Living Forever


What time of day should I take my medicine?



Does it matter if you take your medicine morning, noon or night? That depends on a number of factors.
from Kat Ka/www.shutterstock.com

Nial Wheate, University of Sydney and Andrew Bartlett, University of Sydney

Whether you need to take a drug at a specific time of day depends on the medication and the condition you are treating. For some medicines, it doesn’t matter what time you take it. And for others, the pharmacist may recommend you take it at the same time each day.

But we estimate that for around 30% of all medicines, the time of day you take it does matter. And a recent study shows blood pressure medications are more effective if you take them at night.

So, how do you know if the timing of your medication is critical?




Read more:
Health Check: what should you do with your unused medicine?


When timing doesn’t matter

In most cases, it’s not important when you take your medicine. For instance, you can take non-drowsy antihistamines for hay fever, or analgesics for pain when you need them. It doesn’t matter if it is morning, noon or night.

What is more important is the time interval between each dose. For instance, paracetamol needs to be taken at least four hours apart, any closer and you run the risk of taking a toxic dose.




Read more:
Australia has a paracetamol poisoning problem. This is what we should be doing to reduce harm


Even when a medication doesn’t need to be taken at a particular time, the pharmacist may still recommend you take it at the same time every day anyway.

This daily pattern helps remind you to take it. An example is taking the oral contraceptive at the same time each day, simply out of habit.

For the mini pill, taking it at the same time is actually necessary. But the actual time of day can be whatever works best for you.

When does it matter?

It may seem fairly obvious to take some medicines at particular times. For example, it makes sense to taking sleeping medications, such as temazepam, at night before you go to bed.

Some antidepressants, such as amitryptyline or mirtazapine, have drowsy side effects. So it also makes sense to take them at night.

For other medicines, taking them in the morning is more logical. This is true for diuretics, such as furosemide, which helps you get rid of excess fluid via your urine; you don’t want to be getting up in the night for this.

When a medicine needs to be taken at a specific time, this will be indicated on the box.
Author provided

For other medications, it’s not obvious why they have to be taken at a particular time of day. To understand why, we have to understand our circadian rhythm, our own internal body clock. Some systems in our body work at different times of day within that rhythm.

For instance, the enzymes controlling cholesterol production in your liver are most active at night. So there may be some benefit to taking lipid (cholesterol) lowering drugs, such as simvastatin, at night.

Finally, sometimes it’s important to take medications only on particular days. Methotrexate is a medicine used for rheumatoid arthritis and severe psoriasis, and the timing of this medication is critical.




Read more:
What is rheumatoid arthritis, the condition tennis champion Caroline Wozniacki lives with?


You should only take it on the same day once a week, and when taken this way it is quite safe. But if you mistakenly take it daily, as happened recently with a patient in Victoria, then it can cause serious illness or even death.

What about blood pressure medicines?

One of the ways the body regulates blood pressure is through a pathway of hormones known as the renin, angiotensin and aldosterone system.

This system responds to various signals, like low blood pressure or stressful events, and controls blood volume and the constriction of blood vessels to regulate your blood pressure.

Importantly, this system is more active while you’re asleep at night. And a recent study, which found blood pressure medication is more effective at night,
may change the way we use medicines to treat high blood pressure.




Read more:
Health Check: what do my blood pressure numbers mean?


Two types of drugs typically prescribed to lower blood pressure are angiotensin converting enzyme (ACE) inhibitors, such as perindopril, and angiotensin receptor blockers (known as ARBs), such as irbesartan. These drugs dilate blood vessels (make them wider) to reduce your blood pressure.

Until now, doctors and pharmacists have often advised patients to take these medications in the morning, assuming it’s good to have a hit of the drugs when you’re up and about.

But this study found taking blood pressure medications at night produced a significant reduction (45%) in heart disease, including fewer strokes, heart attacks and heart failure compared to taking them in the morning.

Taking them at night also meant people’s blood pressure was better controlled and their kidneys were healthier.

So if you take one of these drugs to control your blood pressure and aren’t sure what you should do, talk to your pharmacist or doctor. While evidence is building to support taking them at night, this might not be appropriate for you.




Read more:
Health Check: is it OK to chew or crush your medicine?


The Conversation


Nial Wheate, Associate Professor | Program Director, Undergraduate Pharmacy, University of Sydney and Andrew Bartlett, Associate Lecturer Pharmacy Practice, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Does eating dairy foods increase your risk of prostate cancer?



If you’re a male who enjoys dairy, there’s no reason to stop having it.
From shutterstock.com

Rosemary Stanton, UNSW

Research Checks interrogate newly published studies and how they’re reported in the media. The analysis is undertaken by one or more academics not involved with the study, and reviewed by another, to make sure it’s accurate.


Recent headlines have warned a diet high in dairy foods may increase men’s risk of prostate cancer.

The news is based on a recent review published in the Journal of the American Osteopathic Association which claimed to find eating high quantities of plant-based foods may be associated with a decreased risk of prostate cancer, while eating high quantities of dairy products may be associated with an increased risk.

But if you’re a man, before you forego the enjoyment and known nutritional benefits of milk, cheese and yoghurt, let’s take a closer look at the findings.

What the study did

This study was a review, which means the researchers collated the findings of a number of existing studies to reach their conclusions.

They looked at 47 studies which they claim constitute a comprehensive review of all available data from 2006-2017. These studies examined prostate cancer risk and its association with a wide variety of foods including vegetables, fruits, legumes, grains, meat (red, white and processed), milk, cheese, butter, yoghurt, total diary, calcium (in foods and supplements), eggs, fish and fats.




Read more:
Six foods that increase or decrease your risk of cancer


Some studies followed groups of men initially free of prostate cancer over time to see if they developed the disease (these are called cohort studies). Others compared health habits of men with and without prostate cancer (called case-control studies). Some studies recorded the incidence of prostate cancer in the group while others concentrated on the progression of the cancer.

For every potential risk factor, the reviewers marked studies as showing no effect, or an increased or decreased risk of prostate cancer. The results varied significantly for all the foods examined.

For cohort studies (considered more reliable than case-control studies), three studies for vegan diets and one for legumes recorded decreased risk of prostate cancer. For vegetarian diets and vegetables, some reported decreased risk and some recorded no effect. Fruits, grains, white meat and fish appeared to have no effect either way.

An increased risk was reported for eggs and processed meats (one study each), red meat (one out of six studies), fats (two out of five), total dairy (seven out of 14), milk (six out of 15), cheese (one out of six), butter (one out of three), calcium (three out of four from diet and two out of three from supplements) and fats (two out of five).

Notably, some very large cohort studies included in the review showed no association for milk or other dairy products. And most case-control studies, though admittedly less reliable, showed no association.

The authors also omitted other studies published within the review period which showed no significant association between dairy and prostate cancer.

A person’s weight likely has more influence on their risk of developing prostate cancer than whether or not they eat dairy.
From shutterstock.com

So the inconsistency in results across the studies reviewed – including large cohort studies – amount to very limited evidence dairy products are linked to prostate cancer.

Could it be vitamin D?

In earlier research, a link between milk and prostate cancer has been attributed to a high calcium intake, possibly changing the production of a particular form of vitamin D within the body.

Vitamin D is an important regulator of cell growth and proliferation, so scientists believed it may lead to prostate cancer cells growing unchecked. But the evidence on this is limited, and the review adds little to this hypothesis.




Read more:
PSA testing for prostate cancer is only worth it for some


Perhaps the review’s most surprising omission is mention of the World Cancer Research Fund (WCRF) Continuous Update Project report on prostate cancer. This rigorous global analysis of the scientific literature identified much stronger risk factors that should be considered as possible confounding factors.

For example, the evidence is rated as “strong” that being overweight or obese, and being tall (separate to weight), are associated with increased risk of prostate cancer. The exact reasons for this are not fully understood but could be especially significant in Australia where 74% of men are overweight or obese.

A new Australian study found a higher body mass index was a risk factor for aggressive prostate cancer.

For dairy products and diets high in calcium, according to the WCRF, the evidence remains “limited”.




Read more:
Why full-fat milk is now OK if you’re healthy, but reduced-fat dairy is still best if you’re not


It’s about the whole diet

It’s not wise to judge any diet by a single food group or nutrient. A healthy diet overall should be the goal.

That being said, milk, cheese and yoghurt are included in Australia’s Dietary Guidelines because of evidence linking them with a lower risk of heart disease, type 2 diabetes, bowel cancer and excess weight. These dairy products are also sources of protein, calcium, iodine, several of the B complex vitamins, and zinc.

Evidence about dairy products and prostate cancer remains uncertain. So before fussing about whether to skip milk, cheese and yoghurt, men who wish to reduce their risk of prostate cancer would be better advised to lose any excess weight. – Rosemary Stanton


Blind peer review

I agree with the author of this Research Check who highlights there is a high degree of variability in the results of the studies examined in this review.

While the authors searched three journal databases, most comprehensive reviews search up to eight databases. Further, the authors did not undertake any assessment of the methodological quality of the studies they looked at. So the results should be interpreted with caution.

Although the authors concluded higher amounts of plant foods may be protective against prostate cancer, the figure presented within the paper indicates more studies reported no effect compared to a decreased risk, so how they came to that conclusion in unclear. For total dairy they present a figure showing there were as many studies suggesting no effect or lower risk as there were showing higher risk.

Importantly, they did not conduct any meta-analyses, where data are mathematically pooled to generate and overall effect across all studies.

As the reviewer points out, many other important sources of high quality data have not been included and there are a number of recent higher quality systematic reviews that could be consulted on this topic. – Clare CollinsThe Conversation

Rosemary Stanton, Visiting Fellow, School of Medical Sciences, UNSW

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Should I let my kid climb trees? We asked five experts



Falls are the main reason for childhood injuries, but kids usually recover.
from shutterstock.com

Sasha Petrova, The Conversation

We often remember childhood as a time when life seemed infinite and adventures in our backyard felt expansive, as if we were exploring other worlds.

Climbing a tree was its own adventure. You could discover what you were capable of, while also getting the chance to see the world from a different vantage point.

Of course, sometimes you’d fall. But that’s to be expected – there’s a risk in every journey of discovery.

Parents want their children to enjoy the same joys of childhood they look back on fondly, but many struggle with getting the balance right – how much freedom can you give while also making sure your child is safe?

We asked five experts – including a paediatric surgeon who operates on children who’ve fallen out of a tree – if it’s OK to let kids climb trees.

Five out of five experts said yes

Although, in every case, it’s a yes, but…

Here are their detailed responses:


If you have a “yes or no” education question you’d like posed to Five Experts, email your suggestion to: sasha.petrova@theconversation.edu.au


Disclosures: Shelby Laird is a member of the North American Association for Environmental Education as well as its local affiliate, Environmental Educators of North Carolina.The Conversation

Sasha Petrova, Section Editor: Education, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What is rheumatoid arthritis, the condition tennis champion Caroline Wozniacki lives with?


Fabien B. Vincent, Monash University and Michelle Leech, Monash University

Arthritis is a broad term to describe inflammation of the joints which become swollen and painful. There are many different kinds. Osteoarthritis, the most common, is caused by wear and tear.

This is followed by rheumatoid arthritis, an autoimmune condition where the person’s immune system mistakenly attacks and damages its own joints and other organs.

Rheumatoid arthritis is relatively common, affecting around one in 100 people, including young people and even children.

Twenty-nine-year-old Danish tennis player Caroline Wozniacki told fans last year she was diagnosed with this condition. Earlier in 2018, she had won the Australian Open, then struggled with unexplained symptoms.

Researchers do not fully know what causes rheumatoid arthritis, but suspect certain genes may trigger it when combined with environmental and lifestyle factors such as smoking or infections.

How does it feel?

People commonly experience joint pain, but it is particularly bad in the mornings and when they rest. Joints in the hands, feet, wrists, elbows, knees and ankles may be stiff for hours at a time. But unlike osteoarthritis, the pain can actually get better with movement.

If the inflammation in rheumatoid arthritis is not controlled, people experience joint pain, stiffness, fatigue and can almost feel like they have the flu.

The inflammation can lead to damage to the bones and cartilage (cushion) in joints causing deformity and disability. This can affect work, and social and family life.

In 18% to 41% of patients, the condition can cause inflammation in other parts of the body, such as the lungs (this may cause a condition called interstitial lung disease) and the blood vessels (leading to a condition called vasculitis).

People with severe rheumatoid arthritis also have an increased risk of developing lymphoma, a type of cancer of the lymphatic system, which helps rid the body of toxic waste.

How is it diagnosed?

When a GP suspects someone has rheumatoid arthritis, the patient is referred to a rheumatologist for a detailed physical examination focusing on joint pain, tenderness, swelling and stiffness.

The patient will have some routine blood tests to look for signs of inflammation and “autoimmunity” – antibodies directed against the patient’s own tissues.




Read more:
Explainer: what is the immune system?


The person may also have an x-ray of the affected joints (if the symptoms have been present for more than three months) to look for signs of cartilage thinning and bone erosion (small bites out of the bone).

Ultrasound and MRI are less useful for diagnosis, but can sometimes be used to monitor the condition.

How is it treated?

While there is no cure for rheumatoid arthritis, medicines can effectively control the condition and stop visible signs of damage.

With good treatment, it’s now very rare to see deformed joints or people in wheel chairs.

Treatments should start as early as possible and will vary according to how active and severe the condition is. Some people need only a small amount of medicine whereas others will try many different medicines, sometimes in combination.

Because the immune system is overactive and mistaken in its target, the treatment approach is to dampen the immune response.

Initial treatment may include a low dose of steroids called prednisolone, as well as an immune-suppressing drug such as methotrexate or leflunomide, to control the inflammation.




Read more:
Weekly Dose: methotrexate, the anti-inflammatory drug that can kill if taken daily


If the condition is not controlled by these drugs, then other medicines, mostly injections, called “biological” drugs, can be added. These mimic substances naturally produced by the body and block specific substances in the immune system. Very recently, some newer tablets have been approved for rheumatoid arthritis.

Pain management may also be needed with medicines like non-steroidal anti-inflammatory drugs such as ibuprofen.

Inflamed, swollen joints can also periodically be treated by local joint injection of steroids.

If the first line treatments aren’t providing relief, others are progressively added.
Hriana/Shutterstock

People with rheumatoid arthritis will also greatly benefit from physiotherapy and occupational therapy. They will learn exercises to maintain joint flexibility, as well as alternative ways to perform daily tasks that may be difficult or painful.

But the fatigue is very difficult to treat. Gentle graduated exercise programs, a good healthy diet, understanding of the condition and its treatment, as well as psychological support, can help with fatigue.

Most people with rheumatoid arthritis can no longer be distinguished from people without the condition and live full and active lives. However, for a small percentage of unlucky patients who have aggressive disease or cannot tolerate any of the medicines, the course can be more difficult.




Read more:
Explainer: what is Sjögren’s syndrome, the condition Venus Williams lives with?


The Conversation


Fabien B. Vincent, Research Fellow; Rheumatology Research Group, Centre for Inflammatory Diseases, Monash University and Michelle Leech, Rheumatologist, Professor/Director Monash Medical Course/ Deputy Dean Health Faculty, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We have a vaccine for hepatitis B but here’s why we still need a cure



Around 5% of adults and 90% of babies who contract hepatitis B go on to have life-long infection that can only be managed with regular medication.
Ronald Rampsch/Shutterstock

Peter Revill, The Peter Doherty Institute for Infection and Immunity and Margaret Littlejohn, Melbourne Health

Hepatitis B is blood-borne virus that packs a punch. Worldwide, more than 1.3 billion people have been infected with hepatitis B, and 257 million people have developed a life-long infection. This includes 240,000 Australians, many of whom are Indigenous.

Globally, transmission most commonly occurs from mother to baby or in early life. But it’s possible to be infected in adulthood, through sex or blood-to-blood contact.

Most people who are infected in adulthood develop a short infection which their immune response controls. But in around 5% of adults and 90% of babies, the immune response is ineffective and chronic infection develops.




Read more:
Dr G. Yunupingu’s legacy: it’s time to get rid of chronic hepatitis B in Indigenous Australia


Hepatitis B virus causes almost 40% of all liver cancer, which is the fifth most common cancer and the second leading cause of cancer-related death worldwide.

Australian discovery

Hepatitis B virus was discovered in the serum of an Indigenous Australian in 1965 and was first known as the “Australia antigen”.

This quickly led to the development of an effective vaccine in the 1980s, which is now available worldwide. The vaccine has been given to Australian infants since May 2000.

(If you weren’t vaccinated as a baby, you might want to consider doing so through your GP, particularly if you plan to travel to Asia and Africa where hepatitis B is common.)

Unfortunately the vaccine doesn’t do anything for the 240,000 or so Australians who currently live with chronic hepatitis B. Only around 60% of these people have been diagnosed; the rest don’t know they’re infected and don’t receive appropriate care.

How is it currently treated?

There is no cure for chronic hepatitis B virus.

In most cases, treatment requires taking a pill every day for life to remain effective and to reduce the risk of liver cancer. Even then, it doesn’t eliminate the risk.

Chronic hepatitis B hasn’t been cured so far in part because current therapies have failed to destroy the viral reservoir, where the virus hides in the cell.

This is in contrast to hepatitis C virus, which has no such viral reservoir and can now be cured with as little as 12 weeks of treatment.




Read more:
In contrast to Australia’s success with hepatitis C, our response to hepatitis B is lagging


Despite the huge human and economic toll of chronic hepatitis B, research to cure the disease remains underfunded. There is a misconception that because there is a vaccine, hepatitis B is no longer a problem.

The availability of effective cures for the unrelated hepatitis C virus has also led people to believe that “viral hepatitis” is no longer a problem.

Experts estimate that liver cancer deaths will substantially increase in coming decades without a cure for hepatitis B, despite deaths from most cancers decreasing.

Hepatitis B causes 40% of all liver cancer.
Napocska/Shutterstock

How far have we got?

Some exciting research is underway around the world, including the recent identification of the “cell receptor” which allows the virus to infect the body. This has enabled studies of the complete virus replication cycle including the viral reservoir that is untouched by current therapies.

New approaches to a possible cure include mechanisms to block the virus’ entry into the cell and to stop the virus from making the proteins it needs to replicate and infect new cells.

Studies are also underway to enhance patients’ immune responses so their own natural defences can control or even eliminate the virus. This is similar to immunotherapies already being used to treat some cancers.




Read more:
Explainer: the A, B, C, D and E of hepatitis


It’s likely a hepatitis B cure will require a dual-pronged approach, directly targeting the virus while also enhancing the immune response in people who are infected.

The goal is to reduce the amount of virus in the body and restore the person’s immune responses. This is called a “functional cure” and is similar to what happens when a person naturally gets rid of the virus. It would also mean they didn’t need to take drugs any more.

Some of these approaches are now in early stage human clinical trials. More than 30 drugs have been developed and are being tested in people with chronic hepatitis B. However, much more work needs to be done to achieve a cure.The Conversation

Peter Revill, Senior Medical Scientist at VIDRL, Royal Melbourne Hospital, The Peter Doherty Institute for Infection and Immunity and Margaret Littlejohn, Medical Scientist, Melbourne Health

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is coconut water good for you? We asked five experts



Nutritionally, coconut water is OK, but it’s healthier to stick to plain water.
from http://www.shutterstock.com

Alexandra Hansen, The Conversation

In recent years coconut water has left the palm-treed shores of tropical islands where tourists on lounge chairs stick straws straight into the fruit, and exploded onto supermarket shelves – helped along by beverage giants such as Coca-Cola and PepsiCo.

Marketed as a natural health drink, brands spout various health claims promoting coconut water. So before we drank the Kool-Aid, we thought we’d check in with the experts whether the nutritional claims stack up. Is coconut water part of a healthy diet or we should just stick to good old water from the tap?

We asked five experts if coconut water is good for you.

Four out of five experts said no

Here are their detailed responses:


If you have a “yes or no” health question you’d like posed to Five Experts, email your suggestion to: alexandra.hansen@theconversation.edu.au


Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns. Emma Beckett is a member of the Nutrition Society of Australia, Australian Institute for Food Science and Technology. Her research is funded by the NHMRC and AMP Foundation. She has previously consulted for Kellogg’s. Rebecca Reynolds is a registered nutritionist and the owner of The Real Bok Choy, a nutrition and lifestyle consultancy.The Conversation

Alexandra Hansen, Chief of Staff, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How big alcohol is trying to fool us into thinking drinking is safer than it really is



Australia’s drinking guidelines are currently under review.
From shutterstock.com

Peter Miller, Deakin University

Over recent weeks, the alcohol industry has been drumming up media discussion around Australia’s new drinking guidelines.

Australia’s guidelines on alcohol consumption are under ongoing review by the National Health and Medical Research Council (NHMRC), with new draft guidelines expected to be released in November.

The alcohol industry has labelled the current guidelines (two standard drinks per day and four in any heavy episode of drinking) as harsh, and voiced concern the guidelines may be tightened further.




Read more:
Politicians who become lobbyists can be bad for Australians’ health


The global alcohol industry has been increasingly proactive in trying to undermine the ever-improving science on the harms associated with the product they make money from manufacturing, promoting and selling.

This is somewhat unsurprising given the industry would be significantly less profitable if we all drank responsibly.

Drinking guidelines

Panels of scientists develop drinking guidelines around the world by assessing the best and most up-to-date evidence on alcohol and health, and determining consumption levels which might put people at risk.

They then provide the information to health professionals and the public to allow people to make informed decisions about consumption. The guidelines are neither imposed nor legislated.

The current 2009 Australian guidelines recommend healthy adults should drink no more than two standard drinks per day to reduce their lifetime risk of alcohol-related disease or injury. They recommend no more than four standard drinks on one occasion to reduce a person’s risk of injury and death.

So how are the industry players trying to protect our drinking culture from such “harsh” guidelines?

Alcohol Beverages Australia: who they are and what they’re claiming

Alcohol Beverages Australia (ABA) is an industry body for global alcohol producers and retailers, including Asahi Brewers from Japan, Diageo Spirits from the UK, Pernod Ricard from France, Coca-Cola Amatil from the USA, and many others. Bringing together multiple industry groups to lobby government was a key strategy developed by the tobacco industry.

The NHMRC review of Australia’s drinking guidelines was open to public submissions on the health effects of alcohol consumption until January 2017. At this time, the ABA submitted a report claiming drinking alcohol carries health benefits including a reduced risk of heart disease, stroke and diabetes. They requested the review take this into account in drafting any new guidelines.

In their communications with the media this month, the ABA resurfaced their 2017 submission to the process. It seems they have not updated the information to reflect the latest evidence.




Read more:
Ten reasons some of us should cut back on alcohol


The most up-to-date evidence has shown previous research was substantially flawed in terms of the relationship between alcohol consumption and heart disease, blood pressure, breast cancer and overall mortality.

We know consuming any type of alcohol increases the risk of developing cancer of the bowel, mouth, pharynx, larynx, oesophagus, liver and breast. The World Health Organisation has classified alcohol as a class 1 carcinogen, along with asbestos and tobacco, for decades.

Any health benefits the ABA demonstrated evidence for is outweighed by the risks.

The current drinking guidelines in Australia recommend no more than two standard drinks per day for healthy adults.
From shutterstock.com

Alongside claiming the benefits of drinking alcohol need to be considered, to make their case, the ABA have compared drinking guidelines across different countries. In doing so, they are seeking to highlight Australia’s guidelines are ‘stricter’ than those of most other countries.

In making sense of these figures, the difference in drink driving levels is worth considering. It takes the average male four standard drinks to reach 0.05 in two hours and around seven standard drinks to reach 0.08. This is a big difference for most of us.

Those countries with 0.08mg of alcohol per L of blood as the legal limit are willing to accept more than triple the risk of having a car accident than Australia’s 0.05.

We need to ask whether these are countries whose health and safety models we want to follow.




Read more:
Health check: is moderate drinking good for me?


This is not a new problem

The industry is using language like “harsh” and “strict” to ferment public opposition to any tightened guidelines.

This spin strategy is predictable. The alcohol industry has been fighting for many decades to preserve profits over public safety, disregarding consumers’ rights to know the contents of their products, and the harms associated.

They fought against the 0.05 drink driving limit in the 1950s, and have successfully stopped Australian governments telling us about the cancer risk associated with alcohol consumption. For example, while policymakers have proposed warning labels with information about cancer risk be placed on alcoholic drinks, this is yet to eventuate.

The ABA is currently resisting a push to explicitly warn consumers drinking is harmful to unborn babies by means of mandatory labelling on all alcohol containers, suggesting it’s “too much information”.

These examples show how the industry continues to actively muddy efforts to educate the public of the harms of alcohol consumption.




Read more:
Alcohol increases cancer risk, but don’t trust the booze industry to give you the facts straight


Notably, we’ve seen all of this before, particularly in the tobacco industry, or “big tobacco”, which has previously employed strategies to minimise health concerns and delay effective legislation.

So it’s hard not to wonder if the ABA are worried about the bottom line of their corporate masters, and therefore trying to influence deliberations through a media campaign, similar to those previously used by the tobacco industry.The Conversation

Peter Miller, Professor of Violence Prevention and Addiction Studies, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

4 ways to talk with vaccine skeptics



If another parent at playgroup says she’s not vaccinating her child, what’s the best way to respond?
from www.shutterstock.com

Julie Leask, University of Sydney and Maryke Steffens, Macquarie University

Your neighbour is telling you about his new baby. He feels nervous about vaccinating, and says he’s considering delaying Lucy’s vaccines.

Your mother’s group is chatting about vaccines. One mother tells the group Jimmy isn’t vaccinated, and she’s using the Immune-Strengthening Diet instead.

In a Facebook parenting group, someone comments we shouldn’t trust pharmaceutical companies because they’re covering up studies showing vaccines cause autism.

These and similar scenarios may sound familiar. So what do you do when you’re faced with someone who questions vaccination? Do you try to convince them to vaccinate? Do you ignore them? Or might something else work?




Read more:
Six myths about vaccination – and why they’re wrong


Talking about vaccination can be really difficult. Vaccination touches on strong values, like protection of children, social responsibility, and respect for science.

So, if you’re a vaccination supporter, you may feel perplexed, even angry, when people don’t vaccinate their children. If you’re a parent who has overcome minor worries and vaccinated your child, it can be galling when another parent dismisses vaccination, putting others at risk.

But talking about vaccination can also present pitfalls. Attempting to convince someone with strong views they’re wrong can strengthen their commitment to their position.




Read more:
Australians’ attitudes to vaccination are more complex than a simple ‘pro’ or ‘anti’ label


Our work, with a team of researchers, clinicians and the National Centre for Immunisation Research and Surveillance, shows the best way to respond depends on the situation. Your approach will be very different with a person who has fixed negative views on vaccination, compared with someone who is cautious. How you respond also depends on what is most important in your relationship.

Here are some options.

1. Don’t go there

This approach is handy if you encounter a person with fixed beliefs. They may say, “I’ve done my research.”

Your automatic response may be to counter their claims, saying “The science is clear. Vaccinate your kids.”

But if the relationship with this person isn’t important to you, or their emphatic pronouncements are unlikely to do harm, then little is gained by engaging. People with fixed beliefs don’t budge much.




Read more:
A short history of vaccine objection, vaccine cults and conspiracy theories


You may encounter active opposition to vaccination on social media. A small number of anti-vaccination activists colonise online forums.

So avoid protracted conversations. Facebook’s algorithm privileges posts with high engagement, so your interactions may bring them even more attention. Energised by the response, anti-vaccination activists may coordinate and bombard you or your organisation.

This is what happened to US clinic Kids Plus Pediatrics in Pittsburgh. The clinic eventually produced a guidebook on how to handle anti-vaccination attacks.

Debating anti-vaccination messages on social media can backfire.
from www.shutterstock.com

Increasing the visibility of anti-vaccination posts can have other drawbacks. Onlookers may come to see vaccination as riskier, and vaccine refusal as more popular than it really is (in reality, only about 2% of Australian parents decide not to give their children some or all vaccines).

But countering anti-vaccine views can also bring benefits: it can diminish these negative effects, and affirm vaccination for hesitant onlookers or “fence-sitters”.

So which option is best? If this person’s posts are getting exposure anyway or they are influential, then you may decide that responding is worth the risk. Just keep any interactions brief, factual and polite. Otherwise, don’t go there.

2. Agree to disagree

Agreeing to disagree may be an option when you are with friends and family who hold firm views and whose relationship is important to you.

There could be a family get-together with your cousin who steadfastly rejects vaccination and the topic comes up in conversation. Family members start debating it. With strong views on either side, this could be explosive. Here you could say, “This is a topic we all have strong views about. We could just argue, but I propose that we leave this one alone.”

Discussing vaccination would not change your cousin’s mind. Her views are deeply held. Don’t let arguments get in the way of these relationships.

3. Affirm vaccination and move on

This option can be useful when you want to avoid conflict, but also advocate for vaccination.

Parent group situations might warrant this approach. For example, a couple at your antenatal class declare their plan to delay vaccination. While you might feel annoyed, try to focus on a strategic goal: showing other parents it’s not a group norm to delay vaccination.

You could say, “We are planning to vaccinate our baby. We think it’s really important.” While this probably won’t persuade the couple, it may reduce their influence on others.

4. Listen, affirm and recommend

This approach may be suitable when you are with family and friends who are hesitant about vaccinating. For example, your daughter and son-in-law are hesitant about vaccinating their child — your grandchild.




Read more:
Everyone can be an effective advocate for vaccination: here’s how


These relationships may be important to you, and you probably want to encourage them to vaccinate.

We and others recommend several steps:

Understand people’s concerns and motivations

Listen to what people say and ask clarifying questions. This helps you better understand their reasons. Avoid the temptation to jump in, and keep a check on your emotions.

Affirm them as parents

This means acknowledging their concerns, as well as their care as parents. A person who feels respected is more likely to listen to your viewpoint. It’s how we all like to be treated. You could say, “I can see you are trying to do your best.”

Offer to share information

Sharing information means giving factual information relevant to that person, explaining your view, and why you believe it. Use quality information, such as via the World Health Organisation’s Vaccine Safety Net portal. Personalise it: “I believe vaccination is important because …”

Close with a plan

This creates opportunities for future conversations. Some parents review their decisions, such as during a localised outbreak or when the child is older. It’s also good to have an exit strategy because vaccination discussions can go on and on. You might ask, “Can we talk about this again some time?”

Decide how you want to spend your energy

Responding to people who question vaccination can be hard. So be judicious about where you spend your energy.

If you truly want to make a difference, avoid the temptation to reflexively correct what you believe is wrong and getting embroiled in lengthy vaccination debates or games of scientific ping pong.

Jump in without thinking, and you risk wasting your time, affecting relationships with family and friends, or even inadvertently amplifying anti-vaccine views.
Instead, assess that person’s position on vaccination, your goals and what is most important in your relationship.


Information for parents who have questions about immunisation is available here.The Conversation

Julie Leask, Professor, University of Sydney and Maryke Steffens, PhD Candidate, Macquarie University

This article is republished from The Conversation under a Creative Commons license. Read the original article.