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What’s the difference between ‘strep throat’ and a sore throat? We’re developing a vaccine for one of them

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/kim-davis-1535254">Kim Davis</a>, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a>; <a href="https://theconversation.com/profiles/alma-fulurija-1535255">Alma Fulurija</a>, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a>, and <a href="https://theconversation.com/profiles/myra-hardy-1535253">Myra Hardy</a>, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a></em></p> <p>the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”.</p> <p>But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried?</p> <p>Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter.</p> <h2>How are they similar?</h2> <p>It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar.</p> <p>People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days.</p> <p>Thankfully, both types of sore throat usually get better <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655103/">by themselves</a>.</p> <h2>How are they different?</h2> <p>Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus).</p> <p>These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted <a href="https://www.ncbi.nlm.nih.gov/books/NBK401243/#:%7E:text=People%20may%20then%20wonder%20whether,infection%2C%20such%20as%20bacterial%20tonsillitis.">antibiotic side-effects</a>.</p> <p>But strep throat is caused by <em>Streptococcus pyogenes</em> bacteria, also known as strep A. Strep throat is most common in <a href="https://www.tandfonline.com/doi/full/10.2217/fmb-2021-0077">school-aged children</a>, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications.</p> <p>In fact, the potential for complications is one key difference between a viral sore throat and strep throat.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=405&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=405&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=405&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=508&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=508&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=508&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <p>Generally, a viral sore throat is <a href="https://www.bmj.com/content/347/bmj.f6867">very unlikely</a> to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893202/">chronic fatigue syndrome</a>, <a href="https://www.science.org/doi/10.1126/science.abj8222">multiple sclerosis</a> and certain <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00404-7/fulltext">cancers</a>).</p> <p>But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick.</p> <p>Invasive strep A infections and deaths have been <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429">rising in recent years</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786649/">around the world</a>, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear.</p> <p>Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells.</p> <p>The most common example is <a href="https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease">rheumatic heart disease</a>. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection.</p> <p><a href="https://www.nejm.org/doi/10.1056/NEJMoa2102074?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">Around the world</a> more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries.</p> <p>However, parts of Australia have some of the <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50682">highest rates</a> of rheumatic heart disease in the world. <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/all-heart-stroke-and-vascular-disease/arf-and-rhd">More than 5,300</a> Indigenous Australians live with it.</p> <h2>Why do some people get sicker than others?</h2> <p>We know strep A infections and rheumatic heart disease <a href="https://link.springer.com/chapter/10.1007/82_2012_280">are more common</a> in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease.</p> <p>However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease.</p> <p>We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out.</p> <h2>How about a vaccine for strep A?</h2> <p>There is no strep A vaccine but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028081/">many</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545125/">groups</a> in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6495378/">Australia</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902606/">New Zealand</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620221/">and</a> <a href="https://www.clinicalkey.com.au/#!/content/playContent/1-s2.0-S0264410X19316457?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0264410X19316457%3Fshowall%3Dtrue&amp;referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F">worldwide</a> are working towards one.</p> <p>For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the <a href="https://www.asavi.org.au">Australian Strep A Vaccine Initiative</a> to develop strep A vaccines. There’s also a <a href="https://savac.ivi.int/">global consortium</a> working towards the same goal.</p> <p>Companies such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10747066/">Vaxcyte</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696035/">GlaxoSmithKline</a> have also been developing strep A vaccines.</p> <h2>What if I have a sore throat?</h2> <p>Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP.</p> <p>Your GP can examine you, consider running some tests and help you decide if you need antibiotics.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230292/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kim-davis-1535254">Kim Davis</a>, General paediatrician and paediatric infectious diseases specialist, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a>; <a href="https://theconversation.com/profiles/alma-fulurija-1535255">Alma Fulurija</a>, Immunologist and the Australian Strep A Vaccine Initiative project lead, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a>, and <a href="https://theconversation.com/profiles/myra-hardy-1535253">Myra Hardy</a>, Postdoctoral Researcher, Infection, Immunity and Global Health, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-strep-throat-and-a-sore-throat-were-developing-a-vaccine-for-one-of-them-230292">original article</a>.</em></p> </div>

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4 ways to avoid foot pain when travelling

<p>Whether it’s caused by a hectic day of sightseeing or a mad rush through the airports, there’s nothing quite as annoying as foot pain when you’re on holidays. And when you consider how easy it is to avoid (so long as you take the correct preventative measures) you’ll feeling like kicking yourself for putting up with it for all these years.</p> <p>Here are four ways to avoid foot pain when travelling.</p> <p><strong>1. Choosing the right pair of shoes  </strong></p> <p>Out of all the fashion statements, shoes are probably responsible for more chronic foot pain than anything else. So make sure you choose the right pair of shoes for your trip. For example, if you’re going to be walking around all day sightseeing it might be an idea to ditch the stiletto heels for a pair of joggers (even if they’re not quite so aesthetically pleasing).</p> <p>Dr Robert Mathews from Cremorne Medical in NSW says, “I recommend wearing supportive shoe such as running shoes. If you want to wear something more stylish then consider buying some gel insoles to slip in your shoes, you can get a wide variety of these from your local chemist.“</p> <p><strong>2. Manage your feet on flights</strong></p> <p>Foot swelling can become quite a big problem on long haul flight, so managing your feet becomes crucial. Simple, preventative measures anyone can take, like wearing support stocks, standing up every so often to move around or even just flexing your feet and wriggling your toes, can make a big difference and greatly reduce the chance of swelling.</p> <p><strong>3. Slip, slop and slap</strong></p> <p>So many island holidays have been soured by the blistering pain of sunburnt feet. If you’re staying at a resort or near a beach and your feet are exposed, don’t forget to apply sunscreen everywhere. Otherwise you’re going to want to have some aloe vera gel handy!</p> <p><strong>4. Take time to rest</strong></p> <p>While you’re probably in a mad rush to see everything, fear of missing out can put significant strain on your feet. So make sure you set aside plenty of time every day to put your feet up and rest. It also might be worth considering some extra pampering, like a foot bath or even a half hour massage. You are on holidays after all, so why not treat yourself!</p> <p>Dr Matthews adds, “It may also be worth taking with you some thick band aids in case you develop any blisters from long walks.”</p> <p><em>Image credits: Shutterstock</em></p>

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Why are my muscles sore after exercise? Hint: it’s nothing to do with lactic acid

<p><em><a href="https://theconversation.com/profiles/robert-andrew-robergs-435390">Robert Andrew Robergs</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/samuel-l-torrens-1476404">Samuel L. Torrens</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>As many of us hit the gym or go for a run to recover from the silly season, you might notice a bit of extra muscle soreness.</p> <p>This is especially true if it has been a while between workouts.</p> <p>A common misunderstanding is that such soreness is due to lactic acid build-up in the muscles.</p> <p>Research, however, shows lactic acid has <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">nothing to do with it</a>. The truth is far more interesting, but also a bit more complex.</p> <h2>It’s not lactic acid</h2> <p>We’ve known for decades that lactic acid has <a href="https://pubmed.ncbi.nlm.nih.gov/27409551/">nothing to do with</a> muscle soreness after exercise.</p> <p>In fact, as one of us (Robert Andrew Robergs) has long <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004">argued</a>, cells produce lactate, not lactic acid. This process actually <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">opposes</a> not causes the build-up of acid in the muscles and bloodstream.</p> <p>Unfortunately, historical inertia means people still use the term “lactic acid” in relation to exercise.</p> <p>Lactate <a href="https://www.science.org/doi/10.1126/science.1101141">doesn’t cause major problems</a> for the muscles you use when you exercise. You’d probably be <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00114.2004?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub++0pubmed&amp;">worse off</a> without it due to other benefits to your working muscles.</p> <p>Lactate isn’t the reason you’re sore a few days after upping your weights or exercising after a long break.</p> <p>So, if it’s not lactic acid and it’s not lactate, what is causing all that muscle soreness?</p> <h2>Muscle pain during and after exercise</h2> <p>When you exercise, a lot of chemical reactions occur in your muscle cells. All these chemical reactions accumulate products and by-products which cause water to enter into the cells.</p> <p>That causes the pressure inside and between muscle cells to increase.</p> <p>This pressure, combined with the movement of molecules from the muscle cells can stimulate nerve endings and cause <a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">discomfort</a> during exercise.</p> <p>The pain and discomfort you sometimes feel hours to days after an unfamiliar type or amount of exercise has a different list of causes.</p> <p>If you exercise beyond your usual level or routine, you can cause microscopic damage to your muscles and their connections to tendons.</p> <p>Such damage causes the release of ions and other molecules from the muscles, causing localised swelling and stimulation of nerve endings.</p> <p>This is sometimes known as “<a href="https://www.sportsmed.theclinics.com/article/S0278-5919(11)00099-8/fulltext">delayed onset muscle soreness</a>” or DOMS.</p> <p>While the damage occurs during the exercise, the resulting response to the injury builds over the next one to two days (longer if the damage is severe). This can sometimes cause pain and difficulty with normal movement.</p> <h2>The upshot</h2> <p>Research is clear; the discomfort from delayed onset muscle soreness has nothing to do with <a href="https://scholar.google.com/citations?user=UVjRNSUAAAAJ&amp;view_op=view_citation&amp;citation_for_view=UVjRNSUAAAAJ:J_g5lzvAfSwC">lactate</a> or <a href="https://journals.physiology.org/doi/full/10.1152/physiol.00033.2017">lactic acid</a>.</p> <p>The good news, though, is that your muscles adapt rapidly to the activity that would initially cause delayed onset muscle soreness.</p> <p>So, assuming you don’t wait too long (more than roughly two weeks) before being active again, the next time you do the same activity there will be much less damage and discomfort.</p> <p>If you have an exercise goal (such as doing a particular hike or completing a half-marathon), ensure it is realistic and that you can work up to it by training over several months.</p> <p>Such training will gradually build the muscle adaptations necessary to prevent delayed onset muscle soreness. And being less wrecked by exercise makes it more enjoyable and more easy to stick to a routine or habit.</p> <p>Finally, remove “lactic acid” from your exercise vocabulary. Its supposed role in muscle soreness is a myth that’s hung around far too long already.<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/214638/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/robert-andrew-robergs-435390"><em>Robert Andrew Robergs</em></a><em>, Associate Professor - Exercise Physiology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> and <a href="https://theconversation.com/profiles/samuel-l-torrens-1476404">Samuel L. Torrens</a>, PhD Candidate, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-my-muscles-sore-after-exercise-hint-its-nothing-to-do-with-lactic-acid-214638">original article</a>.</em></p>

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

<p><a href="https://theconversation.com/profiles/kristin-graham-1427672">Kristin Graham</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em>; <a href="https://theconversation.com/profiles/helen-banwell-305575">Helen Banwell</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em>, and <a href="https://theconversation.com/profiles/saravana-kumar-181105">Saravana Kumar</a>, <em><a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Ballet flat shoes – those thin-heeled lightweight slip-on shoes – are making a fashion <a href="https://www.vogue.com/slideshow/ballet-flats">comeback</a>. And it’s not hard to see why: they’re versatile, easy to wear, soft, flexible and often worn by celebrities.</p> <p>We have often been warned of the dangers of high-heeled shoes, so you might think ballet flats are problem-free.</p> <p>When you look at the research, however, a complicated picture emerges. There’s no definitive evidence to show ballet flats are generally harmful to foot health in the long-term. But ill-fitting ballet flats can be a problem.</p> <h2>Make sure it fits, especially in the toe box</h2> <p>An estimated <a href="https://pubmed.ncbi.nlm.nih.gov/30065787/">70%</a> of the population are wearing ill-fitting shoes. This mismatch between foot and shoe shape can increase foot pain, <a href="https://pubmed.ncbi.nlm.nih.gov/17507530/">reduce stability</a>, and can mean more blisters, corns and calluses. And habitual wearing of tight shoes has been <a href="https://www.sciencedirect.com/science/article/pii/S0958259207000533">associated</a> with bone changes in the toes and feet over time.</p> <p>Many flats feature a shallow and narrow toe box (the part of the shoe where the toes go). A too-small toe box often doesn’t align with the shape of a foot and ends up squishing the toes. It can also <a href="https://www.sciencedirect.com/science/article/pii/S0958259206000770">increase</a> pressure on top of and under the foot, and <a href="https://jfootankleres.biomedcentral.com/articles/10.1186/1757-1146-6-28">restrict</a> the movement of the forefoot during walking.</p> <p>But a too-big toe box is also a problem. Too much foot movement within the shoe can cause pressure and friction on the skin, which can also lead to calluses, corns, blisters, and wounds.</p> <p>A poorly fitting toe box can also cause micro trauma to toenails which, ultimately, can change <a href="https://www.researchgate.net/profile/Anuva-Bansal/publication/347522694_Traumatic_Nail_Disorders/links/60d6135592851ca94487df7e/Traumatic-Nail-Disorders.pdf">their look and thickness</a>.</p> <p>So if you’re wearing flats, make sure you choose a shoe with the right sized toe box.</p> <h2>What about the heel?</h2> <p>Health professionals often recommend a small heel over a completely flat shoe. Very flat shoes can <a href="https://pubmed.ncbi.nlm.nih.gov/27498844/">place</a> <a href="https://www.sciencedirect.com/science/article/pii/S0268003307002082">more</a> strain on the soft tissues that support the foot arch – specifically, the plantar fascia.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/27498844/">Research</a> has shown moving from a completely flat shoe to a small, raised heel reduces the tension force on the plantar fascia during standing activities.</p> <p>On the other hand, other <a href="https://journals.lww.com/jpojournal/Fulltext/2009/01000/Effects_of_Shoe_Heel_Height_on_the_Roll_Over.7.aspx#:%7E:text=The%20roll%2Dover%20shapes%20seem,without%20a%20change%20in%20alignment.&amp;text=Photographs%20of%20the%20prosthetic%20feet,shapes%20of%20these%20feet%20superimposed">research</a> has shown most people will adapt their ankle and knee motion to accommodate shoes of different heel heights.</p> <h2>What about support?</h2> <p>Ballet flats tend to have very flexible, thin soles and heel counters (the part, coloured red in this picture, that hugs the heel and the back part of the foot).</p> <p>These thin and flexible structures mean flats are often accused of lacking support. But debate rages among foot and shoe experts about how important support is in the first place.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/27729290/">Research</a> on barefoot-style shoes has shown walking in these types of shoes significantly reduces some loads on the knee compared to more stable supportive shoes.</p> <p>Minimalist shoes have also been found to <a href="https://pubmed.ncbi.nlm.nih.gov/30102872/">increase strength</a> in certain foot muscles used when we push off during walking, running or jumping.</p> <p>However, other research found stable supportive shoes can <a href="https://pubmed.ncbi.nlm.nih.gov/33428439/">improve knee pain</a> when walking more than flat flexible shoes.</p> <p>The thin soles in flats mean there is little cushioning under the foot. While more cushioning can improve comfort, and reduce stress and strain on your foot sole <a href="https://www.sciencedirect.com/science/article/abs/pii/S0021929011001758?casa_token=gecXFCMi0LcAAAAA:TazyTd8TRaAl_bG0jprifYIUIlWRDwEH6bVeymBYTWups2iDGMuUjLs2gaNqsiNGHVJhHC3J9AdB">skin</a>, there is no evidence it reduces loads across the lower leg.</p> <p>In fact, walking in cushioned shoes has been shown to <a href="https://pubmed.ncbi.nlm.nih.gov/20191571/">increase</a> the load on the knee compared to flat, flexible shoes.</p> <h2>So, what’s the verdict?</h2> <p>The verdict is mixed. Yes, there’s evidence poorly fitting shoes and a flat heel can be detrimental, with consequences seen in the <a href="https://www.sciencedirect.com/science/article/pii/S0966636221000199">rearfoot</a> (around the ankle) and <a href="https://www.sciencedirect.com/science/article/pii/S0966636218300687">knee</a>.</p> <p>But there’s also no hard evidence ballet flats cause long-term foot health problems.</p> <p>What matters is choosing a well-fitted shoe to suit your foot shape and needs.</p> <p>If you’re shopping for ballet flats, try to:</p> <ul> <li> <p>choose a pair with a toe box that does not cramp your toes and has a sole at least as wide as your foot</p> </li> <li> <p>choose flats that offer at least some structure and support</p> </li> <li> <p>choose a pair with a small heel rather being than completely flat.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207806/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/kristin-graham-1427672">Kristin Graham</a>, Lecturer in Podiatry, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>; <a href="https://theconversation.com/profiles/helen-banwell-305575">Helen Banwell</a>, Lecturer in Podiatry, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a>, and <a href="https://theconversation.com/profiles/saravana-kumar-181105">Saravana Kumar</a>, Professor in Allied Health and Health Services Research, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ballet-flats-are-back-heres-what-the-research-says-about-how-they-affect-your-feet-207806">original article</a>.</em></p>

Beauty & Style

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10 things your feet can reveal about your health

<p><strong>You notice: Dry, flaky feet</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Thyroid problems, especially if moisturiser doesn’t help. When the thyroid gland (the butterfly-shaped gland at the base of your neck) isn’t working properly, it doesn’t produce thyroid hormones, which control metabolic rate, blood pressure, tissue growth and skeletal and nervous system development. </p> <p>“Thyroid problems cause severe dryness of the skin,” says foot specialist Marlene Reid. “When we see cracking on the feet, or if moisturiser doesn’t improve dryness over a few days, we usually refer patients to their primary doctor to make sure their thyroids are okay.” Brittle toenails can also signal thyroid complications.</p> <p><strong>You notice: Bald toes</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Arterial disease. If the fuzz on your toes suddenly disappears, it could signal poor blood circulation caused by peripheral arterial disease (PAD) which builds up plaque in the leg arteries. “Signs of PAD can include decreased hair growth on the feet and ankles, purplish toes and thin or shiny skin,” says podiatric surgeon Suzanne Fuchs. </p> <p>Symptoms are subtle, but doctors can check for a healthy pulse in the foot. In severe cases, they may spot PAD on an X-ray. “If I take an X-ray of a broken foot, and I see a hardening of the arteries, 99 per cent of the time the same thing is happening in the heart blood vessels,” says podiatric surgeon Gary A. Pichney.</p> <p><strong>You notice: Ulcers that don't heal </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Diabetes. Uncontrolled glucose levels can damage nerves and cause poor circulation, so blood doesn’t reach all areas of the body, including the feet. When blood doesn’t get to a wound caused by, say, irritating shoes, the skin doesn’t heal properly, and that’s how diabetic blisters and ulcers can develop. </p> <p>“Many, many people with diabetes are diagnosed first because of foot problems,” says Reid. Other signs of diabetes may include persistent tingling or numbness of the feet. If you suffer from these foot problems, ask your doctor about getting your blood sugar levels tested.</p> <p><strong>You notice: An enlarged, painful big toe</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Gout. Gorged on wine and steak? The painful aftermath could be gout, a type of arthritis that often affects the joint of the big toe. Foods high in purine, a chemical compound found in red meats, fish and certain alcohol, can trigger an attack by raising levels of uric acid in the body. Uric acid is normally excreted through urine, but is overproduced or under-excreted in some people. </p> <p>“You’ll see the deposition of the uric acid in the joint, most commonly the big toe or the ankle,” says podiatric foot and ankle specialist Bob Baravarian. “The patient will wake up with a hard, red, swollen joint. It’s extremely painful.” A doctor may prescribe anti-inflammatory drugs for short-term relief and medicines to reduce uric acid production. You may also need to follow a low-purine diet for long-term prevention.</p> <p><strong>You notice: Small, red lines under the toenail </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> A heart infection. Red streaks underneath the toenails or fingernails could be broken blood vessels known as splinter haemorrhages. While problems like psoriasis, fungal infection, or even just experiencing trauma to the nail can cause splinter haemorrhages, it can also be a sign of endocarditis, or an infection of the heart’s inner lining, according to the American Academy of Family Physicians. (Keep in mind this is a rare condition.) </p> <p>People who have an existing heart condition are at higher risk of developing endocarditis. The infection can result in heart failure if left untreated. If you notice splinter haemorrhages on your toenails or fingernails, and haven’t experienced any recent trauma to the nail, see your doctor to check your heart and blood circulation.</p> <p><strong>You notice: Clubbing</strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Lung cancer or heart disease. Another symptom that appears in both toes and fingers, clubbing is often associated with lung cancer, chronic lung infection, or heart conditions caused by birth defects or infection of the lining of heart valves and chambers. Clubbing often occurs in these conditions because of the lower amount of oxygen in the blood. </p> <p>The tissue swells and results in the ‘clubbed’ appearance – rounder, wider fingers and toes. Though patients are typically aware they have a disease that is causing the clubbing, it’s best to get checked if you see any abnormalities.</p> <p><strong>You notice: Pitted toenails </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Psoriasis. If you find tiny holes, grooves or ridges in your toenails, you may have nail psoriasis. Though most people who experience nail psoriasis also have skin psoriasis (an autoimmune disease that makes skin patchy and irritated), five per cent of people with nail psoriasis aren’t affected elsewhere. </p> <p>“If you’ve never been diagnosed with psoriasis, but your toenails have little pits in them, you should get them checked out,” says Pichney. Other symptoms include white patches and horizontal lines across the nails. To treat psoriasis, your doctor may prescribe topical creams or steroids injected under the nail.</p> <p><strong>You notice: Spooned nails </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Anaemia or lupus. Do you have a depression in the toenail deep enough to hold a water droplet? Also known as koilonychias, spoon-shaped toenails or fingernails are most commonly associated with an iron deficiency, research shows, but it can also come from malnutrition, thyroid disorders or injury. </p> <p>Spooned nails occasionally appear in infants, but normalise in the first few years of life. If you notice spooning, contact your physician, who will obtain a blood test to identify the exact cause.</p> <p><strong>You notice: A straight line under your toenails </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Skin cancer. A dark, vertical line underneath a toenail could be acral lentiginous melanoma, or hidden melanoma – a form of the skin cancer that appears on obscure body parts. (Other hidden melanomas include eye melanoma and mouth melanoma.) </p> <p>“It will be a black line from the base of your nail to the end of the nail,” says Pichney. “It should be seen by a podiatrist or dermatologist. You want to make sure it’s not cancer, but it may be a fungus, which is usually yellow-brown and sporadic throughout the whole nail.”</p> <p><strong>You notice: A suddenly high arch </strong></p> <p><span style="text-decoration: underline;"><em>It could be:</em></span> Nerve damage. “Most high-arched feet are associated with some form of underlying neuromuscular condition,” says Pichney. “If someone experiences thinning of the arch muscles in the foot, it could be an indication of a neurological condition called Charcot-Marie-Tooth (CMT).” </p> <p>An inherited disorder that damages the peripheral nerves (those outside the brain and spinal cord), CMT can also cause changes in gait, numbness in the feet, difficulty balancing, loss of muscles in the lower legs, and later on, similar symptoms in the arms and hands. See your doctor if you notice abnormalities. “For anything that’s different or changes when it comes to the foot, see your podiatrist right away,” says Reid.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/10-subtle-signs-of-disease-your-feet-can-reveal" target="_blank" rel="noopener">Reader's Digest</a>.</em> </p>

Body

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

<p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID?</p> <p>This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”.</p> <p>A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats.</p> <h2>Immunology basics</h2> <p>Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing.</p> <p>When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology.</p> <p>This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual.</p> <h2>Invisibly small changes</h2> <p>Part of this self-protective response is a change in how we perceive threats, including sensory stimuli.</p> <p>When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain.</p> <p>Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>.</p> <h2>Immune memories</h2> <p>This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>.</p> <p>Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are.</p> <p>After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>.</p> <p>Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>.</p> <h2>When to worry and what to do</h2> <p>If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves.</p> <p>While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain.</p> <p>Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>.</p> <p>Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse.</p> <p>Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness.</p> <p>Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications.</p> <h2>All in the mind?</h2> <p>Is this all mind over matter? A little of yes and a lot of no.</p> <p>The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level.</p> <p>But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.</em></p>

Caring

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Simple yoga moves that help with hand and wrist pain

<p><em><strong>Tracy Adshead is a yoga teacher specialising in yoga for seniors. She is passionate about bringing healing and healthy ageing to the community.</strong></em></p> <p>As we age, tendonitis is one of the most common problems associated with the hands and wrists. If you are experiencing pain or having difficulty bending one or more of your fingers normally then you may have a tendon inflammation or irritation. The condition is usually short-lived but because many of our daily activities involve repetitive movements such as knitting, texting or typing, joints can easily become aggravated.</p> <p>Yoga helps us to engage in our daily activities in a less stressful way. We can address the cause of the injury by slowing down and observing our habitual movements, then think about how we can do things differently.</p> <ol> <li>Stop whatever activity triggered the inflammation.</li> <li>After swelling has subsided, rest the hand(s) for 4 – 6 days.</li> </ol> <p>Yoga is best used for helping with the healing process at this point when a very slow range of motion can be performed. Be careful not to stretch the muscles so much that you trigger any pain. This practice should be used to supplement conventional therapy, not replace it:</p> <p><strong>1. Lift up the injured hand in front of you</strong>, if possible straighten out all the fingers, finger-tips pointing towards the ceiling. If the fingers are not able to straighten then just move them to a comfortable position.</p> <p>With a slow count of five, little by little, draw the thumb in towards the palm – it may not touch the palm and that’s fine. Next the index finger for the same count. Repeat for each of the fingers.</p> <p>Open up the hand slowly.</p> <p>Now reverse it, small finger moves first towards the palm for the count of four, then all the rest of the fingers follow, thumb comes last. Open up the hand and repeat once more.</p> <p><strong>2. Spread all of your fingers out like a starfish.</strong> With a slow count of 10, begin to fold all your fingers down, closing the hand down into a fist or as close to. Then slowly, all the way open again spreading the fingers out like a starfish. Repeat five to seven times.</p> <p>When this practice becomes comfortable move into a really active hand movement by speeding up.</p> <p><strong>3. Bring the palms together into “namaste” or “prayer” position in front of the chest.</strong> Press the fingers and palms together as you gently lift up your elbows and stretch your wrists.</p> <p>Inhale, lift the elbows up for the count of three. Exhale, lower the elbows for the count of six. Repeat five times.</p> <p>Consult your doctor before starting any new forms of exercise.</p> <p><em>Images: Getty</em></p>

Body

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4 signs your body is trying to tell you something

<p>Have you noticed any odd changes in your body? Perhaps your nails have become more brittle lately, or you’ve started to get cracks on the corners of your mouth. These small signs might seem insignificant, but they are your body’s way of signalling that a change has occurred.</p> <p>Here are some of the key signs that your body is trying to tell you something:</p> <p><strong>Burping and indigestion</strong></p> <p>Find yourself burping or struggling with indigestion more than usual? It could be a sign that you’re low on stomach acid.</p> <p>If your body is low on stomach acid, you won’t digest foods efficiently, especially those heavy in fat and protein. As digestion slows, food sits in the stomach along with the air you naturally swallow when you eat. The longer food stays in the stomach, the more likely you’ll burp.</p> <p><strong>Yellow spots around your eyes</strong></p> <p>Discoloured spots around your eyes and elbows can be a sign that your cholesterol levels are raised. It’s a condition known as xanthelasma, which can be your body’s way of telling you that your diet or exercise routine is amiss.</p> <p>Be sure to consult a doctor if you need to check your cholesterol. A routine blood test will be able to give you the answer, and you can talk to your doctor about what lifestyle changes will help.</p> <p><strong>Itchy feet</strong></p> <p>Summertime often means more visits to the pool or time exercising outdoors. But sweaty trainers and damp feet can also lead to an increase in fungal infections.</p> <p>If you notice your feet are itchy, take a closer look at the skin. If it’s white and flaking off, or simply damp between the toes you may have a fungal infection. Head to the pharmacist for an anti-fungal cream to clear it up, stat.</p> <p><strong>Cracks in the corners of your mouth</strong></p> <p>Small cracks in the skin at the corner of your mouth is often a sign that your body isn’t getting enough B vitamins. If your diet is high in refined and processed foods- think soft drink, pastries and pasta- B vitamins are often the first to take a hit.</p> <p>The answer? Opt for a diet high in whole foods. Try eating more grains, legumes, salmon and red meat, all foods high in B vitamins. If in doubt, always contact a healthcare professional.</p> <p><strong>Related links:</strong></p> <p><span style="text-decoration: underline;"><em><strong><a href="../health/wellbeing/2015/10/how-to-lose-weight-after-60/">How to lose weight after 60</a></strong></em></span></p> <p><a href="http://www.oversixty.co.nz/health/body/2015/11/how-to-stay-asleep/"><span style="text-decoration: underline;"><em><strong>5 tips to stay asleep all night</strong></em></span></a></p> <p><span style="text-decoration: underline;"><em><strong><a href="http://www.oversixty.co.nz/health/body/2015/11/best-outdoor-exercise-options/">The best ways to exercise outdoors</a></strong></em></span></p> <p><em>Image credit: Shutterstock</em></p>

Body

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Artist can draw with both hands and both feet at the same time

<p dir="ltr">Dutch artist Rajacenna van Dam has taken being ambidextrous to the next level, as she taught herself to not only use both her hands to create her art, but her feet as well. </p> <p dir="ltr">Rajacenna is a former child prodigy who, at the age of 16, was discovered as one of the world’s best and youngest hyper-realistic pencil drawing artists.</p> <p dir="ltr">Now 28 years old, Rajacenna is known worldwide for being quadridextrous, as she uses both her hands and both her feet at the same time to create up to six photo-realistic portraits at the same time.</p> <p dir="ltr">While Rajacenna knew she was talented with her hands, she was surprised to discover the talent transferred to her feet. </p> <p dir="ltr">“I love to challenge myself so I thought why not try for the first time painting with my feet while drawing in a realistic way, while being upside down and also one drawing in 3D,” she said.</p> <p dir="ltr">“It surprised me how much control I was able to have over my feet, something I never realised before. All that time I was drawing while I thought my feet were useless with art and now, I discovered they can do way more than I thought!”</p> <p dir="ltr">Rajacenna’s talent was proven during an EEG scan for a popular scientific TV program when it became clear that during drawing, there is superhuman brain activity to be registered in Rajacenna’s brain, according to neuro therapist and world’s number one EEG Biofeedback expert Bill Scott.</p> <p dir="ltr">Mr Scott said Rajacenna is an “extraordinary human being; she has a very exceptional brain”, claiming, “I have never seen this before in anyone’s brain.”</p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/enZbw1j8-ZE" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></p> <p dir="ltr" style="line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;"><em>Image credits: Youtube</em><span id="docs-internal-guid-59ad9a48-7fff-f220-3f61-c21971eb0597"></span></p>

Art

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10 subtle signs of disease your feet can reveal

<h2>You notice: Dry, flaky feet</h2> <p>It could be: Thyroid problems, especially if moisturiser doesn’t help. When the thyroid gland (the butterfly-shaped gland at the base of your neck) isn’t working properly, it doesn’t produce thyroid hormones, which control metabolic rate, blood pressure, tissue growth and skeletal and nervous system development. “Thyroid problems cause severe dryness of the skin,” says foot specialist Marlene Reid. “When we see cracking on the feet, or if moisturiser doesn’t improve dryness over a few days, we usually refer patients to their primary doctor to make sure their thyroids are okay.” Brittle toenails can also signal thyroid complications.</p> <h2>You notice: Bald toes</h2> <p>It could be: Arterial disease. If the fuzz on your toes suddenly disappears, it could signal poor blood circulation caused by peripheral arterial disease (PAD) which builds up plaque in the leg arteries. “Signs of PAD can include decreased hair growth on the feet and ankles, purplish toes and thin or shiny skin,” says podiatric surgeon Suzanne Fuchs. Symptoms are subtle, but doctors can check for a healthy pulse in the foot. In severe cases, they may spot PAD on an X-ray. “If I take an X-ray of a broken foot, and I see a hardening of the arteries, 99 per cent of the time the same thing is happening in the heart blood vessels,” says podiatric surgeon Gary A. Pichney.</p> <h2>You notice: Ulcers that don’t heal</h2> <p>It could be: Diabetes. Uncontrolled glucose levels can damage nerves and cause poor circulation, so blood doesn’t reach all areas of the body, including the feet. When blood doesn’t get to a wound caused by, say, irritating shoes, the skin doesn’t heal properly, and that’s how diabetic blisters and ulcers can develop. “Many, many people with diabetes are diagnosed first because of foot problems,” says Reid. Other signs of diabetes may include persistent tingling or numbness of the feet. If you suffer from these foot problems, ask your doctor about getting your blood sugar levels tested.</p> <h2>You notice: An enlarged, painful big toe</h2> <p>It could be: Gout. Gorged on wine and steak? The painful aftermath could be gout, a type of arthritis that often affects the joint of the big toe. Foods high in purine, a chemical compound found in red meats, fish and certain alcohol, can trigger an attack by raising levels of uric acid in the body. Uric acid is normally excreted through urine, but is overproduced or under-excreted in some people. “You’ll see the deposition of the uric acid in the joint, most commonly the big toe or the ankle,” says podiatric foot and ankle specialist Bob Baravarian. “The patient will wake up with a hard, red, swollen joint. It’s extremely painful.” A doctor may prescribe anti-inflammatory drugs for short-term relief and medicines to reduce uric acid production. You may also need to follow a low-purine diet for long-term prevention.</p> <h2>You notice: Small, red lines under the toenail</h2> <p>It could be: A heart infection. Red streaks underneath the toenails or fingernails could be broken blood vessels known as splinter haemorrhages. While problems like psoriasis, fungal infection, or even just experiencing trauma to the nail can cause splinter haemorrhages, it can also be a sign of endocarditis, or an infection of the heart’s inner lining, according to the American Academy of Family Physicians. (Keep in mind this is a rare condition.) People who have an existing heart condition are at higher risk of developing endocarditis. The infection can result in heart failure if left untreated. If you notice splinter haemorrhages on your toenails or fingernails, and haven’t experienced any recent trauma to the nail, see your doctor to check your heart and blood circulation.</p> <h2>You notice: Clubbing</h2> <p>It could be: Lung cancer or heart disease.</p> <p>Another symptom that appears in both toes and fingers, clubbing is often associated with lung cancer, chronic lung infection, or heart conditions caused by birth defects or infection of the lining of heart valves and chambers. Clubbing often occurs in these conditions because of the lower amount of oxygen in the blood. The tissue swells and results in the ‘clubbed’ appearance – rounder, wider fingers and toes. Though patients are typically aware they have a disease that is causing the clubbing, it’s best to get checked if you see any abnormalities.</p> <h2>You notice: Pitted toenails</h2> <p>It could be: Psoriasis.</p> <p>If you find tiny holes, grooves or ridges in your toenails, you may have nail psoriasis. Though most people who experience nail psoriasis also have skin psoriasis (an autoimmune disease that makes skin patchy and irritated), five per cent of people with nail psoriasis aren’t affected elsewhere. “If you’ve never been diagnosed with psoriasis, but your toenails have little pits in them, you should get them checked out,” says Pichney. Other symptoms include white patches and horizontal lines across the nails. To treat psoriasis, your doctor may prescribe topical creams or steroids injected under the nail.</p> <h2>You notice: Spooned nails</h2> <p>It could be: Anaemia or lupus.</p> <p>Do you have a depression in the toenail deep enough to hold a water droplet? Also known as koilonychias, spoon-shaped toenails or fingernails are most commonly associated with an iron deficiency, research shows, but it can also come from malnutrition, thyroid disorders or injury. Spooned nails occasionally appear in infants, but normalise in the first few years of life. If you notice spooning, contact your physician, who will obtain a blood test to identify the exact cause.</p> <h2>You notice: A straight line under your toenails</h2> <p>It could be: Skin cancer.</p> <p>A dark, vertical line underneath a toenail could be acral lentiginous melanoma, or hidden melanoma – a form of the skin cancer that appears on obscure body parts. (Other hidden melanomas include eye melanoma and mouth melanoma.) “It will be a black line from the base of your nail to the end of the nail,” says Pichney. “It should be seen by a podiatrist or dermatologist. You want to make sure it’s not cancer, but it may be a fungus, which is usually yellow-brown and sporadic throughout the whole nail.”</p> <h2>You notice: A suddenly high arch</h2> <p>It could be: Nerve damage.</p> <p>“Most high-arched feet are associated with some form of underlying neuromuscular condition,” says Pichney. “If someone experiences thinning of the arch muscles in the foot, it could be an indication of a neurological condition called Charcot-Marie-Tooth (CMT).” An inherited disorder that damages the peripheral nerves (those outside the brain and spinal cord), CMT can also cause changes in gait, numbness in the feet, difficulty balancing, loss of muscles in the lower legs, and later on, similar symptoms in the arms and hands. See your doctor if you notice abnormalities. “For anything that’s different or changes when it comes to the foot, see your podiatrist right away,” says Reid.</p> <p><strong>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/10-subtle-signs-of-disease-your-feet-can-reveal" target="_blank" rel="noopener">Reader's Digest</a>.</strong></p> <p><em>Image: Shutterstock</em></p>

Body

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Keeping to the beat controlled by 69 genes – not just our feet

<p class="spai-bg-prepared">Are you a dancing queen or do you have two left feet? Turns out that keeping to the beat is partly to do with our <a class="spai-bg-prepared" href="https://www.nature.com/articles/news.2007.359" target="_blank" rel="noreferrer noopener">genetics</a>.</p> <p class="spai-bg-prepared">An international team of researchers conducted a study on the genetic variation of 606,825 individuals, all of whom completed a musical ability questionnaire (including “Can you clap in time with a musical beat?”), with some also participating in beat synchronisation experiments including telling rhythms apart (Phenotype Experiment 1) and tapping in time with music (Phenotype Experiment 2).</p> <p class="spai-bg-prepared">Of the participants, 91.57% said yes to the question, “Can you clap in time with a musical beat?” Those who said yes also scored higher in the rhythm perception and tapping synchrony experiments.  </p> <p class="spai-bg-prepared">Looking at the genetic variation, 69 genes showed significant difference between the rhythmic and arhythmic participants, with <em class="spai-bg-prepared">VRK2 </em>being the most strongly associated. This gene has been linked previously to behavioural and psychiatric traits (including depression, schizophrenia and developmental delay), suggesting a biological link between beat synchronisation and neurodevelopment.</p> <div class="newsletter-box spai-bg-prepared"> <div id="wpcf7-f6-p195164-o1" class="wpcf7 spai-bg-prepared" dir="ltr" lang="en-US" role="form"> </div> </div> <p class="spai-bg-prepared">Several physiology traits also seemed to be linked to beat synchronisation, including processing speed, grid strength, usual walking pace, and peak respiratory flow. These may be linked to the evolution of language and sociality through music in early humans.</p> <p class="spai-bg-prepared">For modern humans, our ability to keep the beat may help to predict developmental speech-language disorders, and serve as a mechanism for <a class="spai-bg-prepared" href="https://www.frontiersin.org/articles/10.3389/fnhum.2021.789467/full" target="_blank" rel="noreferrer noopener">rhythm-based rehabilitation</a>, including for <a class="spai-bg-prepared" href="https://cosmosmagazine.com/science/biology/bilingual-patients-recover-better-from-stroke/" target="_blank" rel="noreferrer noopener">stroke</a> and <a class="spai-bg-prepared" href="https://www.nature.com/articles/s41598-017-16232-5" target="_blank" rel="noreferrer noopener">Parkinson’s disease</a>.</p> <p class="spai-bg-prepared">This study has been <a class="spai-bg-prepared" href="https://doi.org/10.1038/s41562-022-01359-x" target="_blank" rel="noreferrer noopener">published</a> in <em class="spai-bg-prepared">Nature Human Behaviour</em>.</p> <figure class="wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio spai-bg-prepared"> <div class="wp-block-embed__wrapper spai-bg-prepared"> <div class="entry-content-asset spai-bg-prepared"> <div class="embed-wrapper spai-bg-prepared"> <div class="inner spai-bg-prepared"><iframe class="spai-bg-prepared" title="The Go-Go's - We Got The Beat (Official Music Video)" src="https://www.youtube.com/embed/f55KlPe81Yw?feature=oembed" width="500" height="281" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div> </div> </div> </div> </figure> <p class="spai-bg-prepared">We got the beat… well maybe some of us!</p> <p><img id="cosmos-post-tracker" class="spai-bg-prepared" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=195164&amp;title=Keeping+to+the+beat+controlled+by+69+genes+%E2%80%93+not+just+our+feet" width="1" height="1" /></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/science/biology/keeping-the-beat-genetics/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/qamariya-nasrullah" target="_blank" rel="noopener">Qamariya Nasrullah</a>. Qamariya Nasrullah holds a PhD in evolutionary development from Monash University and an Honours degree in palaeontology from Flinders University.</em></p> <p><em>Image: Getty Images</em></p> </div>

Body

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How to roll away all your sore back blues

<p>We all know that working a 9-5 and sitting all day leads to various health problems. For me personally, it manifests itself through chronic back pain and tight hip flexors. </p> <p>Fortunately, there's a way for me to soothe these aches and pains from home. I've been using <a href="https://www.therabody.com/anz/en-nz/wave-roller-anz.html" target="_blank" rel="noopener">Therabody's Wave Roller</a> for the past week, and my back pain has significantly reduced. </p> <p>The Wave Roller is a Bluetooth-enabled vibrating foam roller that proposes benefits like increasing blood flow, enhancing mobility, and releasing tension. You can connect the roller to a free Therabody App, where you can find personalised recovery routines targeting all parts of your body, along with instructions and how-tos. </p> <p>Here are some of my initial thoughts. </p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/03_RizWaveroller01.jpg" alt="Therabody Wave Roller in use" width="1280" height="720" /></p> <p>My personal favourites are the mid back and upper back routines, which take up to 5 minutes to complete. Since most of the tension is in my upper body, which causes my lower back to overcompensate, I've decided to focus on these areas. </p> <p>The foam roller comes with a bag and charger and is reasonably lightweight, so you could easily carry it around. The foam itself is a high-density foam, and I like that you can customise the intensity and frequency of the vibrations. </p> <p>There are five customised vibration settings, with 5 being the highest and most intense. I could only handle up to the third setting or the medium-intensity.</p> <p>But, the higher the intensity, the more noise it produces, although I didn't mind it so much for the other benefits it provided. </p> <p>The routines are easy to follow, with pictures demonstrating each move and seamless transitions from one exercise to the next. I also liked that the intensity of the vibrations automatically changes according to what's best for that particular movement. </p> <p>I would have loved seeing a video demonstration before each routine, as I wasn't sure if I was doing some of the exercises quite correctly. </p> <p>I also found that the Wave Roller can be slippery to use in some movements, like when I tried it on my rotator cuffs. </p> <p>Despite this, the Wave Roller is a pleasure to use after a long day, when my muscles are the most tense. I find it a helpful tool in managing pain, soreness, and releasing tension. </p> <p>Although it is on the higher end of the price range compared to other foam rollers, I think it's worth the investment. The technology is advanced, and you can personalise the areas you want to work on using the step-by-step programs in their app. </p> <p>It also feels like you're getting a massage, but it's more personalised and customisable. </p> <p>If using the app seems intimidating or too complicated, you can use the Wave Roller by itself and adjust the intensity using the + and - buttons. </p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/03/02_RizWaveroller.jpg" alt="Therabody Wave Roller" width="1280" height="720" /></p> <p>In summary, here are the pros and cons to consider if you're thinking of purchasing one for yourself. </p> <p><strong>Pros: </strong></p> <ul> <li>Relieves soreness and muscle tension</li> <li>Variety of settings for the vibrations</li> <li>App integration </li> <li>Personalised programs that are quick and easy to follow</li> <li>3-hour battery life and it doesn’t take too long to charge</li> </ul> <p><strong>Cons: </strong></p> <ul> <li>The cost (RRP AU$249), but worth every penny! </li> <li>Medium to High setting intense and pretty noisy </li> <li>Depending on the exercise you do it can be quite slippery</li> <li>Video demonstrations before each exercise would be even better </li> </ul> <p>The Wave Roller series is available via the <a href="https://www.therabody.com/anz/en-nz/home" target="_blank" rel="noopener">Therabody website</a>. </p> <p>Images: Rizna Mutmainah &amp; Therabody</p>

Body

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Sore jaw or damaged teeth? You might be suffering from bruxism

<p><span style="font-weight: 400;">If you’re feeling stressed, you might notice you’re snappier with people or having trouble getting enough sleep. </span></p> <p><span style="font-weight: 400;">But, one area of the body that is greatly affected but seldom talked about when it comes to stress can be found in your mouth.</span></p> <p><span style="font-weight: 400;">Teeth grinding - also known as bruxism - can occur in almost anyone and result in broken fillings and cracked teeth.</span></p> <p><span style="font-weight: 400;">Before you get too worried about your oral health, you should know that everyone grinds their teeth at least a little bit.</span></p> <p><span style="font-weight: 400;">“Everybody grinds their teeth a little bit at night, it’s normal and we do it subconsciously - usually during dream sleep,” Dr Tami Yap, a lecturer in oral medicine at Melbourne University, told </span><span style="font-weight: 400;">The Age</span><span style="font-weight: 400;">. </span></p> <p><span style="font-weight: 400;">“If sleep is fragmented, you’re not getting solid sleep cycles, or you have a period of stress where you mood is impacted into the night-time, you will probably grind more.”</span></p> <p><span style="font-weight: 400;">The problems arise when grinding causes the teeth to become worn down or break, or if it causes the muscles in your face to ache.</span></p> <p><span style="font-weight: 400;">Additional symptoms can vary, from temperature sensitivity or a sore jaw to tension headaches or pieces of your teeth breaking off in your mouth.</span></p> <p><span style="font-weight: 400;">Though there isn’t a simple way to “switch off” tooth grinding, Yap explained, there are some things you can do to manage it.</span></p> <p><strong>What makes us grind our teeth?</strong></p> <p><span style="font-weight: 400;">According to Dr Elizabeth Milford, a dentist and scientific relations consultant for Oral-B, tooth grinding can be triggered by increased anxiety, not getting enough exercise, and poor sleep habits.</span></p> <p><span style="font-weight: 400;">Other habits can also exacerbate night-time tooth grinding, such as smoking, drinking large amounts of alcohol, and taking recreational drugs. But these habits are more influential on how much we grind our teeth during the day.</span></p> <p><span style="font-weight: 400;">Daytime tooth grinding is often triggered by our mood, habits, and stress levels.</span></p> <p><span style="font-weight: 400;">“When we are worried or highly stressed, we are physiologically perceiving a low-grade threat,” Yap explained. “And when this happens, stress hormones run around the body and the sympathetic system is engaged because the body is prioritising you to fight or flight.”</span></p> <p><span style="font-weight: 400;">With this comes extra tension in your muscles, with people often holding their teeth together like you would clench your fist.</span></p> <p><span style="font-weight: 400;">“And if you were clenching your fist, it would be very clear you shouldn’t be doing that. Similarly, if you’re touching your teeth together at times other than eating, you’re going to be loading your teeth more, and you’re going to get cracks, and possibly muscle pain.” </span></p> <p><strong>What can you do about it?</strong></p> <p><span style="font-weight: 400;">Minimising tooth grinding requires a holistic approach. Consciously choosing the position of your mouth and jaw and thinking about what our facial muscles are doing can help reduce it.</span></p> <p><span style="font-weight: 400;">“Teeth should only be touching when you’re eating, maybe when you phonate certain words and sometimes when you swallow,” Dr Yap said. “That amounts to a few minutes a day, the rest of the time the teeth should actually be apart.”</span></p> <p><span style="font-weight: 400;">Dr Yap recommends focusing on breathing, since this helps you become “more aware of how your mood and your stress is impacting changes on your body”.</span></p> <p><span style="font-weight: 400;">Treatment can also include jaw exercises, relaxation techniques, and custom-made dental appliances that reduce pressure on teeth.</span></p> <p><span style="font-weight: 400;">Dentists often recommend night guards, but becoming more aware of how we’re feeling and how our body is reacting will pay off in the long run.</span></p>

Body

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Mum's sweet name for baby born at 18,000 feet

<p>Chrystal Hicks has a unique story to tell her son who was born at 18,000 feet in the air.</p> <p>She was 35 weeks pregnant and unexpectedly started contractions in her small town of Glennallen, Alaska.</p> <p>“At about 7 or 8 p.m., [the contractions] really started getting stronger, and then finally my neighbour came over and called 911,” she told <a rel="noopener" href="https://www.businessinsider.com.au/alaska-woman-son-name-sky-birth-on-plane-2020-8" target="_blank" class="_e75a791d-denali-editor-page-rtflink">Insider</a>.</p> <p>On August 5th, she boarded a Lifemed Alaska plane and her water broke 20 minutes into the flight at an elevation of 18,000 feet.</p> <p>“I had to push right away,” Hicks said. “I rolled over on my back, and then all of a sudden, he was out.”</p> <p>At first, she wasn't sure what to name her fourth child, but her cousin gave her a great idea.</p> <p>Hicks came up with the name Sky Airon which describes succinctly where he was born and the unique story he came with.</p> <p><img style="width: 500px; height:281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7837533/baby-body.jpg" alt="" data-udi="umb://media/c871a24112354244ac850c0190b16517" /></p> <div class="body_text "> <p>Her delivery was shocking for the Lifemed Alaska team, who said that onboard deliveries are rare.</p> <p>“In my 20-plus-year career, I can think of maybe four [births],” Lifemed Alaska’s Chief Operations Officer, Steve Heyano, told Insider.</p> <p>However, the plane flies with an Isolette, which is an incubator that has life-support capabilities just in case a birth does happen on board.</p> <p>Patients on flights are also in good hands with onboard care providers, including neonatal nurse practitioners, flight paramedics and nurses.</p> <p>Despite Sky's exciting start to life, he initially had respiratory problems and was placed on a breathing machine in a neonatal intensive care unit in Anchorage, Alaska.</p> <p>He has since been discharged after two weeks and is safely at home with mum and his new siblings.</p> <p><em>Photo credits: </em><em><a rel="noopener" href="https://www.businessinsider.com.au/alaska-woman-son-name-sky-birth-on-plane-2020-8" target="_blank" class="_e75a791d-denali-editor-page-rtflink">Insider</a></em></p> </div>

Family & Pets

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Over-60s make the leap to virtual “Feisty Feet” dance classes

<p><span><a href="https://nzdc.org.nz/education/feisty-feet">Feisty Feet</a></span> is an over 60s seniors dance class created and facilitated by The New Zealand Dance Company (NZDC), which brings together the wisdom keepers of our communities to express and enjoy themselves through dance.</p> <p>Feisty Feet classes, certified by the <a href="https://www.livestronger.org.nz/">Live Stronger for Longer</a> intiative, are held weekly at two Auckland locations in Takapuna and Point Chevalier, but can now also be accessed from anywhere across New Zealand through a weekly Virtual Class.</p> <p>NZDC tutor <a href="https://nzdc.org.nz/our-team/kerry-ann-stanton">Kerry-Ann Stanton</a>, who manages the class in  Pt. Chevalier, has been teaching and developing Feisty Feet from its inception in 2016. Kerry-Ann says, “I enjoy bringing the joys of movement to people in their older age. Dance has been shown to have a positive influence on people, such as a reduced risk of dementia, reduced stress and depression, providing increased energy and serotonin. These classes are fun, inclusive of all cultures and are a great way to make new friends.”</p> <p>Like most activities in 2020, Feisty Feet was affected by COVID-19, but in a positive way. The disappointment regular class-goers expressed about missing their weekly class during lockdown inspired NZDC to move Feisty Feet online. The Company wanted to stay connected with its seniors dance community from the safety of their homes as a means of combatting loneliness during the isolation period and supporting physical and mental wellbeing.</p> <p><span><a href="https://nzdc.org.nz/our-team/carlene-newall-de-jesus">Carlene Newall de Jesus</a></span>, a community dance advocate, specialist, and lecturer at the University of Auckland is also a core facilitator for Feisty Feet, developing and teaching NZDC’s Takapuna class. She reflects,“The transition to virtual classes was surprisingly smooth. After initially worrying that being together across our screens would be too removed and distanced, it became clear that even in this digital space, physical exploration and connection was still possible. As the virtual classes developed I began to appreciate homes spaces as dancing places and found ways to allow individual contribution even in the digital space.”</p> <p>Survey feedback from class participants also showcased that the benefits of a Feisty Feet class were not lost when moving to an online class.</p> <p>One participant shares, “Although I've never attended a dance class before, learning flowing movements and practising coordination, balance and memory and enjoying the friendly faces of other participants and the encouragement of the tutors got me moving and made me feel content in myself.”</p> <p>Another participant enjoyed the “extra physical movement, using whole body and the associated wellbeing and inspiration and pleasure of communication and meeting new dancers as well as learning new IT skills.”</p> <p>An additional participant reflected how it was “easy to access, no embarassment as on [your] own and no time lost in transportation”</p> <p>Carlene encapsulates the intention of Feisty Feet classes and the desire at NZDC to continue to offer the online class alongside in-person classes: “I believe dance offers a unique combination of exercise, creativity, cognition and socialisation that can be beneficial for older bodies, brains and general wellbeing. The digital platform allows older adults who may not have access to appropriate dance classes in their region, or who are unable to travel to classes, a chance to dance, move and express. Aotearoa is made up of more than just large cities and I am excited to see what sense of community can develop across older New Zealanders from diverse towns and regions.”</p> <p>More Information: <span><a href="https://nzdc.org.nz/education/feisty-feet">nzdc.org.nz/education/feisty-feet</a></span></p> <p><strong>VIRTUAL</strong></p> <p><strong>WHERE</strong>: Online through Zoom</p> <p><strong>WHEN</strong>: Every Friday 9-10am</p> <p><strong>TUTOR</strong>: Carlene Newall de Jesus</p> <p><strong>COST</strong>: $10 per session. Register ahead of class here: <span><a href="https://bit.ly/virtualfeistyfeet">https://bit.ly/virtualfeistyfeet</a></span></p> <p><strong>TAKAPUNA</strong></p> <p><strong>WHERE:</strong> St Peters Anglican Church, 11 Killarney Street, Takapuna</p> <p><strong>WHEN:</strong> Every Wednesday 10-11am until 16 December 2020</p> <p><strong>TUTOR:</strong> Carlene Newall de Jesus</p> <p><strong>COST:</strong> $10 per session or $90 for 10 sessions. Pay in person before class with cash.</p> <p><strong>POINT CHEVALIER</strong></p> <p><strong>WHERE</strong>: Subud Hall, 19 Formby Rd, Pt Chevalier</p> <p><strong>WHEN</strong>: Every Wednesday 11am-noon until 16 December 2020</p> <p><strong>TUTOR</strong>: Kerry-Anny Stanton</p> <p><strong>COST</strong>: $10 per session or $90 for 10 sessions. Pay in person before class with cash.</p> <p>Photos by Caroline Bindon and Ashley David.</p> <p> </p>

Retirement Life

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Check your feet! 'COVID toes' are a new and more rampant sign of coronavirus

<p>Skin doctors are currently looking at a lot of toes, as concern grows that for some people, a symptom COVID-19 might be in an unusual spot.</p> <p>Boston dermatologist Esther Freeman expected to see skin complaints as COVID-19 hit the US but wasn’t expecting them to be toes.</p> <p>"But I was not anticipating those would be toes," Massachusetts General Hospital employee Dr Freeman said to <em><a rel="noopener" href="https://www.9news.com.au/world/covid-toe-rash-possible-coronavirus-infection-sign/5bf041bd-a472-44e9-9e95-f8eb10695447" target="_blank">9news</a>.</em></p> <p>Cases were initially recorded in children but has appeared to have spread to adults as well.</p> <p>Dr Freeman has viewed via telemedicine more toes in the last several weeks than in her entire week.</p> <p>They’re being called ‘COVID toes’, which are red, sore and sometimes itchy swellings on toes.</p> <p>"I think it's much more rampant than we even realize. The good news is it resolves spontaneously," Dr Amy Paller of Northwestern University said.</p> <p>There are many theories as to why ‘COVID toes’ are appearing, including that it could be inflammation triggered by the infection instead of the cold as well as the virus potentially irritating the lining of blood vessels in the skin.</p> <p>"The public health message is not to panic," Dr Freeman said, noting that most toe patients she's seen haven't become severely ill. Are they contagious?</p> <p>"We can't tell if you've got COVID-19 just by looking at your toes," she said.</p>

Body

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Sorry, not sorry: Djokovic speaks out on patting chair umpire's feet

<p>Novak Djokovic has apologised for touching the umpire during his Australian Open final match on Sunday night.</p> <p>The Serb initially defended his decision to tap official Damien Dumusois twice on the foot, describing it as “a nice, really friendly touch”, but expressed his regret on Monday.</p> <p>“In a professional sport, things happen that obviously you’re not proud of,” Djokovic said.</p> <p>“Sometimes you do things that you’re not happy with and you go through different emotions, you go through ups and downs.</p> <p>“Of course, I’m not happy that I touched the chair umpire. And I’m sorry if I offended him or anybody else.</p> <p>“But in the heat of the battle, some decisions that he makes or some decision that happens just distracts you and sets you off the balance a little bit.”</p> <p>According to the official grand slam rule book, Djokovic could be charged with a fine of up to NZ$30,959 for the action.</p> <p>“Players shall not at any time physically abuse any official, opponent, spectator or other person within the precincts of the tournament site,” the rules state. “Violation of this section shall subject a player to a fine up to US$20,000 [NZ$30,959] for each violation.”</p> <p>In the post-match press conference, Djokovic said he did not believe he overstepped the mark. “For touching his shoe? I mean, I didn’t know that’s completely forbidden,” he said after securing his 6-4, 4-6, 2-6, 6-3, 6-4 against Dominic Thiem.</p> <p>“I thought it was a nice, really friendly touch. I wasn’t aggressive with him in terms of physical abuse.”</p>

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Air rage: Bad behavior at 30,000 feet

<p>People do disgusting and disruptive things on airplanes. They show little regard or patience for fellow passengers and their needs. Inconsiderate behavior on the part of passengers can make air travel an unpleasant hassle for everyone. The 2014 annual <a href="http://viewfinder.expedia.com/news/expedia-airplane-etiquette-study-2014">Expedia Airplane Etiquette Study</a> ranked the top on-board etiquette violators as reported by passengers:</p> <ol> <li>Rear Seat Kicker: cited by 67 per cent of study respondents</li> <li>Inattentive Parents: 64 per cent</li> <li>The Aromatic Passenger: 56 per cent</li> <li>The Audio Insensitive (talking or music): 51 per cent</li> <li>The Boozer: 50 per cent</li> <li>Chatty Cathy: 43 per cent</li> </ol> <p>The IATA received more than 8,000 complaints of <a href="http://www.iata.org/pressroom/facts_figures/Documents/Advocacy-presentation-gmd-2014.pdf">unruly passengers</a> in 2013. Is it any wonder <a href="http://dx.doi.org/10.1002/jtr.327">air rage</a> is on the upswing?</p> <p>Consider that up to 16 million Americans may have <a href="http://www.nimh.nih.gov/news/science-news/2006/intermittent-explosive-disorder-affects-up-to-16-million-americans.shtml">Intermittent Explosive Disorder</a>, which causes them lash out inappropriately at people and things – and that’s when they’re nowhere near an airport. The Federal Aviation Administration defines air rage as a passenger’s explosive and unpredictable behavior occasioned by congested travel, unexpected delays, or negative interactions with other passengers and flight personnel. From this point of view, the list of etiquette violators doesn’t really fall within the air rage definition. But from a psychological point of view, the story is different.</p> <p><strong>Mental air rage, silent epidemic</strong></p> <p>What safety and health officials call “explosive air rage” spills out into the public sphere for everyone to witness; these are the verbal attacks on passengers and personnel by someone yelling profanities, threats, complaints, and insults. “<a href="http://www.ashgate.com/isbn/9780754643715">Mental air rage</a>,” on the other hand, is emotional and private. Most people try to suppress mental air rage and prevent it from showing publicly for various reasons including fear, embarrassment, rational self control or compassion. It’s psychologically very real even though it’s far less visible than its explosive counterpart.</p> <p>Mental air rage is just one aspect of the stressed out feelings that go along with the uncertainties and negative emotions of travel and transportation. This charged negative emotional background exists below the surface of consciousness and can lead to a simmering feeling of resentment throughout the travel experience.</p> <p>So it’s not just “that guy” who could blow up at an airline employee when his plane is delayed yet again. Any traveler faces a real risk that at an unpredictable moment the silent air rage simmering below the surface may spring out suddenly as full-blown explosive air rage.</p> <p><strong>Changes for the worse in passenger environment</strong></p> <p>Airlines contribute to harsh and unfriendly traveling conditions when their economic policies create an artificial climate of scarcity, competition and enmity among passengers.</p> <p>The <a href="https://www.yahoo.com/travel/air-rage-isn-t-our-c1409837051635.html">list</a> of contributors to the deteriorating environment for airline passengers is a familiar one. Airlines have reduced legroom and seat width. Checked bag fees encourage passengers to bring more and more on board, leading to battles over limited storage space. The elimination of in-flight meals causes passengers to bring their own odorous food. Policies on personal electronic devices are unclear and inconsistently enforced. Bottomline, the cabins are overloaded.</p> <p>All of these factors increase the mental load on travelers. From there it’s a small step for inconsiderate actions to trigger negative and anti-social behaviors in waiting rooms, airplanes and lavatories. For instance, entering a lavatory on board an airplane and finding it in a disgusting used condition creates an emotional and psychological shock. We are not only repelled and annoyed, but we also feel aggressed against. This stressful situation can ratchet up the mental air rage.</p> <p><strong>How to peacefully prevent air rage</strong></p> <p>To reduce the unpleasantness of travel and the likelihood of air rage, passengers can bring things along to take care of their own comfort – reading materials, climate appropriate clothing, snacks, games and so on. Chatty passengers can form a mini-support group with one or more fellow travelers, sharing and consulting with each other on whatever travel problems are encountered. This tactic can help defuse stressful situations that could otherwise escalate. Even just having alternate scenarios worked out in case you don’t arrive when expected can minimize mental air rage.</p> <p>My <a href="http://www.aijcrnet.com/journals/Vol_4_No_10_October_2014/4.pdf">research</a> suggests some ways airlines can help prevent these incidents as well, via more enlightened crowd management techniques:</p> <ul> <li> <p>When people are waiting, they should be provided with a continuous stream of updated information every five minutes via a variety of formats and media: electric board, signs, announcements, and face-to-face interactions.</p> </li> <li> <p>Elevate the importance of the traveler’s comfort whenever implementing changes. Apologize if decent seating is unavailable. Make up for it by giving something else in return so the traveler doesn’t feel cheated or neglected.</p> </li> <li> <p>Manage lines with more compassion. People shouldn’t stand in line when they can sit and wait. People shouldn’t have to compete physically with each other for an airplane seat</p> </li> <li> <p>Follow compassionate principles to create a social group out of the anonymous people in the waiting room or on the airplane. Encourage discussion among the waiting people. Form a support group out of them so they can assist each other and give each other help, ideas, and support.</p> </li> </ul> <p>Airlines should train employees in techniques that can prevent air rage incidents in the first place as well as how safely to de-escalate episodes once they’ve begun. After all, air rage isn’t just another unpleasant aspect of traveling – it can put everyone onboard at risk.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/35240/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines --></p> <p><em>Written by <span>Leon James, Professor of Psychology, University of Hawaii</span>. Republished with permission of </em><a rel="noopener" href="https://theconversation.com/air-rage-bad-behavior-at-30-000-feet-35240" target="_blank"><em>The Conversation</em></a><em>. </em></p>

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