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Readers response: What is on your anti travel bucket list?

<p>When it comes to travelling, lots of people have a bucket list of places they would love to go and things they would love to experience. </p> <p>But in a similar vain, many travellers have a strict list of places they don't wish to go, and things they can do without ever experiencing. </p> <p>We asked our readers what's on their anti travel bucket lists, and the response was overwhelming. Here's what they said. </p> <p><span dir="auto"><strong>Deedee Cullum</strong> - Large, busy airports where your connecting flight is at the other end of the building.</span></p> <p><span dir="auto"><strong>Colleen Burgess</strong> - The middle seat on every airline!</span></p> <p><span dir="auto"><strong>Karen Ambrose</strong> - We won’t go to America due to the gun culture there. Too dangerous.</span></p> <p><span dir="auto"><strong>Sue Bailey</strong> - Any travel without comprehensive travel insurance - a 'must have'. If you can't afford travel insurance, you can't afford to travel.</span></p> <p><span dir="auto"><strong>Sarah Archie</strong> - USA, China, war countries, countries renowned for civil unrest.</span></p> <p><span dir="auto"><strong>Faye Grave</strong> - Bali.</span></p> <p><span dir="auto"><strong>Pam Coppock</strong> - Anywhere outside Australia for me.</span></p> <p><span dir="auto"><strong>Russell Drury</strong> - Cruise.</span></p> <p><span dir="auto"><strong>Carol O'Brien</strong> - Dealing with unruly passengers on planes &amp; long haul flights.</span></p> <p><span dir="auto"><strong>Judi Tracey</strong> - Dubai. A dear friend of mine was spat in the face there.</span></p> <p><span dir="auto"><strong><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto">Vinc</span></span></span></span></span></span></strong><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><strong>ent Cole</strong> - </span></span></span></span></span></span><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto"><span dir="auto">Qantas!</span></span></span></span></span></span></span></p> <p><em><span dir="auto">Image credits: Shutterstock </span></em></p>

Travel Trouble

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Could the shingles vaccine lower your risk of dementia?

<p><em><a href="https://theconversation.com/profiles/ibrahim-javed-1552271">Ibrahim Javed</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>A <a href="https://www.nature.com/articles/s41591-024-03201-5">recent study</a> has suggested Shingrix, a relatively new vaccine given to protect older adults against shingles, may delay the onset of dementia.</p> <p>This might seem like a bizarre link, but actually, <a href="https://pubmed.ncbi.nlm.nih.gov/34697158/">research</a> has previously shown an older version of the shingles vaccine, Zostavax, reduced the risk of dementia.</p> <p>In this new study, published last week in the journal Nature Medicine, researchers from the United Kingdom found Shingrix delayed dementia onset by 17% compared with Zostavax.</p> <p>So how did the researchers work this out, and how could a shingles vaccine affect dementia risk?</p> <h2>From Zostavax to Shingrix</h2> <p>Shingles is a viral infection caused by the varicella-zoster virus. It causes <a href="https://www.healthdirect.gov.au/shingles">painful rashes</a>, and affects older people in particular.</p> <p>Previously, Zostavax was used to vaccinate against shingles. It was administered as a single shot and provided good protection for about <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/zoster-herpes-zoster">five years</a>.</p> <p>Shingrix has been developed based on a newer vaccine technology, and is thought to offer stronger and longer-lasting protection. Given in two doses, it’s now the preferred option for shingles vaccination in Australia and elsewhere.</p> <p>In November 2023, Shingrix replaced Zostavax on the <a href="https://www.health.gov.au/news/national-immunisation-program-changes-to-shingles-vaccination-from-1-november-2023">National Immunisation Program</a>, making it available for free to those at highest risk of complications from shingles. This includes all adults aged 65 and over, First Nations people aged 50 and older, and younger adults with certain medical conditions that affect their immune systems.</p> <h2>What the study found</h2> <p>Shingrix was approved by the US Food and Drugs Administration in <a href="https://www.drugs.com/history/shingrix.html">October 2017</a>. The researchers in the new study used the transition from Zostavax to Shingrix in the United States as an opportunity for research.</p> <p>They selected 103,837 people who received Zostavax (between October 2014 and September 2017) and compared them with 103,837 people who received Shingrix (between November 2017 and October 2020).</p> <p>By analysing data from electronic health records, they found people who received Shingrix had a 17% increase in “diagnosis-free time” during the follow-up period (up to six years after vaccination) compared with those who received Zostavax. This was equivalent to an average of 164 extra days without a dementia diagnosis.</p> <p>The researchers also compared the shingles vaccines to other vaccines: influenza, and a combined vaccine for tetanus, diphtheria and pertussis. Shingrix and Zostavax performed around 14–27% better in lowering the risk of a dementia diagnosis, with Shingrix associated with a greater improvement.</p> <p>The benefits of Shingrix in terms of dementia risk were significant for both sexes, but more pronounced for women. This is not entirely surprising, because we know women have <a href="https://www.alzheimers.org.uk/blog/why-dementia-different-women">a higher risk</a> of developing dementia due to interplay of biological factors. These include being more sensitive to certain genetic mutations associated with dementia and hormonal differences.</p> <h2>Why the link?</h2> <p>The idea that vaccination against viral infection can lower the risk of dementia has been around for more than two decades. Associations have been <a href="https://pubmed.ncbi.nlm.nih.gov/11762573/">observed</a> between vaccines, such as those for diphtheria, tetanus, polio and influenza, and subsequent dementia risk.</p> <p>Research has shown Zostavax vaccination can <a href="https://bmjopen.bmj.com/content/11/10/e045871">reduce the risk</a> of developing dementia by 20% compared with people who are unvaccinated.</p> <p>But it may not be that the vaccines themselves protect against dementia. Rather, it may be the resulting lack of viral infection creating this effect. Research indicates bacterial infections in the gut, as well as viral infections, are associated with a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10169152/">higher risk of dementia</a>.</p> <p>Notably, untreated infections with herpes simplex (herpes) virus – closely related to the varicella-zoster virus that causes shingles – can <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/trc2.12119">significantly increase</a> the risk of developing dementia. Research has also shown shingles increases the risk of a later dementia diagnosis.</p> <p>The mechanism is not entirely clear. But there are two potential pathways which may help us understand why infections could increase the risk of dementia.</p> <p>First, certain molecules are produced when a baby is developing in the womb to help with the body’s development. These molecules have the potential to cause inflammation and accelerate ageing, so the production of these molecules is silenced around birth. However, viral infections such as shingles can <a href="https://doi.org/10.1016/j.virol.2018.07.011">reactivate</a> the production of these molecules in adult life which could <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717685/#:%7E:text=The%20disease%20mechanisms%20of%20AD,may%20lead%20to%20new%20therapies.">hypothetically lead to dementia</a>.</p> <p>Second, in Alzheimer’s disease, a specific protein called Amyloid-β go rogue and kill brain cells. Certain proteins produced by viruses <a href="https://www.biorxiv.org/content/10.1101/2024.05.16.594465v1">such as COVID</a> and <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/advs.202001299">bad gut bacteria</a> have the potential to support Amyloid-β in its toxic form. In laboratory conditions, these proteins have been shown to <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1003537">accelerate the onset</a> of dementia.</p> <h2>What does this all mean?</h2> <p>With an ageing population, the burden of dementia is only likely to become greater in the years to come. There’s a lot more we have to learn about the causes of the disease and what we can potentially do to prevent and treat it.</p> <p>This new study has some limitations. For example, time without a diagnosis doesn’t necessarily mean time without disease. Some people may have underlying disease with delayed diagnosis.</p> <p>This research indicates Shingrix could have a silent benefit, but it’s too early to suggest we can use antiviral vaccines to prevent dementia.</p> <p>Overall, we need more research exploring in greater detail how infections are linked with dementia. This will help us understand the root causes of dementia and design potential therapies.<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/235597/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/ibrahim-javed-1552271">Ibrahim Javed</a>, Enterprise and NHMRC Emerging Leadership Fellow, UniSA Clinical & Health Sciences, <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/could-the-shingles-vaccine-lower-your-risk-of-dementia-235597">original article</a>.</em></p>

Mind

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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>

Body

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Long COVID puzzle pieces are falling into place – the picture is unsettling

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/ziyad-al-aly-513663">Ziyad Al-Aly</a>, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</a></em></p> <p>Since 2020, the condition known as long COVID-19 has become a <a href="https://www.hhs.gov/civil-rights/for-providers/civil-rights-covid19/guidance-long-covid-disability/index.html">widespread disability</a> affecting the health and quality of life of millions of people across the globe and costing economies billions of dollars in <a href="https://www.oecd.org/en/publications/the-impacts-of-long-covid-across-oecd-countries_8bd08383-en.html">reduced productivity of employees and an overall drop in the work force</a>.</p> <p>The intense scientific effort that long COVID sparked has resulted in <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22long+covid%22+or+%22pasc%22+or+%22post-acute+sequelae+of+covid-19%22+or+%22postacute+sequelae+of+covid-19%22+or+%22post-acute+sequelae+of+SARS-CoV-2%22+or+%22postacute+sequelae+of+SARS-CoV-2%22+or+%22post+covid+condition%22+or+%22post+covid+conditions%22+or+%E2%80%9Cchronic+covid-19%E2%80%9D+or+%E2%80%9Cpost+covid-19+condition%E2%80%9D+or+%E2%80%9Cpost+covid-19+conditions%E2%80%9D+or+%E2%80%9Cpost-covid+condition%E2%80%9D+or+%E2%80%9Cpost-covid+conditions%E2%80%9D+or+%E2%80%9Clong+covid-19%E2%80%9D+or+%28%22long-term%22+and+%22COVID-19%22%29+or+%28%22longterm%22+and+%22COVID-19%22%29+or+%28%22long-term%22+and+%22SARS-CoV-2%22%29+or+%28%22longterm%22+and+%22SARS-CoV-2%22%29+or+%E2%80%9Cpostcovid+condition%E2%80%9D+or+%E2%80%9Cpostcovid+conditions%E2%80%9D+&amp;sort=date">more than 24,000 scientific publications</a>, making it the most researched health condition in any four years of recorded human history.</p> <p><a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">Long COVID</a> is a term that describes the <a href="https://www.yalemedicine.org/conditions/long-covid-post-covid-conditions-pcc">constellation of long-term health effects</a> caused by infection with the SARS-CoV-2 virus. These range from persistent respiratory symptoms, such as shortness of breath, to debilitating fatigue or brain fog that limits people’s ability to work, and conditions such as heart failure and diabetes, which are known to last a lifetime.</p> <p>I am a physician scientist, and I have been deeply immersed in studying long COVID since the early days of the pandemic. I have testified before the U.S. Senate as an <a href="https://www.help.senate.gov/imo/media/doc/baf4e4e7-b423-6bef-7cb4-1b272df66eb8/Al-Aly%20Testimony.pdf">expert witness on long COVID</a>, have <a href="https://scholar.google.com/citations?hl=en&amp;user=DtuRVcUAAAAJ">published extensively on it</a> and was named as one of <a href="https://time.com/6966812/ziyad-al-aly/">Time’s 100 most influential people in health in 2024</a> for my research in this area.</p> <p>Over the first half of 2024, a <a href="https://www.nationalacademies.org/our-work/long-term-health-effects-stemming-from-covid-19-and-implications-for-the-social-security-administration#sl-three-columns-afa91458-20e0-42ab-9bd6-55e3c8262ecc">flurry of reports</a> and <a href="https://doi.org/10.1056/NEJMoa2403211">scientific papers</a> on long COVID added clarity to this complex condition. These include, in particular, insights into how COVID-19 can still wreak havoc in many organs years after the initial viral infection, as well as emerging evidence on viral persistence and immune dysfunction that last for months or years after initial infection.</p> <h2>How long COVID affects the body</h2> <p>A new study that my colleagues and I published in the New England Journal of Medicine on July 17, 2024, shows that the <a href="https://doi.org/10.1056/NEJMoa2403211">risk of long COVID declined</a> over the course of the pandemic. In 2020, when the ancestral strain of SARS-CoV-2 was dominant and vaccines were not available, about 10.4% of adults who got COVID-19 developed long COVID. By early 2022, when the omicron family of variants predominated, that rate declined to 7.7% among unvaccinated adults and 3.5% of vaccinated adults. In other words, unvaccinated people were more than twice as likely to develop long COVID.</p> <p>While researchers like me do not yet have concrete numbers for the current rate in mid-2024 due to the time it takes for long COVID cases to be reflected in the data, the flow of new patients into long COVID clinics has been on par with 2022.</p> <p>We found that the decline was the result of two key drivers: availability of vaccines and changes in the characteristics of the virus – which made the virus less prone to cause severe acute infections and may have reduced its ability to persist in the human body long enough to cause chronic disease.</p> <p>Despite the decline in risk of developing long COVID, even a 3.5% risk is substantial. New and repeat COVID-19 infections translate into millions of new long COVID cases that add to an already staggering number of people suffering from this condition.</p> <p>Estimates for the first year of the pandemic suggests that at <a href="https://doi.org/10.1038/s41579-023-00896-0">least 65 million people</a> globally have had long COVID. Along with a group of other leading scientists, my team will soon publish updated estimates of the global burden of long COVID and its impact on the global economy through 2023.</p> <p>In addition, a major new report by the National Academies of Sciences Engineering and Medicine details all the <a href="https://nap.nationalacademies.org/catalog/27756/long-term-health-effects-of-covid-19-disability-and-function">health effects that constitute long COVID</a>. The report was commissioned by the Social Security Administration to understand the implications of long COVID on its disability benefits.</p> <p>It concludes that long COVID is a complex chronic condition that can result in more than 200 health effects across multiple body systems. These include new onset or worsening:</p> <ul> <li><a href="https://doi.org/10.1038/s41591-022-01689-3">heart disease</a></li> <li><a href="https://doi.org/10.1038/s41591-022-02001-z">neurologic problems</a> such as <a href="https://theconversation.com/mounting-research-shows-that-covid-19-leaves-its-mark-on-the-brain-including-with-significant-drops-in-iq-scores-224216">cognitive impairment</a>, strokes and <a href="https://my.clevelandclinic.org/health/diseases/6004-dysautonomia">dysautonomia</a>. This is a category of disorders that affect the body’s <a href="https://my.clevelandclinic.org/health/body/23273-autonomic-nervous-system">autonomic nervous system</a> – nerves that regulate most of the body’s vital mechanisms such as blood pressure, heart rate and temperature.</li> <li><a href="https://www.cdc.gov/me-cfs/hcp/clinical-care/treating-the-most-disruptive-symptoms-first-and-preventing-worsening-of-symptoms.html">post-exertional malaise</a>, a state of severe exhaustion that may happen after even minor activity — often leaving the patient unable to function for hours, days or weeks</li> <li><a href="https://doi.org/10.1038/s41467-023-36223-7">gastrointestinal disorders</a></li> <li><a href="https://doi.org/10.1681/ASN.2021060734">kidney disease</a></li> <li>metabolic disorders such as <a href="https://doi.org/10.1016/S2213-8587(22)00044-4">diabetes</a> and <a href="https://doi.org/10.1016/S2213-8587(22)00355-2">hyperlipidemia</a>, or a rise in bad cholesterol</li> <li><a href="https://doi.org/10.1038/s41590-023-01724-6">immune dysfunction</a></li> </ul> <p>Long COVID can affect people across the lifespan from children to older adults and across race and ethnicity and baseline health status. Importantly, <a href="https://doi.org/10.1126/science.adl0867">more than 90% of people with long COVID</a> had mild COVID-19 infections.</p> <p>The National Academies report also concluded that long COVID can result in the inability to return to work or school; poor quality of life; diminished ability to perform activities of daily living; and decreased physical and cognitive function for months or years after the initial infection.</p> <p>The report points out that many health effects of long COVID, such as post-exertional malaise and chronic fatigue, cognitive impairment and autonomic dysfunction, are not currently captured in the <a href="https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm">Social Security Administration’s Listing of Impairments</a>, yet may significantly affect an individual’s ability to participate in work or school.</p> <figure><iframe src="https://www.youtube.com/embed/9kJ5GWb2wzw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Many people experience long COVID symptoms for years following initial infection.</span></figcaption></figure> <h2>A long road ahead</h2> <p>What’s more, health problems resulting from COVID-19 can last years after the initial infection.</p> <p>A large study published in early 2024 showed that even people who had a <a href="https://doi.org/10.1038/s41591-024-02987-8">mild SARS-CoV-2 infection still experienced new health problems</a> related to COVID-19 in the third year after the initial infection.</p> <p>Such findings parallel other research showing that the <a href="https://doi.org/10.1016/S1473-3099(24)00171-3">virus persists</a> in various organ systems for months or years after COVID-19 infection. And research is showing that immune responses to the infection are <a href="https://doi.org/10.1126/scitranslmed.adk3295">still evident two to three years</a> after a mild infection. Together, these studies may explain why a SARS-CoV-2 infection years ago could still cause new health problems long after the initial infection.</p> <p>Important progress is also being made in understanding the pathways by which long COVID wreaks havoc on the body. Two preliminary studies <a href="https://doi.org/10.1101/2024.06.18.24309100">from the U.S.</a> and <a href="https://doi.org/10.1101/2024.05.30.596590">the Netherlands</a> show that when researchers transfer auto-antibodies – antibodies generated by a person’s immune system that are directed at their own tissues and organs – from people with long COVID into healthy mice, the animals start to experience long COVID-like symptoms such as muscle weakness and poor balance.</p> <p>These studies suggest that an abnormal immune response thought to be responsible for the generation of these auto-antibodies may underlie long COVID and that <a href="https://doi.org/10.1126/science.zbzipqn">removing these auto-antibodies</a> may hold promise as potential treatments.</p> <h2>An ongoing threat</h2> <p>Despite overwhelming evidence of the wide-ranging risks of COVID-19, a great deal of messaging suggests that it is no longer a threat to the public. Although there is no empirical evidence to back this up, this misinformation has permeated the public narrative.</p> <p>The data, however, tells a different story.</p> <p><a href="https://covid.cdc.gov/covid-data-tracker/#datatracker-home">COVID-19 infections</a> continue to <a href="https://www.cdc.gov/flu/weekly/index.htm">outnumber flu cases</a> and lead to <a href="https://www.cdc.gov/resp-net/dashboard/index.html">more hospitalization</a> and <a href="https://doi.org/10.1001/jama.2024.7395">death</a> than the flu. COVID-19 also leads to <a href="https://doi.org/10.1016/S1473-3099(23)00684-9">more serious long-term health problems</a>. Trivializing COVID-19 as an inconsequential cold or <a href="https://www.theatlantic.com/health/archive/2024/02/covid-anniversary-flu-isolation-cdc/677588/">equating it with the flu</a> does not align with reality.<!-- 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/233759/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/ziyad-al-aly-513663">Ziyad Al-Aly</a>, Chief of Research and Development, VA St. Louis Health Care System. Clinical Epidemiologist, <a href="https://theconversation.com/institutions/washington-university-in-st-louis-732">Washington University in St. Louis</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/long-covid-puzzle-pieces-are-falling-into-place-the-picture-is-unsettling-233759">original article</a>.</em></p> </div>

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Anti-cellulite products are big business – but here’s what the science says

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rebecca-shepherd-423135">Rebecca Shepherd</a>, <em><a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p>Although <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.14815">90% of women have cellulite</a>, we’re yet to see it represented as a normal anatomical characteristic in popular culture. In Greta Gerwig’s 2023 Hollywood blockbuster, for instance, Stereotypical Barbie, played by Margot Robbie, develops dimples on her upper thigh as part of her existential crisis – along with other human faults such as halitosis, flat feet and irrepressible thoughts of death.</p> <p>When Stereotypical Barbie asks doll sage Weird Barbie what the dimples are, she explains: “That’s cellulite. That’s going to spread everywhere. Then you’re going to start getting sad and mushy and complicated.” Barbie’s perfect smooth plastic perfection is marred.</p> <p>Despite its prevalence, then, cellulite has been constructed as a flaw in need of correction. Consumers, it seems, agree, especially when fed a diet of the <a href="https://www.tandfonline.com/doi/full/10.1080/21604851.2021.1913827">photoshop smoothed skin</a> of models, social media influencers – and Hollywood stars.</p> <figure><iframe src="https://www.youtube.com/embed/rmThigh1i8s?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">“NO!” Barbie shouts when Weird Barbie tells her she has cellulite.</span></figcaption></figure> <p>Cellulite’s usually found in areas that have greater amounts of subcutaneous fat, when fat deposits push through the connective tissue beneath the skin, leading to a lumpy appearance. It is common, <a href="https://www.sciencedirect.com/science/article/pii/S0738081X1300076X?via%3Dihub">usually painless</a> and harmless.</p> <p>The human skin is the <a href="https://theconversation.com/the-skin-is-a-very-important-and-our-largest-organ-what-does-it-do-91515">body’s largest organ</a>, made up of three layers. At the surface, the epidermis acts as our first line of defence against the environment. This outermost, impermeable layer is made up of cells that are constantly renewed and shed, protecting our body from external elements.</p> <p>Beneath the epidermis lies the dermis, a robust layer containing fibroblasts, the cells responsible for producing essential proteins such as collagen and elastin. These proteins provide structure and elasticity, contributing to the skin’s strength and flexibility.</p> <p>Deeper still is the hypodermis, also known as the subcutaneous layer. This layer is rich in adipose tissue – mostly made up of fat, which plays a crucial role in cushioning and insulating the body, as well as storing fat that can be used when needed. Beneath these three layers of skin, there is muscle. Running from the muscle to the dermis are <a href="https://journals.lww.com/amjdermatopathology/fulltext/2000/02000/cellulite__from_standing_fat_herniation_to.7.aspx">bands of connective tissue</a>, that holds the adipose tissue in “pockets”.</p> <p>Cellulite does not affect health, although some people report that it affects their <a href="https://www.tandfonline.com/doi/abs/10.1080/07853890.2018.1561731">self-esteem and body image</a> but that’s more to do with the social pressure on women to be physically perfect – or spend money, time and energy trying to be as close to perfect as possible.</p> <p>Cellulite, then, has become big business for the beauty industry. In the lead up to summer especially, companies will promote <a href="https://www.asa.org.uk/advice-online/weight-control-cellulite.html">all manner of products</a> from creams and serums to gadgets and pills, all aimed at creating perfectly smooth limbs. The most popular question seems to be, “Do these treatments work?” but as an anatomist I think the more pressing question is, “Why are healthy women’s bodies considered something to treat, cure or correct?”</p> <p>The beauty and wellness industry has long capitalised on societal standards of beauty. The idea that cellulite is undesirable and <a href="https://journals.lww.com/dermatologicsurgery/abstract/1978/03000/So_Called_Cellulite.9.aspx">should be corrected</a> has been perpetuated since Vogue magazine was the <a href="https://archive.vogue.com/article/1968/4/cellulite-the-new-word-for-fat-you-couldnt-lose-before">first English language magazine</a> to use the term “cellulite”, introducing the concept to thousands of women. This marketing strategy taps into the insecurities of consumers, particularly women, and promotes an endless pursuit of “perfection” for bodies that have normal anatomical variation.</p> <p>By framing cellulite as a condition that needs treatment, companies can sell a wide range of products and services, bolstered by celebrity endorsements, which lend credibility and aspirational value to pseudo-medical “smoothing” products. However, there is limited scientific evidence supporting the effectiveness of these supplements in treating cellulite. In fact, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.1978.tb00416.x">first scientific paper</a> on cellulite, published in 1978, referred to it as “so called cellulite: the invented disease”.</p> <p>Recent product launches include, <a href="https://lemmelive.com/en-gb/products/lemme-smooth-capsules?variant=45597048111318">Lemme Smooth</a>, Kourtney Kardashian-Barker’s latest addition to her vitamin and supplement range. The product’s promotional materials claim that the capsule “visibly reduces cellulite in 28 days”. But what does the science tell us?</p> <p>Supplements like Lemme Smooth claim to improve skin texture and reduce cellulite from within. Kardashian-Barker’s supplement contains a mixture of <a href="https://link.springer.com/article/10.1007/s10298-015-0977-4">french cantaloupe melon</a>, hyaluronic acid, chromium and vitamin C among other ingredients. The body’s ability to absorb and utilise these ingredients in a way that would impact cellulite is still a subject of debate.</p> <p>There is evidence that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110621/#:%7E:text=In%20a%20randomized%2C%20double%2Dblind,in%20part%2C%20to%20the%20skin.">ingested hyaluronic acid</a> can migrate into the skin, stimulating the production of collagens within the dermis – and vitamin C has been shown to <a href="https://www.nature.com/articles/s41598-020-72704-1">thicken the surface layer</a> of the skin. However, the lack of standardisation in testing for the use of these ingredients in the treatment of cellulite means it’s still not clear if they will have a <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1467-2494.2006.00318.x">significant effect</a>.</p> <p>Other products marketed to reduce the appearance of cellulite include topical creams and lotions, containing ingredients like <a href="https://karger.com/books/book/763/chapter-abstract/5600478/Specific-Use-Cosmeceuticals-for-Body-Skin-Texture?redirectedFrom=fulltext">caffeine, retinol, and herbal extracts</a>. Cosmetic products are not able to penetrate the epidermis enough to significantly affect the underlying fat deposits and connective tissue.</p> <p>Some invasive treatments, such as <a href="https://www.aad.org/public/cosmetic/fat-removal/cellulite-treatments-what-really-works">laser therapy, subcision, and acoustic wave therapy</a> can offer more promising results. These procedures work by breaking down the connective tissue bands that cause dimpling and stimulating collagen production in the dermis to improve skin elasticity. While these methods <a href="https://www.aad.org/public/cosmetic/fat-removal/cellulite-treatments-what-really-works">may be more effective</a>, they are often expensive, require multiple sessions to achieve results – and aren’t without risk.</p> <p>Maintaining a healthy diet, drinking lots of water, and regular physical activity can help improve the overall appearance of the skin and reduce the visibility of cellulite. Losing weight and strengthening the muscles in the legs, buttocks and abdomen may make cellulite less noticeable, but it won’t make it <a href="https://jndc-chemistryarticles.info/ijn/article/318">disappear altogether</a>.</p> <p>The bottom line, though, is that cellulite does not need to be treated. It’s a normal anatomical variation that’s been transformed into a condition driving a lucrative market for cures <a href="https://link.springer.com/article/10.1007/s40257-015-0129-5">that don’t exist</a>.</p> <p>My top expert advice in the run up to summer? Be wary of claims from cosmetic companies and save your money.</p> <hr /> <p><em>The Conversation has approached the Lemme Live brand for comment.</em><!-- 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/232318/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/rebecca-shepherd-423135">Rebecca Shepherd</a>, Senior Lecturer in Human Anatomy, School of Anatomy, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</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/anti-cellulite-products-are-big-business-but-heres-what-the-science-says-232318">original article</a>.</em></p> </div>

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COVID vaccines saved millions of lives – linking them to excess deaths is a mistake

<p><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, <em><a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</a></em></p> <p>A recent <a href="https://bmjpublichealth.bmj.com/content/2/1/e000282">study</a> has sparked another <a href="https://nypost.com/2024/06/06/us-news/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths-since-pandemic-study/">round of</a> <a href="https://www.telegraph.co.uk/news/2024/06/04/covid-vaccines-may-have-helped-fuel-rise-in-excess-deaths/">headlines</a> <a href="https://www.gbnews.com/health/covid-vaccine-side-effects-deaths">claiming</a> that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of <a href="https://x.com/DrAseemMalhotra/status/1797922073798717524">I-told-you-sos</a> on social media.</p> <p>Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">The Conversation</a> pointing this out and suggesting some reasons. But has anything changed?</p> <p>The authors of the new study, published in BMJ Public Health, used publicly available data from <a href="https://ourworldindata.org/COVID-vaccinations">Our World in Data</a> to determine which countries had “statistically significant” excess deaths – in other words, excess deaths that couldn’t be explained by mere random variation.</p> <p>They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text – and indeed widely interpreted as such by certain newspapers.</p> <p>There is no doubt that a few deaths were associated with <a href="https://journals.sagepub.com/doi/full/10.1177/25166026211053485">the COVID vaccines</a>, but could the vaccination programme explain the large number of excess deaths – 3 million in 47 countries – that have been reported?</p> <p>Based on <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">death certificates</a>, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathregistrationsummarystatisticsenglandandwales/2022">exceeded COVID deaths</a>.</p> <p>If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK’s <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/excessdeathsinenglandandwales/march2020todecember2021">Office for National Statistics (ONS)</a>. In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated “age-standardised death rates” to account for age differences between those vaccinated and those not.</p> <p>What the ONS found was that in all months from April 2021 to May 2023, the death rate <a href="https://www.ons.gov.uk/redir/eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.eyJpbmRleCI6MSwicGFnZVNpemUiOjEwLCJwYWdlIjoxLCJ1cmkiOiIvcGVvcGxlcG9wdWxhdGlvbmFuZGNvbW11bml0eS9iaXJ0aHNkZWF0aHNhbmRtYXJyaWFnZXMvZGVhdGhzL2RhdGFzZXRzL2V4Y2Vzc2RlYXRoc2luZW5nbGFuZGFuZHdhbGVzIiwibGlzdFR5cGUiOiJyZWxhdGVkZGF0YSJ9.Cot-XDe8Rr07paGllBNnVVz1nTqnXfVafn2woA3tk0c">from all causes was higher</a> in the unvaccinated than in people who had been vaccinated at least once.</p> <p>That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10492612/">protective effect of vaccines</a> against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months.</p> <p>Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic.</p> <h2>Possible causes</h2> <p>If the vaccine is not the cause of the excess deaths, what was?</p> <p>The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries.</p> <p>Possible <a href="https://theconversation.com/summer-2022-saw-thousands-of-excess-deaths-in-england-and-wales-heres-why-that-might-be-189351">explanations</a> for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath.</p> <p>We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.<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/231776/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/paul-hunter-991309">Paul Hunter</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/university-of-east-anglia-1268">University of East Anglia</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/covid-vaccines-saved-millions-of-lives-linking-them-to-excess-deaths-is-a-mistake-231776">original article</a>.</em></p>

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4 anti-ageing mistakes most women make

<p>While there’s no denying it, wrinkles are just part of the natural ageing process, there are some mistakes we all make that will speed up the ageing process. So if you want to keep your youthful glow for longer, be sure to avoid these beauty blunders. </p> <p><strong>Skipping sunscreen</strong></p> <p>READ CAREFULLY: Sunscreen IS THE ultimate anti-ageing tool. Even when it’s not beach-worthy weather outside, but the sun’s UV rays can still damage your skin. This is namely photoageing, the wrinkling, spotting and loss of elasticity caused by exposure to sun. So as part of your daily routine, make sure you slip, slap, slop. </p> <p><strong>Rubbing tired eyes</strong></p> <p>While we’re all guilty of this seemingly harmful action, did you know that simply rubbing your eyes will stretch delicate skin and may cause it to slacken? The skin around our eyes and on our eyelids is the most sensitive and least elastic on our face and the most vulnerable... so keep your fingers away.</p> <p><strong>Skimping on sunglasses</strong></p> <p>As well as being a fashionable accessory, sunglasses also do wonders to minimize lines around your eyes. Shading your eyes from the sun’s glare prevents squinting and crow's feet wrinkles, of course, but it also shields delicate skin from the destructive onslaught of UV rays. Make sure you opt for a pair with UV protection.</p> <p><strong>Neglecting your neck, chest and hands</strong></p> <p>The delicate skin of these areas lack the oil glands of other areas of skin, which results in dryness and accelerated aging. Plus, these areas are often fraught with sunscreen neglect. As well as remembering to apply sunscreen to these areas you should also pay attention to them by applying an anti-ageing serum. </p> <p><em>Image credits: Shutterstock </em></p>

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The growing promise of cancer vaccines

<div class="copy"> <p>A cure for cancer — which is <a href="https://ourworldindata.org/grapher/burden-of-disease-by-cause" target="_blank" rel="noopener">second only to cardiovascular diseases</a> in its contribution to the global burden of disease — has long been a dream.</p> <p>While no magic bullet is yet in sight, three vaccines for particular skin and lung cancer types have advanced to the last stage of clinical trials in recent months.</p> <p>If successful, these vaccines should be available to patients in the next three to 11 years. Unlike vaccines which prevent diseases, these aim to cure them or prevent relapses.</p> <p>Cancer in every person is different because the cells in every cancerous tumour have different sets of genetic mutations. Recognising this, two of the vaccines are personalised and tailor-made for each patient. Oncologists working with pharmaceutical companies have developed these individualised neoantigen therapies.</p> <p>A vaccine typically works by training the immune cells of our body to recognise antigens – proteins from pathogens, such as viruses – against future attacks by the pathogen.</p> <p>In cancer, however, there is no external pathogen. The cells of a cancerous tumour undergo continuous mutations, some of which help them to grow much faster than normal cells while some others help them evade the body’s natural immune system. The mutated proteins in cancerous cells are called ‘neoantigens’.</p> <p>In individualised neoantigen therapy, the gene sequence of the tumour and normal blood cells are compared to identify neoantigens from each patient, and then a subset of neoantigens are chosen that are most likely to induce an immune response. The vaccine for an individual patient targets this chosen subset of neoantigens.</p> <p>These vaccines, jointly developed by pharma giants Moderna and Merck, have been shown in trials conducted so far to be significantly more effective in combination with immunotherapy than immunotherapy alone in preventing both the relapse of melanoma — a type of skin cancer — and non-small cell lung cancer after the tumours had been surgically removed.</p> <p>Following these promising results in phase II clinical trials, the vaccines are now being tested on a larger group of patients in phase III trials. The studies are expected to be complete by 2030 for <a href="https://clinicaltrials.gov/study/NCT05933577" target="_blank" rel="noopener">melanoma</a> and 2035 for <a href="https://www.clinicaltrials.gov/study/NCT06077760?intr=mRNA-4157&amp;rank=3" target="_blank" rel="noopener">lung cancer</a>.</p> <p>The Moderna-Merck cancer vaccine may not be the first to reach the market. The French company OSE Immunotherapeutics <a href="https://www.clinicaltrialsarena.com/news/ose-shares-pipeline-updates-with-plans-phase-iii-trial-for-tedopi/" target="_blank" rel="noopener">published positive results</a> last September from phase III clinical trials of a vaccine using a different approach for advanced non-small cell lung cancer. Its vaccine, Tedopi, is scheduled to start <a href="https://finance.yahoo.com/news/ose-immunotherapeutics-receives-8-4-160000694.html?guccounter=1&amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&amp;guce_referrer_sig=AQAAADAX7Kqu7RTAEowvwOw2f-2cJ7SJ4uLpvjH-3tXzGtifqidaZfPs4eHLz23UqqjHDPjbVE1Vwel5qIKzKbmWvPLfLQzzH_PvKJAMsqTHuz8p5nPoR39RbIToLShEUG53eOeDFg6pWlRc2JPqrX7sGnc3ByO9FFfqXQYpZ4FZ-jgr" target="_blank" rel="noopener">confirmatory trials</a> – which are the last step before regulatory approval – later this year and may be available by 2027.</p> <p>Vaccines for pancreatic cancer being developed by BioNTech and Genentech, and for colon cancer by Gritstone, are also showing promising results in the early phases of clinical trials. Like the vaccines being developed by Moderna and Merck, these too are individualised neoantigen therapies based on messenger RNA (mRNA).</p> <p>There is another kind of RNA therapy also under development that uses small interfering RNA (siRNA) and microRNA (miRNA). Since 2018, six siRNA-based therapies have been approved by the US Food and Drug Administration for the treatment of neural, skin, heart and renal diseases. Several more siRNA drugs are at various clinical trial stages for different types of cancer and a diverse range of other diseases.</p> <p>Within cells, there are two kinds of nucleic acid molecules that contain coded information vital to life: DNA and RNA. While DNA contains genetic information, mRNA — one among the different types of RNA — carries the codes for the proteins. In addition, there are also non-coding RNA, some of which are functionally important. siRNA and miRNA are examples of such non-coding RNA.</p> <p>The RNA vaccine for an individualised neoantigen therapy is a cocktail of mRNA carrying the codes for neoantigens — the mutated fingerprint proteins in cancerous cells. For the <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">Moderna-Merck study</a>, scientists identified 34 neoantigens per patient. They delivered the corresponding mRNA vaccine cocktail packed in lipid nanoparticles, just like the mRNA vaccines for COVID-19 developed by Moderna and Pfizer-BioNTech.</p> <p>When the vaccine is delivered after removing the tumour, it trains the immune system to recognise neoantigens and fight back against the cancer returning. Usually, the body’s natural immune system corrects mutations and prevents us from having cancers. However, in some cases this natural immune response is insufficient, leading to tumour growth. In individualised neoantigen therapy, these mutations in the tumour cells are used for vaccine development and for training the immune system to fight back against relapse after removal of the tumour.</p> <p>Recent advances in artificial intelligence are helping identify potential neoantigens and manage personalised therapies. Firstly, gene sequencing of tumours and normal blood cells of a patient and their comparison produces a huge amount of data. AI is used to find the genetic mutations of the patient’s cancer in such ‘big data’. Moreover, individualised therapy requires timely production and delivery of vaccines that are different for each patient. AI is also useful in the management of such data.</p> <p>The individualised nature of the treatment is probably why it has been <a href="https://www.nature.com/articles/d41591-023-00072-0" target="_blank" rel="noopener">more effective in trials</a> than previous, unsuccessful RNA vaccine candidates. However, this personalisation is also likely to raise challenges for the timely and cost-effective delivery of treatment to populations around the world.</p> <p>The siRNA and miRNA treatments work in a way opposite to mRNA. While each mRNA in a vaccine carries the code for producing a protein from a pathogen (antigen) or tumour (neoantigen) to train our immune systems against future attacks by the pathogen or tumour, siRNA directly targets the mRNA of the antigen or neoantigen and terminates the production of the protein it codes. Thus, the effect of a siRNA is more direct and immediate (like a drug), rather than a protection against future attacks (like a vaccine).</p> <p>Discovered at the turn of this millennium, siRNA-based therapeutics attracted immediate attention, but their initial success was limited due to their inherent low stability, difficulties in delivering them to desired locations, and rapid clearance from the bloodstream. However, in recent years, siRNA therapies have been boosted through chemical modifications that have increased their stability and ability to be delivered to specific locations such as tumours, and improved delivery systems such as lipid nanoparticle encasings.</p> <p>These improvements led to recent successes in FDA approvals of siRNA-based therapies and further <a href="https://www.rockefeller.edu/news/35461-a-new-way-to-target-the-culprit-behind-a-deadly-liver-cancer/" target="_blank" rel="noopener">promising reports of advances</a> in the treatment of diseases including a type of liver cancer.</p> <p><em>Research scientist </em><em><strong>Dr Bidyut Sarkar</strong></em><em> is the DBT-Wellcome Trust India Alliance Intermediate Fellow in the Department of Chemistry at Shiv Nadar Institute of Eminence, Delhi NCR, India.</em></p> <p><em>Originally published under <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank" rel="noopener">Creative Commons</a> by <a href="https://360info.org/" target="_blank" rel="noopener">360info</a>™.</em></p> <p><em>Image credits: Shutterstock </em></p> <div> <p align="center"> </p> </div> <p><em><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=304875&amp;title=The+growing+promise+of+cancer+vaccines" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></em></div> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/the-body/the-growing-promise-of-cancer-vaccines/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/360info-2/">360info</a>. Originally published under Creative Commons by 360info™.</em></p> </div>

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5 sneaky beauty tricks that take a decade off your look

<p>What if we told you there were five super simple turn-back-the-clock tricks that could brighten the face, open up the eyes, improve plumpness and give you enviably shiny hair? Well, that’s exactly what we’re telling you. And these tips don’t require and expensive trip to a beauty salon and can be done in your very own bathroom. </p> <p>When it comes to your skin, just one super-charged anti-ager will instantly boost your beauty routine—and deliver the kind of results we’d all be happy to see in the mirror. Here are five tricks you should definitely try today.</p> <p><strong>Try a Sleeping Beauty elixir</strong><br />They don’t call it beauty sleep for no good reason. While you’re head is on the pillow, it’s the perfect time to slather on an overnight face and neck cream that uses skin brightening ingredients such as vitamin C, algae extract and anti-oxidants. You will wake up more supple, radiant and bright – and in some cases, with firmer skin.</p> <p><strong>Go for bold lip</strong><br />A bold yet fresh lip will instantly brighten and lift the face. The trick is to go one or two shades brighter than you usually do – without option for a blast of neon. Diffuse bright edges with a cotton bud to stop hard lines.</p> <p><strong>Shake the magic wand</strong><br />Eyelashes have the ability to really open up your eyes and thus give you a more youthful look instantly. So everyone, get acquainted with the eyelash curler. A must for opening up tired, droopy eyelids before applying mascara – it works every time. </p> <p><strong>Attempt a gravity-defying mini massage</strong><br />As massages stimulate circulation, cells and collagen, everyone should be giving themself a daily morning face massage using small circular motions. Focus on your forehead, cheeks, chin, and gently pat under eyes to help with firmness and reduce bloating.</p> <p><strong>Let your hair shine on</strong><br />Shiny, healthy hair makes everyone look better – and it one of the easiest beauty tricks to master. Try mashed-up avocado mixed with olive oil as a hair mask – it’s cheap, natural and really effective.</p> <p><em>Image credits: Shutterstock</em></p>

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AstraZeneca admits to Covid vaccine's deadly side effect

<p>AstraZeneca has admitted that their Covid vaccine carries a very rare but deadly side effect, as "dozens" of class-action lawsuits pile up. </p> <p>The UK pharmaceutical giant could be facing damages of up to $38 million, as lawyers representing complainants whose loved ones who were injured or killed from the jab called the vaccine "defective". </p> <p>Those who received the AstraZeneca Covid-19 vaccine could be susceptible to a rare and potentially blood clotting disorder called thrombosis with thrombocytopenia syndrome, or TTS, in which patients suffer from blood clots as well as a low blood platelet count. </p> <p>While the side effect is rare, recent research from RMIT University and Monash University found Australia’s Covid-19 vaccination rollout likely prevented the death of 17,760 people aged over 50 in New South Wales between August 2021 and July 2022, with some researchers suggesting that AstraZeneca alone helped saved as many as six million lives worldwide, according to the <a title="nypost.com" href="https://nypost.com/2024/04/29/world-news/astrazeneca-cops-to-rare-deadly-side-effect-of-covid-jab-as-lawsuits-mount/"><em>New York Post</em>.</a></p> <p>AstraZeneca, which is contesting the claims, acknowledged in a February legal document that its vaccine can “in very rare cases,” cause the clotting condition, while also acknowledging that the potential complication was listed as a side effect of the vaccine since its release.</p> <p>So far, 51 cases have been filed in London’s High Court, estimated to be worth around $190 million (GBP100 million) total, according to the UK newspaper<a title="www.telegraph.co.uk" href="https://www.telegraph.co.uk/news/2024/04/28/astrazeneca-admits-covid-vaccine-causes-rare-side-effect/"> <em>The Telegraph</em></a>.</p> <p>However, thanks to a deal struck between AstraZeneca and the UK government during the worst of the pandemic, the drugmaker has been pre-emptively indemnified against future lawsuits – which means any successful claims for payouts will be born by taxpayers.</p> <p>One of the claimants is father-of-two Jamie Scott, who was left with a permanent brain injury after suffering a clot following receiving the vaccine in April 2021. </p> <p>His wife, Kate, told <a title="www.telegraph.co.uk" href="https://www.telegraph.co.uk/news/2024/04/28/astrazeneca-admits-covid-vaccine-causes-rare-side-effect/"><em>The Telegraph</em> </a>she’s hopeful the company’s admission will accelerate the outcome of their case.</p> <p>“We need an apology, fair compensation for our family and other families who have been affected. We have the truth on our side, and we are not going to give up.”</p> <p><em>Image credits: Getty Images </em></p>

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

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

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What are the new COVID booster vaccines? Can I get one? Do they work? Are they safe?

<p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>As the COVID virus continues to <a href="https://pubmed.ncbi.nlm.nih.gov/36680207/">evolve</a>, so does our vaccine response. From <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">December 11</a>, Australians will have access to <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">new vaccines</a> that offer better protection.</p> <p>These “monovalent” booster vaccines are expected to be a <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">better match</a> for currently circulating strains of SARS-CoV-2, the virus that causes COVID.</p> <p>Pfizer’s monovalent vaccine will be <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/new-covid-19-vaccines-available-to-target-current-variants?language=en">available</a> to eligible people aged five years and older. The Moderna monovalent vaccine can be used for those aged 12 years and older.</p> <p>Who is eligible for these new boosters? How do they differ from earlier ones? Do they work? Are they safe?</p> <h2>Who’s eligible for the new boosters?</h2> <p>The federal government has accepted the Australian Technical Advisory Group (ATAGI) recommendation to use the new vaccines, after Australia’s regulator <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">approved their use last month</a>. However, vaccine eligibility has remained the same since September.</p> <p>ATAGI <a href="https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines?language=en">recommends</a> Australians aged over 75 get vaccinated if it has been six months or more since their last dose.</p> <p>People aged 65 to 74 are recommended to have a 2023 booster if they haven’t already had one.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&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/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=315&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560533/original/file-20231120-21-4igdnx.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=396&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">For people without risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>Adults aged 18 to 64 <em>with</em> underlying risk factors that increase their risk of severe COVID are also recommended to have a 2023 booster if they haven’t had one yet. And if they’ve already had a 2023 booster, they can consider an additional dose.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&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/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=311&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/560532/original/file-20231120-26-70jfyr.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=391&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">Advice for people with risk factors.</span> <span class="attribution"><a class="source" href="https://www.health.gov.au/sites/default/files/2023-10/atagi-recommended-covid-19-vaccine-doses.pdf">Health.gov.au</a></span></figcaption></figure> <p>For adults aged 18 to 64 <em>without</em> underlying risk factors who have already received a 2023 booster, an additional dose isn’t recommended. But if you’re aged 18 to 64 and haven’t had a booster in 2023, you can consider an additional dose.</p> <p>Additional doses aren’t recommended for children <em>without</em> underlying conditions that increase their risk of severe COVID. A primary course is not recommended for children aged six months to five years <em>without</em> additional risk factors.</p> <h2>Monovalent, bivalent? What’s the difference?</h2> <p><strong>From monovalent</strong></p> <p>The initial COVID vaccines were “monovalent”. They had one target – the original viral strain.</p> <p>But as the virus mutated, we assigned new letters of the Greek alphabet to each variant. This brings us to Omicron. With this significant change, we saw “immune evasion”. The virus had changed so much the original vaccines didn’t provide sufficient immunity.</p> <p><strong>To bivalent</strong></p> <p>So vaccines were updated to target an early Omicron subvariant, BA.1, plus the original ancestral strain. With two targets, these were the first of the “bivalent” vaccines, which were approved in Australia <a href="https://theconversation.com/omicron-specific-vaccines-may-give-slightly-better-covid-protection-but-getting-boosted-promptly-is-the-best-bet-190736">in 2022</a>.</p> <p>Omicron continued to evolve, leading to more “immune escape”, contributing to repeated waves of transmission.</p> <p>The vaccines were updated again in <a href="https://theconversation.com/havent-had-covid-or-a-vaccine-dose-in-the-past-six-months-consider-getting-a-booster-199096">early 2023</a>. These newer bivalent vaccines target two strains – the ancestral strain plus the subvariants BA.4 and BA.5.</p> <p><strong>Back to monovalent</strong></p> <p>Further changes in the virus have meant our boosters needed to be updated again. This takes us to the recent announcement.</p> <p>This time the booster targets another subvariant of Omicron known as XBB.1.5 (sometimes known as <a href="https://theconversation.com/the-kraken-subvariant-xbb-1-5-sounds-scary-but-behind-the-headlines-are-clues-to-where-covids-heading-198158">Kraken</a>).</p> <p>This vaccine is monovalent once more, meaning it has only one target. The target against the original viral strain has been removed.</p> <p>According to advice given to the World Health Organization <a href="https://www.who.int/news/item/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines">in May</a>, this is largely because immunity to this original strain is no longer required (it’s no longer infecting humans). Raising immunity to the original strain may also hamper the immune response to the newer component, but we’re not sure if this is occurring or how important this is.</p> <p>The United States <a href="https://theconversation.com/cdc-greenlights-two-updated-covid-19-vaccines-but-how-will-they-fare-against-the-latest-variants-5-questions-answered-213341">approved</a> XBB.1.5-specific vaccines from Pfizer and Moderna in <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating">mid-September</a>. These updated vaccines have also been <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">approved in</a> places including Europe, Canada, Japan and Singapore.</p> <p>In Australia, the Therapeutic Goods Administration (TGA) approved them <a href="https://www.tga.gov.au/products/covid-19/covid-19-vaccines/covid-19-vaccines-regulatory-status">in October</a>.</p> <h2>Do these newer vaccines work?</h2> <p>Evidence for the efficacy of these new monovalent vaccines comes from the results of research <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">Pfizer</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">Moderna</a> submitted to the TGA.</p> <p>Evidence also comes from a <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">preprint</a> (preliminary research available online that has yet to be independently reviewed) and an update Pfizer <a href="https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2023-09-12/10-COVID-Modjarrad-508.pdf">presented</a> to the US Centers for Disease Control.</p> <p>Taken together, the available evidence shows the updated vaccines produce good levels of antibodies in <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">laboratory studies</a>, <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">in humans</a> and <a href="https://www.tga.gov.au/resources/auspar/auspar-spikevax-xbb15">mice</a> when compared to previous vaccines and when looking at multiple emerging variants, including EG.5 (sometimes known as <a href="https://theconversation.com/the-who-has-declared-eris-a-variant-of-interest-how-is-it-different-from-other-omicron-variants-211276">Eris</a>). This variant is the one causing high numbers of cases around the world currently, including in Australia. It is very similar to the XBB version contained in the updated booster.</p> <p>The updated vaccines should also cover <a href="https://theconversation.com/how-evasive-and-transmissible-is-the-newest-omicron-offshoot-ba-2-86-that-causes-covid-19-4-questions-answered-212453">BA.2.86 or Pirola</a>, according to <a href="https://www.tga.gov.au/sites/default/files/2023-10/auspar-spikevax-xbb.1.5-231012.pdf">early results</a> from clinical trials and the US <a href="https://www.cdc.gov/respiratory-viruses/whats-new/covid-19-variant.html">Centers for Disease Control</a>. This variant is responsible for a rapidly increasing proportion of cases, with case numbers growing <a href="https://twitter.com/BigBadDenis/status/1725310295596560662?s=19">in Australia</a>.</p> <p>It’s clear the virus is going to continue to evolve. So performance of these vaccines against new variants will continue to be closely monitored.</p> <h2>Are they safe?</h2> <p>The <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&amp;id=CP-2023-PI-02409-1&amp;d=20231117172310101">safety</a> of the updated vaccines has also been shown to be similar to previous versions. Studies <a href="https://www.medrxiv.org/content/10.1101/2023.08.22.23293434v2">comparing them</a> found no significant difference in terms of the adverse events reported.</p> <p>Given the availability of the updated vaccines, some countries have removed their approval for earlier versions. This is because newer versions are a closer match to currently circulating strains, rather than any safety issue with the older vaccines.</p> <h2>What happens next?</h2> <p>The availability of updated vaccines is a welcome development, however this is not the end of the story. We need to make sure eligible people get vaccinated.</p> <p>We also need to acknowledge that vaccination should form part of a comprehensive strategy to limit the impact of COVID from now on. That includes measures such as mask wearing, social distancing, focusing on ventilation and air quality, and to a lesser degree hand hygiene. Rapidly accessing antivirals if eligible is also still important, as is keeping away from others if you are infected.<!-- 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/217804/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/paul-griffin-1129798"><em>Paul Griffin</em></a><em>, Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-the-new-covid-booster-vaccines-can-i-get-one-do-they-work-are-they-safe-217804">original article</a>.</em></p>

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9 signs you have inflammation in your body. Could an anti-inflammatory diet help?

<p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>There is a lot of health buzz around the term “inflammation” right now. From new scientific <a href="https://medicalxpress.com/news/2023-07-inflammation-discovery-aging-age-related-diseases.html">discoveries</a> to <a href="https://people.com/health/gwyneth-paltrow-addresses-backlash-anti-inflammatory-diet/">celebrities</a> and social media influencers, it seems like everyone is talking about this important bodily process and its potential impact on our health.</p> <p>“<a href="https://www.nature.com/articles/s41574-018-0059-4">Inflammaging</a>” is a specific term you may also have seen. It’s an age-related increase in persistent, low-grade inflammation in blood and tissue, which is a strong risk factor for many conditions and diseases.</p> <p>So, can an anti-inflammatory diet help reduce inflammation? Let’s take a look.</p> <h2>What is inflammation?</h2> <p>When our body becomes injured or encounters an infection, it activates defence mechanisms to protect itself. It does this by instructing our cells to fight off the invader. This fighting process <a href="https://www.nature.com/articles/s41591-019-0675-0#citeas">causes inflammation</a>, which often presents as swelling, redness and pain.</p> <p>In the short-term, inflammation is a sign your body is healing, whether from a grazed knee or a cold.</p> <p>If inflammation persists for a longer time it’s called “chronic”. That can indicate a <a href="https://www.nature.com/articles/s41467-018-05800-6">health problem</a> such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638313/">arthritis</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719998/#B2-ijms-20-03879">heart disease</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523054/">diabetes</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3390758/">dementia</a> or other autoimmune disorders.</p> <p>The <a href="https://www.ncbi.nlm.nih.gov/books/NBK493173/">signs and symptoms</a> of chronic inflammation may be present from several months to years and include:</p> <ol> <li>persistent pain</li> <li>chronic fatigue or insomnia</li> <li>joint stiffness</li> <li>skin problems</li> <li>elevated blood markers (such as <a href="https://www.healthdirect.gov.au/c-reactive-protein-CRP-blood-test">C-reactive protein</a>)</li> <li>gastrointestinal issues (constipation, diarrhoea, acid reflux)</li> <li>depression, anxiety and mood disorders</li> <li>unintended weight gain or loss</li> <li>frequent colds or flu.</li> </ol> <h2>What role does diet play?</h2> <p>The relationship between food and inflammation is <a href="https://www.sciencedirect.com/science/article/pii/S0735109706013350">well recognised</a>. Overall, some food components may activate the immune system by producing pro-inflammatory cytokines (small proteins important in cell signaling) or reducing the production of anti-inflammatory cytokines.</p> <p>A “<a href="https://theconversation.com/clear-evidence-for-a-link-between-pro-inflammatory-diets-and-27-chronic-diseases-heres-how-you-can-eat-better-158451">pro-inflammatory diet</a>” may increase inflammation in the body over the long term. Such diets are usually low in fresh produce like fruits, vegetables and wholegrains, and high in commercially baked goods, fried foods, added sugars and red and processed meats.</p> <p>In contrast, an “<a href="https://academic.oup.com/ajcn/article/80/4/1029/4690355">anti-inflammatory</a>” diet is associated with less inflammation in the body. There is no single anti-inflammatory diet. Two well-recognised, evidence-backed examples are the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet.</p> <p>Anti-inflammatory diets typically include the following elements:</p> <p><strong>1. high in antioxidants.</strong> These compounds help the body fight free radicals or unstable atoms, that in high quantities are linked to illnesses such as cancer and heart disease. The best way to consume antioxidants is by eating lots of fruits and vegetables. Research shows frozen, dried and canned fruits and vegetables can be <a href="https://theconversation.com/frozen-and-tinned-foods-can-be-just-as-nutritious-as-fresh-produce-heres-how-201740">just as good as fresh</a></p> <p><strong>2. high in “healthy”, unsaturated fatty acids.</strong> Monounsaturated fats and omega-3-fatty acids are found in fish (sardines, mackerel, salmon and tuna), seeds, nuts, and plant-based oils (olive oil and flaxseed oil)</p> <p><strong>3. high in fibre and prebiotics.</strong> Carrots, cauliflower, broccoli and leafy greens are good sources of fibre. Prebiotics promote the growth of beneficial microorganisms in our intestines and can come from onions, leeks, asparagus, garlic, bananas, lentils and legumes</p> <p><strong>4. low in processed foods.</strong> These contain refined carbohydrates (pastries, pies, sugar-sweetened beverages, deep-fried foods and processed meats).</p> <h2>Rheumatoid arthritis, dementia, depression</h2> <p>There is mixed evidence for the role of anti-inflammatory diets in rheumatoid arthritis pain management. A recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706441/">2021 systematic review</a> (where researchers carefully group and examine the available evidence on a topic) found eating an anti-inflammatory diet likely leads to significantly lower pain in people with rheumatoid arthritis when compared with other diets.</p> <p>However, the 12 studies included in the review had a high risk of bias – likely because people knew they were eating healthy foods – so the confidence in the evidence was low.</p> <p>Inflammation is strongly implicated in the development of neurodegenerative diseases like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486891/">Alzheimer’s disease and related dementia</a> and evidence suggests anti-inflammatory diets might help to protect the brain.</p> <p>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015034/">2016 review</a> showed an anti-inflammatory diet may be protective against cognitive impairment and dementia, but that further large randomised controlled trials are needed. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673721/">2021 study</a> followed 1,059 people for three years and observed their diet. They reported those with a greater pro-inflammatory diet had an increased risk of developing dementia.</p> <p>Inflammation has also been linked with mental health, with people eating a pro-inflammatory diet reporting more symptoms of <a href="https://pubmed.ncbi.nlm.nih.gov/31152670/">depression</a>. Diet is the fundamental element of <a href="https://www1.racgp.org.au/ajgp/2019/october/lifestyle-interventions-for-mental-health">lifestyle approaches</a> to managing anxiety and mental health.</p> <p>More broadly, a <a href="https://www.mdpi.com/2227-9059/9/8/922">2021 review paper</a> examined recent research related to anti-inflammatory diets and their effect on reducing inflammation associated with ageing. It found compounds commonly found in anti-inflammatory diets could help alleviate the inflammatory process derived from diseases and unhealthy diets.</p> <h2>What about turmeric?</h2> <p>A favourite on social media and vitamin shelves, turmeric is promoted as having anti-inflammatory benefits. These are linked to a specific compound called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5388087/#:%7E:text=Curcuminoids%20are%20phenolic%20compounds%20commonly,several%20important%20functions%20of%20curcuminoids.">curcumin</a>, which gives turmeric its distinctive yellow colour.</p> <p>Research suggests curcumin might act as an anti-inflammatory agent in the body but high-quality clinical trials in humans are <a href="https://www.mdpi.com/1420-3049/16/6/4567">lacking</a>. Most of the <a href="https://www.mdpi.com/1420-3049/16/6/4567">existing studies</a> have been conducted in <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jcp.27360">lab settings</a> using cells or in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608712/">animals</a>. So it’s unclear how much curcumin is needed to see anti-inflammatory benefits or how well <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/">we absorb it</a>.</p> <p>Overall, adding turmeric to your food may provide your body with some health benefits, but don’t rely on it to prevent or treat disease on its own.</p> <h2>Safe eating</h2> <p>Inflammation is a major factor in the link between diet and many health conditions.</p> <p>Eating an anti-inflammatory diet is considered safe, likely to support health and to prevent future chronic conditions. If you are looking for tailored dietary advice or an anti-inflammatory meal plan, it’s best to speak with an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210468/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher &amp; Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/9-signs-you-have-inflammation-in-your-body-could-an-anti-inflammatory-diet-help-210468">original article</a>.</em></p>

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Who’s taking COVID antivirals like Paxlovid? Hint: it helps if you’re rich

<p><em><a href="https://theconversation.com/profiles/nicole-allard-1349026">Nicole Allard</a>, <a href="https://theconversation.com/institutions/the-peter-doherty-institute-for-infection-and-immunity-2255">The Peter Doherty Institute for Infection and Immunity</a></em></p> <p>When it comes to COVID, people living in disadvantaged communities are hit with a triple whammy. First, they’re <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/covid-19/overview">more likely</a> to get infected, and when sick, are more likely to have serious disease. Second, they’re <a href="https://theconversation.com/first-covid-hit-disadvantaged-communities-harder-now-long-covid-delivers-them-a-further-blow-183908">more likely</a> to develop long COVID. Third, our <a href="https://www.mja.com.au/journal/2023/218/10/access-oral-covid-19-antivirals-community-are-eligibility-criteria-and-systems">recent research</a> suggests they’re less likely to get antivirals and when they do, it’s on average later.</p> <p>We’ve just <a href="https://www.mja.com.au/journal/2023/218/10/access-oral-covid-19-antivirals-community-are-eligibility-criteria-and-systems">published the data</a> to map how disadvantage is linked with access to COVID antiviral drugs you can take at home.</p> <p>Here’s why our findings matter and what we can do to level the playing field for this critical part of Australia’s COVID response.</p> <h2>What we did and what we found</h2> <p>Our team looked at Victorian and national prescribing data trends for the oral antiviral medications eligible Australians can take at home – Paxlovid (nirmatrelvir/ritonavir) and Lagevrio (molnupiravir).</p> <p>My health department colleagues linked data from the Pharmaceutical Benefits Scheme with information from the Victorian health department’s COVID surveillance database. They then matched levels of socioeconomic disadvantage by postcode, according to criteria from the Australian Bureau of Statistics.</p> <p>Their analysis showed people living in the most disadvantaged postcodes were 15% less likely to receive oral antivirals compared with those in the most advantaged postcodes.</p> <p>Those in the most disadvantaged postcodes were supplied with the antivirals on average a day later (three days versus two days) than those in the most advantaged postcodes.</p> <p>There are some limitations to our analysis. Not everyone who tests for COVID reports their positive result. And we suspect there may be more under-reporting of infections in disadvantaged areas.</p> <p>Nevertheless, our findings about the influence of disadvantage on antiviral supply are not surprising. In the United States, there have been <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7125e1.htm?utm">similar results</a>.</p> <h2>Why has this happened?</h2> <p>We know <a href="https://www.health.gov.au/health-alerts/covid-19/treatments/eligibility">early access to antivirals</a>, within the first five days of symptoms starting, is important to reduce the chances of severe disease and hospitalisation in those at risk.</p> <p>So why are people in disadvantaged areas less likely to have access to COVID antivirals? The answers are multiple and complex.</p> <p>Some relate to <a href="https://link.springer.com/article/10.1007/s11069-019-03584-6/tables/1">disadvantage</a> that existed before the pandemic – for instance, poverty, homelessness, lower levels of English or formal education, and being less likely to have a regular GP.</p> <p>Some factors relate specifically to antivirals. For instance, to access antivirals, you first have to know they exist and whether you might be eligible, then know how to access them and when. There may be out-of-pocket costs to see a GP to be assessed, then there’s the cost of filling the prescription, even with a concession card.</p> <h2>How can we address this?</h2> <p>We have an opportunity to address this inequity, whether that’s by addressing social determinants of health more broadly, or specifically related to antivirals access.</p> <p>Equity depends on continuing to address the structural inequalities in our health system that create barriers to people accessing primary health services, and tailoring responses to communities.</p> <p>For instance, earlier in the pandemic we saw funding to house homeless people, provide COVID-related health care to non-English speaking communities, and for people isolated at home. These initiatives need to continue.</p> <p>Other countries have also recognised the need for more equitable access to COVID antivirals. Initiatives have included:</p> <ul> <li> <p>COVID medicine <a href="https://phlgroup.co.uk/our-services/cmdu/">delivery units</a> in the United Kingdom. These identify, triage and arrange for high-risk people to receive antivirals at home</p> </li> <li> <p><a href="https://covid19.govt.nz/testing-and-isolation/if-you-have-covid-19/medicines-to-treat-covid-19">pharmacists prescribing antivirals</a> in New Zealand, and</p> </li> <li> <p>“<a href="https://aspr.hhs.gov/TestToTreat/Pages/default.aspx#:%7E:text=To%20find%20a%20participating%20Test%20to%20Treat%20site%20near%20you%3A&amp;text=Call%20the%20Centers%20for%20Disease,more%20than%20150%20other%20languages.">test to treat</a>” services in the US. This is where people can get tested, assessed and access antivirals in one spot, in one visit.</p> </li> </ul> <h2>What needs to happen next?</h2> <p>As <a href="https://theconversation.com/were-in-another-covid-wave-but-its-not-like-the-others-206493">COVID waves continue</a>, we must focus on reducing deaths and hospitalisations. Antiviral treatments are part of our armour and equity must drive our response.</p> <p>Our ongoing COVID response should be designed with consumer input, supported by an adequately funded public health system and be data driven. Here’s what needs to happen next:</p> <ul> <li> <p>encourage a tired public to see COVID testing as an important first step to accessing antiviral treatment, and why they should consider treatment</p> </li> <li> <p>address the health care inequality in primary care (for instance, boosting timely access to a GP people can afford to visit) by increasing resourcing in areas where we know there are gaps</p> </li> <li> <p>provide culturally safe health care, delivered in community languages, co-designed with community input</p> </li> <li> <p>evaluate current and future antiviral medications</p> </li> <li> <p>communicate up-to-date information to the public and health professionals about antivirals, particularity GPs</p> </li> <li> <p>access more data on the coverage and equity of antiviral COVID treatments, to help direct us to the gaps in the health system that need to be plugged.</p> </li> </ul> <h2>Why this matters now</h2> <p>For many of us in the past year, COVID has become another “cold” we encounter and may not even bother testing. Yet, we continue to see <a href="https://www.health.gov.au/health-alerts/covid-19/weekly-reporting">deaths and hospitalisations</a> across the country.</p> <p>Serious COVID infections continue to affect our most vulnerable people. These include elderly people, especially those over 80, First Nations people, people living with a disability and people who are socioeconomically disadvantaged.</p> <p>We have a chance to ensure antivirals are used to reduce existing disparities in hospitalisation and death – not to make them worse.<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/207822/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/nicole-allard-1349026">Nicole Allard</a>, Post doctoral researcher and medical epidemiologist, <a href="https://theconversation.com/institutions/the-peter-doherty-institute-for-infection-and-immunity-2255">The Peter Doherty Institute for Infection and Immunity</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/whos-taking-covid-antivirals-like-paxlovid-hint-it-helps-if-youre-rich-207822">original article</a>.</em></p>

Caring

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Should I get a flu vaccine this year? Here’s what you need to know

<p><em><a href="https://theconversation.com/profiles/paul-griffin-1129798">Paul Griffin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>After having low rates of influenza (flu) transmission in recent years thanks to our COVID control strategies, case numbers are now rising.</p> <p>So far this year, Australia has had <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">more than 32,000</a> lab-confirmed cases of the flu and 32 deaths.</p> <p>Getting a flu vaccine is the best way to protect against getting the flu. These are reformulated each year to protect against the most widely circulating strains – if our predictions are right.</p> <p>Below you’ll find everything you need to know about the 2023 flu vaccine. But first, some flu basics.</p> <h2>What are the different types of flu?</h2> <p>There are two main types of influenza: influenza A and influenza B. On the surface of the influenza virus there are two main proteins, the hemagglutinin (HA or H) and neuraminidase (NA or N).</p> <p>Different strains are named after their versions of the H and N proteins, as in H1N1 or “swine flu”.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&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/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=396&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=396&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=396&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=498&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=498&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/525044/original/file-20230509-15-c78c12.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=498&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">HA is the yellow spike, while the NA is the green oval.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/structure-influenza-virus-infographics-vector-illustration-542924464?src=ixiW0w-59I3I17RpN4L3wQ-1-12">Shutterstock</a></span></figcaption></figure> <p>Minor changes in the proteins (HA and NA) on the surface are common because the enzyme the virus uses to make copies of itself is prone to errors.</p> <p>Sometimes the influenza virus can change more abruptly when it mixes up components from different influenza viruses – including influenza viruses that typically infect birds, pigs or bats – to create a virus that’s basically new.</p> <p>The regular change in the virus is the reason the vaccine is updated every year. The <a href="https://www.tga.gov.au/about-tga/advisory-bodies-and-committees/australian-influenza-vaccine-committee-aivc">Australian Influenza Vaccine Committee</a> meets late in the year to plan what should be included in the vaccine for the following season, after considering what happened in our last flu season and in the Northern hemisphere winter.</p> <h2>What strains does this year’s flu shot protect against?</h2> <p>Modern flu vaccines typically protect against four strains. For this year’s vaccine, the committee <a href="https://www.tga.gov.au/resources/publication/meeting-statements/aivc-recommendations-composition-influenza-vaccines-australia-2023">has recommended</a> it includes:</p> <ul> <li> <p>an A/Sydney/5/2021 (H1N1)pdm09-like virus</p> </li> <li> <p>an A/Darwin/9/2021 (H3N2)-like virus</p> </li> <li> <p>a B/Austria/1359417/2021 (B/Victoria lineage)-like virus</p> </li> <li> <p>a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.</p> </li> </ul> <p>The naming of the viral components can sometimes be confusing. The name is <a href="https://www.cdc.gov/flu/about/viruses/types.htm">derived from</a> the virus type (A or B)/the place it was first isolated/strain number/year isolated (virus subtype).</p> <p>This year’s vaccine therefore includes an influenza A virus similar to the 2009 pandemic-causing H1N1 isolated from Sydney in 2021 and a second influenza A virus (H3N2) isolated in Darwin in 2021.</p> <p>Influenza B viruses are classified into 2 lineages: Victoria and Yamagata. This year’s vaccine includes an influenza B isolated from Austria in 2021 (Victoria lineage) and an influenza B isolated in Phuket in 2013 (Yamagata lineage).</p> <h2>Who should get a flu shot?</h2> <p>Health authorities <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine">recommend</a> everyone aged six months of age or over should get the flu vaccine every year.</p> <p><a href="https://www.health.gov.au/news/2023-national-immunisation-program-influenza-vaccination-early-advice-for-vaccination-providers">Some groups</a> are at greater risk of significant disease from the flu and can access the flu vaccine for free. This includes:</p> <ul> <li> <p>Aboriginal and Torres Strait Islander people aged six months and over</p> </li> <li> <p>children aged six months to five years</p> </li> <li> <p>pregnant women at any stage of pregnancy</p> </li> <li> <p>people aged 65 years or over</p> </li> <li> <p>people aged five years to 65 years who have certain underlying health conditions affecting the heart, lungs, kidneys or immune system, and those with diabetes.</p> </li> </ul> <h2>How can I get it?</h2> <p>You can get a flu shot from your local general practice or pharmacy. Or you may have an opportunity to get vaccinated at your workplace if your employer supplies it.</p> <p>While the vaccine is free for those in the <a href="https://www.health.gov.au/sites/default/files/2023-02/fighting-flu-starts-with-you-consumer-fact-sheet.pdf">above groups</a>, there can be a consultation or administration fee, depending on where you get your vaccine.</p> <p>If you aren’t eligible for a free vaccine, it usually costs around A$20-$30.</p> <h2>Are there different options?</h2> <p>For over 65s, whose immune systems may not work as well as when they were younger, a <a href="https://www.health.gov.au/sites/default/files/2023-03/atagi-advice-on-seasonal-influenza-vaccines-in-2023.pdf">specific vaccine</a> is available that includes an adjuvant which boosts the immune response. This is free for over-65s under the national immunisation program.</p> <p>A high-dose vaccine is also available for people aged 60 and over. However this isn’t currently funded and costs around $70 on a private prescription.</p> <p>People with egg allergies can safely get the egg-based flu vaccine. However there is also a cell-based immunisation for people who don’t want a vaccine made in eggs. When vaccines are grown in eggs, sometimes the virus can change and this might affect the level of protection. Cell-based vaccines aim to address this issue.</p> <p>The cell-based vaccine isn’t funded so patients will pay around $40 for a private prescription.</p> <h2>How well do they work?</h2> <p>The vaccine’s effectiveness depends on how well the strains in the vaccine match those circulating. It generally <a href="https://www.health.gov.au/resources/publications/aisr-2022-national-influenza-season-summary">reduces</a> the chance of being admitted to hospital with influenza by <a href="https://www.health.gov.au/sites/default/files/documents/2022/08/influenza-vaccine-efficacy-effectiveness-and-impact-explained.docx">30-60%</a>.</p> <h2>What are the side effects?</h2> <p>You can’t get the flu from the vaccine as there’s no live virus in it.</p> <p>When people get a flu-like illness after the vaccine, it can be due to mild effects we sometimes see after vaccination, such as headaches, tiredness or some aches and pains. These usually go away <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#possible-side-effects-of-influenza-vaccination">within a day or two</a>.</p> <p>Alternatively, symptoms after getting a flu shot may be due to another respiratory virus such as respiratory syncytial virus (RSV) that circulates in winter.</p> <h2>When’s the best time to get your flu shot?</h2> <p>The vaccine provides <a href="https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/influenza-flu#vaccine-information">peak protection</a> around three to four months <a href="https://www.health.gov.au/topics/immunisation/vaccines/influenza-flu-vaccine#when-to-get-the-influenza-vaccine">after</a> you get it.</p> <p>The <a href="https://www.immunisationcoalition.org.au/news-data/influenza-statistics/">peak of the flu season</a> is usually between June and September, however this changes every year and can vary in different parts of the country.</p> <p>Given this, the best time to get the vaccine is usually around late April or early May. So if you haven’t already, now would be a good time to get it.<!-- 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/203406/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/paul-griffin-1129798">Paul Griffin</a>, Associate Professor, Infectious Diseases and Microbiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/should-i-get-a-flu-vaccine-this-year-heres-what-you-need-to-know-203406">original article</a>.</em></p>

Body

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The best anti-ageing secrets dermatologists won’t tell you for free

<p><strong>The best tips from top dermatologists </strong></p> <p>A wide array of over-the-counter anti-ageing skincare products aim to improve the signs of ageing, such as skin spots, fine lines, wrinkles, and boost collagen. Yet, most of these products are more hype – it’s important for consumers to understand when a product is a cosmetic, drug, or both to evaluate the validity of these claims. So, which products can actually deliver results that improve the signs of ageing?</p> <p>We spoke with medical experts who told us the best anti-ageing secrets for better skin health.</p> <p><strong>Opt for sunscreen to fight ageing skin</strong></p> <p>Sunscreen is one of the best weapons when it comes to protecting your skin against skin cancer, and it’s also one of the best ways to keep your skin looking younger and healthier. “The sun emits ultraviolet radiation that damages skin, both the overlying epidermis and the underlying dermis,” explains dermatologist, Dr Jerome Garden. “In addition to increasing your risk of skin cancer, the sun causes brown spots, red spots, and wrinkles.”</p> <p><strong>Expensive products are not always more effective</strong></p> <p>It may be tempting to splurge on a skin-care item that promises to yield worthy results, but pricey doesn’t always equal quality. There are some great inexpensive products that can produce great results, according to dermatologist, Dr Dendy Engelman. “A higher price tag can mean better quality ingredients or a higher concentration of an ingredient, but the ingredients list is always more important than the brand selling the product,” she says.</p> <p><strong>Don't buy generic skincare</strong></p> <p>You don’t need to spend a fortune to get a high-quality skincare product, but there is a difference between a brand name product and a generic one, according to dermatologist, Dr Joshua Zeichner.</p> <p>“Many generic products are packaged to look similar to the original, and may even have the same ingredients list, however, the difference is the quality of the ingredients and how they are actually formulated,” he says.</p> <p><strong>Skimp on a fancy cleanser</strong></p> <p>No matter what an expensive cleanser may cost, it’s not going to work any more magic than most lower-cost competitors, according to dermatologists. “The goal of a cleanser is to remove dirt, oil, makeup and pollution from the skin without disrupting the outer skin layer – and the ingredients used to create a product that can do this are not expensive,” says Dr Zeichner. “In fact, some of the best quality cleansers are actually among the least expensive products on the market.”</p> <p><strong>Opt for a serum</strong></p> <p>Serums, which are meant to be layered underneath your daily and nightly moisturiser, often are the first skincare products to be skipped. But, they actually play an important role in your daily routine. “Serums contain a high concentration of active ingredients and are lightweight, so they penetrate deeper into your skin to provide maximum benefits,” says dermatologist, Dr Whitney Bowe. </p> <p>She recommends looking for serums that contain ceramides and amino acids, which help to bolster the skin’s natural barrier, and antioxidants, which protect skin from sun damage and free radicals.</p> <p><strong>Don't trust anti-wrinkle face cream claims </strong></p> <p>“We develop fine lines because of repeated folding of the skin from underlying muscles,” explains Dr Zeichner. “Young, healthy skin has a strong foundation that resists folding and bounces back to its original shape, but, with age, that skin foundation gets weaker.” </p> <p>While topical creams will certainly help keep the skin barrier strong, the only way to truly reduce wrinkles is to relax the muscles underneath the skin, according to Dr Zeichner.</p> <p><strong>Wear sunscreen year-round</strong></p> <p>It’s true that even on the cloudiest or snowiest of days, sunscreen should be a part of your daily skincare routine. “Incidental sun exposure for only 10 to 15 minutes a day adds up over time and can cause significant sun damage and accelerated photoaging,” says Dr Engelman. </p> <p>In order to keep skin looking its youngest and healthiest, she recommends applying sunscreen every single day of the year, as brief sun exposures throughout the year can add up to significant damage (think driving with the sunroof open or walking around outdoor shopping centres during peak sun hours).</p> <p><strong>Use retinol - it really works</strong></p> <p>According to dermatologist, Dr Hadley King, topical retinoids are the most effective topical anti-ageing products (after sun protection). “There is great data that supports their effectiveness and safety,” she says. “While prescription retinoids are the most effective, there are now plenty of over-the-counter products that contain retinol and work well, especially on those with sensitive skin.”</p> <p><strong>Invest in laser treatments</strong></p> <p>If you’re looking for fast results without the use of creams, Dr Garden recommends laser treatments, which he specialises in. “We have lasers for brown spots, red spots, blood vessels and wrinkles,” he says. “Newer devices called fractionated lasers can produce impressive results with less downtime than before.” Although they’re on the pricier side, he says that these treatments can offer results far superior to creams. </p> <p>But the only caveat is that these machines are powerful and, in many states, can be operated by unqualified individuals who are not even physicians. He recommends making sure that your laser treatments are being performed by a board-certified dermatologist to avoid complications.</p> <p><strong>Try collagen supplements </strong></p> <p>Collagen is a protein that’s a building block for our hair, skin and nails. “Supplemental collagen is fragmented pieces of amino acids and peptides that connect in the bloodstream with enzymes that trigger the production of collagen,” explains Dr Engelman. “In a collagen-deficient system, this will support and increase collagen production.” It’s important, however, that you choose the right type of collagen, since 16 different strains exist. </p> <p>“For oral supplements, hydrolysed collagen is easiest to digest, as it is broken down into the smallest forms of peptides and amino acids,” she says. “I like pills and powders because they are easy to incorporate no matter what your lifestyle.”</p> <p><strong>Don't fall for 'trendy' products</strong></p> <p>The latest and greatest products on the market might be eye-catching, but their popularity doesn’t mean that they’re effective. “Just because something is ‘hot’ right now in the beauty industry, does not mean that you should run out to purchase it,” says Dr Bowe. “I always encourage my patients to look for scientific studies and statistics which prove that products deliver the results they promise.”</p> <p><strong>Follow a healthy diet</strong></p> <p>No matter how much time, energy and money you spend on your skincare regimen, if you’re not supplementing it with a healthy diet, you’re wasting your efforts, according to experts. “Your skin is a reflection of your overall health and wellness and your diet absolutely impacts the appearance and health of your skin,” says Dr Bowe. </p> <p>“For example, sugar in any form causes multiple changes in our body, from our cellular membranes and our arteries to our hormones, immune systems, gut, and even microbiome – the microbes in our intestines that affect our biology all the way out to our skin.”</p> <p><strong>Allergy pill and a nap may reduce dark circles and puffy eyes</strong></p> <p>There are other causes of dark circles that are unrelated to your skin, such as seasonal allergies or lack of sleep. Dermatologist, Dr Joel Schlessinger recommends trying Clarityne or Zyrtec, drinking more water, or heading to bed an hour earlier to clock in more sleep. If your dark circles and puffiness aren’t improved by any of those suggestions, then he says a well-formulated and hydrating eye cream could help.</p> <p><strong>Avoid sleeping on your side</strong></p> <p>Believe it or not, the way you sleep does have an effect on the smoothness of your skin. “Sleeping on your side presses your cheek into the pillow and causes the skin on your chest to be scrunched, creating new or reinforcing existing wrinkles,” warns Dr Schlessinger. “Train yourself to sleep on your back as much as you can – it will keep skin as flat and smooth as possible.”</p> <p><strong>Don't wait until it's too late too start Botox</strong></p> <p>Some fine lines and wrinkles are caused by repetitive movements, so starting these treatments early, even in your late 20s and early 30s, may potentially help prevent them or slow their progression, according to cosmetic dermatologist, Dr Sejal Shah. </p> <p>“People are often afraid of injectables because they don’t want to look ‘frozen’ or overdone, but many neurotoxins (Botox, Dysport, Xeomin, and Jeuveau) can look very natural when appropriately placed.” Just be sure to seek treatment from trained individuals, such as a board-certified dermatologist.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/beauty/the-best-anti-ageing-secrets-dermatologists-wont-tell-you-for-free?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

Beauty & Style

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"Stay away!": City forced into bizarre anti-travel campaign

<p>Amsterdam has taken desperate measures in the fight to keep the city safe from “messy” tourists determined to cause chaos and call it a night out. </p> <p>The Dutch capital’s new online campaign sets out to primarily tackle the problem of young British men, warning them against their plans to “let loose” while they’re visiting. </p> <p>Hopeful British tourists - between the ages of 18 and 35 - who google things like “stag party Amsterdam”, “pub crawl Amsterdam”, and “cheap hotel Amsterdam” will be made to view short videos that stress the consequences that come with “[causing] nuisance and excessive alcohol and drug use”, according to a statement from the city’s local authorities. </p> <p>One of said videos shows an intoxicated young man being arrested after insulting police officers, with text reading: “Coming to Amsterdam for a messy night + getting trashed = €140 fine + criminal record = fewer prospects.” </p> <p>From there comes the firm and to-the-point statement: “So coming to Amsterdam for a messy night? Stay away.”</p> <p>In another of the campaign’s videos, an unconscious individual can be seen in an ambulance as it rushes to hospital, this time with text that reads: “Coming to Amsterdam to take drugs + lose control = hospital trip + permanent health damage = worried family.” </p> <p>It concludes with the same message as the other. </p> <p>Amsterdam welcomes approximately 20 million tourists each year, and is well known for its red light district. It’s this same hotspot that has played a major role in establishing the city as the place to party in Europe. </p> <p>However, local residents have voiced their displeasure for years, fed up with the chaos that drunken tourists bring their way, and prevent them from enjoying their own city as they want to. </p> <p>“Visitors will remain welcome, but not if they misbehave and cause nuisance. In that case we as a city will say: rather not, stay away,” Amsterdam’s deputy mayor Sofyan Mbarki said.</p> <p>“Amsterdam is already taking lots of measures against excessive tourism and nuisance, and we are taking more measures than other large cities in Europe. But we have to do even more [in] the coming years if we want to give tourism a sustainable place in our city.”</p> <p>From there, he went on to note that in order to keep their city a liveable place, they had to turn their attention to “restriction instead of irresponsible growth.” </p> <p>This isn’t the only - or even first - step city officials have taken towards achieving their goal, having just passed new regulations that make it illegal for anyone to smoke cannabis while in the red light district. </p> <p>The video campaign may yet expand to include visitors from beyond the UK, authorities have suggested. They also plan to launch another campaign called “How to Amsterdam”, which aims to reign in tourists already visiting. This campaign will utilise social media and street signs, with warnings about everything from drunkenness to noise, drugs, and urinating in public. </p> <p>Providers who offer bachelor party experiences have reportedly been contacted by the council as well, in the hope that they can reduce - and prevent - trouble in the city’s centre, while they also await the results of research into a potential tourist tax. </p> <p><em>Images: YouTube</em></p>

Travel Trouble

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Tech millionaire’s “creepy” $100k offer sparks wave of backlash

<p>US tech millionaire and Silicon Valley entrepreneur Steve Kirsch has been slammed for making a “creepy” offer towards a female passenger who was travelling on the same plane.</p> <p>In a tweet, Kirsch claimed that he offered the stranger $US100,000 to remove her face mask for the flight.</p> <p>"I am on board a Delta flight right now. The person sitting next to me in first-class refused $100,000 to remove her mask for the entire flight. No joke," he tweeted.</p> <p>Kirsch, who became infamous for spreading misinformation about the COVID-19 vaccines throughout the pandemic, said that he "explained" to his seatmate that masks "don’t work".</p> <p>He also claims that the woman worked for a pharmaceutical company, and he started by offering her $US100 but worked his way up.</p> <p>She rejected his offer, but Kirsch persisted and said that if she removed the mask to eat and drink she "she could be infected with one breath".</p> <p>Many have slammed the entrepreneur for his actions.</p> <p>“Ew. Do you make a habit of offering money to random women to remove coverings from their bodies mid-air?" posted Jess Piper, a former Democrat state representative nominee, in her response to Kirsch's post.</p> <p>“Stop bugging people who are minding their own business with your creepy nonsense,” commented Alastair McAlpine, an infectious disease expert.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">I am on board a Delta flight right now. The person sitting next to me in first class refused $100,000 to remove her mask for the entire flight. No joke. This was after I explained they don’t work. She works for a pharma company. <a href="https://t.co/Q8Hwzhkmxf">pic.twitter.com/Q8Hwzhkmxf</a></p> <p>— Steve Kirsch (@stkirsch) <a href="https://twitter.com/stkirsch/status/1634189428150390785?ref_src=twsrc%5Etfw">March 10, 2023</a></p></blockquote> <p>"This is wildly creepy, you get that, right? Every part of this. From the request, to the expression, to the fact you decided to tweet this!" commented one user.</p> <p>“All you’re doing here is admitting you patronised and harassed a woman who made a decision she thought was best for her,” wrote another.</p> <p>Last week, Kirsch tried to pull the same stunt on a different flight.</p> <p>He tweeted that he offered his seatmates $US10,000 to remove their masks for the flight, but they also declined his offer.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">I asked the people sitting next to me on the plane if I paid them $10,000 would they remove their mask for the duration of the flight? Both declined the offer. </p> <p>Maybe I should offer $100,000 next time? This can quantify the amount of brainwashing. <a href="https://t.co/VLlymusmcq">pic.twitter.com/VLlymusmcq</a></p> <p>— Steve Kirsch (@stkirsch) <a href="https://twitter.com/stkirsch/status/1633166204054675456?ref_src=twsrc%5Etfw">March 7, 2023</a></p></blockquote> <p>"Maybe I should offer $100,000 next time? This can quantify the amount of brainwashing," he added.</p> <p>Delta airlines have said that masks are optional for both domestic and international travel unless required by “applicable governments”.</p> <p>American federal law no longer requires masks be worn in airports or on planes, but certain cities and states may still make it a requirement at their airports.</p> <p><em>Image: Twitter</em></p>

Travel Trouble

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Fran Drescher calls for an end to “bull***t” vaccine mandates

<p dir="ltr">Fran Drescher has divided audiences after using her platform to go on a tirade about bringing an end to “bull***t” vaccine mandates. </p> <p dir="ltr">The former star of <em>The Nanny</em> took to the stage at the 2023 Screen Actors Guild (SAG) Awards on Sunday, and used the opportunity to voice her controversial opinions about Covid-19 restrictions. </p> <p dir="ltr">“As the nation declares an end to the Covid emergency this May, I hope we will see everyone return to work in equal opportunity,” Drescher, 65, said in her speech during the telecast,<em> <a href="https://nypost.com/2023/02/27/fran-drescher-calls-for-end-to-vaccine-mandate-in-sag-speech/?utm_campaign=SocialFlow&amp;utm_medium=SocialFlow&amp;utm_source=NYPTwitter">Page Six</a></em> reports. </p> <p dir="ltr">The entertainment industry’s pandemic protocols were originally set to end on January 31st, but have been extended until April 1st. </p> <p dir="ltr">Meanwhile, more than 20 US states still enforce vaccine mandates to varying degrees.</p> <p dir="ltr">“Our industry brings billions of production dollars to states across the nation, but if they want our business, let’s wield our financial influence to make governors act in the best interest of freedom, diversity, inclusion and democracy,” Drescher said.</p> <p dir="ltr">“As my character Bobbi Flekman said in <em>This Is Spinal Tap</em> – money talks and bulls**t walks!”</p> <p dir="ltr">Her divisive comments were met with a mixed reaction online, with many viewers claiming it was “irresponsible” for Drescher to use her platform in such a way.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Fran Drescher’s comments on the <a href="https://twitter.com/hashtag/CovidVaccine?src=hash&amp;ref_src=twsrc%5Etfw">#CovidVaccine</a> were irresponsible. Using her logic, people wouldn’t be universally vaccinated against diseases like measles and tetanus. Public health is PUBLIC because it takes collective work.</p> <p>— 🇺🇦мег 🇺🇦 (@sassybibrarian) <a href="https://twitter.com/sassybibrarian/status/1630038810095648768?ref_src=twsrc%5Etfw">February 27, 2023</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">God I love Fran Drescher, but her speech at the SAG awards could have been an email.</p> <p>— Francis (@Fusterduster) <a href="https://twitter.com/Fusterduster/status/1630022506668249088?ref_src=twsrc%5Etfw">February 27, 2023</a></p></blockquote> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Woody Harrelson and now Fran Drescher. Big weekend for anti-vaxxers.</p> <p>— 𝐓𝐨𝐦𝐚𝐬 ⁽ʷʰᵒ ⁱˢ ᵍᵃʸ⁾ (@cinema_gay) <a href="https://twitter.com/cinema_gay/status/1630021950293655554?ref_src=twsrc%5Etfw">February 27, 2023</a></p></blockquote> <p dir="ltr">Elsewhere in her speech, Drescher also discussed her efforts to help make Hollywood more environmentally friendly by joining with Green Council with a goal to eliminate single-use plastic both on camera and behind the scenes.</p> <p dir="ltr">She also applauded IMDb for “taking a stand against ageism, stereotyping and gender rigidity by allowing our members to define themselves their way on their profile page – for free.”</p> <p dir="ltr"><em>Image credits: Getty Images</em><span id="docs-internal-guid-1cf5b55a-7fff-4610-144c-c7e3ae12e9d4"></span></p>

Body

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Thousands of Tasmanian devils are dying from cancer – but a new vaccine approach could help us save them

<p>Tasmanian devils are tough little creatures with a ferocious reputation. Tragically, each year thousands of Tasmanian devils suffer and die from contagious cancers – devil facial tumours.</p> <p>We have discovered that a modified virus, like the attenuated adenovirus used in the AstraZeneca COVID-19 vaccine, can make devil facial tumour cells more visible to the devil immune system.</p> <p>We have also found key immune targets on devil facial tumour cells. These combined advances allow us to move forward with a vaccine that helps the devil immune system find and fight the cancer.</p> <p>And we have a clever way to deliver this vaccine, too – with edible baits.</p> <p><strong>A puzzling cancer</strong></p> <p>Tasmanian devils mainly suffer from the original devil facial tumour, or DFT1. A second type of devil facial tumour (DFT2) has begun emerging in southern Tasmania that further threatens the already endangered devil population.</p> <p>DFT1 and DFT2 are <a href="https://www.tcg.vet.cam.ac.uk/about/DFTD">transmissible cancers</a> – they spread living cancer cells when the devils bite each other.</p> <p>This has presented a puzzle: a cancer cell that comes from another animal should be detected by the immune system as an invader, because it is “genetically mismatched”. For example, in human medicine, tissue transplants need to be genetically matched between the donor and recipient to avoid the immune system rejecting the transplant.</p> <p>Somehow, DFT1 and DFT2 seem to evade the immune system, and devils die from tumours spreading throughout their body or from malnutrition due to the facial tumours disrupting their ability to eat.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&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/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=338&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=338&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=338&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=424&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=424&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/495558/original/file-20221116-12-jv29a8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=424&amp;fit=crop&amp;dpr=3 2262w" alt="Close-up of a Tasmanian devil held by human hands, with a tumour on its lower jaw" /></a><figcaption><span class="caption">A Tasmanian devil with DFT1.</span> <span class="attribution">Andrew S. Flies @WildImmunity</span></figcaption></figure> <p>On the bright side, the immune systems of a few wild devils <em>have</em> been able to overcome DFT1. Furthermore, <a href="https://www.nature.com/articles/srep43827">previous vaccine and immunotherapy trials</a> showed the devil immune system can be activated to kill DFT1 cells and clear away sizeable tumours.</p> <p>This good news from both the field and the laboratory has allowed our team to zoom in on key DFT protein targets that the devil immune system can attack. This helps us in our quest to develop a more effective and scalable vaccine.</p> <p><strong>How can we vaccinate wild animals?</strong></p> <p>Even if we succeed in producing a <a href="https://doi.org/10.1080/14760584.2020.1711058">protective DFT vaccine</a>, we can’t trap and inject every devil.</p> <p>Luckily, clever researchers in Europe in the 1970s figured out that <a href="https://doi.org/10.1371/journal.pntd.0003953">vaccines can be incorporated into edible food baits</a> to vaccinate wildlife across diverse landscapes and ecosystems.</p> <p>In 2019, we hypothesised an oral bait vaccine could be made to protect devils from DFT1 and DFT2. Fast forward to November 2022 and the pieces of this ambitious project are falling into place.</p> <p>First, using samples from <a href="https://doi.org/10.1007/s00432-021-03601-x">devils with strong anti-tumour responses</a>, we have found that the main immune targets are <a href="https://doi.org/10.1098/rsob.220208">major histocompatibility proteins</a>. These are usually the main targets in transplant rejection. This tells us what to put into the vaccine.</p> <p>Second, we tested a virus-based delivery system for the vaccine. We used a weakened adenovirus most of the human population has already been exposed to, and found that in the lab this virus can enter devil facial tumour cells.</p> <p>Importantly, the weakened adenovirus can be modified to produce proteins that can <a href="https://doi.org/10.1099/jgv.0.001812">stimulate the devil immune system</a>. This means it forces the devil facial tumour cells to show the major histocompatibility proteins they normally hide, making the cells “visible” to cancer-killing immune cells.</p> <p>This vaccine approach is much like the AstraZeneca COVID-19 vaccine that uses a weakened chimpanzee adenovirus to deliver cargo to our immune system, getting it to recognise SARS-CoV-2. <a href="https://www.aphis.usda.gov/wildlife_damage/nepa/states/US/us-2019-onrab-ea.pdf">Adenoviral vaccines have also been widely used</a> in oral bait vaccines to protect raccoons from the rabies virus.</p> <p><strong>Edible protection</strong></p> <p>But there were additional challenges to overcome. Our collaborators in the USA who research and develop other wildlife vaccines suggested that developing an effective bait for devils might be as challenging as making the vaccine itself.</p> <p>Our first studies of placebo baits in the wild confirmed this. Contrary to previous studies which showed devils eating most of the baits, we found the baits were also readily consumed by other species, including eastern quolls, brushtail possums, and Tasmanian pademelons.</p> <p>This led us to test an automatic bait dispenser supplied by our collaborators at the US Department of Agriculture National Wildlife Research Center. The <a href="https://www.publish.csiro.au/WR/justaccepted/WR22070">dispensers proved quite effective</a> at reducing the amount of “off target” bait consumption and showed devils could successfully retrieve the baits with their dexterous paws.</p> <figure><iframe src="https://www.youtube.com/embed/5BEBfFqOY8k?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Tasmanian devil retrieving a placebo bait from an automatic bait dispenser.</span></figcaption></figure> <p>Encouragingly, a recent mathematical modelling study suggests an <a href="https://lettersinbiomath.journals.publicknowledgeproject.org/index.php/lib/article/view/555">oral bait vaccine could eliminate DFT1</a> from Tasmania.</p> <p>Successful delivery of the vaccine would be a demanding and long-term commitment. But with it, we could prevent the suffering and deaths of thousands of individual devils, along with helping to reestablish a healthy wild devil population.</p> <p><strong>Can’t stop now</strong></p> <p>A bit of additional good news fell into place in late 2022 with the announcement that our international team was awarded an Australian Research Council Linkage Project grant to develop better baits and ways to monitor wildlife health in the field.</p> <p>These oral bait vaccine techniques that eliminate the need to catch and jab animals could be applied to future wildlife and livestock diseases, not just Tassie devils.</p> <p>Building on this momentum, we are planning to start new vaccine trials in 2023. We don’t know yet if this new experimental vaccine can prevent devils from getting devil facial tumours.</p> <p>However, the leap we have made in the past three years and new technology gives us momentum and hope that we might be able to stop DFT2 before it spreads across the state. Perhaps, we can even eliminate DFT1.<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/194536/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em>Writen by Andrew S. Flies, </em><em>Chrissie Ong</em><em> and Ruth Pye. Republished with permission from <a href="https://theconversation.com/thousands-of-tasmanian-devils-are-dying-from-cancer-but-a-new-vaccine-approach-could-help-us-save-them-194536" target="_blank" rel="noopener">The Conversation</a>.</em></p> <p><em>Image: Getty Images</em></p>

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