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How was Halloween invented? Once a Celtic pagan tradition, the holiday has evolved to let kids and adults try on new identities

<a href="https://theconversation.com/profiles/linus-owens-457047">Linus Owens</a>, <a href="https://theconversation.com/institutions/middlebury-1247">Middlebury</a> “It’s alive!” Dr. Frankenstein cried as his creation stirred to life. But the creature had a life of its own, eventually escaping its creator’s control. Much like Frankenstein’s monster, traditions are also alive, which means they can change over time or get reinvented. Built from a hodgepodge of diverse parts, Halloween is one such tradition that has been continually reinvented since its ancient origins as <a href="https://press.uchicago.edu/ucp/books/book/distributed/T/bo46408548.html">a Celtic pagan ceremony</a>. Yet beneath the superhero costumes and bags of candy still beats the heart of the original. The Celts lived in what’s now Ireland as far back as 500 B.C. They celebrated New Year’s Day on Nov. 1, which they called <a href="https://www.loc.gov/folklife/halloween-santino.html">Samhain</a>. They believed that leading up to the transition to the new year, the door between the worlds of the living and the dead swung open. The souls of the recently dead, previously trapped on Earth, could now pass to the underworld. Since they thought spirits came out after dark, this supernatural activity reached its peak the night before, on Oct. 31. The Celts invented rituals to protect themselves during this turbulent time. They put on costumes and disguises to fool the spirits. They lit bonfires and stuck candles inside carved turnips – the first jack-o’-lanterns – to scare away any spirits looking for mischief. If all else failed, they carried a pocketful of treats to pay off wayward spirits and send them back <a href="https://global.oup.com/academic/product/halloween-9780195168969?cc=us&lang=en&">on their way to the underworld</a>. Sound familiar? <a href="https://theconversation.com/halloweens-celebration-of-mingling-with-the-dead-has-roots-in-ancient-celtic-celebrations-of-samhain-191300">Although focused on the dead</a>, Samhain was ultimately <a href="https://utpress.org/title/halloween-other-festivals/">for the living</a>, who needed plenty of help of their own when transitioning to the new year. Winter was cold and dark. Food was scarce. Everyone came together for one last bash to break bread, share stories and stand tall against the dead, strengthening community ties at the time they were needed most. When Catholics arrived in Ireland around A.D. 300, they opened another door between worlds, unleashing considerable conflict. They sought to convert the Celts by changing their pagan rituals into Christian holidays. They rechristened Nov. 1 “All Saints Day,” which today remains a celebration of Catholic saints. But the locals held on to their old beliefs. They believed the dead still wandered the Earth. So the living still dressed in costumes. This activity still took place the night before. It just had a new name to fit the Catholic calendar: “All Hallows Eve,” which is <a href="https://www.loc.gov/folklife/halloween-santino.html">where we got the name Halloween</a>. Irish immigrants <a href="https://www.irishpost.com/heritage/how-irish-great-famine-brought-halloween-to-america-161376">brought Halloween to America in the 1800s</a> while escaping the Great Potato Famine. At first, Irish Halloween celebrations were an oddity, viewed suspiciously by other Americans. As such, Halloween wasn’t celebrated much in America at the time. As the Irish integrated into American society, Halloween was reinvented again, this time as an all-American celebration. It became a holiday primarily for kids. Its religious overtones faded, with supernatural saints and sinners being replaced by generic ghosts and goblins. Carved turnips gave way to the <a href="https://www.merriam-webster.com/words-at-play/the-history-of-jack-o-lantern">pumpkins</a> now emblematic of the holiday. Though trick-or-treating resembles ancient traditions like guising, where costumed children went door to door for gifts, <a href="https://www.bakersfield.com/opinion/jack-santino-five-myths-about-halloween/article_6fe79e19-d106-52cc-a895-4a3a72d09c93.html">it’s actually an American invention</a>, created to entice kids away from rowdy holiday pranks toward more wholesome activities. Halloween has become a tradition many new immigrants adopt along their journey toward American-ness and is increasingly <a href="https://www.cambridgescholars.com/product/978-1-4438-0153-9">being exported around the world</a>, with locals reinventing it in new ways to adapt it to their own culture. What’s so special about Halloween is that it turns the world upside down. The dead walk the Earth. Rules are meant to be broken. And kids exercise a lot of power. They decide what costume to wear. They make demands on others by asking for candy. “Trick or treat” is their battle cry. They do things they’d never get away with any other time, but on Halloween, they get to act like adults, trying it on to see how it fits. Because Halloween allows kids more independence, it’s possible to mark significant life stages through holiday firsts. First Halloween. First Halloween without a parent. First Halloween that’s no longer cool. First Halloween as a parent. Growing up used to mean growing out of Halloween. But today, <a href="https://www.usatoday.com/story/money/business/2012/10/24/halloween-adults-costumes-elvira-mistress-of-the-dark/1593177/">young adults</a> seem even more committed to Halloween than kids. What changed: adults or Halloween? Both. Caught between childhood and adulthood, today’s young adults find Halloween a perfect match to their struggles to find themselves and make their way in the world. Their participation has reinvented Halloween again, now bigger, more elaborate and <a href="https://www.newsweek.com/halloween-prices-cost-more-expensive-pumpkin-candy-costumes-1754635">more expensive</a>. Yet in <a href="https://theconversation.com/why-has-halloween-become-so-popular-among-adults-104896">becoming an adult celebration</a>, it comes full circle to return to its roots as a holiday celebrated mainly by adults. Halloween is a living tradition. You wear a costume every year, but you’d never wear the same one. You’ve changed since last year, and your costume reflects that. Halloween is no different. Each year, it’s the same celebration, but it’s also something totally new. In what ways are you already reinventing the Halloween of the future today? <a href="https://theconversation.com/profiles/linus-owens-457047">Linus Owens</a>, Associate Professor of Sociology, <a href="https://theconversation.com/institutions/middlebury-1247">Middlebury</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-was-halloween-invented-once-a-celtic-pagan-tradition-the-holiday-has-evolved-to-let-kids-and-adults-try-on-new-identities-192379">original article</a>.

Art

Are you over 75? Here’s what you need to know about vitamin D

<a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even <a href="https://pubmed.ncbi.nlm.nih.gov/38337682/">more crucial</a> as we age. New guidelines from the international Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommend</a> people aged 75 and over should consider taking vitamin D supplements. But why is vitamin D so important for older adults? And how much should they take? <h2>Young people get most vitamin D from the sun</h2> In Australia, it is possible for most people under 75 to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun for a few minutes on most days. The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer. But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommends</a> people get 800 IU (international units) of vitamin D a day from food or supplements. <h2>Why you need more as you age</h2> This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D. Overall, older adults also tend to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/">less exposure</a> to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors. As we age, our skin also becomes <a href="https://pubmed.ncbi.nlm.nih.gov/18290718/">less efficient</a> at synthesising vitamin D from sunlight. The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889852913000145">harder for the body to maintain</a> adequate levels of the vitamin. All of this combined means older adults need more vitamin D. <h2>Deficiency is common in older adults</h2> Despite their higher needs for vitamin D, people over 75 may not get enough of it. Studies <a href="https://www.abs.gov.au/articles/vitamin-d">have shown</a> one in five older adults in Australia have vitamin D deficiency. In higher-latitude parts of the world, such as the United Kingdom, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627050/">almost half</a> don’t reach sufficient levels. This increased risk of deficiency is partly due to <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">lifestyle factors</a>, such as spending less time outdoors and insufficient dietary intakes of vitamin D. It’s difficult to get enough vitamin D from food alone. <a href="https://dietitiansaustralia.org.au/health-advice/vitamin-d">Oily fish, eggs and some mushrooms</a> are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference. In some countries such as the <a href="https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/">United States</a>, most of the dietary vitamin D comes from fortified products. However, in <a href="https://pubmed.ncbi.nlm.nih.gov/35253289">Australia</a>, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it. <h2>Why vitamin D is so important as we age</h2> Vitamin D <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367643/">helps the body absorb calcium</a>, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis. Keeping bones healthy is crucial. Studies <a href="https://pubmed.ncbi.nlm.nih.gov/28726112/">have shown</a> older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured. Vitamin D may also help <a href="https://pubmed.ncbi.nlm.nih.gov/28202713/">lower the risk</a> of respiratory infections, which can be more serious in this age group. There is also emerging evidence for other potential benefits, including <a href="https://pubmed.ncbi.nlm.nih.gov/29233204/">better brain health</a>. However, this requires more research. According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">moderate evidence</a> to suggest vitamin D supplementation can lower the risk of premature death. The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all. <h2>Should we get our vitamin D levels tested?</h2> The Endocrine Society’s guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">suggest</a> routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75. There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders. Routine <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498906">testing</a> can also be expensive and inconvenient. In most cases, the <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommended approach</a> to over-75s is to consider a daily supplement, without the need for testing. You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation. Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.<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/231820/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, PhD Candidate - Nutrition and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-you-over-75-heres-what-you-need-to-know-about-vitamin-d-231820">original article</a>.

Body

Yes, you do need to clean your tongue. Here’s how and why

<a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health. The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity. But there’s no need to wait for a trip to the doctor. Cleaning your tongue <a href="https://pubmed.ncbi.nlm.nih.gov/21797979/">twice a day</a> can help you check how your tongue looks and feels – and improve your breath. <h2>What does a healthy tongue look like?</h2> Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move. The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface. These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. <figure><iframe src="https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light <a href="https://my.clevelandclinic.org/health/symptoms/24600-tongue-color">pink</a>. A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or <a href="https://www.healthline.com/health/tongue-problems-2">other issues</a>. <h2>How should I clean my tongue?</h2> Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine. You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface. Or you can use a special <a href="https://pubmed.ncbi.nlm.nih.gov/26865433/">tongue scraper</a>. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush. Your co-workers will thank you as well – cleaning your tongue can help combat <a href="https://pubmed.ncbi.nlm.nih.gov/24165218/">stinky breath</a>. Tongue scrapers are particularly <a href="https://pubmed.ncbi.nlm.nih.gov/15341360/">effective</a> at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface. <h2>What’s that stuff on my tongue?</h2> So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP. Here’s what your tongue might be telling you. White coating Developing a white coating on the tongue’s surface is one of the <a href="https://pubmed.ncbi.nlm.nih.gov/31309703/">most common changes</a> in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days. In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause <a href="https://www.nature.com/articles/s41368-022-00163-7">serious illnesses</a>. Yellow coating This may indicate oral thrush, a <a href="https://www.nidirect.gov.uk/conditions/oral-thrush-adults">fungal infection</a> that leaves a raw surface when scrubbed. Oral thrush is <a href="https://www.aafp.org/pubs/afp/issues/2008/1001/p845.html">common</a> in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary <a href="https://pubmed.ncbi.nlm.nih.gov/7636666/">suppression of the immune system</a> or <a href="https://www.stanfordchildrens.org/en/topic/default?id=candidiasis-in-children-90-P01888">antibiotic</a> use. If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month. Black coating Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a <a href="https://my.clevelandclinic.org/health/diseases/17918-black-hairy-tongue">black hairy tongue</a>. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene. Pink patches Pink patches surrounded by a white border can make your tongue look like a map – this is called “<a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396">geographic tongue</a>”. It’s <a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/diagnosis-treatment/drc-20354401">not known</a> what causes this condition, which usually doesn’t require treatment. Pain and inflammation A red, sore tongue can indicate a <a href="https://medlineplus.gov/ency/article/003047.htm">range of issues</a>, including: <ul> <li>nutritional deficiencies such as folic acid or vitamin B12</li> <li>diseases including <a href="https://my.clevelandclinic.org/health/diseases/22377-pernicious-anemia">pernicious</a> anaemia, <a href="https://www.rch.org.au/kidsinfo/fact_sheets/kawasaki_disease/">Kawasaki disease</a> and <a href="https://www.childrens.health.qld.gov.au/health-a-to-z/scarlet-fever">scarlet fever</a></li> <li>inflammation known as <a href="https://www.ncbi.nlm.nih.gov/books/NBK560627/">glossitis</a></li> <li>injury from hot beverages or food</li> <li>ulcers, including cold sores and canker sores</li> <li><a href="https://www.nidcr.nih.gov/health-info/burning-mouth">burning mouth syndrome</a>.</li> </ul> Dryness Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt. <h2>What about cancer?</h2> White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a <a href="https://oralcancerfoundation.org/cdc/premalignant-lesions/">higher risk</a> of turning into cancer, compared to other parts of the mouth. <a href="https://pubmed.ncbi.nlm.nih.gov/36852511/">Oral cancers</a> have low survival rates due to delayed detection – and they are on the rise. So <a href="https://youtu.be/Y6QkKhEjS5M">checking your tongue</a> for changes in colour, texture, sore spots or ulcers is <a href="https://www.dhsv.org.au/oral-health-programs/oral-cancer-screening-and-prevention">critical</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/237130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, Professor and Head of Discipline - Oral Health, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-you-do-need-to-clean-your-tongue-heres-how-and-why-237130">original article</a>.

Body

200-year-old message in a bottle unearthed

In a discovery that has the archaeology world buzzing (and possibly rolling its ancient eyes), a team of student volunteers in northern France has unearthed something rather unexpected during their dig at a Gaulish village. While they were hoping for the usual – ancient pottery shards, perhaps a coin or two – they instead stumbled upon what can only be described as the 19th-century equivalent of a DM in a bottle. The scene played out like a low-budget historical drama: volunteers painstakingly sifting through centuries-old dirt on the cliff-tops near Dieppe when, voilà! They found an earthenware pot containing a small glass vial, like something you might see in a vintage pharmacy, but with fewer essential oils and more existential surprises. Guillaume Blondel, the team leader and head of the archaeological service for the nearby town of Eu, was immediately intrigued. “It was the kind of vial that women used to wear around their necks containing smelling salts,” he explained, before casually dropping the bombshell: inside the vial was a note. Cue dramatic music. After what we can only assume was a long, suspenseful pause, Blondel and his team opened the note, which turned out to be written by none other than P.J. Féret, a 19th-century intellectual who clearly had a flair for both excavation and theatrics. The note, written with all the panache of a man who had just unearthed Caesar’s salad fork, read: "P.J. Féret, a native of Dieppe, member of various intellectual societies, carried out excavations here in January 1825. He continues his investigations in this vast area known as the Cité de Limes or Caesar’s Camp." Naturally, Blondel was floored. “It was an absolutely magic moment,” he said, no doubt imagining Féret winking at him from the beyond. “We knew there had been excavations here in the past, but to find this message from 200 years ago? It was a total surprise.” Local records confirm that P.J. Féret was indeed the real deal. He wasn’t just a dabbler in dirt – he was a notable dabbler in dirt who had conducted an earlier dig at the site in 1825. In a stroke of irony not lost on Blondel, he mused, “Most archaeologists prefer to think that there won’t be anyone coming after them because they’ve done all the work.” Féret, however, clearly believed in leaving a trail of breadcrumbs – or, in this case, a literal note in a bottle, just to remind future archaeologists that he got there first. Féret: 1, Modern Archaeology: 0. Of course, this whole affair raises some important questions: Did Féret expect someone to find this? Did he laugh to himself as he buried it, imagining Blondel’s reaction? Did Féret know how cliff erosion would eventually turn his humble Gaulish village into a treasure trove for future archaeologists? Or was he simply trolling them from the past? Whatever the case, Féret’s note may not have contained ancient secrets, but it certainly delivered some 19th-century sass. And if we’ve learned anything from this dig, it’s this: archaeology isn’t just about discovering the past – it’s also about being occasionally roasted by it. As Blondel and his team continue their emergency dig (which was ordered due to cliff erosion eating away at the site like a bad buffet), they’ve already uncovered a number of artefacts, mostly pottery, from around 2,000 years ago. But will any of them have the audacity to leave a note for the archaeologists of 2225? We’ll have to wait and see. In the meantime, Féret is probably laughing somewhere in the afterlife, shaking his head and muttering, “Amateurs”. Images: Guillaume Blondel / Facebook

International Travel

Why do I need to take some medicines with food?

<a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to? There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food. To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food. Different brands of the same medicine may also have different recommendations when it comes to taking it with food. <h2>Food impacts drug absorption</h2> Food can affect how fast and how much a drug is absorbed into the body in up to <a href="https://academic.oup.com/jpp/article-abstract/71/4/510/6122024?login=false">40% of medicines</a> taken orally. When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption. Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505616/">gastric emptying</a>. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption. Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly. But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach. <h2>Food can make medicines more tolerable</h2> Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets. Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452716/">one in four users affected</a>. To combat these side effects, it is generally recommended to be taken with food. The same <a href="https://amhonline.amh.net.au/auth">advice</a> is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline). Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed. <h2>Can food make medicines safer?</h2> Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/medications/latest-release">within a two-week period</a>. While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of <a href="https://www.tandfonline.com/doi/full/10.1586/14737175.6.11.1643#d1e212">bleeding, ulceration and perforation</a> with long-term use. But there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">isn’t enough research</a> to show taking ibuprofen with food reduces this risk. Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration. The <a href="https://amhonline.amh.net.au/auth">Australian Medicines Handbook</a>, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">A systematic review published in 2015</a> found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses. To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs">non-steroidal anti-inflammatory medicines</a> at the same time. For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a <a href="https://australianprescriber.tg.org.au/articles/peptic-ulcer-disease-and-non-steroidal-anti-inflammatory-drugs.html">proton pump inhibitor</a>, a medicine that reduces stomach acid and protects the stomach lining. <h2>How much food do you need?</h2> When you need to take a medicine with food, how much is enough? Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone. However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised. Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.<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/235782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Associate Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-take-some-medicines-with-food-235782">original article</a>.

Body

Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

<a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">updated treatment guidelines</a> from the Australian Commission on Safety and Quality in Health Care. So what is knee osteoarthritis and what are the best ways to manage it? <h2>More than 2 million Australians have osteoarthritis</h2> Osteoarthritis is the most common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. It <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">costs the economy</a> A$4.3 billion each year. Osteoarthritis commonly <a href="https://pubmed.ncbi.nlm.nih.gov/33560326/">affects</a> the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles. Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs. <h2>Is it caused by ‘wear and tear’?</h2> Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is <a href="https://pubmed.ncbi.nlm.nih.gov/31192807/">not caused by</a> “wear and tear”. <a href="https://pubmed.ncbi.nlm.nih.gov/21281726/">Research shows</a> the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">not required</a> to diagnose knee osteoarthritis or guide treatment decisions. Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have <a href="https://pubmed.ncbi.nlm.nih.gov/37795555/">shown this</a> in people with osteoarthritis, and other common pain conditions such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9545091/">back</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33789444/">shoulder</a> pain. This has led to a global call for a <a href="https://pubmed.ncbi.nlm.nih.gov/38354847/">change in the way</a> we think and communicate about osteoarthritis. <h2>What’s the best way to manage osteoarthritis?</h2> Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">include</a> education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines. Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms. Health professionals who use positive and reassuring language <a href="https://pubmed.ncbi.nlm.nih.gov/35750241/">can improve</a> people’s knowledge and beliefs about osteoarthritis and its management. Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/36593092/">paracetamol and anti-inflammatories</a> and can <a href="https://pubmed.ncbi.nlm.nih.gov/26488691/">prevent or delay</a> the need for joint replacement surgery in the future. Many types of exercise <a href="https://pubmed.ncbi.nlm.nih.gov/30830561/">are effective</a> for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you. Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time. Weight management is important for those who are overweight or obese. Weight loss <a href="https://pubmed.ncbi.nlm.nih.gov/34843383/">can reduce knee pain and disability</a>, particularly when combined with exercise. Losing as little as 5–10% of your body weight <a href="https://pubmed.ncbi.nlm.nih.gov/36474793/">can be beneficial</a>. Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. <a href="https://pubmed.ncbi.nlm.nih.gov/33786837/">Recommended medicines</a> include paracetamol and non-steroidal anti-inflammatory drugs. Opioids are <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">not recommended</a>. The risk of harm outweighs any potential benefits. <h2>What about surgery?</h2> People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement. Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain. However, high-quality research <a href="https://pubmed.ncbi.nlm.nih.gov/24369076/">has shown</a> arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis. Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">53,500 Australians</a> had a knee replacement for their osteoarthritis. Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management. The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments. <h2>I have knee osteoarthritis. What should I do?</h2> The <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> links to free evidence-based resources to support people with osteoarthritis. These include: <ul> <li>education, such as a <a href="https://www.england.nhs.uk/wp-content/uploads/2023/07/making-a-decision-about-knee-osteoarthritis-v1.pdf.pdf">decision aid</a> and <a href="http://www.futurelearn.com/courses/taking-control-hip-and-knee-osteoarthritis">four-week online course</a></li> <li>self-directed <a href="https://healthsciences.unimelb.edu.au/departments/physiotherapy/chesm/patient-resources/my-knee-exercise">online exercise</a> and <a href="https://myjointyoga.com.au/">yoga</a> programs</li> <li><a href="https://www.gethealthynsw.com.au/program/standard-coaching/">weight management support</a></li> <li>pain management strategies, such as <a href="https://www.myjointpain.org.au/">MyJointPain</a> and <a href="http://www.paintrainer.org/">painTRAINER</a>.</li> </ul> If you have osteoarthritis, you can use the <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard">care standard</a> to inform discussions with your health-care provider, and to make informed decisions about your care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236779/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/belinda-lawford-1294188">Belinda Lawford</a>, Postdoctoral research fellow in physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/joshua-zadro-504754">Joshua Zadro</a>, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/rana-hinman-1536232">Rana Hinman</a>, Professor in Physiotherapy, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">original article</a>.

Body

Woman “bullied” on plane over budget seating trick

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

Travel Trouble

Sorting a loved one’s finances after their death – what you need to know

<a href="https://theconversation.com/profiles/kate-reed-1548385">Kate Reed</a>, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> Financial anxiety is often talked about, but rarely in the context of bereavement. Following the death of a loved one, relatives usually have to complete a range of financial “death administration” tasks. These can be anything from closing bank accounts and settling utility bills to managing probate (things like property sales, asset management and inheritance distribution). The <a href="https://bereavementcommission.org.uk/media/xube5elb/ukbc_summary_report_low-res.pdf">UK Commission on Bereavement</a> has estimated that 61% of adults struggle to deal with such time consuming and time sensitive administrative responsibilities. While research has begun to shed light on some of the financial difficulties bereaved people can face after the death of a <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-015-0194-1">spouse</a> or a <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1468-4446.12190">family member</a>, the emotional toll of navigating financial admin after bereavement remains <a href="https://www.bereavementjournal.org/index.php/bcj/article/view/1114">largely invisible</a>. But the good news is there are several resources that can help bereaved people to navigate these processes, including the UK government’s own <a href="https://www.gov.uk/when-someone-dies">step-by-step guide</a>. We conducted <a href="https://thenbs.org/partnerships/death-admin-research-report">research</a> on death admin in collaboration with the <a href="https://thenbs.org/">National Bereavement Service</a>, an organisation that provides free practical and emotional support for anyone who has lost a loved-one. The study showed how government services provide a gateway to sorting out a range of financial issues. Financial organisations require proof of the death through a death certificate. This is provided when you <a href="https://www.gov.uk/when-someone-dies">register</a> a death with the local registrar of births, marriages and deaths. Where there is an inquest, an interim death certificate will be issued. Often, multiple copies of the death certificate are needed. And, at £12.50 for <a href="https://www.gov.uk/order-copy-birth-death-marriage-certificate">each copy</a> (£12 in <a href="https://www.mygov.scot/birth-death-marriage-certificate#:%7E:text=You%20can%20order%20a%20certificate,orders%20made%20in%20another%20way.">Scotland</a>), the financial burden falling on bereaved people can quickly grow. In terms of tax, pensions and benefits, the registrar provides a unique reference number that bereaved people can use to inform the government through a service called <a href="https://www.gov.uk/after-a-death/organisations-you-need-to-contact-and-tell-us-once">Tell Us Once</a>. This is an initiative that notifies national and local government bodies including HM Revenue and Customs (to deal with personal tax and to cancel certain benefits and tax credits) and the Department for Work and Pensions (to cancel benefits and entitlements like universal credit or the state pension). The <a href="https://www.gov.uk/valuing-estate-of-someone-who-died?step-by-step-nav=4f1fe77d-f43b-4581-baf9-e2600e2a2b7a">government website</a> also provides help on how to value the person’s estate and work out inheritance tax. <h2>Avoiding family fall-outs</h2> But other financial aspects of death administration can be more challenging to navigate. Probate, for example, is the legal right to deal with someone’s property, money and possessions (their “estate”) when they die. You can <a href="https://www.gov.uk/applying-for-probate?step-by-step-nav=4f1fe77d-f43b-4581-baf9-e2600e2a2b7a">check</a> on the UK government website whether you require probate. It remains one of the most challenging aspects of death administration. Our <a href="https://thenbs.org/partnerships/death-admin-research-report">research</a> shows that people often seek legal advice to manage probate because they are scared to get things wrong, or because they want to avoid future disputes with family members. The process of closing bank accounts and managing assets can be straightforward when the deceased person had made clear arrangements and had few bank accounts. But financial concerns often arise in situations where there are multiple or complicated banking systems. As one of the participants in our research stated: “It’s been a real mess … my dad had quite a few properties, and it’s been quite difficult winding those down.” Worse still, bereaved people can face threatening letters from companies like utilities providers in relation to bills and closing accounts. We found organisations often lack compassion in this context. We encountered cases of companies continuing to write directly to the deceased person, causing further distress to their loved-ones. One of our participants told us that their stepmother was “still getting the bill with my father’s name on, which distresses her”. It is also worth noting that certain types of death present particular administrative and financial challenges. For example, in 2022 17% of deaths in England and Wales were subject to a <a href="https://www.gov.uk/government/statistics/coroners-statistics-2022/coroners-statistics-2022-england-and-wales#inquests-opened">coroner’s inquest</a>. These deaths can be more difficult to administer on the Tell Us Once initiative due to the time-lag and extra bureaucracy involved. In addition, many people die without a will, which usually makes navigating financial issues much harder. The location of the death can also have financial implications. For example, our <a href="https://www.bereavementjournal.org/index.php/bcj/article/view/1114">research</a> shows how financing a care home stay is usually interconnected with inheritance or selling the person’s house, which places extra pressure on those trying to release the funds. Many organisations could make their administrative processes clearer and train their staff to be more compassionate towards people who have recently been bereaved. There are, however, glimmers of hope that things are improving. My own father died last year and while my experiences of helping my mum deal with the financial aspects of death administration have been mixed, we did experience many acts of kindness and compassion along the way. There is also excellent practical guidance out there from organisations like the <a href="https://thenbs.org/">National Bereavement Service</a>, which along with emotional support from charities like <a href="https://www.cruse.org.uk/">Cruse Bereavement Support</a> are vital to helping people navigate complex administrative systems. The COVID pandemic and death of the queen in 2022 have likely meant that, as a society, we are talking more about death and grief both publicly and privately. Death and bereavement happen to us all, and it is crucial that we talk more openly, not just about our emotional concerns, but about the practical and financial implications too.<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/231967/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kate-reed-1548385">Kate Reed</a>, Professor of Sociology and Director of the Sheffield Methods Institute, <a href="https://theconversation.com/institutions/university-of-sheffield-1147">University of Sheffield</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sorting-a-loved-ones-finances-after-their-death-what-you-need-to-know-231967">original article</a>.

Money & Banking

Castor oil is all the rage among health influencers – what you need to know about this alternative remedy

<a href="https://theconversation.com/profiles/veronique-seidel-1542416">Veronique Seidel</a>, <a href="https://theconversation.com/institutions/university-of-strathclyde-1287">University of Strathclyde</a> Castor oil, which was once used by fascists in Italy as <a href="https://www.rcpe.ac.uk/remoteandruralremedies/activities/exhibitions/medicines.html#:%7E:text=Due%20to%20its%20use%20as,the%20bludgeon%20and%20castor%20oil'.">punishment</a> because of its quick-acting laxative effect, is now a weight-loss trend on TikTok. Not drinking it, but rubbing it on your belly. Influencers are also pouring it in their belly buttons and wrapping towels soaked in it around their midriff. They claim it can <a href="https://www.tiktok.com/@karinawaldron/video/7333667470756072709?lang=en">melt belly fat</a> and <a href="https://www.tiktok.com/@sarahjmce/video/7322670147473362207?lang=en&q=castor%20oil&t=1716463274921">help with bloating</a>. Castor oil – made from the beans of the castor plant – is an ancient medicine. References to it appear in an ancient Egyptian medical text called the <a href="https://www.nationalgeographic.com/premium/article/castor-oil-real-health-benefits">Ebers Papyrus</a> (1550BC). It was used as a laxative and to treat various skin conditions. Cleopatra is said to have <a href="https://www.washingtonpost.com/lifestyle/wellness/cleopatra-used-it-as-a-beauty-aid-now-castor-oil-is-staging-a-cosmetics-comeback/2019/07/05/2d457584-92c5-11e9-aadb-74e6b2b46f6a_story.html?itid=sr_1_4c3daa8b-2b15-41d9-9b45-f1b2af1d7cf7">used it</a> in her hair and to brighten the whites of her eyes. The odourless oil is rich in a fatty substance called ricinoleic acid that strongly stimulates bowel movements. Today, it is an approved <a href="https://dps.fda.gov/omuf/monographsearch/monograph_m007">over-the-counter remedy</a> in some countries for short-term constipation and is used for cleansing the bowel before medical examinations. However, there’s not much scientific evidence to indicate that this laxative effect is better than other commonly used laxatives, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3862068/">senna</a> – which has also been used for centuries. Other reported traditional uses for the oil include as a cure for sore and itchy eyes, to relieve joint and period pain, and as a means to induce labour. But, again, the evidence for these things is scant. Castor oil isn’t just imbibed, it is also widely used in skin creams, hair conditioners and other cosmetic products, such as lipsticks. It is used to moisturise, soothe irritated skin and reduce the appearance of wrinkles. Its moisturising properties have been attributed to ricinoleic acid. As part of haircare products, it is said to help with hair loss and dandruff. But taking castor oil as a standalone product is not risk free. The main side-effects of imbibing the oil are abdominal cramps, vomiting, bloating and dizziness. Vulnerable people, such as the elderly, babies, pregnant or breastfeeding women, and those with liver or kidney failure should avoid taking castor oil. As should anyone with inflammatory bowel disease, appendicitis or gastrointestinal obstruction or perforation. The side-effects of castor oil can also be exacerbated in people with <a href="https://www.degruyter.com/document/doi/10.1515/jom-1988-880520/html">eating disorders</a> who may choose to use the oil to lose weight by speeding up the passage of food through the gut. However, if you want to apply the oil to your skin or scalp, proceed with caution. In some people, it can trigger an allergic reaction. It is always advised to apply a small amount of pure castor oil or a castor oil-containing cosmetic product onto a small patch of skin. If there is no allergic reaction after 24 hours, then it can be assumed that the product can be applied safely to a larger area of the body. Ultimately, though, there are generally safer and better remedies out there. And rubbing it on your belly – sadly – won’t melt the fat.<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/232782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/veronique-seidel-1542416">Veronique Seidel</a>, Senior Lecturer, Pharmacy and Biomedical Sciences, <a href="https://theconversation.com/institutions/university-of-strathclyde-1287">University of Strathclyde</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/castor-oil-is-all-the-rage-among-health-influencers-what-you-need-to-know-about-this-alternative-remedy-232782">original article</a>.

Body

You don’t need a doctor to get more physically active – here are 10 simple steps you can take by yourself

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> We all know physical activity has many <a href="https://www.nhs.uk/live-well/exercise/exercise-health-benefits/">health benefits</a>, including for mental health. It helps <a href="https://theconversation.com/exercise-can-reduce-stress-and-improve-sleep-particularly-for-women-with-breast-cancer-186144">manage stress</a>, ease joint or back pain, and boost energy levels. Exercise can also improve <a href="https://theconversation.com/exercise-and-the-brain-three-ways-physical-activity-changes-its-very-structure-150203">brain function</a> and <a href="https://theconversation.com/exercise-really-can-help-you-sleep-better-at-night-heres-why-that-may-be-192427">sleep</a>, and lift mood. In contrast, inactivity or spending too much time <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308180/">sedentary</a> is a leading factor in developing a range of diseases. The <a href="https://www.who.int/publications/i/item/9789240015128">World Health Organization</a> recommends we should do a weekly minimum of 150-300 minutes of moderate intensity physical activity, such as walking, or 75 minutes of vigorous physical activity, such as swimming, jogging or an exercise class – as well as <a href="https://theconversation.com/strength-training-could-be-the-answer-to-one-of-the-worlds-worst-killers-228665">regular strength training</a>. However, many people <a href="https://www.who.int/teams/health-promotion/physical-activity/global-status-report-on-physical-activity-2022">fail to meet these guidelines</a>. So what to do about this <a href="https://www.weforum.org/agenda/2022/12/lack-exercise-inactivity-preventable-diseases/">health crisis</a>? There is already <a href="https://www.bmj.com/content/376/bmj-2021-068465">evidence</a> that when GPs give patients guidance and continued support to increase physical activity, this encourages them to be more physically active – at least in the short term. However, we don’t yet know the best way for doctors to communicate with patients to help them sustain these increased activity levels so the current guidance and support on offer to patients isn’t as effective as it could be. <figure><iframe src="https://www.youtube.com/embed/vCCD1xHKpZc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For example, my <a href="https://www.bmj.com/content/386/bmj-2023-078713">latest research</a> examines the <a href="https://www.bmj.com/content/340/bmj.c1900">“motivational interviewing” (MI)</a> method GPs currently use to encourage patients to change their lifestyle. MI is a patient-centred, non-confrontational communication style that helps patients address any problem behaviour by exploring their ambivalence towards changing it. MI has been shown to help patients with a host of health problems, including <a href="https://pubmed.ncbi.nlm.nih.gov/25577724/">addiction issues</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/23001832/">eating disorders</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/25726920/">smokers</a> and those with <a href="https://pubmed.ncbi.nlm.nih.gov/33637368/">diabetes</a> to change their behaviour. However, I found that while MI programmes can help patients increase their total amount of physical activity – the benefits are only short term. <h2>Ten simple ways to be more physically active</h2> If you want more physical activity in your life, then, there are many self-directed things you can do to help yourself, without joining a programme or seeing your GP. Here are ten simple and effective ways to help you become – and stay – more physically active: 1) Don’t sit, stand We <a href="https://theconversation.com/sitting-is-bad-for-your-health-and-exercise-doesnt-seem-to-offset-the-harmful-effects-225056">sit a lot</a>. In fact, it’s likely you’re sitting right now – and you needn’t be. Sitting for long periods has been <a href="https://doi.org/10.1016/j.amepre.2010.05.024">linked</a> with many adverse health outcomes, so try to stand more. <figure><iframe src="https://www.youtube.com/embed/wUEl8KrMz14?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> 2) Take the stairs Being physically active needn’t mean expensive gym memberships. Try building physical activity into your daily routine. One easy way to do this is by swapping the lift or escalator for the stairs. 3) Make it fun If you like doing something, you’re <a href="https://theconversation.com/why-you-shouldnt-let-guilt-motivate-you-to-exercise-220342">more likely</a> to continue doing it. Why not try an activity you liked doing as a child, or even something new? Who knows, you might enjoy it. 4) Phone a friend Exercising <a href="https://theconversation.com/exercise-can-be-punishing-but-heres-how-to-stop-thinking-of-it-as-a-punishment-76167">with a friend</a> or loved one is a great way to stay motivated, and it can make physical activity more fun too. 5) Do less, more often <a href="https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-023-01272-8">“Snacktivity”</a> – a term for breaking up your activity into shorter <a href="https://theconversation.com/forget-the-gym-in-january-exercise-snacking-is-the-way-forward-69702">activity “snacks”</a> – can help you increase activity in convenient, manageable bursts while reaping the health benefits. 6) Track your progress Activity trackers aren’t a fad. There is <a href="https://doi.org/10.1016/S2589-7500(22)00111-X">evidence</a> that just using an activity tracker such as a pedometer to count steps or a smart watch that logs activity can help increase your activity levels, reduce body fat and increase muscle mass – and increase your overall physical fitness. 7) Get into a habit We know it takes about ten weeks to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/">form a habit</a>. Repetition is key – so stick with it and keep going. Once you’ve formed a physical activity habit, it will be <a href="https://www.psychologytoday.com/gb/basics/habit-formation#:%7E:text=Building%20healthy%20habits%20can%20involve,listening%20to%20music%20while%20exercising">hard to shake it off</a>.). 8) Hold still Try to incorporate <a href="https://en.wikipedia.org/wiki/Isometric_exercise">isometric exercises</a> like the plank or wall squats into your routine. These exercises, which need no equipment, require you to tighten muscles and hold still – and have been shown to <a href="https://bjsm.bmj.com/content/57/20/1317">lower your blood pressure</a>. 9) Set a goal Give yourself an achievable target to work towards – it will <a href="https://theconversation.com/three-tips-to-help-you-stay-motivated-to-keep-exercising-all-year-long-175868">motivate you</a> to reach your goal. 10) Reward yourself And don’t forget to reward yourself when you meet that goal. You can also build in rewards to mark your progress along the way. After all, who doesn’t like to treat themselves when they’ve done well?<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/231991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, Associate professor, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/you-dont-need-a-doctor-to-get-more-physically-active-here-are-10-simple-steps-you-can-take-by-yourself-231991">original article</a>. </div>

Body

Second marriage asset protection: What you need to know

Of paramount importance for many people in a second marriage is how to protect their assets if their relationship breaks down, or in the event of their death. Although second marriages bring a level of complexity, there are a number of strategies that you can implement to ensure that your assets are protected. Let’s explore some of the options available to you and what you need to know to protect your assets. Binding Financial Agreement A Binding Financial Agreement, often referred to as a pre-nup, allows you and your spouse to put in place a legal agreement which outlines how your assets will be dealt with in the event that your relationship breaks down. Should you wish, it can also extend to the provision of financial support for either party. The intention is for each party to protect their own assets, and such agreements can be put in place prior to a marriage or during a marriage if both parties consent. Like any legal document, a Binding Financial Agreement needs to be well drafted to ensure that it encompasses all relevant information, and it is important that you seek the advice of a family lawyer to assist you with putting this important document in place. Joint Assets v Individual Assets The manner in which you hold your assets is of paramount importance. All joint assets pass to the surviving party. If you and your spouse own a property as joint proprietors upon your death this property will automatically pass to your spouse. By changing the manner in which you hold the property from joint proprietors to tenants in common allows you and your spouse to deal with your individual interest in the property in your respective Wills. Additionally, you need to be mindful of any bank accounts or other investments that you hold jointly with your spouse as these are not individual assets that you can make provision for and will pass to your spouse upon your death. Your Will It is imperative that you put a Will in place that is reflective of your current circumstances and adequately provides for both your spouse and your children from a previous relationship in the manner that you desire. For many parents in second marriages with children from a previous relationship, protecting their children’s inheritance is of paramount importance. Discretionary Testamentary Trusts which are created in accordance with the provisions of your Will, can make provision for your spouse during their lifetime, whilst also ensuring that most of your assets go to your children. If you are the sole registered proprietor of your residence in which you and your spouse reside you may make provision in your Will providing a life interest in your residence to your spouse subject to some conditions being adhered to. This will allow your spouse to reside in your residence for the duration of their life then subsequent to their death the property may then pass to your children. Dying without a valid Will in place deems that you died intestate, and your assets will be distributed in accordance with a government formula and may not end up with the people who you would like to receive them. Your spouse would be entitled to a share of your assets, however this may not have been your intention, or the share that they would receive may be significantly more than you would like them to receive. It is therefore crucial that you take the time to put a well drafted Will in place so that your assets pass to those who you would like to receive them upon your death. Mutual Wills Agreement A Mutual Wills Agreement is a separate document to your Will and essentially is an agreement between you and your spouse that both of you will not change your Will without the consent of the your spouse or their legal personal representative upon their death. This document is intended to prevent the remaining spouse from altering their Will and disinheriting step-children or making other adverse changes to their Will. The Right People in Key Roles The roles of executor of your Will and your attorney in respect to your Power of Attorney documents are important roles and it is paramount that you appoint trusted people to undertake these roles as essentially you are handing control of your assets to those who assume these roles. Your attorney is entrusted to look after your finances and provide the best care for you in the event that you become incapacitated so you need to choose wisely. Communication is Crucial It is important that there is transparency for you and your family. By having important conversations with your spouse and children you can openly discuss your intentions and expectations so that all parties are relevantly informed and fully understand what your wishes are and what you have put in place. In order to evaluate the best options for you it is important that you obtain the appropriate professional advice to determine which is the best strategy for your own individual circumstances so that the relevant documents are put in place which offer you the best asset protection possible. Melisa Sloan is principal of Madison Sloan Lawyers and author of Big Moments: Expert Advice for Conquering those moments that define us. www.melisasloan.com.au Image credits: Shutterstock

Money & Banking

“Don’t marry him”: Bride-to-be shares wild altercation with her future in-laws over her wedding dress

A woman has been told to “run” from her fiancé after sharing a wild conversation she had with her future in-laws about her wedding dress. The bride-to-be shared that ever since she was a child, she wanted to wear her mother’s wedding dress on her own big day. However, the woman was then confronted by her soon-to-be in-laws, with drama ensuing over her wedding dress. Taking to Reddit’s “Am I The A**hole?” page, the woman explained, "My mother's wedding dress has been passed down for generations and I remember being a little girl dreaming of walking down the aisle in it." Despite her wishes to wear the family heirloom on her big day, she said things went south at a dinner at her sister-in-law’s (SIL) house when she "tapped her spoon against the glass and said that she had to make a toast." "She then said she would be right back before going into another room and returning with a large plastic bag," the bride continues. "Everyone seemed to be excited but I just felt confused." As she "awkwardly smiled", her SIL opened the bag to reveal her wedding dress from her wedding two years earlier as her in-laws began clapping, as her future sister-in-law announced she wanted the bride to wear her dress at her upcoming nuptials. "I tried to smile but I guess I didn't do a good job of hiding my disappointment and everyone began asking me what was wrong," the bride-to-be continues, adding that she tried to explain that she wanted to wear her mother's wedding dress. At this point, her SIL began to cry and her in-laws began berating her, causing the bride to burst into tears and run outside. "My fiancé didn't even come after me and after crying my eyes out on the steps for what felt like hours, he finally came outside and yelled at me to get into the car," she says. Confused, she got into the car only for her fiancé to berate her for making "such a big scene" leaving him feeling "embarrassed in front of his family." "He sounds so mad and he even said he couldn't believe he chose to marry such a 'bitchy c--t' (his exact words)." The woman tried to explain how important it was to her to wear her mother's dress and that she had already promised her mother she would be wearing it on her big day. "I felt like my fiancé's family planned this and put me on the spot thinking I wouldn't stand up for myself and just agree to wear SIL's dress," she continues. "I don't think I did anything wrong but a part of me thinks I should have just gone along with it and then told SIL in private that I wouldn't be wearing the dress." Hundreds of people were quick to comment on her post, suggesting that she “run” not only from her in-laws, but from her partner as well. "Ma'am you need to leave that whole family behind including your fiancé," one said. "You just had a peek into your future if you carry on with this relationship." "Don't you dare marry that man!!!" another said. "The problem doesn't exist as the wedding shouldn't be happening anymore," another added. One Redditor suggested she "be thankful that he is showing you who he really is before you marry him." "You have just had a glimpse of what your future is going to look like if you go through with your wedding." Image credits: Shutterstock

Family & Pets

Heading to Bali or somewhere tropical these holidays? Here’s what you need to know about dengue fever

<a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> If you’re looking to escape the Australian winter for your next holiday, don’t forget where there’s warmth, there will also be mosquitoes. In turn, tropical destinations can be hot spots of mosquito-borne diseases such as dengue. In fact, Australian health authorities have warned travellers to Bali <a href="https://www.health.wa.gov.au/Media-releases/2024/May/Dengue-fever-warning-for-Western-Australian-travellers">to be aware</a> of the risk of dengue, with cases surging in the region. So here’s how to protect yourself and your family on holidays. <h2>What is dengue?</h2> <a href="https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue">Dengue virus infection</a> (commonly known as dengue fever, or just dengue) is caused by viruses spread by the bite of a mosquito. The mosquito species that typically transmit dengue are Aedes aegypti and Aedes albopictus. There are four strains of dengue virus. Each has the potential to cause illness that can range from <a href="https://www.cdc.gov/dengue/signs-symptoms/index.html">mild to severe and potentially life threatening</a>. Symptoms <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/dengue.aspx">typically include</a> rash, fever, chills, headache, muscle and joint pain, and fatigue. People also often report abdominal pain, nausea and vomiting. While infection with just one of these viruses can make you sick, subsequent exposure to other strains can have more <a href="https://theconversation.com/explainer-what-are-antibodies-and-why-are-viruses-like-dengue-worse-the-second-time-68227">serious health implications</a>. In these cases, symptoms can also include the presence of blood in vomit, bleeding gums and breathing difficulties. Dengue infection must be confirmed via a blood test, but there are <a href="https://www.healthdirect.gov.au/dengue-fever">no specific treatments</a>. Most people will recover on their own however <a href="https://www.cdc.gov/dengue/treatment/index.html">staying hydrated is crucial</a> and pain relief can help with symptoms. If more severe illness occurs, seek urgent medical care. <h2>Are travellers at risk?</h2> The disease is now endemic in around 100 countries and <a href="https://www.cdc.gov/dengue/areas-with-risk/index.html">an estimated 4 billion people</a> are considered at risk. Asian countries represent <a href="https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue">around 70%</a> of the global disease burden. Even <a href="https://theconversation.com/how-the-paris-olympics-could-become-a-super-spreader-event-for-dengue-231853">Europe is at risk</a>. <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498">One of the worst years</a> on record was 2023, but the burden of dengue continues to grow. In the first four months of 2024, Indonesia reported <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON518">three times as many cases</a> of dengue compared to the same period in 2023. Dengue is not a new risk to Australian travellers. Before COVID disrupted international travel, the number of Australians returning from tropical destinations with dengue <a href="https://europepmc.org/article/med/23692160">was steadily increasing</a>. For example, between 2010 and 2016, there was an average <a href="https://www.mdpi.com/2414-6366/3/1/9">annual increase of 22%</a> of travellers returning to Victoria with dengue. Almost half of these people contracted the illness in Indonesia. Bali is well documented as posing <a href="https://academic.oup.com/jtm/article/25/1/tay061/5065180?login=false">a risk of dengue</a> to travellers. International travel restrictions due to COVID <a href="https://academic.oup.com/jtm/article/31/2/taae014/7577676">abruptly stopped this trend</a>. But now Australians are again embracing international travel, <a href="https://www.dailymail.co.uk/news/article-13303747/Worrying-reason-Aussie-travellers-Bali-coming-sick.html">cases are rising once more</a>. Bali isn’t the only destination with <a href="https://www.washingtonpost.com/health/2024/06/30/dengue-puerto-rico-mosquito-climate-change/">a surge in dengue</a>, but we know it’s a popular holiday destination for Australian travellers. There’s little doubt plenty of families will be heading to Bali these school holidays. <h2>How about the risk in Australia?</h2> Not all mosquitoes can spread dengue viruses. This is why the risk is different in Bali and other tropical regions compared to Australia. Although there are more than 40 Australian mosquito species known or suspected to be transmitting local pathogens, such as <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005070">Ross River virus</a>, Australia is generally free of local dengue risk due to the limited spread of Aedes aegypti and Aedes albopictus. While Aedes aegypti is found in <a href="https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/diseases/mosquito-borne/dengue/virus-fever">parts of Queensland</a>, thanks to interventions by the <a href="https://www.worldmosquitoprogram.org/en/global-progress/australia/cairns-and-surrounds">World Mosquito Program</a> and local authorities dengue risk is low. These interventions include the release of laboratory-bred mosquitoes that prevent mosquitoes in the environment <a href="https://www.worldmosquitoprogram.org/en/work/wolbachia-method">spreading viruses</a>, as well as <a href="https://www.sciencedirect.com/science/article/pii/S2221169115309096">community education</a>. But <a href="https://theconversation.com/after-decades-away-dengue-returns-to-central-queensland-117821">local cases</a> occasionally occur. Aedes albopictus is not currently found <a href="https://theconversation.com/how-we-kept-disease-spreading-asian-tiger-mozzies-away-from-the-australian-mainland-72873">on the Australian mainland</a> but is present in the islands of the Torres Strait. A dengue outbreak <a href="https://www.torres-cape.health.qld.gov.au/about-us/news/further-cases-of-dengue-fever-on-mer">has occurred</a> there this year. <h2>Keep mozzies away during the day, not just at night</h2> While there is a vaccine available, it’s not recommended for <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50471">short-term travellers</a>. There are <a href="https://www.health.gov.au/resources/publications/atagi-advice-on-the-use-of-dengvaxiar-for-australians">strict eligibility criteria</a> for its use, so speak to a health professional for advice. For the majority of travellers, preventing mosquito bites is the only way to prevent disease. But there are differences in the behaviour of dengue mosquitoes that mean the normal measures to avoid mosquito bites may not be as effective. During the Australian summer, mosquitoes found in local wetlands can be <a href="https://theconversation.com/the-worst-year-for-mosquitoes-ever-heres-how-we-find-out-68433">incredibly abundant</a>. We tend to need to reach for the repellent and cover up to stop bites as soon as the sun starts going down. Aedes aegypti and Aedes albopictus <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010818">can aggressively bite people</a> but they’re not as abundant as the swarms of summer mosquitoes back home. They also bite during the day, not just at night. So for those travelling to Bali or other areas at risk of dengue, putting insect repellent on <a href="https://www.smartraveller.gov.au/news-and-updates/global-dengue-fever-outbreaks">throughout the day</a> is recommended. <h2>What to pack for protection</h2> If you’re staying in a major resort, there’s likely to be a mosquito control program in place. This may include minimising available water for mosquito breeding in combination with insecticide use. Mosquitoes are also less likely to be an issue in air-conditioned accommodation. But if you’re planning to spend time out and about visiting local villages, markets, or in nature, it’s best to protect against bites. Light coloured and <a href="https://www.health.wa.gov.au/Media-releases/2024/May/Dengue-fever-warning-for-Western-Australian-travellers">loose fitting clothing</a> will help stop mosquito bites (and help keep you cool). Covered shoes can help too – dengue mosquitoes <a href="https://www.npr.org/sections/goatsandsoda/2016/02/22/465594861/why-zika-spreading-mosquitoes-love-ankles">love smelly feet</a>. Finally, it’s best to take some insect repellent with you. There may not be any available at your destination, and formulations on sale might not have been through the same thorough testing as products <a href="https://www.apvma.gov.au/">approved in Australia</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/233670/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, Clinical Associate Professor and Principal Hospital Scientist, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/heading-to-bali-or-somewhere-tropical-these-holidays-heres-what-you-need-to-know-about-dengue-fever-233670">original article</a>.

Travel Tips

How much do you need to know about how your spouse spends money? Maybe less than you think

<a href="https://theconversation.com/profiles/scott-rick-1534612">Scott Rick</a>, <a href="https://theconversation.com/institutions/university-of-michigan-1290">University of Michigan</a> Love is in the air, and wedding season is upon us. Like many elder millennials, I grew up watching sitcoms in the 1980s and ‘90s. Whenever those series needed a ratings boost, they would feature a wedding. Those special episodes taught me that weddings usually involve young lovebirds: think Elvin and Sondra from “The Cosby Show,” Cory and Topanga from “Boy Meets World,” or David and Darlene from “Roseanne.” But those were different times. People are getting married later in life than they used to: In the United States, <a href="https://www.census.gov/content/dam/Census/library/visualizations/time-series/demo/families-and-households/ms-2.pdf">the median age of newlyweds</a> has grown to 28 for women and 30 for men. This trend means that many Americans now enter marriage after being self-reliant for several years, including managing their own money. Will they be eager to change that once they get married? Don’t count on it. A 2017 <a href="https://bettermoneyhabits.bankofamerica.com/content/dam/bmh/pdf/ar6vnln9-boa-bmh-millennial-report-winter-2018-final2.pdf">Bank of America survey</a> suggests that millennial married couples are around 15 percentage points more likely than their predecessors to keep their finances separate. This is not necessarily a good development. As a behavioral scientist <a href="https://michiganross.umich.edu/faculty-research/faculty/scott-rick">who studies money and relationships</a>, I find that joint accounts <a href="https://doi.org/10.1093/jcr/ucad020">can bring partners closer</a>. There are some risks, however. Joint accounts create transparency, and intuitively, transparency feels like a good thing in relationships. But I argue that some privacy is important even for highly committed couples – <a href="https://us.macmillan.com/books/9781250280077/tightwadsandspendthrifts">and money is no exception</a>. <h2>The newlywed game</h2> Behavioral scientists <a href="https://kelley.iu.edu/faculty-research/faculty-directory/profile.html?id=jgolson">Jenny Olson</a>, <a href="https://som.yale.edu/faculty-research/faculty-directory/deborah-small">Deb Small</a>, <a href="https://www.kellogg.northwestern.edu/faculty/directory/finkel_eli.aspx">Eli Finkel</a> and I recently conducted <a href="https://academic.oup.com/jcr/article-abstract/50/4/704/7077142">an experiment with engaged and newlywed couples</a>. Each of the pairs had entirely separate accounts, but they were undecided about how they wanted to manage their money moving forward. We randomly assigned each of the 230 couples to one of three groups. One group kept their money in separate accounts; one merged their cash into a joint account and stopped using separate accounts; and one managed their money however they liked. We followed couples for two years, periodically asking them to complete surveys assessing their relationship dynamics and satisfaction. Our relationship quality measure included items such as “I cannot imagine another person making me as happy as my partner does” and “Within the last three months, I shouted or yelled at my partner.” Among the couples who could do whatever they wanted, most kept things separate. They and the couples assigned to keep separate accounts experienced a steady decline in relationship quality over time. This is a fairly typical pattern. For instance, in <a href="https://academic.oup.com/sf/article-abstract/79/4/1313/2234046">a large study that tracked U.S. couples’ marital happiness for 17 years</a>, <a href="https://www.unk.edu/academics/social-work/faculty_staff/van_laningham.php">sociologist Jody Van Laningham</a> and colleagues found that “marital happiness either declines continuously or flattens after a long period of decline.” Declines during the first two years of marriage are particularly important. Social scientist <a href="https://liberalarts.utexas.edu/prc/faculty/hustontl">Ted Huston</a> and colleagues call those first two years <a href="https://doi.org/10.1037/0022-3514.80.2.237">the “connubial crucible</a>.” They find that relationship dynamics that develop during that crucial period can foreshadow relationship quality for many years to come. Couples in our study who were prompted to take the plunge into a joint account, however, maintained their initial level of relationship satisfaction over the course of the two-year experiment. <h2>Tit-for-tat</h2> Our survey results suggest that, by turning “my money” and “your money” into “our money,” a joint account can help to reduce scorekeeping within a relationship. For example, we found that couples with joint accounts were more likely to agree with statements such as “When one person does something for the other, the other should not owe the giver anything.” Relationships usually don’t start with a scorekeeping orientation. In the 1980s and ‘90s, psychologist <a href="https://psychology.yale.edu/people/margaret-clark">Margaret Clark</a> and colleagues conducted experiments where partners had the option of keeping track of each other’s contributions to a shared task. <a href="https://clarkrelationshiplab.yale.edu/sites/default/files/files/Resource%20allocation%20in%20intimate%20relationships.pdf">They observed</a> that intimate relationships often begin with a “communal” orientation, where partners help one another without keeping careful track of who’s doing what. Eventually, however, they take on more of an “exchange” orientation – where inputs are tracked and timely reciprocity is expected. Couples that manage to stave off a tit-for-tat mindset <a href="https://doi.org/10.1177/0956797610373882">tend to be happier</a>. <h2>Too much of a good thing?</h2> The data from our experiment with young couples clearly suggests that using only a joint account is better than using only separate accounts. However, I argue in my new book, “<a href="https://us.macmillan.com/books/9781250280077/">Tightwads and Spendthrifts</a>,” that just a joint account is probably not optimal. When partners use only a joint account, they get an up-close-and-personal view of how the other person is spending money. This kind of transparency is <a href="https://www.businessinsider.com/money-habits-successful-married-couples-avoid-2016-11">normally viewed</a> as a good thing. Some commentators argue that a healthy marriage should have no secrets whatsoever. For example, Willard Harley, Jr., a clinical psychologist who primarily writes for Christian audiences, argues that you should “reveal to your spouse <a href="https://www.marriagebuilders.com/the-policy-of-radical-honesty.htm">as much information about yourself as you know</a>: your thoughts, feelings, habits, likes, dislikes, personal history, daily activities, and plans for the future.” In addition, if your goal is to minimize optional spending, <a href="https://doi.org/10.1002/jcpy.1083">research suggests</a> that the transparency that comes with a joint account can be helpful. We spend less when someone is looking over our shoulder. Still, there are reasons to believe that <a href="https://doi.org/10.1177/0265407500172005">complete transparency can be harmful for couples</a>. Many people have become convinced that if they could just stop buying lattes and avocado toast, they could invest that money and become rich. Unfortunately, the underlying math is highly dubious, as journalist Helaine Olen points out in <a href="https://www.penguinrandomhouse.com/books/308568/pound-foolish-by-helaine-olen/">her book “Pound Foolish</a>.” Still, many people view small indulgences as their primary obstacle to wealth. Complete transparency around these financially inconsequential “treats” <a href="https://slate.com/business/2021/09/partner-hates-retail-therapy-money-advice.html">can lead to unnecessary arguments</a>. Also, spouses may have different passions that their partner does not fully understand. Expenses that seem perfectly reasonable to another hobbyist may seem outrageous <a href="https://academic.oup.com/jcr/article-abstract/19/2/256/1929895">to someone without the proper context</a> – another source of <a href="https://www.sciencedirect.com/science/article/abs/pii/S2352250X21000750">avoidable disagreements</a>. <h2>'Translucent,’ not transparent</h2> I propose that many couples may benefit from a combination of joint and separate accounts. A joint account is essential for ensuring that both partners have immediate and equal access to “our money.” Ideally, all income would be direct-deposited into the joint account, which would help to blur the gap between partners’ earnings. Conspicuous income differences <a href="https://doi.org/10.1086/432228">can jeopardize relationship quality</a>. Separate accounts attached to the joint account can allow some privacy for individual purchases and help partners maintain a sense of autonomy and individuality. Each person gets to spend some of “our money” without their partner looking over their shoulder. Spouses would have a high-level understanding of how much their partner is spending per week or per month, but avoid the occasionally irritating details. This kind of partial financial transparency – <a href="https://us.macmillan.com/books/9781250280077/tightwadsandspendthrifts">what I call “financial translucency</a>” – could help couples strike the right balance between financial and psychological well-being. Of course, this approach requires a lot of trust. If the relationship is already on thin ice, complete financial transparency may be necessary. However, if the relationship is generally in the “good, but could be even better” category, I would argue that financial translucency is worth considering.<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/230070/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/scott-rick-1534612">Scott Rick</a>, Associate Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-michigan-1290">University of Michigan</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-do-you-need-to-know-about-how-your-spouse-spends-money-maybe-less-than-you-think-230070">original article</a>.

Money & Banking

What you need to know about protecting your children’s inheritance

For many people, ensuring that their children’s inheritance is protected is of paramount importance to them. There are a number of strategies that you can put in place to achieve this objective, you just need to determine which one bests suits you and your family’s circumstances. Put a Will in place By putting a Will in place, you get to decide who your assets go to, allowing you to make provision in your Will for them to pass to your children upon your death. If you do not have a Will in place then it is up to the government where your assets get paid and this may mean that your assets do not pass to your children, or do not pass to them in the manner that you desire. Play it safe and ensure things go the way you want them by taking the time to put a Will in place. Testamentary trust Let me introduce you to Testamentary Trusts. These amazing vehicles allow you to transfer your wealth to your children in the most asset protective and tax effective way possible. With an increasing number of marriages crumbling and divorce rates soaring, the last thing you want is your hard earned wealth passing to your child’s estranged partner in the event of one of your child’s marriage breakdown. By making provision in your Will leaving your children’s inheritance in a Testamentary Trust it protects their inheritance from any divorce or family law risks if your child’s relationship breaks down. Additionally, you may have a child who works in a high-risk occupation – a doctor, financial advisor or perhaps carrying on the role of a director. Alternatively, your child may be an entrepreneur, taking risks in their own business operations. If something adverse happened to your child whilst they were undertaking these roles and they were sued, they could be personally liable for them for any actions brought upon them by the aggrieved party. Creditors and other associated parties could only seek recourse to moneys owed by your child from them in their own personal capacity. If your child had received their inheritance in their own name, and hence the assets were now individual assets, the creditors and other associated parties would have recourse in recovering funds owed to them by your child. However, if your child’s inheritance was paid to a Testamentary Trust for their benefit at the time of your death then these assets would be held on trust for them and are not personal assets, hence the creditors and other associated parties would not have recourse in respect to these assets. Blended marriages If you have children from a previous marriage, it’s imperative that you obtain the appropriate legal advice in respect to how to protect your assets for your children. There are a number of options that you can put in place including a Binding Financial Agreement and a Mutual Wills Agreement. There are also strategies that you can put in place which ensure that your assets pass to your children upon your death. Options are also available where you may wish for your partner to receive some benefit of some of your assets during your lifetime with all assets passing to your children upon your partner’s death. Choose the right executor If you have young children, it will be your executor who looks after your children’s inheritance until your children reach the age that you have stipulated in your Will that you would like them to receive your assets. It is therefore imperative that you have the best person possible to undertake this role as you are effectively giving them the keys to everything that you own and control. That’s big. You need to appoint someone that you trust implicitly to undertake this role. You need to appoint your most trusted ally. Your executor also needs to be financial savvy or receptive to obtaining the appropriate financial advice to enable them to look after and grow your children’s inheritance. It is important that you seek the appropriate advice so that you can put the best strategies in place that protect your children’s inheritance in the best manner possible. There are a number of ways that you can protect your children’s inheritance, you just need to find the best one that works for you and your children. Melisa Sloan, author of Big Moments, expert advice for conquering those moments that define us, is a lawyer, industry leader, author and board director who loves helping people put in place beautiful legacies. For more information visit www.melisasloan.com.au Image credits: Shutterstock

Money & Banking

What is ‘breathwork’? And do I need to do it?

<a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/judy-pickard-831093">Judy Pickard</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> From “breathwork recipes” to breathing techniques, many <a href="https://www.instagram.com/p/C5WpkWxNrDI/">social media</a> and <a href="https://www.healthline.com/health/breathing-exercise">health websites</a> are recommending breathwork to reduce stress. But breathwork is not new. Rather it is the latest in a long history of breathing techniques such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336946/">Pranayama</a> from India and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312231/#:%7E:text=Qigong%2C%20on%20the%20other%20hand,one%20or%20two%20balancing%20poses.">qigong</a> from China. Such practices have been used for thousands of years to promote a healthy mind and body. The benefits can be immediate and obvious. Try taking a deep breath in through your nose and exhaling slowly. Do you feel a little calmer? So, what’s the difference between the breathing we do to keep us alive and breathwork? <h2>Breathwork is about control</h2> Breathwork is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873947/#bib3">not the same</a> as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">other mindfulness practices</a>. While the latter focus on observing the breath, breathwork is about <a href="https://www.nature.com/articles/s41598-022-27247-y">controlling inhalation and exhalation</a>. Normally, breathing happens automatically via messages from the brain, outside our conscious control. But we can control our breath, by directing the movement of our diaphragm and mouth. <a href="https://www.medicalnewstoday.com/articles/diaphragmatic-breathing">The diaphragm</a> is a large muscle that separates our thoracic (chest) and abdominal (belly) cavities. When the diaphragm contracts, it expands the thoracic cavity and pulls air into the lungs. Controlling how deep, how often, how fast and through what (nose or mouth) we inhale is the crux of breathwork, from <a href="https://www.healthline.com/health/breath-of-fire-yoga">fire breathing</a> to the <a href="https://www.headspace.com/content/meditation/humming-bee-breath/9422">humming bee breath</a>. <h2>Breathwork can calm or excite</h2> Even small bits of breathwork can have physical and mental health benefits and <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">complete the stress cycle</a> to avoid burnout. Calming breathwork includes diaphragmatic (belly) breathing, slow breathing, pausing between breaths, and specifically slowing down the exhale. In diaphragmatic breathing, you consciously contract your diaphragm down into your abdomen to inhale. This pushes your belly outwards and makes your breathing deeper and slower. You can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3681046/">slow the breath</a> by doing: <ul> <li> <a href="https://www.medicalnewstoday.com/articles/321805">box breathing</a> (count to four for each of four steps: breathe in, hold, breathe out, hold), or </li> <li> <a href="https://pubmed.ncbi.nlm.nih.gov/38092805/">coherent breathing</a> (controlled slow breathing of five or six breaths per minute), or </li> <li> <a href="https://www.healthline.com/health/alternate-nostril-breathing#benefits">alternate nostril breathing</a> (close the left nostril and breathe in slowly through the right nostril, then close the right nostril and breathe out slowly through the left nostril, then repeat the opposite way). </li> </ul> You can slow down the exhalation specifically by counting, humming or pursing your lips as you breathe out. In contrast to these calming breathing practices, energising fast-paced breathwork increases arousal. For example, <a href="https://www.webmd.com/balance/what-is-breath-of-fire-yoga">fire breathing</a> (breathe in and out quickly, but not deeply, through your nose in a consistent rhythm) and <a href="https://www.healthline.com/health/breathing-exercise#breath-focus">Lion’s breath</a> (breathe out through your mouth, stick your tongue out and make a strong “haa” sound). <h2>What is happening in the body?</h2> Deep and slow breathing, especially with a long exhale, is the best way to <a href="https://theconversation.com/our-vagus-nerves-help-us-rest-digest-and-restore-can-you-really-reset-them-to-feel-better-210469">stimulate the vagus nerves</a>. The vagus nerves pass through the diaphragm and are the main nerves of the parasympathetic nervous system. Simulating the vagus nerves calms our sympathetic nervous system (fight or flight) stress response. This improves mood, lowers the stress hormone <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/">cortisol</a> and helps to regulate emotions and responses. It also promotes more <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/">coordinated brain activity</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6189422/">improves immune function and reduces inflammation</a>. Taking deep, diaphragmatic breaths also has <a href="https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing">physical benefits</a>. This improves blood flow, lung function and exercise performance, increases oxygen in the body, and strengthens the diaphragm. <a href="https://link.springer.com/article/10.1007/s12671-023-02294-2#:%7E:text=Accumulating%20evidence%20supports%20the%20efficacy,et%20al.%2C%202001">Slow breathing</a> reduces heart rate and blood pressure and increases heart rate variability (normal variation in <a href="https://www.health.harvard.edu/blog/heart-rate-variability-new-way-track-well-2017112212789">time between heart beats</a>). These are linked to better heart health. Taking shallow, quick, rhythmic breaths in and out through your nose stimulates the sympathetic nervous system. Short-term, controlled activation of the stress response is healthy and <a href="https://pubmed.ncbi.nlm.nih.gov/36624160/">develops resilience to stress</a>. <h2>Breathing in through the nose</h2> We are designed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986941/">inhale through our nose</a>, not our mouth. Inside our nose are lots of <a href="https://www.ncbi.nlm.nih.gov/books/NBK544232/">blood vessels, mucous glands and tiny hairs called cilia</a>. These warm and humidify the air we breathe and filter out germs and toxins. We want the air that reaches our airways and lungs to be clean and moist. Cold and dry air is irritating to our nose and throat, and we don’t want germs to get into the body. <a href="https://journals.physiology.org/doi/full/10.1152/ajpregu.00148.2023?utm_source=AJPRegu&utm_medium=PressRelease&utm_campaign=1.17.2024">Nasal breathing</a> increases parasympathetic activity and releases nitric oxide, which improves airway dilation and lowers blood pressure. Consistently breathing through our mouth <a href="https://www.sciencefocus.com/the-human-body/mouth-breathing">is not healthy</a>. It can lead to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455204/">pollutants</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967998/#:%7E:text=Hence%2C%20we%20sought%20to%20synthesize,barriers%20to%20long%2Dterm%20enjoyment.">infections</a> reaching the lungs, snoring, sleep apnoea, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986941/">dental issues</a> including cavities and jaw joint problems. <h2>A free workout</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/">Slow breathing</a> – even short sessions at home – can reduce stress, anxiety and depression in the general population and among those with clinical depression or anxiety. Research on breathwork in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309518/">helping post-traumatic stress disorder</a> (PTSD) is also promising. Diaphragmatic breathing to improve lung function and strengthen the diaphragm can improve breathing and exercise intolerance in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9690833/">chronic heart failure</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/33076360/">chronic obstructive pulmonary disease</a> and <a href="https://www.medicalnewstoday.com/articles/diaphragmatic-breathing#conditions-it-can-help-with">asthma</a>. It can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967998/#:%7E:text=Hence%2C%20we%20sought%20to%20synthesize,barriers%20to%20long%2Dterm%20enjoyment.">improve exercise performance</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/19875429/">reduce oxidative stress</a> (an imbalance of more free radicals and/or less antioxidants, which can damage cells) after exercise. <h2>A mind-body connection you can access any time</h2> If you feel stressed or anxious, you might subconsciously <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/breathing-to-reduce-stress">take shallow, quick breaths</a>, but this can make you feel more anxious. Deep diaphragmatic breaths through your nose and focusing on strong exhalations can help break this cycle and bring calm and mental clarity. Just <a href="https://www.nature.com/articles/s41598-022-27247-y">a few minutes a day</a> of breathwork can improve your physical and mental health and wellbeing. Daily deep breathing exercises <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1040091/full">in the workplace</a> reduce blood pressure and stress, which is important since <a href="https://theconversation.com/what-is-burnout-and-how-to-prevent-it-in-the-workplace-insights-from-a-clinical-psychologist-196578">burnout rates are high</a>. Bottom line: any conscious control of your breath throughout the day is positive. So, next time you are waiting in a line, at traffic lights or for the kettle to boil, take a moment to focus on your breath. Breathe deeply into your belly through your nose, exhale slowly, and enjoy the benefits.<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/231192/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/theresa-larkin-952095">Theresa Larkin</a>, Associate professor of Medical Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/judy-pickard-831093">Judy Pickard</a>, Senior Lecturer, Clinical Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-breathwork-and-do-i-need-to-do-it-231192">original article</a>.

Body

I’ve been given opioids after surgery to take at home. What do I need to know?

<a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a> Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home. These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence. However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery. <h2>Which types of opioids are most common?</h2> The <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">most commonly prescribed</a> opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia). In fact, <a href="https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.16063">about half</a> of new oxycodone prescriptions in Australia occur after a recent hospital visit. <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">Most commonly</a>, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain. Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels. Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box. Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery. Controlling your pain after surgery is <a href="https://www.nps.org.au/assets/4811a27845042173-00a4ff09097b-postoperative-pain-management_36-202.pdf">important</a>. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots. Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover. <h2>But there are also risks</h2> As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over. Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use. But up to <a href="https://pubmed.ncbi.nlm.nih.gov/35545810/">one in ten</a> Australians still take them up to four months after surgery. <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/msc.1837">One study</a> found people didn’t know how to safely stop taking opioids. Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect. Dependency and side effects are also more common with <a href="https://www.anzca.edu.au/getattachment/535097e6-9f50-4d09-bd7f-ffa8faf02cdd/Prescribing-slow-release-opioids-4-april-2018#:%7E:text=%E2%80%9CSlow%2Drelease%20opioids%20are%20not,its%20Faculty%20of%20Pain%20Medicine.">slow-release opioids</a> than immediate-release opioids. This is because people are usually on slow-release opioids for longer. Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed <a href="https://journals.sagepub.com/doi/full/10.1177/0310057X231163890">more than twice</a> the amount they needed. This results in unused opioids at home, which <a href="https://www.anzca.edu.au/getattachment/558316c5-ea93-457c-b51f-d57556b0ffa7/PS41-Guideline-on-acute-pain-management">can be dangerous</a> to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision. <h2>How to mimimise the risks</h2> Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac). These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed. Other techniques to manage pain include physiotherapy, exercise, <a href="https://theconversation.com/hot-pack-or-cold-pack-which-one-to-reach-for-when-youre-injured-or-in-pain-161086">heat packs or ice packs</a>. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most. However, if you do need opioids, there are some ways to make sure you use them <a href="https://www.safetyandquality.gov.au/sites/default/files/2022-04/opioid-analgesic-stewardship-in-acute-pain-clinical-care-standard.pdf">safely and effectively</a>: <ul> <li> ask for <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16085">immediate-release</a> rather than slow-release opioids to lower your risk of side effects </li> <li> do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing </li> <li> as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen </li> <li> before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time. </li> </ul> <h2>If you’re concerned about side effects</h2> If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include: <ul> <li> <a href="https://theconversation.com/health-check-what-causes-constipation-114290">constipation</a> – your pharmacist will be able to give you lifestyle advice and recommend laxatives </li> <li> drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor </li> <li> weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately. </li> </ul> <h2>If you’re having trouble stopping opioids</h2> Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose. You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these. <h2>How about leftover opioids?</h2> After you have finished using opioids, take any leftovers to your local pharmacy to <a href="https://theconversation.com/health-check-what-should-you-do-with-your-unused-medicine-81406">dispose of them safely</a>, free of charge. Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children. <hr /> For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has <a href="https://www.choosingwisely.org.au/resources/consumers-and-carers/patient-guide-to-managing-pain-and-opioid-medicines">free online information</a> about managing pain and opioid medicines.<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/228615/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/katelyn-jauregui-1527878">Katelyn Jauregui</a>, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/asad-patanwala-1529611">Asad Patanwala</a>, Professor, Sydney School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/jonathan-penm-404921">Jonathan Penm</a>, Senior lecturer, School of Pharmacy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/shania-liu-1433659">Shania Liu</a>, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, <a href="https://theconversation.com/institutions/university-of-alberta-1232">University of Alberta</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ive-been-given-opioids-after-surgery-to-take-at-home-what-do-i-need-to-know-228615">original article</a>.

Body

The hidden risks of buy now, pay later: What shoppers need to know

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/vivek-astvansh-1318943">Vivek Astvansh</a>, <a href="https://theconversation.com/institutions/mcgill-university-827">McGill University</a> and <a href="https://theconversation.com/profiles/chandan-kumar-behera-1479139">Chandan Kumar Behera</a>, <a href="https://theconversation.com/institutions/indian-institute-of-management-lucknow-6023">Indian Institute of Management Lucknow</a> <iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" src="https://narrations.ad-auris.com/widget/the-conversation-canada/the-hidden-risks-of-buy-now-pay-later-what-shoppers-need-to-know" width="100%" height="400"></iframe> <a href="https://www.canada.ca/en/financial-consumer-agency/services/loans/buy-now-pay-later.html">Buy now, pay later</a> is a relatively new form of financial technology that allows consumers to purchase an item immediately and repay the balance at a later time in instalments. Unlike applying for a credit card, buy now, pay later <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4591446">doesn’t require a credit check</a>. Instead, <a href="https://doi.org/10.1108/EJM-11-2021-0923">these programs use algorithms</a> to perform <a href="https://www.investopedia.com/terms/s/soft-inquiry.asp">“soft” credit checks</a> to determine <a href="https://theconversation.com/if-it-looks-like-debt-lets-treat-it-like-debt-buy-now-pay-later-schemes-need-firmer-regulation-in-nz-211820">a shopper’s eligibility</a>. This means buy now, pay later loans target <a href="https://www.theguardian.com/money/2022/jan/27/buy-now-pay-later-schemes-entice-consumers-spend-more">low-income, tech-savvy</a> <a href="https://www.cnbc.com/2022/10/27/gen-z-and-millennials-prefer-buy-now-pay-later-services.html">millennials and Gen Z shoppers</a> in an effort to <a href="https://libertystreeteconomics.newyorkfed.org/2023/09/who-uses-buy-now-pay-later/">supposedly improve financial inclusion</a> for these groups. However, the newness of buy now, pay later programs means existing <a href="https://doi.org/10.1111/acfi.13100">consumer credit laws don’t cover it</a>. This lack of regulation puts shoppers at financial risk of accumulating higher levels of debt. <h2>Credit cards versus buy now, pay later</h2> There are three key differences between credit cards and buy now, pay later loans. First, while buy now, pay later loans are a line of credit like credit cards are, <a href="https://www.cnbc.com/2022/05/04/klarna-to-report-buy-now-pay-later-data-to-uk-credit-bureaus.html">they don’t impact credit reports</a>. Because of this, shoppers might be less cautious when using buy now, pay later services. Credit cards typically have annual interest rates ranging from <a href="https://www.bankrate.com/finance/credit-cards/what-is-credit-card-apr/#credit-card-apr-vs-credit-card-interest">15 to 26 per cent</a>. While most buy now, pay later loans have no interest, longer term loans have <a href="https://www.cbsnews.com/news/buy-now-pay-later-loans-interest-rate-fees-tips-what-to-know/">annual interest rates of about 37 per cent</a>. Shoppers are <a href="https://hbswk.hbs.edu/item/buy-now-pay-later-how-retails-hot-feature-hurts-lower-income-shoppers">at risk of overusing buy now, pay later programs</a> and accumulating more debt than they can manage. In addition, formal lenders, such as banks, currently have no way of knowing what buy now, pay later debt a person is carrying. The lender, therefore, likely incurs more risk than they are aware of. Second, credit cards typically provide <a href="https://doi.org/10.1080/1369118X.2022.2161830">an interest-free period</a>, after which <a href="https://doi.org/10.1177/03128962211032448">borrowers must pay interest</a>. In contrast, buy now, pay later users typically don’t have interest fees, but can incur <a href="https://doi.org/10.1108/IJBM-07-2022-0324">late fees for missed or late payments</a>. Falling behind on payment terms <a href="https://www.forbes.com/sites/andriacheng/2020/12/16/why-retailers-are-embracing-buy-now-pay-later-service-this-holiday-season/">can result in charges</a> that exceed <a href="https://stateline.org/2022/02/02/regulators-scrutinize-buy-now-pay-later-plans/">typical credit card interest rates</a>, causing more harm than interest payments. Low-income buy now, pay later users are <a href="https://hbswk.hbs.edu/item/buy-now-pay-later-how-retails-hot-feature-hurts-lower-income-shoppers">particularly vulnerable</a> to <a href="https://www.consumerfinance.gov/data-research/research-reports/consumer-use-of-buy-now-pay-later-insights-from-the-cfpb-making-ends-meet-survey/">using overdrafts to cover their buy now, pay later payments</a>. Third, people typically have just a few credit cards, making it easier to keep track of payments. Buy now, pay later users, on the other hand, usually engage with multiple buy now, pay later lenders through retailers. As a result, it’s difficult for them to keep track of all the buy now, pay later lenders and retailers they made purchases from. <h2>What are the Canadian governments doing?</h2> Canada classifies buy now, pay later as an unsecured instalment loan, which means lenders are subject to laws at the federal and provincial levels. Under federal law, there is an <a href="https://www.sec.gov/Archives/edgar/data/1711291/000171129122000011/curo-20211231.htm">annual interest rate cap of 60 per cent</a>. Provincial laws require buy now, pay later lenders to disclose the cost of credit and extend consumer protection rights to buy now, pay later shoppers. At the provincial level, <a href="https://www.canada.ca/en/financial-consumer-agency/services/loans/buy-now-pay-later.html">specific laws come into play</a>. Manitoba, Alberta, Québec, and Ontario have passed laws that require lenders to be licensed before they offer these products and be subject to regulatory oversight. These laws regulate high-cost credit products that have annual rates of 32 per cent or higher. This means buy now, pay later services should fall under this category. However, I found no evidence of buy now, pay later lenders being licensed in Canada. This means either lenders are not aware they fall under these laws, or no one is enforcing them. This ambiguity over whether or not buy now, pay later lenders are subject to regulatory oversight could be a hindrance for banks like the <a href="https://financialpost.com/fp-finance/fintech/why-higher-interest-rates-threaten-the-buy-now-pay-later-bubble">Bank of Nova Scotia and the Canadian Imperial Bank of Commerce</a>, as it deters them from entering the buy now, pay later market despite its profitability. <h2>Questions to ask before using buy now, pay later</h2> Before signing up for a buy now, pay later loan, shoppers should consider the following six questions. 1. Payment structure. How much of the invoice amount needs to be paid upfront? The norm is typically 25 per cent. What is the number of remaining instalments? The answer to this is usually four. Lastly, what is the frequency of instalments? The norm is biweekly. 2. Sensitive information. Does the lender require you to provide information about your chequing account? This is sensitive information to give away and puts you at risk of data breaches. Most buy now, pay later lenders withdraw instalment amounts from chequing accounts or debit cards, potentially exposing shoppers to greater risks than credit cards. 3. Interest charges Does the buy now, pay later lender charge interest on instalment payments? The norm is no. 4. Late fees How much is the late fee, when does it apply and what is the maximum amount of the late fee? Typically, late fees don’t exceed $8 or one-quarter of the invoice amount. Late fees usually kick in if your scheduled payment remains unpaid after 10 days. 5. Data responsibility. Who is responsible for your data? Whether it’s the retailer, the buy now, pay later lender or a company whose cloud storage the provider may be using, you should know. In general, the buy now, pay later lender holds this responsibility. 6. Licensing. Is the buy now, pay later lender licensed to sell the loan? Usually, the <a href="https://dfpi.ca.gov/wp-content/uploads/sites/337/2020/03/afterpay-settlement.pdf">answer to this question is no</a>. <h2>Buy now, pay later regulation</h2> Two sets of laws and regulations should be implemented to address some of these issues. The first set of regulations focuses on how buy now, pay later lenders interact with consumers. These lenders should clearly communicate <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4359956">all terms and conditions of their loans</a>, including late charges, interest charges and payment schedules, on their platforms to ensure shoppers are fully informed of their financial obligations. The Financial Conduct Authority in the United Kingdom recently issued guidelines allowing buy now, pay later lenders to <a href="https://www.ft.com/content/ca428bc8-65c3-49ed-8ba6-0d6f206098aa">terminate, suspend or restrict access to shopper accounts</a> for any reason without notice. Effective September 2024, New Zealand will require buy now, pay later lenders to <a href="https://theconversation.com/if-it-looks-like-debt-lets-treat-it-like-debt-buy-now-pay-later-schemes-need-firmer-regulation-in-nz-211820">check a shopper’s credit</a> before providing them a buy now, pay later loan. The second set of regulations defines the scope and boundaries of buy now, pay later lenders. On Dec. 9, 2022, California became the first American state to <a href="https://dfpi.ca.gov/2022/12/09/buy-now-pay-later-protect-yourself-before-you-check-out/">classify buy now, pay later as a loan</a>. Such classifications allowed California regulators to <a href="https://stateline.org/2022/02/02/regulators-scrutinize-buy-now-pay-later-plans/">question lenders about their transparency in disclosing the terms of their offerings</a>. The hope is that these laws and regulations will facilitate microlending and not impede the existence of buy now, pay later services, but rather make it safer and more secure for both lenders and users.<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/215421/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/vivek-astvansh-1318943">Vivek Astvansh</a>, Associate Professor of Quantitative Marketing and Analytics, <a href="https://theconversation.com/institutions/mcgill-university-827">McGill University</a> and <a href="https://theconversation.com/profiles/chandan-kumar-behera-1479139">Chandan Kumar Behera</a>, PhD Student in Marketing, <a href="https://theconversation.com/institutions/indian-institute-of-management-lucknow-6023">Indian Institute of Management Lucknow</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-hidden-risks-of-buy-now-pay-later-what-shoppers-need-to-know-215421">original article</a>. </div>

Money & Banking

Everything you need to know about tipping in the US

There are few social customs in the US more confusing to travellers than tipping. To most Americans, gratuities are normal, like adding sales tax at the register. To foreign visitors, though, the very idea can induce anxiety or panic. We're notoriously poor tippers. Partly this is accidental ignorance, but partly it is self-righteous rejection of an institution many of us see as unfair. I once had a meal in New York with a woman from Brisbane who refused to tip "on principle." I nodded in agreement ... and then tipped for both of us. The truth is, federal minimum wage for adults in the US is just US$7.25 an hour. In industries where tipping is routine, employers are legally allowed to pay wages as low as US$2.13 an hour. So while travellers may stage a quiet rebellion, refusing to tip, the bereaved party is never going to be the restaurant owners (who earns their profit through the itemised bill), but the poor waiters. Until the US government raises minimum wages to Australian levels (something that will probably never happen), tipping is here to stay. Which means travellers need to accept it, then learn the rules. First rule: After clearing immigration get your hands on a stack of "singles" (US$1 bills). You're going to need them. Getting around In theory, tips should only go to people who are helpful; the more helpful, the more bountiful their reward. In reality, tips are par for the course, and to "stiff" somebody is tantamount to slapping them in the face. If a airport porter helps you with your bags, give them US$1-2 per bag. If they meet you at the gate with a wheelchair, give them US$3-5. For most travellers, the first real test comes with transports away from the airport. If you're lucky enough to have a hotel worker collect you from Arrivals, give them US$10-15 for the effort. If you take a taxi, a little more thought will be required. Many taxis now have seat-back displays that offer "default tipping" amounts at the end of a journey: in New York, 20, 25, and 30 per cent. You should only really tip 30 per cent if the taxi turns out to be the Batmobile, getting you to your destination in record time. Even 20 per cent can sometimes feels a little high. Tipping is subjective: I often manually override the default, leaving 15-20 per cent, or a few extra dollars if I'm paying in cash. If you hire a car and take advantage of valet (all but mandatory in Los Angeles), be prepared to tip the worker US$3-5 upon pick-up, depending on how ritzy the establishment is. A quick rule of thumb: more ritz equals more tip. Hotels If you arrive at the hotel and somebody opens the door for you, that's on the house. If they carry your bags, that is not on the house. Give them US$2-3 a bag. If the hotel has a concierge, their friendliness isn't contingent on your generosity. But if they perform a service for you - book a trip, hire a car, charter a private jet to the Bahamas - acknowledge this effort with US$10-20 at the end of your stay, presented with a handshake. One case where tipping can have a direct impact on the quality of service you receive is housekeeping. Each morning, leave US$2-5 on your pillow with a thank you note. This ensures different cleaners get their due, and it also means cleaners will be extra diligent for the rest of your stay. If you think this is a little rich, keep in mind that these people are picking up your dirty towels, so spare change for a cup of coffee is the least you can do. One point of confusion with hotel tipping is the in-room dining. Some hotels include a default tip on their dining bills; some include a "service charge," which goes to the hotel, and should not be treated as a tip. If there's no obvious tip included on the bill, slip the server 15-20 per cent when they knock on your door. Dining and drinking Nobody can force you to tip in a restaurant, though they can try to counteract your miserliness by stating on the menu that tips are automatically added to the final charge. This is increasingly common in areas catering to large numbers of foreign travellers; it's also pretty standard when your table has more than six people. If tips have been added by the time you come to hand over your card, no further gratuity is needed. If no tip has been included, you might need to leave some money on the table. How much exactly depends on what kind of table it is. If it is a fast food table, no tip. If it is a table at a restaurant ranging from modest diner to upmarket eatery, 15-20 per cent for the waiter is standard (err on the high side in major cities like New York and San Francisco). If you leave less than 15 per cent, staff will assume you weren't happy with their service. If you leave two pennies on top of the bill - a code - they will know you were very unhappy, and feel bad even as they silently loathe you for being a Scrooge. It is almost never okay to withhold a tip; if you're considering doing that, you should also be considering complaining to the manager. If it is a very fancy restaurant, perhaps one with Michelin stars, prepare to hand over 25 per cent of the bill (before tax) to the waiter, who will divide it up among his or her support staff. You should also tip the sommelier if they suggest wine, and perhaps the maitre'd, if they gave you a fabulous table. Always, without exception, tip a bartender a dollar for every drink; bigger tips can mean stronger second cocktails in my experience. As for coffee shops, despite the increasing prevalence of tip jars, and "suggested tips" when paying with a card, this is cheekiness and should only be taken seriously if the barista goes out of their way, like the man who once drew Darth Vader in my cappuccino crema. Everything else This guide covers the most common situations a traveller will have to contend when in the US, though the list is not exhaustive. For example, do you tip a massage therapist? Yes, 10-20 per cent. A hairdresser? Same. Tour guide or hiking leader? 15-20 per cent of the total charge, depending on their performance. That Elvis impersonator who officiated your wedding in a Las Vegas chapel? Same. Tip anyone, in fact, that provides you with a service: 15 per cent is a good default to keep in mind. Just remember, nobody is affronted by the offer of a gratuity, so you shouldn't feel bashful about giving one. Written by Lance Richardson. First appeared on <a href="http://Stuff.co.nz" target="_blank" rel="noopener">Stuff.co.nz</a>. Image credits: Shutterstock

International Travel

Yes, adults can develop food allergies. Here are 4 types you need to know about

<a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> If you didn’t have food allergies as a child, is it possible to develop them as an adult? The short answer is yes. But the reasons why are much more complicated. Preschoolers are about <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">four times more likely to have a food allergy</a> than adults and are more likely to grow out of it as they get older. It’s hard to get accurate figures on adult food allergy prevalence. The Australian National Allergy Council reports <a href="https://nationalallergycouncil.org.au/about-us/our-strategy">one in 50 adults</a> have food allergies. But a US survey suggested as many as <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">one in ten adults</a> were allergic to at least one food, with some developing allergies in adulthood. <h2>What is a food allergy</h2> <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">Food allergies</a> are immune reactions involving <a href="https://www.aaaai.org/tools-for-the-public/allergy,-asthma-immunology-glossary/immunoglobulin-e-(ige)-defined">immunoglobulin E (IgE)</a> – an antibody that’s central to triggering allergic responses. These are known as “IgE-mediated food allergies”. Food allergy symptoms that are not mediated by IgE are usually delayed reactions and called <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">food intolerances or hypersensitivity</a>. Food allergy symptoms can include hives, swelling, difficulty swallowing, vomiting, throat or chest tightening, trouble breathing, chest pain, rapid heart rate, dizziness, low blood pressure or <a href="https://www.allergy.org.au/hp/papers/acute-management-of-anaphylaxis-guidelines?highlight=WyJhbmFwaHlsYXhpcyJd">anaphylaxis</a>. IgE-mediated food allergies can be life threatening, so all adults need an <a href="https://allergyfacts.org.au/allergy-management/newly-diagnosed/action-plan-essentials">action management plan</a> developed in consultation with their medical team. Here are four IgE-mediated food allergies that can occur in adults – from relatively common ones to rare allergies you’ve probably never heard of. <h2>1. Single food allergies</h2> The most <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">common IgE-mediated food allergies</a> in adults in a US survey were to: <ul> <li>shellfish (2.9%)</li> <li>cow’s milk (1.9%)</li> <li>peanut (1.8%)</li> <li>tree nuts (1.2%)</li> <li>fin fish (0.9%) like barramundi, snapper, salmon, cod and perch.</li> </ul> In these adults, about 45% reported reacting to multiple foods. This compares to <a href="https://pubmed.ncbi.nlm.nih.gov/25316115/">most common childhood food allergies</a>: cow’s milk, egg, peanut and soy. Overall, adult food allergy prevalence appears to be increasing. Compared to <a href="https://pubmed.ncbi.nlm.nih.gov/14657884/">older surveys published in 2003</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/15241360/">2004</a>, peanut allergy prevalence has increased about three-fold (from 0.6%), while tree nuts and fin fish roughly doubled (from 0.5% each), with shellfish similar (2.5%). While new <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">adult-onset food allergies are increasing</a>, childhood-onset food allergies are also more likely to be retained into adulthood. Possible reasons for both <a href="https://pubmed.ncbi.nlm.nih.gov/38214821/">include</a> low vitamin D status, lack of immune system challenges due to being overly “clean”, heightened sensitisation due to allergen avoidance, and more frequent antibiotic use. <h2>2. Tick-meat allergy</h2> Tick-meat allergy, also called α-Gal syndrome or mammalian meat allergy, is an allergic reaction to galactose-alpha-1,3-galactose, or α-Gal for short. <a href="https://pubmed.ncbi.nlm.nih.gov/33529984/">Australian immunologists first reported</a> links between α-Gal syndrome and tick bites in 2009, with cases also reported in the United States, Japan, Europe and South Africa. The <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">US Centers for Disease Control estimates</a> about 450,000 Americans <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a2.htm">could be affected</a>. The α-Gal contains a carbohydrate molecule that is bound to a <a href="https://pubmed.ncbi.nlm.nih.gov/38318181/">protein</a> molecule in <a href="https://alphagalinformation.org/what-is-a-mammal/">mammals</a>. The IgE-mediated allergy is triggered after repeated bites from ticks or <a href="https://www.insectshield.com/pages/chiggers">chigger mites</a> that have bitten those mammals. When tick saliva crosses into your body through the bite, antibodies to α-Gal are produced. When you subsequently eat foods that contain α-Gal, the allergy is triggered. These triggering foods include meat (lamb, beef, pork, rabbit, kangaroo), dairy products (yoghurt, cheese, ice-cream, cream), <a href="https://en.wikipedia.org/wiki/Gelatin">animal-origin gelatin</a> added to gummy foods (jelly, lollies, marshmallow), prescription medications and over-the counter supplements containing gelatin (<a href="https://www.drugs.com/inactive/gelatin-57.html">some antibiotics, vitamins and other supplements</a>). Tick-meat allergy reactions can be hard to recognise because they’re usually delayed, and they can be severe and include anaphylaxis. Allergy <a href="https://www.allergy.org.au/patients/food-allergy/mammalian-meat-tick-faq">organisations produce management guidelines</a>, so always discuss management with your doctor. <h2>3. Fruit-pollen allergy</h2> Fruit-pollen allergy, called pollen food allergy syndrome, is an <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">IgE-mediated allergic reaction</a>. In susceptible adults, pollen in the air provokes the production of IgE antibodies to antigens in the pollen, but these antigens are similar to ones found in some fruits, vegetables and herbs. The problem is that <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">eating those plants</a> triggers an allergic reaction. The <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">most allergenic tree pollens</a> are from birch, cypress, Japanese cedar, <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/latex-allergy">latex</a>, grass, and ragweed. Their pollen can cross-react with <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">fruit and vegetables</a>, including kiwi, banana, mango, avocado, grapes, celery, carrot and potato, and some herbs such as caraway, coriander, fennel, pepper and paprika. Fruit-pollen allergy is not common. Prevalence <a href="https://pubmed.ncbi.nlm.nih.gov/38002141/">estimates are between 0.03% and 8%</a> depending on the country, but it can be life-threatening. Reactions range from itching or tingling of lips, mouth, tongue and throat, called <a href="https://pubmed.ncbi.nlm.nih.gov/20306812/">oral allergy syndrome</a>, to mild <a href="https://www.allergy.org.au/patients/skin-allergy/urticaria-hives">hives</a>, to anaphylaxis. <h2>4. Food-dependent, exercise-induced food allergy</h2> During heavy exercise, the stomach produces less acid than usual and gut permeability increases, meaning that small molecules in your gut are more likely to escape across the membrane into your blood. These include food molecules that trigger an IgE reaction. If the person already has IgE antibodies to the foods eaten before exercise, then the risk of triggering food allergy reactions is increased. This allergy is called <a href="https://pubmed.ncbi.nlm.nih.gov/37893663/">food-dependent exercise-induced allergy</a>, with symptoms ranging from hives and swelling, to difficulty breathing and anaphylaxis. <a href="https://pubmed.ncbi.nlm.nih.gov/30601082/">Common trigger foods include</a> wheat, seafood, meat, poultry, egg, milk, nuts, grapes, celery and other foods, which could have been eaten many hours before exercising. To complicate things even further, allergic <a href="https://pubmed.ncbi.nlm.nih.gov/33181008/">reactions can</a> occur at lower levels of trigger-food exposure, and be more severe if the person is simultaneously taking non-steroidal inflammatory medications like aspirin, drinking alcohol or is sleep-deprived. Food-dependent exercise-induced allergy is extremely rare. Surveys have estimated prevalence as between <a href="https://www.sciencedirect.com/science/article/pii/S1555415517300259">one to 17 cases per 1,000 people worldwide</a> with the highest prevalence between the teenage years to age 35. Those affected often have other allergic conditions such as hay fever, asthma, allergic conjunctivitis and dermatitis. <h2>Allergies are a growing burden</h2> The <a href="https://pubmed.ncbi.nlm.nih.gov/36509408/">burden on physical health, psychological health</a> and health costs due to food allergy is increasing. In the US, this <a href="https://pubmed.ncbi.nlm.nih.gov/38393624/">financial burden was estimated as $24 billion per year</a>. Adult food allergy needs to be taken seriously and those with severe symptoms should wear a medical information bracelet or chain and carry an <a href="https://www.healthdirect.gov.au/how-to-use-an-adrenaline-autoinjector-epipen-anapen">adrenaline auto-injector pen</a>. Concerningly, surveys suggest only <a href="https://pubmed.ncbi.nlm.nih.gov/30646188/">about one in four adults</a> with food allergy have an adrenaline pen. If you have an IgE-mediated food allergy, discuss your management plan with your doctor. You can also find more information at <a href="https://allergyfacts.org.au/">Allergy and Anaphylaxis Australia</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/223342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-adults-can-develop-food-allergies-here-are-4-types-you-need-to-know-about-223342">original article</a>.

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