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‘Girl math’ may not be smart financial advice, but it could help women feel more empowered with money

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ylva-baeckstrom-1463175">Ylva Baeckstrom</a>, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a> If you’ve ever calculated cost per wear to justify the price of an expensive dress, or felt like you’ve made a profit after returning an ill-fitting pair of jeans, you might be an expert in <a href="https://www.standard.co.uk/news/world/girl-maths-tiktok-trend-its-basically-free-b1100504.html">“girl math”</a>. With videos about the topic going viral on social media, girl math might seem like a silly (<a href="https://www.glamourmagazine.co.uk/article/girl-math-womens-spending-taken-seriously">or even sexist</a>) trend, but it actually tells us a lot about the relationship between gender, money and emotions. Girl math introduces a spend classification system: purchases below a certain value, or made in cash, don’t “count”. Psychologically, this makes low-value spending feel safe and emphasises the importance of the long-term value derived from more expensive items. For example, girl math tells us that buying an expensive dress is only “worth it” if you can wear it to multiple events. This approach has similarities to <a href="https://www.investopedia.com/terms/m/modernportfoliotheory.asp">portfolio theory</a> – a method of choosing investments to maximise expected returns and minimise risk. By evaluating how each purchase contributes to the shopping portfolio, girl math shoppers essentially become shopping portfolio managers. <h2>Money and emotions</h2> People of all genders, rich or poor, feel anxious when dealing with their personal finances. Many people in the UK do not understand pensions or saving enough to <a href="https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/workplacepensions/articles/pensionparticipationatrecordhighbutcontributionsclusteratminimumlevels/2018-05-04">afford their retirement</a>. Without motivation to learn, people avoid dealing with money altogether. One way to find this motivation, as girl math shows, is by having an emotional and tangible connection to our finances. On the surface, it may seem that women are being ridiculed and encouraged to overspend by using girl math. From a different perspective, it hints at something critical: for a person to really care about something as seemingly abstract as personal finance, they need to feel that they can relate to it. Thinking about money in terms of the value of purchases can help create an <a href="https://www.thetimes.co.uk/article/every-time-i-use-my-card-my-phone-buzzes-and-that-stops-me-shopping-ps0fjx6nj">emotional relationship</a> to finance, making it something people want to look after. <figure><iframe src="https://www.youtube.com/embed/GPzA7B6dcxc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>The girl math we need</h2> Women are a consumer force to be reckoned with, controlling <a href="https://www.forbes.com/sites/bridgetbrennan/2015/01/21/top-10-things-everyone-should-know-about-women-consumers/#7679f9d6a8b4">up to 80%</a> of consumer spending globally. The girl math trend is a demonstration of women’s mastery at applying portfolio theory to their shopping, making them investment powerhouses whose potential is overlooked by the financial services industry. <a href="https://www.theguardian.com/world/2019/oct/28/women-paid-less-than-men-over-careers-gender-pay-gap-report">Women are disadvantaged</a> when it comes to money and finance. Women in the UK earn on average £260,000 less than men during their careers and the retirement income of men is twice as high as women’s. As I’ve found in <a href="https://www.routledge.com/Gender-and-Finance-Addressing-Inequality-in-the-Financial-Services-Industry/Baeckstrom/p/book/9781032055572">my research</a> on gender and finance, women have lower financial self-efficacy (belief in their own abilities) compared to men. This is not helped by women feeling patronised when seeking financial advice. Because the world of finance was created by men for men, its language and culture are <a href="https://www.routledge.com/Gender-and-Finance-Addressing-Inequality-in-the-Financial-Services-Industry/Baeckstrom/p/book/9781032055572">intrinsically male</a>. Only in the mid-1970s did women in the UK gain the legal right to open a bank account without a male signature and it was not until 1980 that they could apply for credit independently. With the law now more (<a href="https://www.worldbank.org/en/news/press-release/2023/03/02/pace-of-reform-toward-equal-rights-for-women-falls-to-20-year-low">but not fully</a>) gender equal, the financial services industry has failed to connect with women. Studies show that 49% of women are <a href="https://www.ellevest.com/magazine/disrupt-money/ellevest-financial-wellness-survey">anxious about their finances</a>. However they have not bought into patronising offers and <a href="https://www.fa-mag.com/news/gender-roles-block-female-financial-experience--ubs-says-73531.html">mansplaining by financial advisers</a>. This outdated approach suggests that it is women, rather than the malfunctioning financial system, <a href="https://www.theguardian.com/commentisfree/2020/sep/16/women-are-not-financially-illiterate-they-need-more-than-condescending-advice">who need fixing</a>. Women continue to feel that they do not belong to or are able to trust the world of finance. And why would women trust an industry with a <a href="https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandworkinghours/bulletins/genderpaygapintheuk/2019">gender pay gap</a> of up to 59% and a severe lack of women in senior positions? Girl math on its own isn’t necessarily good financial advice, but if it helps even a handful of women feel more empowered to manage and understand their finances, it should not be dismissed.  <a href="https://theconversation.com/profiles/ylva-baeckstrom-1463175">Ylva Baeckstrom</a>, Senior Lecturer in Finance, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</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/girl-math-may-not-be-smart-financial-advice-but-it-could-help-women-feel-more-empowered-with-money-211780">original article</a>. </div>

Money & Banking

Loyalty programs may limit competition, and they could be pushing prices up for everyone

<a href="https://theconversation.com/profiles/alexandru-nichifor-1342216">Alexandru Nichifor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/scott-duke-kominers-1494057">Scott Duke Kominers</a>, <a href="https://theconversation.com/institutions/harvard-university-1306">Harvard University</a> Loyalty programs enable firms to offer significantly lower prices to some of their customers. You’d think this would encourage strong competition. But that isn’t always what actually happens. <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4377561">New research</a> shows that paradoxically, by changing the way companies target customers, loyalty programs can sometimes reduce price competition. The research also points to solutions. <h2>A win-win proposition?</h2> Joining a loyalty program is supposed to be a win-win. You – the customer – get to enjoy perks and discounts, while the company gains useful commercial insights and builds brand allegiance. For example, a hotel chain loyalty program might reward travellers for frequent stays, with points redeemable for future bookings, upgrades or other benefits. The hotel chain, in turn, records and analyses how you spend money and encourages you to stay with them again. Such programs are commonplace across many industries – appearing everywhere from travel and accommodation to supermarket or petrol retailing. But they are increasingly coming under scrutiny. In 2019, the Australian Competition and Consumer Commission (ACCC) <a href="https://www.accc.gov.au/about-us/publications/customer-loyalty-schemes-final-report">cautioned</a> consumers about the sheer volume of personal data collected when participating in a loyalty program, and what companies can do with it. Hidden costs – such as having to pay a redemption fee on rewards or losing benefits when points expire – are another way these schemes can harm consumers. But a larger question – how loyalty programs impact consumers overall – remains difficult to settle, because their effect on competitiveness is unclear. As the ACCC’s <a href="https://www.accc.gov.au/about-us/publications/customer-loyalty-schemes-final-report">final report</a> notes, on the one hand: "Loyalty schemes can have pro-competitive effects and intensify competition between rivals leading to competing loyalty discounts and lower prices for consumers." But on the other hand: "Loyalty schemes can also reduce the flexibility of consumers’ buying patterns and responsiveness to competing offers, which may reduce competition." <h2>How a two-speed price system can hurt everyone</h2> A new economic theory research <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4377561">working paper</a>, coauthored by one of us (Kominers), suggests that on competitive grounds alone, loyalty programs can sometimes harm all consumers – both ordinary shoppers and the program’s own members. It’s easy to see how the ordinary shopper can be worse off. Since a firm’s loyalty program enables it to offer discounted prices to its members, the firm can raise the base prices it offers to everyone else. Those not participating in the program pay more than they otherwise would have, and the firm can respond by saying “join our program!” instead of having to lower its price. But sometimes, even the program’s own members can end up worse off. When a given customer’s loyalty status is not visible to a firm’s competitors – as is the case in many loyalty programs today – it’s hard for those competitors to identify them and entice them to switch. The main way to compete for those customers becomes to lower the base price for everyone, but this means missing out on the high base margins achieved through the existence of your own loyalty program – remember, having a loyalty program means you can charge non-members more. It’s often more profitable for firms to just maintain high base prices. This, in turn, reduces overall price competition for loyal customers, so firms can raise prices for them, too. <h2>What’s the solution?</h2> Despite these effects on competition, loyalty programs still offer benefits for consumers and an opportunity for brands to form closer relationships with them. So, how do we preserve these benefits while enabling price competition? The research suggests an answer: making a customer’s loyalty status verifiable, transparent and portable across firms. This would make it possible for firms to tailor offers for their competitors’ loyal customers. This is already happening in the market for retail electricity. While there aren’t loyalty programs there per se, a consumer’s energy consumption profile, which could be used by a competitor to calibrate a personalised offer, is known only to their current electricity supplier. To address this, in 2015, the Victorian government launched a <a href="https://compare.energy.vic.gov.au">program</a> encouraging households to compare energy offers. This process involved first revealing a customer’s energy consumption profile to the market, and then asking retailers to compete via personalised offers. By opening information that might have otherwise been hidden to the broader market, this approach enabled firms to compete for each other’s top customers, in a way that could be emulated for loyalty programs. Such systems in the private sector could build upon “<a href="https://thepointsguy.com/guide/airline-status-matches-challenges/">status match</a>” policies at airlines. These allow direct transfer of loyalty status, but currently rely on a lengthy, individual-level verification process. For example, a design paradigm known as “<a href="https://hbr.org/2022/05/what-is-web3">Web3</a>” – where customer transactions and loyalty statuses are recorded on public, shared blockchain ledgers – offers a way to make loyalty transparent across the market. This would enable an enhanced, decentralised version of status match: a firm could use blockchain records to verifiably identify who its competitors’ loyal customers are, and directly incentivise them to switch. Both startups and established firms have experimented with building such systems. <h2>What next?</h2> New academic research helps us model and better understand when loyalty programs could be weakening supply side competition and undermining consumer welfare. A neat universal solution may prove elusive. But targeted government or industry interventions – centred on increasing the transparency of a customer’s loyalty status and letting them move it between firms – could help level the playing field between firms and consumers.<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/220669/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexandru-nichifor-1342216">Alexandru Nichifor</a>, Associate Professor, Faculty of Business and Economics, University of Melbourne, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/scott-duke-kominers-1494057">Scott Duke Kominers</a>, Sarofim-Rock Professor of Business Administration, <a href="https://theconversation.com/institutions/harvard-university-1306">Harvard University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/loyalty-programs-may-limit-competition-and-they-could-be-pushing-prices-up-for-everyone-220669">original article</a>.

Money & Banking

Vitamin D supplements can keep bones strong – but they may also have other benefits to your health

<a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> Most of us don’t worry about getting vitamin D when the weather’s warm and the sun is shining. But as winter approaches, accompanied by overcast days and long nights, you may be wondering if it could be useful to take a vitamin D supplement – and what benefit it might have. During the summer, the best way to get vitamin D is by getting a bit of sunshine. Ultraviolet rays (specifically UVB, which have a shorter wavelength) interact with a form of cholesterol called <a href="https://www.ncbi.nlm.nih.gov/books/NBK278935/">7-dehydrocholesterol</a> in the skin, which is then converted into vitamin D. Because vitamin D production is dependent on UVB, this means our ability to make it <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/#:%7E:text=From%20about%20late%20March%2Fearly,enough%20vitamin%20D%20from%20sunlight.">declines in the winter months</a>. Vitamin D production also <a href="https://pubmed.ncbi.nlm.nih.gov/24494042/">depends on where you live</a>, with people living nearer to the equator making more vitamin D than those living nearer the poles. Vitamin D deficiency is a <a href="https://assets.publishing.service.gov.uk/media/5a804e36ed915d74e622dafa/SACN_Vitamin_D_and_Health_report.pdf">problem in the UK</a> during the winter months. This is due to its northerly position and cloudy weather, and lack of time spent outdoors. One study of over 440,000 people in the UK found that <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">18% were vitamin D deficient</a> during the winter months. Vitamin D deficiency was even higher in certain ethnic groups – with the data showing 57% of Asian participants and 38% of black participants were vitamin D deficient. This is because the melanin content of skin determines a person’s ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946242/#:%7E:text=Skin%20pigmentation%2C%20i.e.%2C%20melanin%2C,%5B7%5D%20and%20more%20generally.">make UVB into vitamin D</a>. Given the prevalence of vitamin D deficiency in the UK, and the importance it has for our health, in 2016 the UK’s Science Advisory Council on Nutrition outlined recommendations for the <a href="https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report#:%7E:text=In%20a%20change%20to%20previous,aged%204%20years%20and%20older">amount of vitamin D</a> people should aim to get in the winter. They recommend people aim to get ten micrograms (or 400 IU – international units) of vitamin D per day. This would help people avoid severe deficiency. This can be achieved either by taking a supplement, or eating <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/ask-the-expert/foods-high-in-vitamin-d">certain foods</a> that are rich in vitamin D – including fatty fish such as herring, mackerel and wild salmon. A 100 gram serving of fresh herring, for example, would have approximately five micrograms of vitamin D. The clearest benefit of taking a vitamin D supplement is for <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/">bone health</a>. In fact, vitamin D was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899558/">first discovered</a> 100 years ago because of its ability to prevent the disease rickets, which causes weak bones that bend. Although rickets <a href="https://www.nhs.uk/conditions/rickets-and-osteomalacia/#:%7E:text=The%20number%20of%20rickets%20cases,from%20sunlight%2C%20can%20develop%20rickets.">isn’t very common</a> in the UK today, it can still occur in children if they lack vitamin D. In adults, vitamin D deficiency can cause bone pain, tenderness and muscles weakness, as well as increased risk of osteomalacia – often called “soft bone disease” – which leads to weakening or softening bones. The reason a lack of vitamin D can have such an effect on bone health is due to the vitamin’s relationship with <a href="https://pubmed.ncbi.nlm.nih.gov/18844850/">calcium and phosphate</a>. Both of these minerals help keep our bones strong – but they require vitamin D in order to be able to reinforce and strengthen bones. <h2>Other health benefits</h2> In addition to its effects on the skeleton, a growing body of research is beginning to indicate that vitamin D supplements may have additional benefits to our health. For example, <a href="https://ar.iiarjournals.org/content/42/10/5009.long">research shows</a> there’s a link between vitamin D deficiency and increased risk of catching certain viral illnesses, including the <a href="https://pubmed.ncbi.nlm.nih.gov/19237723/">common cold</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231123/">flu</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385774/">COVID</a>. Similarly, several studies – <a href="https://pubmed.ncbi.nlm.nih.gov/32904944/">including my own</a> – have demonstrated in cell models that vitamin D promotes immunity against microbes, such as the bacteria which causes tuberculosis. This means vitamin D may potentially prevent some types of infections. Vitamin D may also dampen inflammatory immune responses, which could potentially protect against autoimmune diseases, such as <a href="https://pubmed.ncbi.nlm.nih.gov/29243029/">multiple sclerosis</a> and <a href="https://www.frontiersin.org/articles/10.3389/fmed.2020.596007/full">rheumatoid arthritis</a>. One 2022 trial, which looked at over 25,000 people over the age of 50, found taking a 2,000 IU (50 micrograms) vitamin D supplement each day was associated with an <a href="https://www.bmj.com/content/376/bmj-2021-066452">18% lower risk</a> of autoimmune disease – notably rheumatoid arthritis. Vitamin D supplements may also be linked with lower risk of cardiovascular disease. A <a href="https://www.bmj.com/content/381/bmj-2023-075230">major Australian study</a>, which looked at over 21,000 people aged 60-84, found that participants who took a 2,000 IU vitamin D supplement a day for five years had a lower risk of suffering a major cardiovascular event (such as stroke or heart attack) compared to those who didn’t take a supplement. It’s currently not known why vitamin D may have these benefits on these other areas of our health. It’s also worth noting that in many of these trials, very few of the participants were actually vitamin D deficient. While we might speculate the observed health benefits may be even greater in people with vitamin D deficiency, it will be important for future research to study these factors. While it’s too early to say whether vitamin D supplements have broad health benefits, it’s clear it’s beneficial for bone health. It may be worthwhile to take a supplement in the winter months, especially if you’re over 65, have darker skin or spent a lot of time indoors as these factors can put you at <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-deficiency/faq-20058397#:%7E:text=However%2C%20some%20groups%20%E2%80%94%20particularly%20people,sun%20exposure%20or%20other%20factors.">increased risk of vitamin D deficiency</a>. The research also shows us that we should be rethinking vitamin D supplementation advice. While in the UK it’s recommended people get 400 IU of vitamin D a day, many trials have shown 2,000 IU a day is associated with health 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/219521/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, Professor of Molecular Endocrinology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</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/vitamin-d-supplements-can-keep-bones-strong-but-they-may-also-have-other-benefits-to-your-health-219521">original article</a>.

Body

Sam Kerr’s alleged comments may have had a racial element, but they were not ‘racist’

<a href="https://theconversation.com/profiles/mario-peucker-192086">Mario Peucker</a>, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> Footballer Sam Kerr has been charged with “racially aggravated harassment” over a January 2023 incident in which she allegedly insulted a London police officer. According to <a href="https://www.theguardian.com/football/2024/mar/06/sam-kerr-allegedly-called-police-officer-a-stupid-white-bastard-source-says">widespread media reports</a>, she is said to have called the officer a “stupid white bastard”. Kerr has pleaded not guilty to the charge and has <a href="https://www.9news.com.au/world/sam-kerr-legal-team-reportedly-challenge-allegations-of-police-harassment/744598ef-75f9-4e03-acb5-7b37aecde8d1">reportedly denied</a> using the word “bastard”. According to section 33 of the British Crime and Disorder Act, to be found guilty of such an offence, the conduct would have had to cause – or have intended to cause – alarm or distress. Regardless of the court’s ultimate verdict, one big question seems to occupy the minds of many: does the phrase attributed to Kerr constitute racism? Kerr was born in Western Australia, and has Indian ancestry on her father’s side. Can she be racist towards a white person, and more specifically to a white police officer? Assuming it is true Kerr used the term “white”, there is a racial element. But “racial” is not the same as “racist”. <h2>Definitions of racism</h2> It is important to note here that “race” is not a biological category (there is only one human race). Race is a <a href="https://www.scientificamerican.com/article/race-is-a-social-construct-scientists-argue/">social construct</a>, invented and cemented centuries ago to legitimise colonial atrocities, oppression and forms of subjugation including slavery. There are many definitions of racism, but there has been a broad consensus for decades that racism is more than “just” prejudice and discriminatory behaviour. It is not simply a matter of less favourable treatment of an individual or group of people based on their actual or ascribed ethnic background, skin colour, origin or related characteristics. Racism also reflects and manifests as systemic exclusion and marginalisation based on historically rooted power imbalances and racial hierarchies that put white people at the top. To put it very simply, the scholarly (if not the legal) definition is that “<a href="https://psycnet.apa.org/record/1998-07453-002">racism equals power plus prejudice</a>”. In a vicious cycle, everyday racism and discrimination are shaped and justified by racial hierarchies, while they operate continuously in a way that cements power imbalances and racial marginalisation. This may sound a bit abstract, but if we do not recognise this power dynamic, we trivialise racism as little more than name-calling. We will fail to understand how racism operates and how it continues to affect people from racially marginalised groups in their daily lives. One way to illustrate the systemic nature of racism is to look at the persistent lack of representation of people of colour in leadership positions in the corporate sector, the media and governments in Australia and elsewhere. In the United Kingdom, where the alleged incident occurred, institutional racism – including within the police force – has been recognised since the release of the <a href="https://www.gov.uk/government/publications/the-stephen-lawrence-inquiry">Macpherson report</a> in 1999. It was reaffirmed in 2023 by the <a href="https://www.met.police.uk/SysSiteAssets/media/downloads/met/about-us/baroness-casey-review/update-march-2023/baroness-casey-review-march-2023a.pdf">Baroness Casey Review</a>, despite some political pushback. The review found “Met officers are 82% White and 71% male, and the majority do not live in the city they police. As such, the Met does not look like the majority of Londoners.” <h2>Reverse racism?</h2> Anti-discrimination legislation in the UK and Australia usually does not speak explicitly of “racism”. It outlaws certain acts that are motivated, partially or wholly, by a person’s race (or other personal identity markers). Legislators introduced these laws with the intention of enhancing the legal protections for those who were considered vulnerable to racism. In Australia, for example, the <a href="https://www.legislation.gov.au/C2004A00274/latest/text">Racial Discrimination Act</a> (1975) is often celebrated as a legal cornerstone in the country’s journey away from its racist “White Australia” history towards a modern multicultural society. The United Nations’ <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/international-convention-elimination-all-forms-racial">International Convention on the Elimination of All Forms of Racial Discrimination</a> (1965), ratified by Australia in 1975 and the UK in 1969, makes its intention explicit when it calls on all state parties to make it an offence to disseminate “ideas based on racial superiority”. The issue of power structures should also be seen through an institutional lens. It is difficult to imagine a person on the streets of London with more institutional power than a white police officer. Being called a “stupid bastard” might hurt someone’s feelings. But while I’m in no position to judge whether Sam Kerr’s alleged actions have caused “distress” to the officer – as the law would require – labelling the incident as racist is clearly not in line with what racism means. Such a definition would not align with the concept’s institutional and systemic dimensions. It is not what anti-discrimination laws were intended to outlaw. Claims of anti-white or “reverse” racism are based on a shallow, misguided and inaccurate understanding of what racism really constitutes. If Kerr’s court case fails to acknowledge the deeper purpose of anti-racism legislation by equating “racial” with “racist”, it risks setting a highly problematic precedent that would undermine efforts to acknowledge and tackle racism in all its forms. What would be the message to those millions of people in the UK, Australia and elsewhere who have to face racism every day without recognition of the harm it causes and without the support and capacity to sue the perpetrators? What would they think about their right to equality and their place in society?<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/225267/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mario-peucker-192086">Mario Peucker</a>, Associate Professor and Principal Research Fellow, Institute for Sustainable Industries and Liveable Cities, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sam-kerrs-alleged-comments-may-have-had-a-racial-element-but-they-were-not-racist-225267">original article</a>.

Legal

Taking expensive medicines or ones unavailable in Australia? Importing may be the answer

<a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> The cost-of-living crisis may be driving some Australians to look for cheaper medicines, especially if those medicines are not subsidised or people don’t have a Medicare card. Options can include buying their medicines from overseas, in a process called “<a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation</a>”. Others also use this option to import medicine that is not available in Australia. Here’s what’s involved and what you need to know about the health and legal risks. <h2>Cost-of-living crisis bites</h2> Many Australians, particularly those with long-term illnesses, are finding it increasingly hard to afford health care. The <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">Australian Bureau of Statistics</a> reports the proportion of people who delayed or did not see a GP due to cost doubled in 2022-23 (7%) compared with 2021-22 (3.5%). A <a href="https://australianhealthcareindex.com.au/wp-content/uploads/2022/11/Australian-Healthcare-Index-Report-Nov-22.pdf">survey</a> published in 2022 of over 11,000 people found more than one in five went without a prescription medicine due to the cost. For those with a Medicare card it’s usually best (and cheapest) to get medicines locally, especially if you also have a concession card. However, for some high-cost medicines, personal importation may be cheaper. That’s when an individual arranges for medicine to be sent to them directly from an overseas supplier. A 2023 study found <a href="https://www.publish.csiro.au/AH/AH23143?jid=AHv47n6&xhtml=5AA1F839-38C8-45E8-A458-79DCDB7597FB">1.8%</a> of Australians aged 45 or older had imported prescription medicines in the past 12 months. That indicates potentially hundreds of thousands of Australians are importing prescription medicines each year. Almost half of the survey respondents indicated they would consider importing medicines to save money. <h2>What’s involved?</h2> Australia’s drug regulator, the Therapeutic Goods Administration (TGA), allows individuals to import up to three months’ supply of medicines for their own personal use (or use by a close family member) under the <a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation scheme</a>. This often involves ordering a medicine through an overseas website. If the medicine would require a prescription in Australia, you must also have a legally valid prescription to import it. Selling or supplying these medicines to others outside your immediate family is strictly prohibited. <h2>How could this help?</h2> For some high-cost medicines, personal importation may be cheaper than having the medicine dispensed in Australia. This is most likely for medicines not subsidised by the <a href="https://www.pbs.gov.au/info/about-the-pbs">Pharmaceutical Benefits Scheme</a> (the PBS). People who do not hold a Medicare card may also find it cheaper to import certain medicines as they do not have access to PBS-subsidised medicines. For example, for people with a specific type of leukaemia, treatment with sorafenib is not covered by the PBS. For these patients it could be up to about ten times more expensive to have their treatment dispensed in Australia as it is to import. That’s because there is a cheaper generic version available overseas. Personal importation may also allow you to access medicines that are available overseas but are not marketed in Australia. <h2>What are the risks?</h2> All medicines carry risks, and medicine sold online can pose additional dangers. The TGA does not regulate medicines sold overseas, so the safety and quality of such medicines can be uncertain; they may not be produced to <a href="https://www.tga.gov.au/what-tga-regulates">Australian standards</a>. While similar regulatory agencies exist in other countries, when ordering medicines from overseas websites it can be difficult to determine if the product you are buying has been assessed to ensure it is safe and will do what it says it will do. The medicines purchased could be counterfeit or “fake”. Products bought through unverified or overseas websites may have undisclosed ingredients, contain a dose that differs from that on the label, or lack the active ingredient entirely. <a href="https://www.tga.gov.au/importing-therapeutic-goods">Not all medicines</a> can be legally imported through the personal importation scheme. Certain medicines are never allowed to be imported into Australia, and others can only be imported by a medical professional on behalf of a patient. So if you attempt to import a restricted medicine, the Australian Border Force <a href="https://www.abf.gov.au/entering-and-leaving-australia/can-you-bring-it-in/categories/medicines-and-substances">may seize it</a>. Not only would you lose your medicine, but you could also receive a fine or face <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use#:%7E:text=If%20you%20try%20to%20import,a%20fine%20or%20jail%20time.">jail time</a>. As with any purchase from an overseas business, there is also a risk you may lose your money and you might not be protected by Australian consumer laws. If you do choose to import medicines by buying them from an overseas website, you should also consider what could happen if delivery is delayed and you don’t get your medicine in time. <h2>Where can I get more advice?</h2> If you are thinking about importing medicines you should first discuss this with a health professional, such as your GP or pharmacist. They can help you determine if personal importation is permitted for the medicine you need. You can also discuss if this is the best option for you. If you are having difficulty covering the cost of your medicines your doctor or pharmacist can also explore other potential alternatives to ensure you are receiving the most cost-effective treatment available in Australia. <h2>Where do I go online?</h2> If you then decide to import, here are some reputable sites to help navigate the global online medicines market: <ul> <li> <a href="https://everyone.org/">everyone.org</a> helps people everywhere in the world access the latest medicines not available in their own countries </li> <li> <a href="https://buysaferx.pharmacy/">Alliance for Safe Online Pharmacies</a> is a not-for-profit organisation that collates information on how to find safe online pharmacies based in different regions of the world </li> <li> <a href="https://www.pharmacychecker.com/accredited-online-pharmacies/">PharmacyChecker</a> has also collated a list of trusted online pharmacies that ship medicines internationally. </li> </ul> Australian government websites about importing medicines include those from <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use">the TGA</a> and on what to consider when buying medicines online from <a href="https://www.healthdirect.gov.au/buying-medicines-online#overseas">overseas</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/219394/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, Senior Lecturer in Pharmacy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</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/taking-expensive-medicines-or-ones-unavailable-in-australia-importing-may-be-the-answer-219394">original article</a>.

Caring

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

<a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person. The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors. Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s. The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million. <h2>What’s CJD got to do with Alzehimer’s?</h2> CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell. Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s. <h2>Human growth hormone used to come from donated organs</h2> Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue. But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>. An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people. hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk. <h2>What are the latest findings about Alzheimer’s disease?</h2> The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission. The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease. They considered other explanations for the findings but concluded donated hGH was the likely cause. Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease. Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible. However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident. <h2>When was this process used in Australia?</h2> In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility. <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch. The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small. Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution. <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide. Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk. The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<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/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.

Mind

Nick Kyrgios admits tennis career "may be over"

Australian tennis star Nick Kyrgios is seriously considering retirement as he revealed that he is "at a crossroads" in his career. In a column written for The Sydney Morning Herald, the 28-year-old said that despite his desire to compete at the highest level, he might never make it back to playing professional tennis. He also said that he has enjoyed being away from the courts doing the media rounds. "I sat down with my agent, Stuart Duguid, a couple of days ago to talk about my future," he wrote. "The reality is, there is a part of me that knows my time in the sport may be over. And I'm OK with that. "It's a conversation that needed to be had. I'm at a crossroads in my career and have reached a point where life after tennis is a prospect that excites me." He also added that despite knowing he can still compete for titles, his body is letting him down, as he continues to recover from his <a href="https://www.oversixty.com.au/news/news/nick-kyrgios-pulls-out-of-australian-open-a-day-before-first-match" target="_blank" rel="noopener">knee injury</a> in January 2023. "I sit there and watch some of the players on tour and know within myself that this generation is not as strong as some of the players I have gone up against," he wrote. "I know I can be one of the best in the world and win major tournaments -- if my body lets me. The fire still burns, but it's not my everything." The 2022 Wimbledon finalist also confirmed that he won't be making himself available for this year's Paris Olympics, saying that the treatment he got from the Australian Olympic Committee in the lead-up to the 2016 Rio Games was one of the key factors. "I was No. 13 at the time and had a genuine chance at winning a medal. For them to forbid me from representing my country for behavioural reasons is something that I just can't forget," he said. He added that his "mentality has changed", and despite still having the desire to play for his country, his decision is final. Kyrgios has barely been on court after withdrawing from last year's Australian Open, but he has been commentating on the tournament for Eurosport, adding that his future may be in the box, rather than on the court. Image: Getty

Retirement Life

It’s time to limit how often we can travel abroad – ‘carbon passports’ may be the answer

<a href="https://theconversation.com/profiles/ross-bennett-cook-1301368">Ross Bennett-Cook</a>, <a href="https://theconversation.com/institutions/university-of-westminster-916">University of Westminster</a> The summer of 2023 has been very significant for the travel industry. By the end of July, international tourist arrivals globally <a href="https://www.unwto.org/news/international-tourism-swiftly-overcoming-pandemic-downturn">reached 84% of pre-pandemic levels</a>. In <a href="https://joint-research-centre.ec.europa.eu/jrc-news-and-updates/eu-tourism-almost-full-recovery-pre-pandemic-levels-2023-10-23_en">some European countries</a>, such as France, Denmark and Ireland, tourism demand even surpassed its pre-pandemic level. This may be great <a href="https://skift.com/insight/state-of-travel/">news economically</a>, but there’s concern that a return to the status quo is already showing dire environmental and social consequences. The summer saw record-breaking heatwaves across many parts of the world. People were forced to flee <a href="https://www.theguardian.com/world/2023/jul/24/greece-wildfires-corfu-evia-rhodes-heatwave-northern-hemisphere-extreme-weather-temperatures-europe">wildfires in Greece</a> and <a href="https://www.independent.co.uk/climate-change/news/hawaii-fires-update-biden-b2393188.html">Hawaii</a>, and extreme <a href="https://www.manchestereveningnews.co.uk/news/world-news/foreign-office-issues-spain-weather-27339111">weather warnings</a> were issued in many popular holiday destinations like Portugal, Spain and Turkey. Experts <a href="https://theconversation.com/european-heatwave-whats-causing-it-and-is-climate-change-to-blame-209653">attributed these extreme conditions</a> to climate change. Tourism is part of the problem. The tourism sector <a href="https://wttc.org/Portals/0/Documents/Reports/2021/WTTC_Net_Zero_Roadmap.pdf">generates around one-tenth</a> of the greenhouse gas emissions that are driving the climate crisis. The negative impacts of tourism on the environment have become so severe that some are suggesting drastic changes to our travel habits are inevitable. In a <a href="https://www.intrepidtravel.com/sites/intrepid/files/basic_page/files/A%20Sustainable%20Future%20For%20Travel%20From%20Crisis%20To%20Transformation-231016-02.pdf">report</a> from 2023 that analysed the future of sustainable travel, tour operator Intrepid Travel proposed that “carbon passports” will soon become a reality if the tourism industry hopes to survive. <h2>What is a carbon passport?</h2> The idea of a carbon passport centres on each traveller being assigned a yearly carbon allowance that they cannot exceed. These allowances can then “ration” travel. This concept may seem extreme. But the idea of personal carbon allowances is not new. A <a href="https://publications.parliament.uk/pa/cm200708/cmselect/cmenvaud/565/565.pdf">similar concept</a> (called “personal carbon trading”) was discussed in the House of Commons in 2008, before being shut down due to its perceived complexity and the possibility of public resistance. The <a href="https://www.nature.org/en-us/get-involved/how-to-help/carbon-footprint-calculator/#:%7E:text=A%20carbon%20footprint%20is%20the,is%20closer%20to%204%20tons.">average annual carbon footprint</a> for a person in the US is 16 tonnes – one of the highest rates in the world. In the UK this figure sits at 11.7 tonnes, still more than five times the figure recommended by the <a href="https://www.openaccessgovernment.org/the-average-british-carbon-footprint-is-five-times-over-paris-agreement-recommendations/152669/#:%7E:text=Despite%20rising%20environmental%20awareness%20across,equivalent%20(tCO2e)%20per%20year.">Paris Agreement</a> to keep global temperature rise below 1.5°C. Globally, the average annual carbon footprint of a person is closer to 4 tonnes. But, to have the best chance of preventing temperature rise from overshooting 2°C, the average global carbon footprint <a href="https://www.nature.org/en-us/get-involved/how-to-help/carbon-footprint-calculator/#:%7E:text=Globally%2C%20the%20average%20carbon%20footprint,tons%20doesn't%20happen%20overnight!">needs to drop</a> to under 2 tonnes by 2050. This figure equates to around <a href="https://www.theguardian.com/environment/ng-interactive/2019/jul/19/carbon-calculator-how-taking-one-flight-emits-as-much-as-many-people-do-in-a-year">two return flights</a> between London and New York. Intrepid Travel’s report predicts that we will see carbon passports in action by 2040. However, <a href="https://www.politico.eu/article/travel-short-haul-flights-europe-under-fire-climate-change-cop26/">several laws and restrictions</a> have been put in place over the past year that suggest our travel habits may already be on the verge of change. <h2>Targeting air travel</h2> Between 2013 and 2018, the amount of CO₂ emitted by commercial aircrafts worldwide <a href="https://theicct.org/sites/default/files/publications/ICCT_CO2-commercl-aviation-2018_20190918.pdf">increased by 32%</a>. Improvements in fuel efficiency are slowly reducing per passenger emissions. But <a href="https://www.sciencedirect.com/science/article/pii/S1352231014004889">research</a> from 2014 found that whatever the industry’s efforts to reduce its carbon emissions, they will be outweighed by the growth in air traffic. For emission reductions to have any meaningful effect, ticket prices would have to rise by 1.4% each year, discouraging some people from flying. However, in reality, <a href="https://www.climatecentral.org/news/increase-in-flights-will-outweigh-carbon-cuts-17875">ticket prices are falling</a>. Some European countries are beginning to take measures to reduce air travel. As of April 1 2023, passengers on short-haul flights and older aircraft in Belgium have been <a href="https://www.euronews.com/green/2022/12/12/private-jets-and-short-haul-flights-face-pollution-busting-tax-increases-in-belgium">subject to increased taxes</a> to encourage alternative forms of travel. Less than two months later France banned <a href="https://www.bbc.co.uk/news/world-europe-65687665">short-haul domestic flights</a> where the same trip can be made by train in two-and-a-half hours or less. <a href="https://businesstravelerusa.com/news/spain-to-follow-frances-lead-plans-to-ban-short-haul-domestic-flights/">Spain</a> is expected to follow suit. A similar scheme could also be on the horizon for Germany. In 2021, a <a href="https://www.cleanenergywire.org/news/seventy-percent-germans-favour-banning-short-haul-flights-survey">YouGov poll</a> found that 70% of Germans would support such measures to fight climate change if alternative transport routes like trains or ships were available. <h2>Cruises and carbon</h2> It’s not just air travel that’s being criticised. An <a href="https://www.transportenvironment.org/wp-content/uploads/2023/06/The-return-of-the-cruise-June-2023.pdf">investigation</a> by the European Federation for Transport and Environment in 2023 found that cruise ships pump four times as many sulphuric gases (which are proven to cause acid rain and <a href="https://www.forbes.com/sites/jamesellsmoor/2019/04/26/cruise-ship-pollution-is-causing-serious-health-and-environmental-problems/?sh=468ee2f637db">several respiratory conditions</a>) into the atmosphere than all of Europe’s 291 million cars combined. Statistics like these have forced European destinations to <a href="https://www.ft.com/content/8727387d-590d-43bd-a305-b5ec208a4dfe">take action</a> against the cruise industry. In July, Amsterdam’s council <a href="https://www.bbc.co.uk/news/world-europe-66264226">banned cruise ships</a> from docking in the city centre in a bid to reduce tourism and pollution – an initiative that has shown success elsewhere. In 2019 Venice was the most polluted European port, due to large numbers of cruise ship visits. But it dropped to 41st place in 2022 after a ban on large cruise ships entering the city’s waters <a href="https://www.transportenvironment.org/discover/europes-luxury-cruise-ships-emit-as-much-toxic-sulphur-as-1bn-cars-study/">reduced air pollutants from ships</a> in Venice by 80%. <h2>Changing destinations</h2> Intrepid Travel’s report also highlights that not only how we travel, but <a href="https://joint-research-centre.ec.europa.eu/jrc-news-and-updates/global-warming-reshuffle-europes-tourism-demand-particularly-coastal-areas-2023-07-28_en">where we travel</a> will soon be impacted by climate change. Boiling temperatures will probably diminish the allure of traditional beach destinations, prompting European tourists to search for cooler destinations such as Belgium, Slovenia and Poland for their summer holidays. <a href="https://www.travelweekly.com/Travel-News/Tour-Operators/Travelers-seek-cooler-destinations-this-summer">Several travel agencies</a> reported seeing noticeable increases in holiday bookings to cooler European destinations like Scandinavia, Ireland and the UK during 2023’s peak summer travel months. Whatever the solution may be, changes to our travel habits look inevitable. Destinations across the globe, from <a href="https://www.theneweuropean.co.uk/barcelonas-war-on-tourism-ada-colau/">Barcelona</a> to the <a href="https://www.dw.com/en/italy-tourism-bans-controls-fees-restrictions/a-66453047">Italian riveria</a> and even <a href="https://theconversation.com/death-on-everest-the-boom-in-climbing-tourism-is-dangerous-and-unsustainable-114033">Mount Everest</a> are already calling for limits on tourist numbers as they struggle to cope with crowds and pollution. Holidaymakers should prepare to change their travel habits now, before this change is forced upon them. <a href="https://theconversation.com/profiles/ross-bennett-cook-1301368">Ross Bennett-Cook</a>, Visiting Lecturer, School of Architecture + Cities, <a href="https://theconversation.com/institutions/university-of-westminster-916">University of Westminster</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/its-time-to-limit-how-often-we-can-travel-abroad-carbon-passports-may-be-the-answer-216503">original article</a>.

International Travel

Drug resistance may make common infections like thrush untreatable

<a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> We’ve all heard about antibiotic resistance. This happens when bacteria develop strategies to avoid being destroyed by an antibiotic. The consequences of antibiotic resistance mean an antibiotic previously used to cure bacterial infections no longer works effectively because the bacteria have become resistant to the drug. This means it’s getting harder to cure the infections some bacteria cause. But unfortunately, it’s only one part of the problem. The same phenomenon is also happening with other causes of infections in humans: fungi, viruses and parasites. “Antimicrobial resistance” means the drugs used to treat diseases caused by microbes (bugs that cause infection) no longer work. This occurs with antibacterial agents used against bacteria, antifungal agents used against fungi, anti-parasitic agents used against parasites and antiviral agents used against viruses. This means a wide range of previously controllable infections are becoming difficult to treat – and may become untreatable. <h2>Fighting fungi</h2> Fungi are responsible for a range of infections in humans. Tinea, ringworm and vulvovaginal candidiasis (thrush) are some of the more familiar and common superficial fungal infections. There are also life-threatening fungal infections such as aspergillosis, cryptococcosis and invasive fungal bloodstream infections including those caused by Candida albicans and Candida auris. Fungal resistance to antifungal agents is a problem for several reasons. First, the range of antifungal agents available to treat fungal infections is limited, especially compared to the range of antibiotics available to treat bacterial infections. There are only four broad families of antifungal agents, with a small number of drugs in each category. Antifungal resistance further restricts already limited options. Life-threatening fungal infections happen less frequently than life-threatening bacterial infections. But they’re rising in frequency, especially among people whose immune systems are compromised, including by <a href="https://7news.com.au/news/qld/first-heart-transplant-patient-to-die-from-fungal-infection-at-brisbanes-prince-charles-hospital-identified-as-mango-hill-gp-muhammad-hussain-c-12551559">organ transplants</a> and chemotherapy or immunotherapy for cancer. The threat of getting a drug-resistant fungal infection makes all of these health interventions riskier. The greatest <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2017.00735/full">burden of serious fungal disease</a> occurs in places with limited health-care resources available for diagnosing and treating the infections. Even if infections are diagnosed and antifungal treatment is available, antifungal resistance reduces the treatment options that will work. But even in Australia, common fungal infections are impacted by resistance to antifungal agents. Vulvovaginal candidiasis, known as thrush and caused by Candida species and some closely related fungi, is usually reliably treated by a topical antifungal cream, sometimes supplemented with an oral tablet. However, instances of <a href="https://www.theage.com.au/national/victoria/they-can-t-sit-properly-doctors-treat-growing-number-of-women-with-chronic-thrush-20230913-p5e499.html">drug-resistant thrush</a> are increasing, and new treatments are needed. <h2>Targeting viruses</h2> Even <a href="https://theconversation.com/why-are-there-so-many-drugs-to-kill-bacteria-but-so-few-to-tackle-viruses-137480">fewer antivirals</a> are available than antibacterial and antifungal agents. Most antimicrobial treatments work by exploiting differences between the microbe causing the infection and the host (us) experiencing the infection. Since viruses use our cells to replicate and cause their infection, it’s difficult to find antiviral treatments that selectively target the virus without damaging us. With so few antiviral drugs available, any resistance that develops to one of them significantly reduces the treatment options available. Take COVID, for example. Two antiviral medicines are in widespread use to treat this viral infection: Paxlovid (containing nirmatrelvir and ritonavir) and Lagevrio (molnupiravir). So far, SARS-CoV-2, the virus that causes COVID, has not developed significant resistance to either of these <a href="https://www.cidrap.umn.edu/covid-19/low-levels-resistance-paxlovid-seen-sars-cov-2-isolates">treatments</a>. But if SARS-CoV-2 develops resistance to either one of them, it halves the treatment options. Subsequently relying on one would likely lead to its increased use, which may heighten the risk that resistance to the second agent will develop, leaving us with no antiviral agents to treat COVID. The threat of antimicrobial resistance makes our ability to treat serious COVID infections rather precarious. <h2>Stopping parasites</h2> Another group of microbes that cause infections in humans are single-celled microbes such as Plasmodium, Giardia, Leishmania, and Trypanosoma. These microbes are sometimes referred to as parasites, and they are becoming increasingly resistant to the very limited range of anti-parasitic agents used to treat the infections they cause. Several Plasmodium species cause malaria and anti-parasitic drugs have been the cornerstone of malaria treatment for decades. But their usefulness has been significantly reduced by the <a href="https://www.mmv.org/our-work/mmvs-pipeline-antimalarial-drugs/antimalarial-drug-resistance">development of resistance</a>. Giardia parasites cause an infection called giardiasis. This can resolve on its own, but it can also cause severe gastrointestinal symptoms such as diarrhea, nausea, and bloating. These microbes have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207226/">developed resistance</a> to the main treatments and patients infected with drug-resistant parasites can have protracted, unpleasant infections. <h2>Resistance is a natural consequence</h2> Treating infections influences microbes’ evolutionary processes. Exposure to drugs that stop or kill them pushes microbes to either evolve or die. The exposure to antimicrobial agents provokes the evolutionary process, selecting for microbes that are resistant and can survive the exposure. The pressure to evolve, provoked by the antimicrobial treatment, is called “selection pressure”. While most microbes will die, a few will evolve in time to overcome the antimicrobial drugs used against them. The evolutionary process that leads to the emergence of resistance is inevitable. But some things can be done to minimise this and the problems it brings. Limiting the use of antimicrobial agents is one approach. This means reserving antimicrobial agents for when their use is known to be necessary, rather than using them “just in case”. Antimicrobial agents are precious resources, holding at bay many infectious diseases that would otherwise sicken and kill millions. It is imperative we do all we can to preserve the effectiveness of those that remain, and give ourselves more options by working to discover and develop new ones.<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/213460/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, Senior Research Fellow, School of Medicine, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</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/drug-resistance-may-make-common-infections-like-thrush-untreatable-213460">original article</a>.

Body

5 reasons why climate change may see more of us turn to alcohol and other drugs

<a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a> Climate change will affect every aspect of our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01859-7/fulltext">health and wellbeing</a>. But its potential harms go beyond the body’s ability to handle extreme heat, important as this is. Extreme weather events, such as floods, droughts, storms and wildfires, are becoming more frequent and severe. These affect our <a href="https://pubmed.ncbi.nlm.nih.gov/36165756/">mental health</a> in a multitude of <a href="https://www.nature.com/articles/s41558-018-0102-4">ways</a>. Coping with climate change can be overwhelming. Sometimes, the best someone can do is to seek refuge in alcohol, tobacco, over-the-counter and prescription drugs, or other psychoactive substances. This is understandable, but dangerous, and can have serious consequences. We outline <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221132739">five ways</a> climate change could increase the risk of harmful substance use. <h2>1. Mental health is harmed</h2> Perhaps the most obvious way climate change can be linked to harmful substance use is by damaging mental health. This <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12448">increases the risk</a> of new or worsened substance use. People with a mental disorder are <a href="https://www.hindawi.com/journals/psychiatry/2018/5697103/">at high risk</a> of also having a <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-25#:%7E:text=Prevalence%20of%20comorbidity%20in%20epidemiological%20studies&text=Among%20subjects%20with%20an%20alcohol,a%20comorbid%20SUD%20%5B39%5D.">substance-use disorder</a>. This often precedes their mental health problems. Climate change-related increases in the number and nature of extreme events, in turn, are escalating risks to mental health. For example, extreme heat is linked to increased <a href="https://pubmed.ncbi.nlm.nih.gov/27727320/">distress</a> across the whole population. In extreme heat, more people go to the <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2789481">emergency department</a> for psychiatric problems, including for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969720338249">alcohol</a> and <a href="https://www.nature.com/articles/s43856-023-00346-1">substance use</a> generally. This is even true for <a href="https://www.sciencedirect.com/science/article/pii/S0048969720325572">a single very hot day</a>. Post-traumatic stress disorder, depression, anxiety and <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja13.10307">other mental health</a> problems are <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00367/full">common</a> at the time of extreme weather events and can persist for months, even years afterwards, especially if people are exposed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116266/">multiple events</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101235/">increase</a> the likelihood of using substances as a way to cope. <h2>2. Worry increases</h2> With <a href="https://climatecommunication.yale.edu/publications/climate-change-in-the-american-mind-beliefs-attitudes-december-2022/">increasing public awareness</a> of how climate change is endangering wellbeing, people are <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/worriesaboutclimatechangegreatbritain/septembertooctober2022#:%7E:text=The%20level%20of%20worry%20about,lives%20right%20now%20(29%25).">increasingly worried</a> about what will happen if it remains unchecked. Worrying isn’t the same as meeting the criteria for a mental disorder. But <a href="https://www.undp.org/publications/peoples-climate-vote">surveys</a> show climate change generates complex emotional responses, <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00278-3/fulltext">especially in children</a>. As well as feelings of worry, there is anxiety, fear, guilt, anger, grief and helplessness. Some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/">emotional states</a>, such as <a href="https://www.pnas.org/doi/full/10.1073/pnas.1909888116">sadness</a>, are linked with long-term tobacco use and also make substance use <a href="https://pubmed.ncbi.nlm.nih.gov/16011392/">relapse</a> more likely. <h2>3. Physical injuries hurt us in many ways</h2> Physical injuries caused by extreme weather events – such as smoke inhalation, burns and flood-related cuts and infections – increase the risk of harmful substance use. That’s partly because they <a href="https://pubmed.ncbi.nlm.nih.gov/20033251/">increase</a> the risk of psychological distress. If injuries cause long-term illness or disability, consequent feelings of hopelessness and depression can dispose some people to self-medicate with alcohol or other drugs. Substance use itself can also generate long-term physiological harm, disabilities or other chronic health problems. These are <a href="https://www.tandfonline.com/doi/abs/10.3109/00952999609001655">linked with</a> higher rates of harmful substance use. <h2>4. Our day-to-day lives change</h2> A single catastrophic event, such as a storm or flood, can devastate lives overnight and change the way we live. So, too, can the more subtle changes in climate and day-to-day weather. Both can disrupt behaviour and routines in ways that risk new or worsened substance use, for example, using stimulants to cope with fatigue. Take, for example, hotter temperatures, which disrupt <a href="https://www.cell.com/one-earth/fulltext/S2590-3322(22)00209-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2590332222002093%3Fshowall%3Dtrue">sleep</a>, undermine <a href="https://jhr.uwpress.org/content/57/2/400">academic performance</a>, <a href="https://www.nature.com/articles/s41562-017-0097">reduce physical activity</a>, and promote <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00173-5/fulltext">hostile language</a> and <a href="https://www.cambridge.org/core/elements/abs/climate-change-and-human-behavior/F64471FA47B8A6F5524E7DDDDE571D57">violent behaviour</a>. <h2>5. It destabilises communities</h2> Finally, climate change is destabilising the socioeconomic, natural, built and geopolitical <a href="https://www.nature.com/articles/s41558-018-0102-4">systems</a> on which human wellbeing – <a href="https://theconversation.com/climate-change-and-health-ipcc-reports-emerging-risks-emerging-consensus-24213">indeed survival</a> – depends. Damaged infrastructure, agricultural losses, school closures, homelessness and displacement are significant <a href="https://www.nature.com/articles/s41558-018-0102-4">sources of psychosocial distress</a> that prompt acute (short-term) and chronic (long-term) stress responses. <a href="https://doi.org/10.1196/annals.1441.030">Stress</a>, in turn, can <a href="https://doi.org/10.1007/s002130100917">increase</a> the risk of <a href="https://link.springer.com/article/10.1007/s002130100917">harmful substance use</a> and make people more likely to relapse. <h2>Why are we so concerned?</h2> Substance-use disorders are economically and socially <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30337-7/fulltext">very costly</a>. Risky substance use that doesn’t meet the criteria for a formal diagnosis <a href="https://digitalcommons.fiu.edu/srhreports/health/health/32/">can also harm</a>. Aside from its direct physical harm, harmful substance use disrupts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843305/">education</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234116/">employment</a>. It increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676144/">accidents</a> and <a href="https://www.tandfonline.com/doi/abs/10.1080/09595230600944479">crime</a>, and it undermines social relationships, intimate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795906/#:%7E:text=Results%20indicated%20that%20alcohol%20use,drinkers%20with%20low%20relationship%20satisfaction.">partnerships</a> and <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/abs/longitudinal-relations-between-parental-drinking-problems-family-functioning-and-child-adjustment/CE508589A9E799FD6DC9E23DF364FB8F">family functioning</a>. <h2>Politicians take note</h2> As we head towards the <a href="https://www.cop28.com">COP28 global climate talks</a> in Dubai, climate change is set to hit the headlines once more. Politicians know climate change is undermining human health and wellbeing. It’s well past time to insist they act. As we have seen for populations as a whole, there are multiple possible ways for climate change to cause a rise in harmful substance use. This means multidimensional <a href="https://www.nature.com/articles/s41558-018-0102-4">prevention strategies</a> are needed. As well as addressing climate change more broadly, we need strategies including: <ul> <li> supporting vulnerable individuals, especially <a href="https://journals.sagepub.com/doi/full/10.1177/21677026211040787">young people</a>, and marginalised commmunities, who are <a href="https://www.nature.com/articles/s41558-018-0102-4">hit hardest</a> by extreme weather-related events </li> <li> focusing health-related policies more on broadscale health promotion, for example, healthier eating, active transport and community-led mental health support </li> <li> investing in climate-resilient infrastructure, such as heat-proofing buildings and greening cities, to prevent more of the destabilising effects and stress we know contributes to mental health problems and harmful substance use. </li> </ul> There is now <a href="https://news.un.org/en/story/2022/10/1129912">no credible pathway</a> to avoiding dangerous climate change. However, if <a href="https://carnegieendowment.org/2023/01/12/climate-protests-tracking-growing-unrest-pub-88778#:%7E:text=These%20are%20just%20a%20few,even%20more%20numerous%20and%20influential.">increasing rates</a> of climate protests are anything to go by, the world may finally be ready for radical change – and perhaps for reduced harmful substance use.<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/217894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, Honorary Professor, Centre for Health Systems and Safety Research, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, Associate Professor, Psychosocial Difficulties, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</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/5-reasons-why-climate-change-may-see-more-of-us-turn-to-alcohol-and-other-drugs-217894">original article</a>.

Mind

“May her memory be a blessing”: Father of Hamas victim speaks out

The grieving father of a 23-year-old German-Israeli woman, Shani Louk, who was kidnapped from the Nova music festival by Hamas militants on October 7, has shared his devastation after it was confirmed that his daughter had been found dead. The Israeli Ministry of Foreign Affairs confirmed the discovery and identification of Shani Louk's body on Monday. Louk was attending the festival in southern Israel when Hamas breached the border between Gaza and Israel, leading to a series of tragic events. However, her father, Nissim Louk, remembers his daughter as someone who was enjoying herself "until the last moment". "Until about 6.45pm, Shani was still dancing, cheering, and going wild at the party and was surrounded by all her best friends — and they had fun all night," he told the Israeli news outlet, N12. He emphasised that she was killed instantly and didn't suffer. Just ten minutes earlier, she was still immersed in the festival's joy. “She was killed on the spot and not only did she not suffer, 10 minutes earlier she was still enjoying herself.” Mr Louk also criticised the government's response, calling it a failure. He claimed that the government ministries underestimated the situation, were unresponsive, and failed to take adequate measures. He pointed out the responsibility of then-Prime Minister Benjamin Netanyahu in the events and expressed his discontent with the government's handling of the situation. Shani Louk was kidnapped at the festival and subjected to torture and captivity by Hamas terrorists. The Israeli Ministry of Foreign Affairs stated that she "experienced unfathomable horrors", and expressed their condolences, saying, "May her memory be a blessing." The attack by Hamas militants on the festival was a horrifying event. They blocked off access to the festival site from both the north and the south before storming the area on foot. Videos from the site showed them encircling the crowds on three sides, leading to casualties and chaos. Shani's mother, Ricarda Louk, revealed that she last spoke to her daughter after hearing rockets and alarms sounding in southern Israel. She called to ensure her daughter's safety, and Shani informed her that she was at the festival with few places to hide. Her abduction occurred as she was trying to reach her car, with military personnel preventing people from leaving the scene. The tragedy at the Nova festival was immense, with more than 260 bodies found at the site by Israeli rescue service Zaka. However, based on CNN's analysis, the total death toll could be even higher. Additionally, a number of hostages were taken to Gaza during the attack, with the latest figures indicating that up to 239 hostages are believed to be held by Hamas in the enclave. In a glimmer of hope amidst the tragedy, a female Israeli soldier who had been kidnapped by Hamas on October 7 was released during ground operations in Gaza, as confirmed by the Israel Defence Forces. The soldier received medical attention, is in good health, and has been reunited with her family. Images: CNN / N12

Caring

An entry fee may not be enough to save Venice from 20 million tourists

<a href="https://theconversation.com/profiles/sameer-hosany-292658">Sameer Hosany</a>, <a href="https://theconversation.com/institutions/royal-holloway-university-of-london-795">Royal Holloway University of London</a> Venice’s history, art and architecture attract an estimated <a href="https://www.responsibletravel.com/copy/overtourism-in-venice">20 million</a> visitors every year. The city, a <a href="https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=ac36ced945412121372dc892cc31498fb268247c">Unesco World Heritage site</a>, is often crammed with tourists in search of special <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/mar.21665">memories</a>. But for the people who actually live there, this level of tourism has become unsustainable. So from 2024, day-trippers will be charged a €5 (£4.31) fee as part of an <a href="https://www.nytimes.com/2023/09/12/world/europe/venice-tourist-fee-italy.html#:%7E:text=The%20City%20Council%20passed%20an,popular%20but%20equally%20fragile%20place.&text=Starting%20next%20spring%2C%20day%2Dtrippers,5%20euros%20for%20the%20privilege.">attempt</a> to better manage the flow of visitors. The city’s mayor has <a href="https://travelweekly.co.uk/news/tourism/controversial-e5-venice-tourist-tax-finally-approved">described the charge</a> – which will be implemented on 30 particularly busy days in the spring and summer – as an attempt to “protect the city from mass tourism”. It comes after cruise ships were banned from entering the fragile Venice lagoon in 2021. Both policies are designed to respond to the particular problem facing Venice, which is that <a href="https://www.theguardian.com/world/2022/jul/02/venice-day-trippers-will-have-to-make-reservations-and-pay-fee">around 80%</a> of its tourists come just for the day. Research has shown that such a high proportion of day-trippers – who tend to spend little – <a href="https://www.sciencedirect.com/science/article/pii/0160738395000658">pushes</a> a tourist destination <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1541-0064.1980.tb00970.x">towards decline</a>. So from next year, all travellers to Venice will have to register their visit in advance and obtain a QR code online. Day trippers will then have to pay the fee; visitors staying overnight will not. Other exemptions include children under 14, as well as people who travel to the city for work and study, or to visit family members. To enforce the policy, the municipal police and authorised inspectors will carry out random checks. Anyone without the proper QR code will face a fine of up to €300 (£261). But some have expressed doubts about whether the €5 fee – the price of a coffee or an ice cream – will be enough to dissuade tourists from travelling to this iconic ancient city. One city politician <a href="https://www.nytimes.com/2023/09/12/world/europe/venice-tourist-fee-italy.html">commented</a> that the charge means Venice has become “a theme park, a Disneyland,” where “you get in by paying an entrance fee.” Certainly the charge is a lot less than Bhutan’s (recently reduced) “sustainable development fee” of <a href="https://globetrender.com/2023/09/17/bhutan-woos-more-tourists-reduced-entry-tax/">US$100 (£82) per night</a>, which applies to all tourists, and was introduced to encourage “high value, low impact” tourism. Research also indicates that strategies aiming at persuading tourists to come at less crowded times <a href="https://www.sciencedirect.com/book/9780080436746/seasonality-in-tourism">do not reduce numbers</a> at peak periods, but actually end up increasing overall demand. <h2>‘Veniceland’</h2> But Venice has to try something. For <a href="https://www.mdpi.com/2071-1050/11/24/6937">researchers</a>, Venice is the embodiment of <a href="https://www.cabidigitallibrary.org/doi/book/10.1079/9781786399823.0000">overtourism</a>, and residents clearly suffer from the consequences – living with the congestion, environmental damage and affects on their lifestyle and culture that 20 million visitors can cause. This can then lead to a negative response, known as “<a href="https://www.researchgate.net/publication/348605007_Overtourism_and_Tourismphobia_A_Journey_Through_Five_Decades_of_Tourism_Development_Planning_and_Local_Concerns">tourismphobia</a>”.Another term, “<a href="https://dokufest.com/en/festival/2013/cities-beyond-borders/das-venedig-prinzip-the-venice-syndrome#:%7E:text=The%20film%20shows%20what%20remains,municipal%20council%20with%20scorn%3B%20a">Venice Syndrome</a>” has been used to describe the <a href="https://www.sciencedirect.com/science/article/pii/S0264275123001816#:%7E:text=It%20explains%20the%20data%2Dgathering,between%20urban%20form%20conditions%20and">decline of the city’s</a> permanent population, as citizens feel forced to leave. Venice’s population is around 50,000 and has been consistently falling, from a peak of <a href="https://www.blueguides.com/venice-in-peril/">175,000</a>. If the population falls below 40,000, there is concern that Venice will cease to be a <a href="https://www.responsibletravel.com/copy/overtourism-in-venice">viable living city</a>. Those who remain have often expressed their discontent. Well publicised protests have included the “<a href="https://www.reuters.com/article/us-venice-funeral-idUKTRE5AD1DQ20091114">Funeral of Venice</a>” in 2009, a mock funeral to mourn the sharp drop in population, and “<a href="https://scholarworks.gsu.edu/cgi/viewcontent.cgi?article=1065&context=anthro_theses">Welcome to Veniceland</a>” in 2010, which claimed that Venice was becoming more of a theme park. And while “tourist taxes” <a href="https://www.tandfonline.com/doi/full/10.1080/14616688.2019.1669070">remain popular strategies</a> to address overtourism, their effectiveness remains debatable. Instead, research suggests that a <a href="https://www.tandfonline.com/doi/abs/10.1080/14616688.2019.1669070">combination</a> of specific economic measures (like fees and variable pricing) and non-economic policies (such as educating visitors) is the best option. That combination needs to be specially designed for each destination. There can be no one-size-fits-all solution. A <a href="https://www.e-unwto.org/doi/pdf/10.18111/9789284420070">report</a> by the World Tourism Organisation on overtourism identifies 11 different strategies and 68 measures to manage visitors’ growth in urban destinations. Barcelona, often seen as a city which has done well in handling mass tourism, has successfully used a <a href="https://www.econstor.eu/bitstream/10419/216242/1/CESifo-Forum-2019-03-p20-24.pdf">well targeted approach</a>. This has included harnessing new technology to develop a data driven management system to control visitor flows and overcrowding. It also deliberately engaged with the public when deciding on policies, and came up with specific strategies like limiting the number of new souvenir shops. But it did not resort to charging an entrance fee. Venice will be the first city in the world to do so – and other locations struggling with mass tourism will be keeping a close eye on whether such a bold move turns out to be a success.<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/213703/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sameer-hosany-292658">Sameer Hosany</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/royal-holloway-university-of-london-795">Royal Holloway University of London</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/an-entry-fee-may-not-be-enough-to-save-venice-from-20-million-tourists-213703">original article</a>.

International Travel

How ‘dad jokes’ may prepare your kids for a lifetime of embarrassment, according to psychology

<a href="https://theconversation.com/profiles/shane-rogers-575838">Shane Rogers</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/marc-hye-knudsen-1466723">Marc Hye-Knudsen</a>, <a href="https://theconversation.com/institutions/aarhus-university-967">Aarhus University</a> This Father’s Day you may be rolling out your best “<a href="https://www.merriam-webster.com/dictionary/dad%20joke">dad jokes</a>” and watching your children laugh (or groan). Maybe you’ll hear your own father, partner or friend crack a dad joke or two. You know the ones: "What is the most condescending animal? A pan-DUH!" "Why don’t scientists trust atoms? Because they make up everything!" Yes, dad jokes can be fun. They play an important role in how we interact with our kids. But dad jokes may also help prepare them to handle embarrassment later in life. <h2>What are dad jokes?</h2> Dad jokes are a distinct style of humour consisting of puns that are simple, wholesome and often involve a cheesy delivery. These jokes usually feature obvious wordplay and a straightforward punchline that leaves listeners either chuckling or emitting an exaggerated groan. This corny brand of humour is popular. There are hundreds of <a href="https://www.menshealth.com/trending-news/a34437277/best-dad-jokes/">websites</a>, <a href="https://www.youtube.com/watch?v=SAgYiERRDPY&t=248s">YouTube videos</a> and <a href="https://www.tiktok.com/@mmmjoemele/video/7207443872232770858">TikToks</a> dedicated to them. You can even play around with <a href="https://edition.cnn.com/interactive/2019/06/us/dad-joke-generator-trnd/">dad joke generators</a> if you need some inspiration. <h2>Why are dad jokes so popular?</h2> People seem to love dad jokes, partly because of the puns. A <a href="https://linkinghub.elsevier.com/retrieve/pii/S0191886922005025">study</a> published earlier this year found people enjoy puns more than most other types of jokes. The authors also suggested that if you groan in response to a pun, this can be a sign you enjoy the joke, rather than find it displeasing. Other research shows dad jokes work on at least <a href="https://www.degruyter.com/document/doi/10.26613/esic.5.2.248/html">three levels</a>: 1. As tame puns Humour typically <a href="https://journals.sagepub.com/doi/10.1177/0956797610376073">violates</a> a kind of boundary. At the most basic level, dad jokes only violate <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781315731162-7/puns-tacit-linguistic-knowledge-debra-aarons">a language norm</a>. They require specific knowledge of the language to “get” them, in a way a fart joke does not. The fact that dad jokes are wholesome and inoffensive means dads can tell them around their children. But this also potentially makes them tame, which other people might call unfunny. 2. As anti-humour Telling someone a pun that’s too tame to deserve being told out loud is itself a violation of the norms of joke-telling. That violation can in turn make a dad joke funny. In other words, a dad joke can be so unfunny this makes it funny – a type of <a href="https://daily.jstor.org/the-dubious-art-of-the-dad-joke/">anti-humour</a>. 3. As weaponised anti-humour Sometimes, the purpose of a dad joke is not to make people laugh but to make them groan and roll their eyes. When people tell dad jokes to <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2F0033-2909.127.2.229">teasingly</a> annoy someone else for fun, dad jokes work as a kind of <a href="https://www.degruyter.com/document/doi/10.26613/esic.5.2.248/html">weaponised</a> anti-humour. The stereotypical scenario associated with dad jokes is exactly this: a dad telling a pun and then his kids rolling their eyes out of annoyance or cringing from embarrassment. <h2>Dad jokes help dads be dads</h2> Dad jokes are part of a father’s toolkit for engaging with his loved ones, a way to connect through laughter. But as children grow older, the way they receive puns change. <a href="https://psychcentral.com/lib/humor-as-a-key-to-child-development#1">Children</a> at around six years old enjoy hearing and telling puns. These are generally innocent ones such as: "Why is six afraid of seven? Because seven ate nine!" As children age and their language and reasoning abilities develop, their understanding of humour becomes more complex. In adolescence, they may start to view puns as unfunny. This, however, doesn’t stop their fathers from telling them. Instead, fathers can revel in the embarrassment their dad jokes can produce around their image-conscious and <a href="https://www.psychologytoday.com/intl/blog/surviving-your-childs-adolescence/202203/adolescence-and-the-age-painful-embarrassment">sensitive</a> adolescent children. In fact, in a study, one of us (Marc) <a href="https://www.degruyter.com/document/doi/10.26613/esic.5.2.248/html">suggests</a> the playful teasing that comes with dad jokes may be partly why they are such a widespread cultural phenomenon. This playful and safe teasing serves a dual role in father-child bonding in adolescence. Not only is it playful and fun, it can also be used to help <a href="https://www.dadsuggests.com/home/the-best-dad-jokes">educate</a> the young person how to handle feeling embarrassed. Helping children learn how to deal with embarrassment is no laughing matter. Getting better at this is a very important part of learning how to <a href="https://www.tandfonline.com/doi/abs/10.1080/01650250143000535">regulate emotions</a> and develop <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2022.980104/full">resilience</a>. Modelling the use of humour also has benefits. Jokes can be a useful <a href="https://link.springer.com/article/10.1007/s12144-019-00296-9">coping strategy</a> during <a href="https://psychcentral.com/lib/humor-as-weapon-shield-and-psychological-salve">awkward situations</a> – for instance, after someone says <a href="https://www.youtube.com/watch?v=nuRnsrHEQFg">something awkward</a> or to make someone laugh who has <a href="https://www.helpguide.org/articles/relationships-communication/managing-conflicts-with-humor.htm">become upset</a>. <h2>Dad jokes are more than punchlines</h2> So, the next time you hear your father unleash a cringe-worthy dad joke, remember it’s not just about the punchline. It’s about creating connections and lightening the mood. So go ahead, let out that groan, and share a smile with the one who proudly delivers the dad jokes. It’s all part of the fun.<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/212109/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/shane-rogers-575838">Shane Rogers</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> and <a href="https://theconversation.com/profiles/marc-hye-knudsen-1466723">Marc Hye-Knudsen</a>, Cognition and Behavior Lab, <a href="https://theconversation.com/institutions/aarhus-university-967">Aarhus University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-dad-jokes-may-prepare-your-kids-for-a-lifetime-of-embarrassment-according-to-psychology-212109">original article</a>.

Family & Pets

Research reveals who’s been hit hardest by global warming in their lifetime - and the answer may surprise you

<a href="https://theconversation.com/profiles/andrew-king-103126">Andrew King</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/ed-hawkins-104793">Ed Hawkins</a>, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a>; <a href="https://theconversation.com/profiles/hunter-douglas-1460792">Hunter Douglas</a>, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>, and <a href="https://theconversation.com/profiles/luke-harrington-489028">Luke Harrington</a>, <a href="https://theconversation.com/institutions/university-of-waikato-781">University of Waikato</a> Earth is warming and the signs of climate change are everywhere. We’ve seen it in the past few weeks as temperatures hit record highs around the world – both in the Northern Hemisphere and the <a href="https://theconversation.com/why-is-australia-having-such-a-warm-winter-a-climate-expert-explains-210693">warm Australian winter</a>. Global warming is caused by humanity’s greenhouse gas emissions, which continue at <a href="https://theconversation.com/global-carbon-emissions-at-record-levels-with-no-signs-of-shrinking-new-data-shows-humanity-has-a-monumental-task-ahead-193108">near-record pace</a>. These emissions are predominantly generated by people in the world’s wealthiest regions. Our world-first analysis, <a href="https://iopscience.iop.org/article/10.1088/2752-5295/aceff2">published today</a>, examines the experience of global warming over the lifetimes of people around the world: young and old, rich and poor. We sought to identify who has perceived warmer temperatures most keenly. We found middle-aged people in equatorial regions have lived through the most perceptible warming in their lifetimes. But many young people in lower-income countries could experience unrecognisable changes in their local climate later in life, unless the world rapidly tackles climate change. <h2>Measuring the climate change experience</h2> We examined temperature data and population demographics information from around the world. Key to our analysis was the fact that not all warming is due to human activity. Some of it is caused by natural, year-to-year variations in Earth’s climate. These natural ups and downs are due to a number of factors. They include variations in the energy Earth receives from the sun, the effects of volcanic eruptions, and transfers of heat between the atmosphere and the ocean. This variability is stronger in mid-to-high-latitude parts of the world (those further from the equator) than in low-latitude areas (in equatorial regions). That’s because the weather systems further away from the equator draw in hot or cold air from neighbouring areas, but equatorial areas don’t receive cold air at all. That’s why, for example, the annual average temperature in New York is naturally more variable than in the city of Kinshasa (in the Democratic Republic of Congo). To account for this, we applied what’s known as the “<a href="https://archive.ipcc.ch/ipccreports/tar/wg1/346.htm#:%7E:text=The%20%EF%BF%BDsignal%20to%20noise,to%20this%20natural%20variability%20noise.">signal-to-noise ratio</a>” at each location we studied. That allowed us to separate the strength of the climate change “signal” from the “noise” of natural variability. Making this distinction is important. The less naturally variable the temperature, the clearer the effects of warming. So warming in Kinshasa over the past 50 years has been much more perceptible than in New York. Our study examined two central questions. First, we wanted to know, for every location in the world, how clearly global warming could be perceived, relative to natural temperature variability. Second, we wanted to know where this perceived change was most clear over human lifetimes. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/541474/original/file-20230807-17-ogjdti.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" alt="Annual-average temperatures at four major cities with signal-to-noise ratios shown for 20, 50 and 80 years up to 2021." /></a><figcaption>Annual-average temperatures at four major cities with signal-to-noise ratios shown for 20, 50 and 80 years up to 2021. Author provided</figcaption></figure> <h2>Our results</h2> So what did we find? As expected, the most perceptible warming is found in tropical regions – those near the equator. This includes developing parts of the world that constitute the Global South – such as Africa, Latin America and the Caribbean, and Asia. Household incomes in the Global South are typically lower than in industrialised nations (known as the Global North). We might, then, conclude people in the poorest parts of the world have experienced the most perceptible global warming over their lifetimes. But that’s not always the case. Why? Because most parts of the Global South have younger populations than wealthier regions. And some people under the age of 20, including in northern India and parts of Sub-Saharan Africa, haven’t experienced warming over their lifetimes. In these places, the lack of recent warming is likely down to a few factors: natural climate variability, and the local cooling effect of particles released into the atmosphere from <a href="https://iopscience.iop.org/article/10.1088/1748-9326/ac3b7a">pollution</a> and changes in land use. There’s another complication. Some populated regions of the world also experienced slight cooling in the mid-20th century, primarily driven by human-caused <a href="https://www.nature.com/articles/nature10946">aerosol emissions</a>. So, many people born earlier than the 1950s have experienced less perceptible warming in their local area than those born in the 1960s and 1970s. This may seem counter-intuitive. But a cooling trend in the first few decades of one’s life means the warming experienced over an entire lifespan (from birth until today) is smaller and less detectable. So what does all this mean? People in equatorial areas born in the 1960s and 1970s – now aged between about 45 and 65 – have experienced more perceptible warming than anyone else on Earth. <h2>Rich countries must act</h2> Our findings are important, for several reasons. Identifying who has experienced significant global warming in their lives may help explain <a href="https://www.nature.com/articles/nclimate2660">attitudes to tackling climate change</a>. Our findings also raise significant issues of fairness and equity. Humanity will continue to warm the planet until we reach global net-zero emissions. This means many young people in lower-income countries may, later in life, experience a local climate that is unrecognisable to that of their youth. Of course, warming temperatures are not the only way people experience climate change. Others include sea-level rise, more intense drought and rainfall extremes. We know many of these impacts are felt most acutely by <a href="https://www.aljazeera.com/opinions/2022/5/11/climate-change-is-devastating-the-global-south">the most vulnerable populations</a>. Cumulative greenhouse gas emissions are much higher in the Global North, due to economic development. To address this inequality, rich industrialised nations must take a leading role in reducing emissions to net-zero, and helping vulnerable countries adapt to climate change.<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/211108/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-king-103126">Andrew King</a>, Senior Lecturer in Climate Science, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/ed-hawkins-104793">Ed Hawkins</a>, Professor of Climate Science, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a>; <a href="https://theconversation.com/profiles/hunter-douglas-1460792">Hunter Douglas</a>, PhD Candidate, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>, and <a href="https://theconversation.com/profiles/luke-harrington-489028">Luke Harrington</a>, Senior Lecturer in Climate Change, <a href="https://theconversation.com/institutions/university-of-waikato-781">University of Waikato</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/research-reveals-whos-been-hit-hardest-by-global-warming-in-their-lifetime-and-the-answer-may-surprise-you-211108">original article</a>.

Travel Trouble

1 in 6 women are diagnosed with gestational diabetes. But this diagnosis may not benefit them or their babies

<a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> When Sophie was pregnant with her first baby, she had an <a href="https://www.ncbi.nlm.nih.gov/books/NBK279331/#:%7E:text=Oral%20glucose%20tolerance%20tests%20(OGTT,enough%20by%20the%20body's%20cells.)">oral glucose tolerance</a> blood test. A few days later, the hospital phoned telling her she had gestational diabetes. Despite having only a slightly raised glucose (blood sugar) level, Sophie describes being diagnosed as affecting her pregnancy tremendously. She tested her blood glucose levels four times a day, kept food diaries and had extra appointments with doctors and dietitians. She was advised to have an induction because of the risk of having a large baby. At 39 weeks her son was born, weighing a very average 3.5kg. But he was separated from Sophie for four hours so his glucose levels could be monitored. Sophie is not alone. About <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">one in six</a> pregnant women in Australia are now diagnosed with gestational diabetes. That was not always so. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827530/">New criteria</a> were developed in 2010 which dropped an initial screening test and lowered the diagnostic set-points. Gestational diabetes diagnoses have since <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">more than doubled</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=487&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=487&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=487&fit=crop&dpr=3 2262w" alt="" /><figcaption>Gestational diabetes rates more than doubled after the threshold changed. AIHW, Author provided</figcaption></figure> But <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">recent</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33704936/">studies</a> cast doubt on the ways we diagnose and manage gestational diabetes, especially for women like Sophie with only mildly elevated glucose. Here’s what’s wrong with gestational diabetes screening. <h2>The glucose test is unreliable</h2> The test used to diagnose gestational diabetes – the oral glucose tolerance test – has poor reproducibility. This means subsequent tests may give a different result. In a <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2214956">recent Australian trial</a> of earlier testing in pregnancy, one-third of the women initially classified as having gestational diabetes (but neither told nor treated) did not have gestational diabetes when retested later in pregnancy. That is a problem. Usually when a test has poor reproducibility – for example, blood pressure or cholesterol – we repeat the test to confirm before making a diagnosis. Much of the increase in the incidence of gestational diabetes after the introduction of new diagnostic criteria was due to the switch from using two tests to only using a single test for diagnosis. <h2>The thresholds are too low</h2> Despite little evidence of benefit for either women or babies, the current Australian criteria diagnose women with only mildly abnormal results as having “gestational diabetes”. Recent studies have shown this doesn’t benefit women and may cause harms. A <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">New Zealand trial</a> of more than 4,000 women randomly assigned women to be assessed based on the current Australian thresholds or to higher threshold levels (similar to the pre-2010 criteria). The trial found no additional benefit from using the current low threshold levels, with overall no difference in the proportion of infants born large for gestational age. However, the trial found several harms, including more neonatal hypoglycaemia (low blood sugar in newborns), induction of labour, use of diabetic medications including insulin injections, and use of health services. The study authors also looked at the subgroup of women who were diagnosed with glucose levels between the higher and lower thresholds. In this subgroup, there was some reduction in large babies, and in shoulder problems at delivery. But there was also an increase in small babies. This is of concern because being small for gestational age can also have consequences for babies, including long-term health consequences. <figure class="align-center "><img src="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=349&fit=crop&dpr=1 600w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=349&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=349&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=438&fit=crop&dpr=1 754w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=438&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=438&fit=crop&dpr=3 2262w" alt="" /><figcaption>NEJM, Author provided</figcaption></figure> <h2>Testing too early</h2> Some centres have begun testing women at higher risk of gestational diabetes earlier in the pregnancy (between 12 and 20 weeks). However, a <a href="https://pubmed.ncbi.nlm.nih.gov/37144983/">recent trial</a> showed no clear benefit compared with testing at the usual 24–28 weeks: possibly fewer large babies, but again matched by more small babies. There was a reduction in transient “respiratory distress” – needing extra oxygen for a few hours – but not in serious clinical events. <h2>Impact on women with gestational diabetes</h2> For women diagnosed using the higher glucose thresholds, dietary advice, glucose monitoring and, where necessary, insulin therapy has been shown to reduce complications during delivery and the post-natal period. However, current models of care can also cause harm. Women with gestational diabetes are often denied their preferred model of care – for example, midwifery continuity of carer. In rural areas, they may have to transfer to a larger hospital, requiring longer travel to antenatal visits and moving to a larger centre for their birth – away from their families and support networks for several weeks. Women say the diagnosis often dominates their antenatal care and their whole <a href="https://pubmed.ncbi.nlm.nih.gov/32028931/">experience of pregnancy</a>, reducing time for other issues or concerns. Women from culturally and linguistically diverse communities <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03981-5">find it difficult</a> to reconcile the advice given about diet and exercise with their own cultural practices and beliefs about pregnancy. Some women with gestational diabetes <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-2745-1">become</a> extremely anxious about their eating and undertake extensive calorie restrictions or disordered eating habits. <h2>Time to reassess the advice</h2> Recent evidence from both randomised controlled trials and from qualitative studies with women diagnosed with gestational diabetes suggest we need to reassess how we currently diagnose and manage gestational diabetes, particularly for women with only slightly elevated levels. It is time for a review to consider all the problems described above. This review should include the views of all those impacted by these decisions: women in childbearing years, and the GPs, dietitians, diabetes educators, midwives and obstetricians who care for them. This article was co-authored by maternity services consumer advocate Leah Hardiman.<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/205919/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/1-in-6-women-are-diagnosed-with-gestational-diabetes-but-this-diagnosis-may-not-benefit-them-or-their-babies-205919">original article</a>.

Body

More than a game: Crosswords and puzzles may reduce dementia risk

Playing games, doing crosswords, writing letters or learning something new are all associated with reduced dementia risk in older adults, according to a large, long-term study. A team of Melbourne and US-based researchers study tracked 10,318 older Australians over a period of ten years (2010 to 2020), collecting detailed information on the types of leisure activities they engaged in, along with regular health checks and cognitive assessments. The study is <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2807256" target="_blank" rel="noreferrer noopener">published</a> in JAMA Network Open. Paper co-author Dr Joanne Ryan from Monash University says “the findings show that engaging in mentally stimulating activities can help preserve cognitive function and may help delay the onset of dementia.” “We know the importance of physical activity. We need to think about helping to keep our mind stimulated as well.” <iframe title="Why do Women Live Longer than Men? And What About Gender Diverse People?" src="https://omny.fm/shows/huh-science-explained/why-do-women-live-longer-than-men-and-what-about-g/embed?in_playlist=podcast&style=Cover" width="100%" height="180" frameborder="0"></iframe> Adult literacy activities such as writing, using a computer or taking education classes were associated with an 11% lower risk of dementia, the study found. Active mental health activities such as playing games or doing puzzles were associated with a 9% lower risk. Creative activities like craft or woodwork and passive mental activities (reading books, watching television or listening to the radio) also reduced risks but to a lesser extent. Meanwhile, social activities were not associated with dementia risk. Ryan says this was a “little bit unexpected”. But she says it’s possible one of the reasons is those who volunteered to participate in the study were broadly already socially engaged. The median age of those participating in the study was 73.8 years. Around 2% of the cohort participating in the study developed dementia, Ryan says. Dementia risk varies depending on age and health status of individuals, she says. For instance, “we know that the risk of dementia actually increases exponentially as you get then over 80 years and over 90 years,” she says. Image credits: Getty Images <div id="contributors"> <a href="https://cosmosmagazine.com/health/body-and-mind/more-than-a-game-crosswords-and-puzzles-may-reduce-dementia-risk/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock">Petra Stock</a>. </div>

Mind

Missing Titanic sub: what are submersibles, how do they communicate, and what may have gone wrong?

<a href="https://theconversation.com/profiles/stefan-b-williams-1448728">Stefan B. Williams</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> An extensive <a href="https://www.bbc.com/news/world-us-canada-65953872">search and rescue operation</a> is underway to locate a commercial submersible that went missing during a dive to the Titanic shipwreck. According to the US Coast Guard, contact with the submersible was lost about one hour and 45 minutes into the dive, with five people onboard. The vessel was <a href="https://www.9news.com.au/world/titanic-submersible-search-oceangate-expeditions-vessel-missing-as-us-coast-guard-launches-search/9d7352d8-6a6d-4dc1-afac-ce07dc63cea3">reported overdue</a> at 9.13pm local time on Sunday (12.13pm AEST, Monday). The expedition was being run by US company OceanGate as part of an eight-day trip with guests paying US$250,000 per head to visit the wreck site. As of <a href="https://edition.cnn.com/americas/live-news/titanic-submersible-missing-search-06-19-23/h_c2b5400daf8538d8717f50c619d762ac">Monday afternoon</a> (Tuesday morning in Australia), US Coast Guard Rear Admiral John Mauger said the watercraft likely had somewhere between 70 and the full 96 hours of oxygen available to the passengers. The Titanic’s wreck sits some 3,800 metres deep in the Atlantic, about 700km south of St John’s, Newfoundland. Finding an underwater vehicle the size of a small bus in this vast and remote expanse of ocean will be no small feat. Here’s what the search and rescue teams are up against. <h2>OceanGate’s Titan submersible goes missing</h2> Submersibles are manned watercraft that move in a similar fashion to submarines, but within a much more limited range. They’re often used for research and exploration purposes, including to search for shipwrecks and to document underwater environments. Unlike submarines, they usually have a viewport to allow passengers look outside, and outside cameras that provide a broader view around the submersible. The missing submersible in question is an OceanGate <a href="https://oceangate.com/our-subs/titan-submersible.html">Titan</a> watercraft, which can take five people to depths of up to 4,000m. The Titan is about 22 feet (6.7m) in length, with speeds of about 3 knots (or 5.5km per hour). Although submersibles are often connected to a surface vessel by a tether, video and photos suggest the Titan was likely operating independently of the surface ship. According to OceanGate’s website, the Titan is used “for site survey and inspection, research and data collection, film and media production, and deep-sea testing of hardware and software”. It also has a “real-time hull health monitoring (RTM) system”. This would likely include strain gauges to monitor the health of the Titan’s carbon fibre hull. A strain gauge is a kind of sensor that can measure applied force and small deformations in material resulting from changes in pressure, tension and weight. The Titan’s carbon fibre hull connects two domes made of composite titanium – a material that can withstand deep-sea pressures. At 3,800m below sea level (the depth of the Titanic) you can expect pressures about 380 times greater than the atmospheric pressure we’re used to on the surface of the earth. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=413&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=413&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=413&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=518&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=518&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532840/original/file-20230620-23-c6k9lo.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=518&fit=crop&dpr=3 2262w" alt="Several tube like shapes on a rectangular concrete platform underwater" /></a><figcaption>Titan on the launch platform underwater, awaiting a signal to commence the dive. <a class="source" href="https://oceangate.com/gallery/gallery-titan.html#nanogallery/titangallery/0/4">OceanGate</a></figcaption></figure> <h2>Communication and rescue efforts</h2> The Titan would have had an acoustic link with its surface vessel, set up through a transponder (a device for receiving a sonar signal) on its end, and a transceiver (a device that can both transmit and receive communications) on the surface vessel. This link allows for underwater acoustic positioning, as well as for short text messages to be sent back and forth to the surface vessel – but the amount of data that can be shared is limited and usually includes basic telemetry and status information. The Titan is a battery-operated watercraft. Given it has lost all contact with its surface vessel, it may have suffered a power failure. Ideally, there would be an emergency backup power source (such as an independent battery) to maintain emergency and life support equipment – but it’s unclear if the missing vessel had any power backup on hand. According to reports, at least two aircraft, a submarine and sonar buoys were being used to search for the vessel. The sonar buoys will be listening for underwater noise, including any emergency distress beacons that may have gone off. One of the major challenges in the rescue effort will be contending with weather conditions, which will further shrink an already narrow search window. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=413&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=413&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=413&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=518&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=518&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532842/original/file-20230620-49349-cnzdk6.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=518&fit=crop&dpr=3 2262w" alt="A dark blue image with a tube like shape floating in the lower third" /></a><figcaption>Titan commencing a dive to 4,000m underwater. <a class="source" href="https://oceangate.com/gallery/gallery-titan.html#nanogallery/titangallery/0/1">OceanGate</a></figcaption></figure> <h2>What might have happened?</h2> In a best case scenario, the Titan may have lost power and will have an inbuilt safety system that will help it return to the surface. For instance, it may be equipped with additional weights that can be dropped to instantly increase its buoyancy and bring it back to the surface. Alternatively, the vessel may have lost power and ended up at the bottom of the ocean. This would be a more problematic outcome. The worst case scenario is that it has suffered a catastrophic failure to its pressure housing. Although the Titan’s composite hull is built to withstand intense deep-sea pressures, any defect in its shape or build could compromise its integrity – in which case there’s a risk of implosion. Another possibility is that there may have been a fire onboard, such as from an electrical short circuit. This could compromise the vehicle’s electronic systems which are used for navigation and control of the vessel. Fires are a disastrous event in enclosed underwater environments, and can potentially incapacitate the crew and passengers. Time is of the essence. The search and rescue teams will need to find the vessel before its <a href="https://web.archive.org/web/20230331121053/https://oceangateexpeditions.com/tour/titanic-expedition/">limited supplies</a> of oxygen and water run out. There’s an ongoing debate in scientific circles regarding the relative merit of manned submersibles, wherein each deployment incurs a safety risk – and the safety of the crew and passengers is paramount. Currently, most underwater research and offshore industrial work is conducted using unmanned and robotic vehicles. A loss to one of these vehicles might compromise the work being done, but at least lives aren’t at stake. In light of these events, there will likely be intense discussion about the risks associated with using these systems to support deep-sea tourism.<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/208100/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stefan-b-williams-1448728">Stefan B. Williams</a>, Professor, Australian Centre for Field Robotics, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/missing-titanic-sub-what-are-submersibles-how-do-they-communicate-and-what-may-have-gone-wrong-208100">original article</a>. Images: Getty

Technology

Why understanding how spiders spin silk may hold clues for treating Alzheimer’s disease

<a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> Really, we should envy spiders. Imagine being able to make silk like they do, flinging it around to get from place to place, always having a <a href="https://pubs.acs.org/doi/10.1021/acsmacrolett.8b00678">strong-as-steel safety line</a> or spinning a comfy hammock whenever they need a rest. The fascinating properties of spider silk make it no wonder that scientists have been trying to unravel its secrets for decades. If we could understand and recreate the spinning process, we could produce artificial spider silk for a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0141813021021292">range of medical applications</a>. For example, artificial silk can help <a href="https://doi.org/10.1016/j.biomaterials.2021.120692">regenerate the nerves that connect our brain and limbs</a>, and can shuttle <a href="https://doi.org/10.1021/acs.biomac.0c01138">drug molecules directly into the cells where they are needed</a>. <figure><iframe src="https://www.youtube.com/embed/zNtSAQHNONo?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Spider silk is made of <a href="https://www.sciencedirect.com/topics/engineering/spidroins">proteins called spidroins</a>, which the spider stores in a silk gland in its abdomen. There are several types of spidroin for spinning different sorts of silk. Spiders <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673682/">store them as a liquid</a> that resembles oil droplets. But one of the questions that has eluded scientists so far is how spiders turn these liquid droplets into silk. We decided to investigate why the spidroins form droplets, to get us closer to replicating a spider’s spinning process. <h2>Weaving a web</h2> The trick that spiders use to speed up their spinning process can be used to spin better artificial silk, or even develop new spinning processes. In 2017, we learned to <a href="https://www.nature.com/articles/ncomms15504">make synthetic silk fibres</a> by emulating the silk gland, but we did not know how things work inside the spider. Now we know that forming droplets first <a href="https://pubmed.ncbi.nlm.nih.gov/37084706/">speeds up the conversion to these fibres</a>. An important clue to how the droplets and fibres are related came from an unexpected area of our research – on <a href="https://pubmed.ncbi.nlm.nih.gov/23013511/">Alzheimer’s and Parkinson’s diseases</a>. Proteins that are involved in these diseases, called <a href="https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/alpha-synuclein#:%7E:text=%CE%B1%2DSynuclein%20is%20a%20highly,linked%20to%20familial%20Parkinson%20disease.">alpha-synuclein</a> and <a href="https://www.alz.org/media/Documents/alzheimers-dementia-tau-ts.pdf">tau</a>, can assemble into tiny, oil-like droplets in human cells. Tau is a protein that helps stabilise the internal skeleton of nerve cells (neurons) in the brain. This internal skeleton has a tube-like shape through which nutrients and other essential substances travel to reach different parts of the neuron. In Alzheimer’s disease, an abnormal form of tau builds up and clings to the normal tau proteins, creating “tau tangles”. Alpha-synuclein is found in large quantities in <a href="https://www.webmd.com/mental-health/what-is-dopamine">dopamine-producing nerve cells</a>. Abnormal forms of this protein are linked to Parkinson’s disease. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528217/original/file-20230525-25-p40y48.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Beautiful spider web with water drops close-up" /></a><figcaption>The trick spiders use to speed up their spinning process can be used to spin better artificial silk. <a class="source" href="https://www.shutterstock.com/image-photo/beautiful-spider-web-water-drops-close-155560781">Aastels/Shutterstock</a></figcaption></figure> Oil droplets of either one of these proteins form in humans when they become entangled, like boiled spaghetti on a plate. At first, the proteins are flexible and elastic, much like spidroin oil droplets. But if the proteins remain entangled, they get stuck together which alters their shape, changing them into rigid fibres. These can be toxic to human cells – for example, in neurodegenerative conditions such as Alzheimer’s. However, <a href="https://pubmed.ncbi.nlm.nih.gov/33148640/">spidroins can form droplets</a> too. This left us wondering if the same mechanism that causes neurodegeneration in humans could help the spider to convert liquid spidroins into rigid silk fibres. To find out, we used a <a href="https://www.nature.com/articles/nchembio.2269">synthetic spidroin called NT2RepCT</a>, which can be produced by bacteria. Under the microscope, we could see that this synthetic spidroin formed liquid droplets when it was dissolved in phosphate buffer, a type of salt found in the spider’s silk gland. This allowed us to replicate spider silk spinning conditions in the lab. <h2>Silky science</h2> Next, we studied how the spidroin proteins act when they form droplets. To answer this question, we turned to an analysis technique <a href="https://www.britannica.com/science/mass-spectrometry">called mass spectrometry</a>, to measure how the weight of the proteins changed when they formed droplets. To our surprise, we saw that the spidroin proteins, which normally form pairs, instead split into single molecules. We needed to do more work to find out how these protein droplets help spiders spin silk. Previous research has shown spidroins have different parts, called domains, with separate functions. The end part of the spidroin, called c-terminal domain, makes it form pairs. The c-terminal also starts <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1001921">fibre formation when it comes into contact with acid</a>. So, we made a spidroin which contained only the c-terminal domain and tested its ability to form fibres. When we used phosphate buffer to entangle the proteins into droplets, they turned into rigid fibre instantly. When we added acid without first making droplets, fibre formation took much longer. This makes sense since the spidroin molecules must find each other when forming a fibre. Entangling the spidroins like spaghetti helps them rapidly assemble into silk. This finding tells us how the spider can instantly convert its spidroins into a solid thread. It also uncovered how nature uses the same mechanism that can make brain proteins toxic to create some of its most amazing structures. The surprising parallel between spider silk spinning and fibres toxic to humans could one day lead to new clues about how to fight neurodegenerative disorders. Scientists may use spider silk research, including what we have learned about the spider silk domains, to keep human proteins from sticking together – to stop them from becoming toxic. If spiders can learn how to keep their sticky proteins in check, perhaps so can we.<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/205857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-landreh-1328287">Michael Landreh</a>, Researcher, Department of Microbiology, Tumor and Cell Biology, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> and <a href="https://theconversation.com/profiles/anna-rising-1440132">Anna Rising</a>, Researcher in Veterinary medicine biochemistry, <a href="https://theconversation.com/institutions/karolinska-institutet-1250">Karolinska Institutet</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-understanding-how-spiders-spin-silk-may-hold-clues-for-treating-alzheimers-disease-205857">original article</a>. Images: Getty

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People thinking of voluntary assisted dying may be able to donate their organs. We need to start talking about this

<a href="https://theconversation.com/profiles/robert-ray-1441988">Robert Ray</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> The number of people needing an organ transplant vastly outweighs the number of organs available. <a href="https://www.donatelife.gov.au/sites/default/files/2023-02/OTA%202022%20Donation%20and%20Transplantation%20Activity%20Report.pdf">In 2022</a> there were about 1,800 Australians waiting for an organ but only about 1,200 people received an organ transplant. But in <a href="https://onlinelibrary.wiley.com/doi/10.1111/imj.16085">a recent paper</a>, I outline one unexplored option for increasing the number of potential organ donors in Australia – transplanting organs from people undergoing voluntary assisted dying. This would involve transplanting organs only after someone had died. It’s estimated <a href="https://jamanetwork.com/journals/jama/article-abstract/2616383">about 10%</a> of people eligible for voluntary assisted dying are likely to be medically suitable to donate their organs. Based on <a href="https://www.safercare.vic.gov.au/sites/default/files/2022-09/Voluntary%20Assisted%20Dying%20Review%20Board%20Report%20of%20Operations%20July%202021-June%2022_FINAL.pdf">Victorian figures</a> alone, this could lead to about an extra 40 potential organ donors each year. This type of organ donation has taken place <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297969/">for more than 20 years</a> in Europe, and more recently in Canada. Organs transplanted from donors undergoing voluntary assisted dying <a href="https://jamanetwork.com/journals/jamasurgery/article-abstract/2769118">have</a> <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.16267">similar</a> <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.16971">success rates</a> to more traditional donations. Yet, this is a discussion we’ve yet to have in Australia. Here are some of the ethical and practical issues we need to start talking about. <h2>Is this ethical? It’s tricky</h2> The main ethical challenge is ensuring a person isn’t motivated to end their life prematurely so they can donate their organs. <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.13746">Internationally</a>, <a href="https://jme.bmj.com/content/42/8/486.short">this challenge</a> is mainly addressed by having <a href="https://www.sciencedirect.com/science/article/pii/S1600613523000291">independent assessments</a> by multiple doctors. This is to ensure the motivation is genuine and honest, much like assessing someone before voluntary assisted dying. Similarly, it is important the doctor of someone undergoing voluntary assisted dying isn’t persuading them to donate an organ. This means any doctor overseeing voluntary assisted dying may be limited in how much they can discuss organ donation with their patient. Again, this <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.13746">has been managed internationally</a> by having separate, independent doctors overseeing organ donation and voluntary assisted dying, <a href="https://www.cmaj.ca/content/190/44/E1305.short">without one influencing</a> the other. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=437&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=437&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=437&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=549&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=549&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=549&fit=crop&dpr=3 2262w" alt="Elderly woman in bed hand on covers" /></a><figcaption>Is this what people really want, with so little time left? <a class="source" href="https://www.shutterstock.com/image-photo/senior-woman-laying-on-bed-hospital-1054837748">Shutterstock</a></figcaption></figure> Organ donation may also affect the way voluntary assisted dying is conducted, which <a href="https://www.sciencedirect.com/science/article/pii/S1600613523000291">may impact</a> participants’ very limited quality of life. That’s because determining if someone is eligible to donate an organ involves a number of <a href="https://jme.bmj.com/content/43/9/601.short">investigations</a>. These may include blood tests, radiology (imaging) and numerous clinical encounters to exclude diseases such as cancer, which would prevent someone donating their organs. These investigations may be exhausting but necessary. This burden must be weighed against the participant’s wishes and motivation to donate their organs. So people must also be informed of the impact organ donation will have on their limited life left. The choices of people considering this option must be respected and they must be given multiple opportunities to review their decision, without undue influence or bias. <h2>Practical issues: coordination, location, regulation</h2> Practically, combining organ donation and voluntary assisted dying is <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.13746">challenging</a>. This includes the difficulty organising and coordinating specialists in organ donation, voluntary assisted dying and transplantation. This is why, internationally, organ donation of this nature mostly occurs in large hospitals, where it’s easier to coordinate. So if people want to donate an organ this way, they may spend their last moments in an unfamiliar environment. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="Patient being wheeled on stretcher through hospital corridors" /></a><figcaption>People may have to be moved to a large hospital with the facilities and staff on hand. <a class="source" href="https://www.shutterstock.com/image-photo/surgeon-assistant-team-transport-move-stretcher-2062330820">Shutterstock</a></figcaption></figure> Efforts have been made <a href="https://jamanetwork.com/journals/jamasurgery/article-abstract/2776765">internationally</a> to prioritise these valuable last moments by giving people the choice of where voluntary assisted dying occurs (<a href="https://www.cmaj.ca/content/190/44/E1305.short">such as their home</a>). But this currently only occurs in a minority of cases and increases the complexity of organ donation. Regulating the process is also essential to developing a safe, trustworthy and effective program. Ideally a centralised organisation such as Australia’s national <a href="https://www.donatelife.gov.au">Organ and Tissue Authority</a> would organise, undertake and regulate this. However, this may be challenging given voluntary assisted dying practices are specific to each state. <h2>The challenges ahead</h2> If someone considering voluntary assisted dying wants to donate their organs and is deemed eligible, there is currently <a href="https://onlinelibrary.wiley.com/doi/10.1111/imj.16085">no legal barrier in Australia</a> to stop them. What might prevent them is how their doctor responds, and whether there are the services and organisations willing to fulfil this request ethically and practically. The next step in considering this form of organ donation is to discuss the prospect publicly. Every extra donated organ is potentially lifesaving. So we should make every effort to consider potential safe and ethical ways to increase donation and transplantation rates.<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/206298/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/robert-ray-1441988">Robert Ray</a>, Affiliate Associate Lecturer, School of Medicine, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credit: 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/people-thinking-of-voluntary-assisted-dying-may-be-able-to-donate-their-organs-we-need-to-start-talking-about-this-206298">original article</a>.

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Scented products may be making us sick

From body wash, air fresheners and hand soap to our household cleaners, scented products may be making us sick, according to new research. The University of Melbourne study found that one in three Australians reported adverse health effects – including breathing problems, migraine headaches, skin irritation and asthma attacks – from fragranced products. "There's a belief that fragrance products in some way improve air quality but the opposite is actually true: fragrance products impair rather than improve indoor air quality and they pose a range of health and economic risks," says lead author Professor Anne Steinemann, a world expert on environmental pollutants, air quality, and health effects. "Some people have immediate, severe and disabling health effects. But the effects can be very subtle and insidious and people may not realise they're being affected until it's too late." Steinemann says the findings confirm her previous research on the subjects, including an <a href="http://www.smh.com.au/lifestyle/health-and-wellbeing/wellbeing/a-problem-of-hidden-hazards-common-fragrances-a-public-health-problem-20161026-gsax8k.html">American study she published in 2016</a> and a yet-to-be published British study. "There's something about these fragrance chemicals. It doesn't matter whether the product is called 'green', 'organic', 'natural' or with 'essential oils', basically if it has a fragrance it can cause health problems," she said. "When I've analysed these fragranced products called 'green', 'organic', 'all-natural', there's little difference in the hazardous chemicals they emit compared to regular versions." There is currently no law in Australia that requires the disclosure of all the chemicals in a fragrance or a consumer product. "We have very little information on the toxicity of these mixtures – there's a focus on individual chemicals. Also very little information on the toxicity of a natural versus synthetic version of a chemical,” says Steinemann. Images: Getty

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People thinking of voluntary assisted dying may be able to donate their organs. We need to start talking about this

Scented products may be making us sick

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‘Girl math’ may not be smart financial advice, but it could help women feel more empowered with money

Loyalty programs may limit competition, and they could be pushing prices up for everyone

Vitamin D supplements can keep bones strong – but they may also have other benefits to your health

Sam Kerr’s alleged comments may have had a racial element, but they were not ‘racist’

Taking expensive medicines or ones unavailable in Australia? Importing may be the answer

Alzheimer’s may have once spread from person to person, but the risk of that happening today is incredibly low

Nick Kyrgios admits tennis career "may be over"

It’s time to limit how often we can travel abroad – ‘carbon passports’ may be the answer

Drug resistance may make common infections like thrush untreatable

5 reasons why climate change may see more of us turn to alcohol and other drugs

“May her memory be a blessing”: Father of Hamas victim speaks out

An entry fee may not be enough to save Venice from 20 million tourists

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1 in 6 women are diagnosed with gestational diabetes. But this diagnosis may not benefit them or their babies

More than a game: Crosswords and puzzles may reduce dementia risk

Missing Titanic sub: what are submersibles, how do they communicate, and what may have gone wrong?

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People thinking of voluntary assisted dying may be able to donate their organs. We need to start talking about this

Scented products may be making us sick

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