruit bowl in the middle of the kitchen counter, or wholegrain crackers and unsalted nuts within easy reach. </li> <li> Discuss food preferences with your family and come up with some healthy meals everyone likes. For younger children, <a href="https://healthykids.nsw.gov.au/downloads/file/campaignsprograms/NewFoodsFussyEaters.pdf">try serving</a> only a small amount of the new food, and serve new foods alongside foods they already like eating and are familiar with. </li> <li> If you rely a lot on take-away meals or meal delivery services, try making a list ahead of time of restaurants and meals you like that are also healthier. You might consider choosing lean meat, chicken, or fish that has been grilled, baked or poached (rather than fried), and looking for meals with plenty of vegetables or salad. </li> <li> Remember, fruit and vegetables taste better and are often cheaper when they are in season. Frozen or canned vegetables are a <a href="https://www.sbs.com.au/news/article/the-cost-of-fresh-fruit-and-veggies-is-rising-is-canned-or-frozen-produce-just-as-healthy/tzuhnfrnr">healthy and quick alternative</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231489/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ol> <a href="https://theconversation.com/profiles/nina-van-dyke-822557">Nina Van Dyke</a>, Associate Professor and Associate Director, Mitchell Institute, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-know-what-to-eat-to-stay-healthy-so-why-is-it-so-hard-to-make-the-right-choices-231489">original article</a>.

Food & Wine

Flight attendant reveals the unexpected reason why it's so cold on planes

When it comes to packing essentials in your carry-on for your next flight, many people add a jumper, extra socks, or even their own blanket to their bags. Because one thing’s for sure: you’ll probably be cold on your flight. But have you ever stopped to think of the reason why the cabin of a plane is so cold? According to a Canadian flight attendant, it's to do with keeping you feeling good. Vanessa Settimi told Reader's Digest that a cooler cabin helps passengers who are prone to fainting or have motion sickness during turbulence. She also clarified that despite what travellers may think, cabin crew don’t have control over the cabin temperature. "Temperature in the cabin is controlled by the pilots. Even though travellers often ask to get the temperature turned up during flights, it is kept on the cooler side." She went on to say that the key to staying warm on your next flight is bringing extra layers. "Now this might just be the flight attendant in me," says Settimi, "but you will never catch me flying as a traveller in sandals and a tank top!" Image credits: Shutterstock

Travel Trouble

Is social media making you unhappy? The answer is not so simple

<a href="https://theconversation.com/profiles/melissa-humphries-584274">Melissa Humphries</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/lewis-mitchell-266859">Lewis Mitchell</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> You may have seen headlines that link social media to sadness and depression. Social media use goes up, happiness goes down. But recent studies suggest those findings might not be so straightforward. Although it is true that people’s feelings of envy and depression are linked to high social media use, there is evidence to suggest social media use may not be causing that relationship. Instead, your mindset may be the biggest thing affecting how social media connects to your wellbeing. People who feel they are able to use social media, rather than social media “using them”, tend to gain more benefits from their online interactions. <h2>Why do people use social media?</h2> Social media covers a broad range of platforms: social networking, discussion forums, bookmarking and sharing content, disseminating news, exchanging media like photos and videos, and microblogging. These appeal to a wide range of users, from individuals of all ages through to massive businesses. For some, social media is a way to connect with people we may not otherwise see. In the United States, 39% of people say they <a href="https://www.americansurveycenter.org/research/the-state-of-american-friendship-change-challenges-and-loss">are friends with people they only interact with online</a>. For older people, this is especially important for increasing feelings of connectedness and wellbeing. Interestingly though, for older people, <a href="https://www.sciencedirect.com/science/article/pii/S0747563223004545">social media contact with family does not increase happiness</a>. Meanwhile, younger adults report increased happiness when they have more social media contact with family members. Teens, in particular, find social media most useful for <a href="https://www.pewresearch.org/internet/2022/11/16/connection-creativity-and-drama-teen-life-on-social-media-in-2022/">deepening connections and building their social networks</a>. With social media clearly playing such an important role in society, many researchers have tried to figure out: does it make us happier or not? <h2>Does social media make us happier?</h2> Studies have taken a variety of approaches, including asking people directly through surveys or looking at the content people post and seeing how positive or negative it is. One survey study from 2023 showed that as individuals’ social media use increased, <a href="https://www.researchgate.net/publication/372582895_The_Relationship_Between_Social_Media_Addiction_Happiness_and_Life_Satisfaction_in_Adults_Analysis_with_Machine_Learning_Approach">life satisfaction and happiness decreased</a>. Another found that <a href="https://www.tandfonline.com/doi/full/10.1080/0144929X.2023.2286529">less time on social media</a> was related to increases in work satisfaction, work engagement and positive mental health – so improved mental health and motivation at work. Comparing yourself to others on social media is connected to feelings of envy and depression. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955439/">there is evidence</a> to suggest depression is the predictor, rather than the outcome, of both social comparison and envy. All this shows <a href="https://academic.oup.com/jcmc/article/29/1/zmad048/7612379?login=false">the way you feel about social media matters</a>. People who see themselves using social media rather than “being used” by it, tend to gain benefits from social media and not experience the harms. Interviews with young people (15–24 years) using social media suggest that positive mental health among that age group was influenced by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8933808/">three features</a>: <ul> <li>connection with friends and their global community</li> <li>engagement with social media content</li> <li>the value of social media as an outlet for expression.</li> </ul> There are also studies that look at the emotions expressed by more frequent social media users. The so-called “<a href="https://epjdatascience.springeropen.com/articles/10.1140/epjds/s13688-017-0100-1">happiness paradox</a>” shows that most people think their friends on social media appear happier than themselves. This is a <a href="https://dl.acm.org/doi/10.1145/3110025.3110027">seeming impossibility</a> that arises because of <a href="https://www.nature.com/articles/srep04603">the mathematical properties</a> of how friendship networks work on social media. In one of our studies, Twitter content with recorded locations showed residents of cities in the United States that <a href="https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0064417.g007">tweeted more tended to express less happiness</a>. On the other hand, in Instagram direct messages, happiness has been found to be <a href="https://journals.sagepub.com/doi/full/10.1177/20563051241229655">four times more prevalent than sadness</a>. <h2>How does internet use in general affect our wellbeing?</h2> Some of the factors associated with decreased mental health are not aligned with social media use alone. <a href="https://journals.sagepub.com/doi/full/10.1177/0963721419838244">One recent study</a> shows that the path to decreased wellbeing is, at least partially, connected to digital media use overall (rather than social media use specifically). This can be due to sleep disruption, reduced face-to-face social interaction or physical activity, social comparison, and cyberbullying. None of these exist for social media alone. However, social media platforms are known to be driven by recommendation algorithms that may send us down “rabbit holes” of the same type of (increasingly extreme) content. This can lead to a distorted view of the world and our place in it. The important point here is to maintain a diverse and balanced information diet online. Interestingly, interacting on social media is not the only thing affecting our mental state. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090315">Rainfall influnces</a> the emotional content of social media posts of both the user experiencing rain, and parts of their extended network (even if they don’t experience rain!). This suggests that how we feel is influenced by the emotions in the posts we see. The good news is that happy posts are the most influential, with each happy post encouraging close to two additional happy updates from a user’s friends. The secret to online happiness therefore may not be to “delete your account” entirely (which, <a href="https://www.nature.com/articles/s41562-018-0510-5">as we have found</a>, may not even be effective), but to be mindful about what you consume online. And if you feel like social media is starting to use you, it might be time to change it up a bit.<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/232490/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/melissa-humphries-584274">Melissa Humphries</a>, Senior Lecturer, School of Computer and Mathematical Sciences, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/lewis-mitchell-266859">Lewis Mitchell</a>, Professor of Data Science, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-social-media-making-you-unhappy-the-answer-is-not-so-simple-232490">original article</a>.

Mind

"So embarrassing": Tourist slammed for "stupid" stunt in Bali

A British tourist has gone viral for all the wrong reasons after his "stupid" stunt in a Bali resort left him red-faced. The British traveller was believed to be staying at the 5-star Apurva Kempinski hotel in Nusa Dua, considered the island’s most luxurious location, when he came across a large decorative bowl filled with water and flower petals. The man was then filmed and egged on by a friend who can be heard saying "Okay now put your face in it", before he followed the instruction. When he went to submerge himself, he proceeded to accidentally tip over the bowl sending water and rose petals flying through the lobby of the resort, and all over himself too. The video, which has amassed a whopping 41 million views, was quickly subject to a wave of backlash online, with many slamming the tourist's "stupid" actions. <div class="embed" style="font-size: 16px; box-sizing: inherit; margin: 0px; padding: 0px; border: 0px; vertical-align: baseline; outline: currentcolor !important;"><iframe class="embedly-embed" style="box-sizing: inherit; margin: 0px; padding: 0px; border-width: 0px; border-style: none; vertical-align: baseline; width: 600px; max-width: 100%; outline: currentcolor !important;" title="tiktok embed" src="https://cdn.embedly.com/widgets/media.html?src=https%3A%2F%2Fwww.tiktok.com%2Fembed%2Fv2%2F7380708475237666081&display_name=tiktok&url=https%3A%2F%2Fwww.tiktok.com%2F%40milzo09%2Fvideo%2F7380708475237666081&image=https%3A%2F%2Fp16-sign-useast2a.tiktokcdn.com%2Fobj%2Ftos-useast2a-p-0037-euttp%2F9eff1d6040b74f98b167ccb18b4559ef_1718455117%3Fx-expires%3D1718924400%26x-signature%3DIcusEtP7QnSZKUZGZe5cGhO6cFg%253D&key=59e3ae3acaa649a5a98672932445e203&type=text%2Fhtml&schema=tiktok" width="340" height="700" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe></div> “You come to Bali without bringing your brain? Why do you have to destroy everything in someone else’s country?” one person wrote. “Omg money can’t buy brains. So stupid and embarrassing.” said another. A third added sarcastically, “Well that’s just lovely isn’t it, so careful and respectful and cultured.” Despite the thousands of comments sharing their condemnation of the tourist's actions, others were quick to leap to his defence, saying it was clearly an accident. “I mean it’s just a bowl of water and flowers. Nothing broke it’ll be OK. Just say you’re sorry,” one person said. “Am I the only one who feels bad for him,” another wrote .Other viewers admitted they would be “mortified” if it had happened to them. “I would just lay on the floor like I passed out,” one joked. “I would leave the country,” another wrote. It’s not clear what happened afterwards but many were hopeful the tourist helped staff clean up the mess. Image credits: TikTok

Travel Trouble

“Love is so sweet": Man's sweet mid-air proposal goes viral

Love is in the air! A smitten passenger took his love to the skies and proposed to his girlfriend while on board an Air Peace flight, with the romantic moment captured on camera. A social media user took to TikTok to share the sweet proposal, with the caption: “POV: My friend was proposed to in a plane.” The minute-long video showed a man getting out of his seat on board the packed plane to use the aircraft’s PA system so that he could ask for his girlfriend’s hand in marriage. “She’s so precious and her name is Precious,” the man said before popping the question. “Please, my Precious, I want to ask, will you marry me?” “If you will, just come out and say ‘yes’ to me, my precious,” he added before walking down the aisle of the aircraft. Other passengers cheered for the couple, and in a second video, the man is seen greeting Precious, then getting down on one knee to offer her the ring. Precious was overjoyed at the proposal and said yes, hugging her new fiance. While it is unclear where the plane was travelling, Air Peace is a Nigerian carrier that operates flights to destinations in West Africa and the Middle East, according to the NY Post. TikTok users were also touched by the romantic act, with many of them congratulating the couple. “This is beautiful,” one wrote. “Love is so sweet for real,” another swooned. Images: TikTok

Relationships

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

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

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Why do airlines charge so much for checked bags? This obscure rule helps explain why

<a href="https://theconversation.com/profiles/jay-l-zagorsky-152952">Jay L. Zagorsky</a>, <a href="https://theconversation.com/institutions/boston-university-898">Boston University</a> Five out of the six <a href="https://www.oag.com/blog/biggest-airlines-in-the-us">biggest U.S. airlines</a> have <a href="https://www.cnbc.com/2024/03/05/delta-is-the-latest-airline-to-raise-its-checked-bag-fee.html">raised their checked bag fees</a> since January 2024. Take American Airlines. In 2023, it cost US$30 to check a standard bag in with the airline; <a href="https://www.usatoday.com/story/travel/airline-news/2024/02/20/american-airlines-bag-fees-mileage-earning/72669245007/">today, as of March 2024, it costs $40</a> at a U.S. airport – a whopping 33% increase. As a <a href="https://www.bu.edu/questrom/">business school</a> <a href="https://www.bu.edu/questrom/profile/jay-zagorsky/">professor who studies travel</a>, I’m often asked why airlines alienate their customers with baggage fees instead of bundling all charges together. <a href="https://www.vox.com/2015/4/16/8431465/airlines-carry-on-bags">There are</a> <a href="https://www.usatoday.com/story/travel/columnist/2023/06/21/bag-fees-will-stay-a-while-cruising-altitude/70338849007/">many reasons</a>, but an important, often overlooked cause is buried in the U.S. tax code. <h2>A tax-law loophole</h2> Airlines pay the federal government <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D">7.5% of the ticket price</a> when <a href="https://www.pwc.com/us/en/services/tax/library/aircraft-club-nov-2023-air-transport-excise-tax-rates-for-2024.html">flying people domestically, alongside other fees</a>. The airlines dislike these charges, with their <a href="https://www.airlines.org/dataset/government-imposed-taxes-on-air-transportation/">trade association arguing</a> that they boost the cost to the consumer of a typical air ticket by around one-fifth. However, the U.S. Code of Federal Regulations <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D/section-49.4261-8">specifically excludes baggage</a> from the 7.5% transportation tax as long as “the charge is separable from the payment for the transportation of a person and is shown in the exact amount.” This means if an airline charges a combined $300 to fly you and a bag round-trip within the U.S., it owes $22.50 in tax. If the airline charges $220 to fly you plus separately charges $40 each way for the bag, then your total cost is the same — but the airline only owes the government $16.50 in taxes. Splitting out baggage charges saves the airline $6. Now $6 might not seem like much, but it can add up. Last year, passengers took <a href="https://www.transtats.bts.gov/Data_Elements.aspx?Data=1">more than 800 million trips on major airlines</a>. Even if only a fraction of them check their bags, that means large savings for the industry. How large? The government has <a href="https://www.bts.dot.gov/topics/airlines-and-airports/baggage-fees-airline-2023">tracked revenue from bag fees</a> for decades. In 2002, airlines charged passengers a total of $180 million to check bags, which worked out to around 33 cents per passenger. Today, as any flyer can attest, bag fees are a lot higher. Airlines collected over 40 times more money in bag fees last year than they did in 2002. When the full data is in for 2023, <a href="https://www.bts.dot.gov/baggage-fees">total bag fees</a> will likely top $7 billion, which is about $9 for the average domestic passenger. <a href="https://viewfromthewing.com/the-real-reason-airlines-charge-checked-bag-fees-and-its-not-what-you-think">By splitting out the cost of bags</a>, airlines avoided paying about half a billion dollars in taxes just last year. In the two decades since 2002, flyers paid a total of about $70 billion in bag fees. This means separately charging for bags saved airlines about $5 billion in taxes. <iframe id="88MYD" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/88MYD/2/" width="100%" height="400px" frameborder="0"></iframe> It seems clear to me that tax savings are one driver of the unbundling of baggage fees because of a quirk in the law. The U.S. government doesn’t apply the 7.5% tax to <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D/section-49.4261-3">international flights that go more than 225 miles</a> beyond the nation’s borders. Instead, there are fixed <a href="https://www.airlines.org/dataset/government-imposed-taxes-on-air-transportation">international departure and arrival taxes</a>. This is why major airlines charge $35 to $40 <a href="https://www.aa.com/i18n/travel-info/baggage/checked-baggage-policy.jsp">for bags if you’re flying domestically</a>, but don’t charge a bag fee when you’re flying to Europe or Asia. <h2>Do travelers get anything for that money?</h2> This system raises an interesting question: Do baggage fees force airlines to be more careful with bags, since customers who pay more expect better service? To find out, I checked with the Bureau of Transportation Statistics, which has been <a href="https://www.bts.gov/content/mishandled-baggage-reports-filed-passengers-largest-us-air-carriersa">tracking lost luggage for decades</a>. For many years, it calculated the number of mishandled-baggage reports per thousand airline passengers. The government’s data showed mishandled bags peaked in 2007 with about seven reports of lost or damaged luggage for every thousand passengers. That means you could expect your luggage to go on a different trip than the one you are taking about once every 140 or so flights. By 2018, that estimate had fallen to once every 350 flights. In 2019, the government <a href="https://www.bts.gov/topics/airlines-and-airports/number-30a-technical-directive-mishandled-baggage-amended-effective-jan">changed how it tracks</a> mishandled bags, calculating figures based on the total number of bags checked, rather than the total number of passengers. The new data show about six bags per thousand checked get lost or damaged, which is less than 1% of checked bags. Unfortunately, the data doesn’t show improvement since 2019. Is there anything that you can do about higher bag fees? Complaining to politicians probably won’t help. In 2010, two senators <a href="https://www.nj.com/business/2010/04/us_senators_present_bill_to_ba.html">tried to ban bag fees</a>, and their bill went nowhere. Given that congressional action failed, there’s a simple way to avoid higher bag fees: <a href="https://www.cnn.com/travel/article/packing-expert-travel-world-handbag/index.html">travel light</a> and <a href="https://www.nytimes.com/2023/07/08/opinion/carry-on-packing-airlines-lost-luggage.html">don’t check any luggage</a>. It may sound tough not to have all your belongings when traveling, but it might be the best option as bag fees take off.<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/225857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jay-l-zagorsky-152952">Jay L. Zagorsky</a>, Associate Professor of Markets, Public Policy and Law, <a href="https://theconversation.com/institutions/boston-university-898">Boston University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-airlines-charge-so-much-for-checked-bags-this-obscure-rule-helps-explain-why-225857">original article</a>.

Travel Trouble

Summer’s over, so how much sun can (and should) I get?

<a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a> As we slide of out summer, you might be wondering how careful you need to be about sun exposure. Excessive exposure causes <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/prevention-policy/national-cancer-prevention-policy/skin-cancer-statistics-and-issues/uv-radiation">skin cancer</a>, but sun exposure also has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">benefits</a>. How do you balance the two? A new <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">position statement</a> from cancer, bone health and other experts <a href="https://www.assc.org.au/wp-content/uploads/2023/01/Sun-Exposure-Summit-PositionStatement_V1.9.pdf">aims to help</a> Australians balance the good and bad effects of sun exposure by taking into account their skin colour, risk of skin cancer, and where they live. <h2>What are the benefits of sunlight?</h2> Ultraviolet (UV) radiation (the wavelengths in sunlight that cause skin cancer) also leads to vitamin D production. <a href="https://dermnetnz.org/topics/vitamin-d">Vitamin D</a> is very important for maintaining strong bones, and is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">multiple other health benefits</a>. But vitamin D probably isn’t the whole story. Sunshine, including UV radiation, is thought to affect health in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">other ways</a> such as improving our mood and reducing the risk of autoimmune diseases and infections. So for many people, avoiding the sun and taking a vitamin D supplement may not be the best approach. <h2>How much time does it take to make vitamin D?</h2> It’s complicated, but for most people and most of the year across most of Australia, it’s a lot less than you think. The <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">amount of time needed</a> depends on the amount of skin covered by clothing and the intensity of UV radiation (indicated by the UV index). More skin exposed and higher UV index equate to less time needed. Both the UV index and the amount of the year that UV radiation is high increase as you get closer to the equator. In summer, all of Australia is bathed in sunshine. But in winter, opposite ends of the country have <a href="https://onlinelibrary.wiley.com/doi/10.1111/php.13854">very different exposures</a>. In summer, everybody except those with deeply pigmented skin can make enough vitamin D in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">just five minutes</a> between 9am and 3pm, anywhere in Australia, provided they are wearing shorts and a T-shirt. In winter it’s a different story. In <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Darwin and Brisbane</a>, 5–10 minutes between 10am and 3pm will do the trick, but in <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">Hobart</a>, factoring in winter clothing, it will take nearly an hour in the middle of the day. Hover your mouse over the lines below to see the length of exposure needed at specific times of day. <iframe id="X5szQ" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/X5szQ/" width="100%" height="400px" frameborder="0"></iframe> Staying out for longer than needed doesn’t necessarily make more vitamin D, but it <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib25">does cause skin damage</a>. <h2>Hang on, what about those with darker skin?</h2> People with deeply pigmented, brown to black skin accumulate both vitamin D and DNA damage at a much slower rate than people with lighter skin tones. When UV radiation hits a DNA strand, it causes the DNA to become distorted. If the distortion isn’t fixed, it will cause a mistake when the DNA is copied for a new cell, causing a permanent mutation that sometimes leads to cancer. Melanin, the brown pigment in the skin, absorbs UV photons before that can happen, and the high melanin content in the darkest skin tones provides <a href="https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fj.201701472R">60 times</a> as much UV protection as the small amount in very fair skin. The flip side is the risk of vitamin D deficiency is much higher than the risk of skin cancer. The new statement accounts for this by putting people into <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">three groups</a> based on their risk of skin cancer, with specialised advice for each group. <h2>Highest skin cancer risk</h2> This includes people with very pale skin that burns easily and tans minimally, but also people with darker white or olive skin who can tan easily but have extra skin cancer risk factors because they: <ul> <li>have had skin cancer before</li> <li>have a family history of melanomas</li> <li>have many moles</li> <li>are taking immunosuppressant medications.</li> </ul> For these people, the harms of sun exposure almost certainly <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub">outweigh the benefits</a>. These people should wear sunscreen every day the <a href="https://www.arpansa.gov.au/our-services/monitoring/ultraviolet-radiation-monitoring/ultraviolet-radiation-index">UV index</a> is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, and use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">five sunsmart steps</a> whenever the UV index is above three: <ul> <li>slip on clothing covering as much of the body as possible</li> <li>slop on SPF30+ sunscreen on areas that can’t be covered up</li> <li>slap on a hat</li> <li>seek shade</li> <li>slide on sunglasses.</li> </ul> They shouldn’t spend time outdoors deliberately to make vitamin D, but should discuss vitamin D supplements with their doctor. <h2>Intermediate skin cancer risk</h2> This means people with dark white/olive skin that sometimes burns but tans easily, and who don’t have other skin cancer risk factors. These people should still apply sunscreen as part of their usual routine on all days when the UV index is forecast to get to <a href="https://www.assc.org.au/peak-health-bodies-recommend-new-approach-to-sunscreen-use/">three or more</a>, but they can spend enough time outdoors to get a “dose” of vitamin D on most days of the week. Once the time needed for their vitamin D dose is up, they should also use the <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> steps to avoid accumulating DNA damage. If they’re unable to do this because of health or lifestyle factors, like being housebound, working night shifts, or always covering up with clothing, they should see their doctor about whether they need vitamin D supplements. <h2>Lowest skin cancer risk</h2> This covers people with deeply pigmented brown to black skin that rarely or never burns. These people can <a href="https://www.sciencedirect.com/science/article/pii/S1326020023052949?via%3Dihub#bib14">safely spend enough time outdoors</a> to make vitamin D and get the other benefits of sunshine. But because more time is needed, it can be difficult, particularly when the weather is cold. Vitamin D supplements might be needed. They don’t need to routinely protect their skin, but might need to <a href="https://www.cancer.org.au/cancer-information/causes-and-prevention/sun-safety/be-sunsmart">slip-slop-slap-seek-slide</a> if they are outdoors for more than two hours. <h2>How do I get the feel-good effects of sunshine?</h2> Spending time outdoors in the early morning is the best way to get the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9976694/">feel-good effects</a> of sunshine. An early morning walk is a great idea for all of us, but it won’t make vitamin D.<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/224144/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katie-lee-228942">Katie Lee</a>, PhD Candidate, Dermatology Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/rachel-neale-891731">Rachel Neale</a>, Principal research fellow, <a href="https://theconversation.com/institutions/qimr-berghofer-medical-research-institute-1811">QIMR Berghofer Medical Research Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/summers-over-so-how-much-sun-can-and-should-i-get-224144">original article</a>.

Body

Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

<a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> Rumours and conspiracies have been <a href="https://www.nytimes.com/2024/02/28/style/princess-kate-middleton-health.html">swirling</a> following the abdominal surgery and long recovery period of Catherine, Princess of Wales, earlier this year. They intensified on Monday when Kensington Palace released a photo of the princess with her three children. <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/C4U_IqTNaqU/?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/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a> </div> </blockquote> The photo had clear signs of tampering, and international wire services <a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">withdrew the image</a> amid concerns around manipulation. The princess later <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised for any confusion</a> and said she had “experimented with editing” as many amateur photographers do. Image editing is extremely common these days, and not all of it is for nefarious purposes. However, in an age of rampant misinformation, how can we stay vigilant around suspicious images? <h2>What happened with the royal photo?</h2> A close look reveals at least eight inconsistencies with the image. Two of these relate to unnatural blur. Catherine’s right hand is unnaturally blurred, even though her left hand is sharp and at the same distance from the camera. The left side of Catherine’s hair is also unnaturally blurred, while the right side of her hair is sharp. These types of edits are usually made with a blur tool that softens pixels. It is often used to make the background of an image less distracting or to smooth rough patches of texture. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&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/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=358&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=358&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=358&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=450&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=450&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=450&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>At least eight logical inconsistencies exist in the doctored image the Prince and Princess of Wales posted on social media. <a class="source" href="https://www.instagram.com/p/C4U_IqTNaqU/">Photo by the Prince of Wales/Chart by T.J. Thomson</a></figcaption></figure> Five of the edits appear to use the “clone stamp” tool. This is a Photoshop tool that takes part of the same or a different image and “stamps” it onto another part. You can see this with the repeated pattern on Louis’s (on the left) sweater and the tile on the ground. You can also see it with the step behind Louis’s legs and on Charlotte’s hair and sleeve. The zipper on Catherine’s jacket also doesn’t line up. The most charitable interpretation is that the princess was trying to remove distracting or unflattering elements. But the artefacts could also point to multiple images being blended together. This could either be to try to show the best version of each person (for example, with a smiling face and open eyes), or for another purpose. <blockquote class="twitter-tweet"> Like many amateur photographers, I do occasionally experiment with editing. I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother’s Day. C — The Prince and Princess of Wales (@KensingtonRoyal) <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616?ref_src=twsrc%5Etfw">March 11, 2024</a></blockquote> <h2>How common are image edits?</h2> Image editing is increasingly common as both photography and editing are increasingly becoming more automated. This sometimes happens without you even knowing. Take HDR (high dynamic range) images, for example. Point your iPhone or equivalent at a beautiful sunset and watch it capture the scene from the brightest highlights to the darkest shadows. What happens here is your camera makes multiple images and automatically stitches them together to make an image <a href="https://www.adobe.com/creativecloud/photography/hub/guides/what-is-hdr-photography.html">with a wider range of contrast</a>. While face-smoothing or teeth-whitening filters are nothing new, some smartphone camera apps apply them without being prompted. Newer technology like Google’s “Best Take” <a href="https://blog.google/products/photos/how-google-photos-best-take-works/">feature</a> can even combine the best attributes of multiple images to ensure everyone’s eyes are open and faces are smiling in group shots. On social media, it seems everyone tries to show themselves in their best light, which is partially why so few of the photos on our <a href="https://www.tandfonline.com/doi/abs/10.1080/15551393.2020.1862663">camera rolls</a> make it onto our social media feeds. It is also why we often edit our photos to show our best sides. But in other contexts, such as press photography, the <a href="https://www.ap.org/about/news-values-and-principles/telling-the-story/visuals">rules are much stricter</a>. The Associated Press, for example, bans all edits beyond simple crops, colour adjustments, and “minor adjustments” that “restore the authentic nature of the photograph”. Professional photojournalists haven’t always gotten it right, though. While the majority of lens-based news workers adhere to ethical guidelines like those published by the <a href="https://nppa.org/resources/code-ethics">National Press Photographers Association</a>, others have let deadline pressures, competition and the desire for exceptional imagery cloud their judgement. One such example was in 2017, when British photojournalist Souvid Datta admitted to <a href="https://time.com/4766312/souvid-datta/">visually plagiarising</a> another photographer’s work within his own composition. <blockquote class="twitter-tweet"> Photographer Souvid Datta appears to have plagiarized Mary Ellen Mark: <a href="https://t.co/iO1Lm8CowU">https://t.co/iO1Lm8CowU</a> <a href="https://t.co/jswHyApGNj">pic.twitter.com/jswHyApGNj</a> — PetaPixel (@petapixel) <a href="https://twitter.com/petapixel/status/859824132258537472?ref_src=twsrc%5Etfw">May 3, 2017</a></blockquote> Concerns around false or misleading visual information are at an all-time high, given advances in <a href="https://theconversation.com/nine-was-slammed-for-ai-editing-a-victorian-mps-dress-how-can-news-media-use-ai-responsibly-222382">generative artificial intelligence (AI)</a>. In fact, this year the World Economic Forum named the risk of misinformation and disinformation as the world’s greatest <a href="https://www.weforum.org/agenda/2024/01/ai-disinformation-global-risks/">short-term threat</a>. It placed this above armed conflict and natural disasters. <h2>What to do if you’re unsure about an image you’ve found online</h2> It can be hard to keep up with the more than <a href="https://theconversation.com/3-2-billion-images-and-720-000-hours-of-video-are-shared-online-daily-can-you-sort-real-from-fake-148630">3 billion photos</a> that are shared each day. But, for the ones that matter, we owe it to ourselves to slow down, zoom in and ask ourselves a few simple <a href="https://www.aap.com.au/factcheck-resources/how-we-check-the-facts/">questions</a>: 1. Who made or shared the image? This can give clues about reliability and the purpose of making or sharing the image. 2. What’s the evidence? Can you find another version of the image, for example, using a <a href="https://tineye.com/">reverse-image search engine</a>? 3. What do trusted sources say? Consult resources like <a href="https://www.aap.com.au/factcheck/">AAP FactCheck</a> or <a href="https://factcheck.afp.com/">AFP Fact Check</a> to see if authoritative sources have already weighed in.<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/225553/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, Senior Lecturer in Visual Communication & Digital Media, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a> 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/yes-kate-middletons-photo-was-doctored-but-so-are-a-lot-of-images-we-see-today-225553">original article</a>. Hero image: The Conversation / X / Instagram

Technology

I want to eat healthily. So why do I crave sugar, salt and carbs?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> We all want to eat healthily, especially as we reset our health goals at the start of a new year. But sometimes these plans are sabotaged by powerful cravings for sweet, salty or carb-heavy foods. So why do you crave these foods when you’re trying to improve your diet or lose weight? And what can you do about it? There are many reasons for craving specific foods, but let’s focus on four common ones: <h2>1. Blood sugar crashes</h2> Sugar is a key energy source for all animals, and its taste is one of the most basic sensory experiences. Even without specific sweet taste receptors on the tongue, a strong preference for sugar can develop, indicating a mechanism beyond taste alone. Neurons <a href="https://www.nature.com/articles/s41593-021-00982-7">responding to sugar</a> are activated when sugar is delivered to the gut. This can increase appetite and make you want to consume more. Giving into cravings also drives an appetite for more sugar. In the long term, research suggests a high-sugar diet can affect <a href="https://www.bmj.com/content/369/bmj.m2382">mood</a>, digestion and <a href="https://pubmed.ncbi.nlm.nih.gov/33339337/">inflammation</a> in the <a href="https://www.science.org/doi/10.1126/scitranslmed.aay6218?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">gut</a>. While there’s a lot of <a href="https://www.sciencedirect.com/science/article/pii/S0149763402000040?via%3Dihub#aep-section-id23">variation between individuals</a>, regularly eating sugary and high-carb foods can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/30951762/">rapid spikes and crashes</a> in blood sugar levels. When your blood sugar drops, your body can respond by craving quick sources of energy, often in the form of sugar and carbs because these deliver the fastest, most easily accessible form of energy. <h2>2. Drops in dopamine and serotonin</h2> Certain neurotransmitters, such as <a href="https://pubmed.ncbi.nlm.nih.gov/30595479/">dopamine</a>, are involved in the reward and pleasure centres of the brain. Eating sugary and carb-rich foods can trigger the release of dopamine, creating a pleasurable experience and reinforcing the craving. Serotonin, the feel-good hormone, suppresses <a href="https://www.sciencedirect.com/science/article/pii/S1569733910700886">appetite</a>. Natural changes in serotonin can influence daily fluctuations in mood, energy levels and attention. It’s also associated with eating more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829131/">carb-rich snacks in the afternoon</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/21985780/">Low carb diets</a> may reduce serotonin and lower mood. However, a recent systematic review suggests little association between these diets and risk for <a href="https://www.sciencedirect.com/science/article/pii/S0165032722013933?via%3Dihub">anxiety and depression</a>. Compared to men, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189179/">women tend to crave more carb rich foods</a>. Feeling irritable, tired, depressed or experiencing carb cravings are part of premenstrual <a href="https://pubmed.ncbi.nlm.nih.gov/29218451/">symptoms</a> and could be <a href="https://www.ncbi.nlm.nih.gov/books/NBK560698/">linked to</a> reduced <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9928757/">serotonin levels</a>. <h2>3. Loss of fluids and drops in blood sugar and salt</h2> Sometimes our bodies crave the things they’re missing, such as hydration or even salt. A low-carb diet, for example, <a href="https://www.ncbi.nlm.nih.gov/books/NBK537084/">depletes</a> insulin levels, decreasing sodium and water retention. <a href="https://www.sciencedirect.com/science/article/pii/S1933287419302673">Very low-carb diets</a>, like ketogenic diets, induce “ketosis”, a metabolic state where the body switches to using fat as its primary energy source, moving away from the usual dependence on carbohydrates. Ketosis is often associated with increased urine production, further contributing to potential fluid loss, electrolyte imbalances and salt cravings. <h2>4. High levels of stress or emotional turmoil</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214609/">Stress</a>, boredom and emotional turmoil can lead to cravings for comfort foods. This is because stress-related hormones can impact our appetite, satiety (feeling full) and food preferences. The stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425607/">cortisol</a>, in particular, can drive cravings for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">sweet comfort foods</a>. A <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453000000354">2001 study</a> of 59 premenopausal women subjected to stress revealed that the stress led to higher calorie consumption. <a href="https://pubmed.ncbi.nlm.nih.gov/37295418/">A more recent study</a> found chronic stress, when paired with high-calorie diet, increases food intake and a preference for sweet foods. This shows the importance of a healthy diet during stress to prevent weight gain. <h2>What can you do about cravings?</h2> Here are four tips to curb cravings: 1) don’t cut out whole food groups. Aim for a well-balanced diet and make sure you include: <ul> <li> sufficient protein in your meals to help you feel full and reduce the urge to snack on sugary and carb-rich foods. Older adults should aim for 20–40g protein per meal with a particular focus on <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/jhn.12838">breakfast and lunch</a> and an overall daily protein intake of at least <a href="https://apps.who.int/iris/handle/10665/43411">0.8g</a> per kg of body weight for <a href="https://pubmed.ncbi.nlm.nih.gov/35187864/">muscle health</a> </li> <li> fibre-rich foods, such as vegetables and whole grains. These make you feel full and <a href="https://pubmed.ncbi.nlm.nih.gov/32142510/">stabilise your blood sugar</a> levels. Examples include broccoli, quinoa, brown rice, oats, beans, lentils and bran cereals. Substitute refined carbs high in sugar like processed snack bars, soft drink or baked goods for more complex ones like whole grain bread or wholewheat muffins, or nut and seed bars or energy bites made with chia seeds and oats </li> </ul> 2) manage your stress levels. Practise stress-reduction techniques like meditation, deep breathing, or yoga to manage emotional triggers for cravings. Practising <a href="https://pubmed.ncbi.nlm.nih.gov/30570305/">mindful eating</a>, by eating slowly and tuning into bodily sensations, can also reduce daily calorie intake and curb cravings and stress-driven eating 3) get enough sleep. Aim for <a href="https://pubmed.ncbi.nlm.nih.gov/33054337/">seven to eight</a> hours of quality sleep per night, with a minimum of seven hours. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031614/">Lack of sleep</a> can disrupt hormones that regulate hunger and cravings 4) control your portions. If you decide to indulge in a treat, control your portion size to avoid overindulging. Overcoming cravings for sugar, salt and carbs when trying to eat healthily or lose weight is undoubtedly a formidable challenge. Remember, it’s a journey, and setbacks may occur. Be patient with yourself – your success is not defined by occasional cravings but by your ability to manage and overcome them.<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/212114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-want-to-eat-healthily-so-why-do-i-crave-sugar-salt-and-carbs-212114">original article</a>.

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I want to eat healthily. So why do I crave sugar, salt and carbs?