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“They are treating us like chumps": Karl fires up over supermarket practices

In a heated interview on the Today show, Karl Stefanovic confronted Treasurer Jim Chalmers over the conduct of major supermarket chains, accusing them of treating Australian consumers like "chumps". The exchange followed the release of the Australian Competition and Consumer Commission’s (ACCC) final report into supermarket practices, highlighting concerns over price-gouging, misleading discounts and "shrinkflation". The ACCC’s inquiry found that the dominance of Woolworths, which controls 38% of the national grocery market, and Coles, which holds 29%, has resulted in an “oligopolistic” effect. Despite this, the regulator refrained from endorsing Opposition Leader Peter Dutton’s call for greater powers to dismantle the supermarket giants, cautioning that there was no “silver bullet” solution. Treasurer Chalmers acknowledged the ongoing cost-of-living pressures, saying that “Australians are still feeling that pressure at the checkout. And that’s why we’re cracking down on the supermarkets.” He added that the government was working to foster greater competition in the industry to prevent further consumer exploitation. However, Stefanovic challenged Chalmers, arguing that no significant changes had been made to curb supermarket dominance. “They are treating us like chumps and they continue to,” he said. “And I’ve not seen anything that’s going to stop them from doing that.” Chalmers then defended the government’s economic policies, citing key improvements including declining inflation, rising real wages and economic growth. “We know that people are still under pressure,” he admitted but insisted that progress was being made. In response to the ACCC report, Coles issued a statement claiming the company also faces financial pressures, including rising rents and electricity costs. “We do not control these inflationary costs in the economy – but they contribute to higher grocery prices for Australian households,” the statement read. Coles also defended its pricing strategy, stating that grocery inflation (excluding tobacco) remained at just 1% for the first half of the financial year. The company assured that it is reviewing the ACCC’s recommendations and has already implemented changes to improve pricing transparency and customer communication. Images: The Today show

Money & Banking

Oscars 2025: who will likely win, who should win, and who barely deserves to be there

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ari-mattes-97857">Ari Mattes</a>, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> We’ve probably all had a moment when we stopped taking the Oscars too seriously. For me, it was when Denzel Washington <a href="https://www.forbes.com/sites/timlammers/2024/05/02/why-denzel-washington-once-told-a-co-star-losing-an-oscar-is-better/#:%7E:text=Washington's%20second%20Oscar%20win%20%E2%80%94%20which,called%20at%20the%20Academy%20podium.">won best actor</a> for Training Day (2001), a crime film in which he displays virtually none of his acting chops. And as popular cinema becomes uglier (it’s mostly shot on digital video now, which almost never looks as good as film) and streamers (or logistics companies such as Amazon) take over film production, it’s becoming increasingly difficult to appreciate the point of the ceremony. From this year’s ten nominees for best picture, The Brutalist, Conclave and I’m Still Here are good – while (most of) the other nominees are only okay. <h2>Some well-made films, but nothing outstanding</h2> Writer-director Sean Baker’s Anora is nominated for best picture this year, after already <a href="https://aframe.oscars.org/news/post/2024-cannes-film-festival-winners-list-palme-dor">winning the Palme d’Or</a>. It’s a moderately sweet film in the tradition of Pretty Woman – having more nudity and sex, and a disappointing ending, doesn’t automatically make it edgier. It’s too long by at least half an hour, with some okay performances. It’s certainly not bad, but the idea that this is one of the “best pictures” of 2024 is alarming – or would be, if I wasn’t already so cynical. Most importantly, there’s nothing formally or aesthetically compelling about it, in which case I might have forgiven the silly (anti) Cinderella story. <figure><iframe src="https://www.youtube.com/embed/vgrXTvL_l_c?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Another nominee, A Complete Unknown, is similarly well-made. Timothée Chalamet gives a predictably moody performance as Bob Dylan, and it’s fun to learn something about the relationships between Dylan and musical legends Joan Baez and Pete Seeger. But there’s also something fundamentally weird about watching a memoir about a person as iconic as Dylan. It veers too often into the terrain of impersonation, and this is even more off-putting given Dylan is still alive. Throw in Chalamet’s (certainly accomplished) singing of Dylan’s songs, and it feels like we’re watching someone do karaoke really well. <figure><iframe src="https://www.youtube.com/embed/FdV-Cs5o8mc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> The Substance tries to shock and titillate the viewer with its caricature of celebrity in an era of body modification and mega-media corporations. Demi Moore, Margaret Qualley and Dennis Quaid try hard to be funny, but the whole thing plays like an undergraduate essay that makes the same point ad nauseam. Though the actors surely had fun, there’s nothing compelling about their guffawing. This is also the problem with messy hybrid musical-thriller Emilia Pérez, the other over-the-top genre film tipped by some to win the award. The film, following a cartel leader who disappears and transitions into a woman, is overly dependent on making a point about the world outside of itself. This point is so obvious that it rapidly becomes tedious, with insufficient attention given to the formal and narrative tensions and ambiguities that compel an audience to engage with a film on a serious, visceral level. Dune: Part Two sounds and looks good, but is more meandering than Part One in developing Herbert’s unwieldy epic. If you liked Part One, you’ll probably like Part Two, but it’s not exactly cutting-edge material. <figure><iframe src="https://www.youtube.com/embed/Qlbr7gJgBus?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Nickel Boys is a low-key, sentimental rendition of Colson Whitehead’s novel about two African American boys sent to a reform school in Florida in the early 1960s, and their coming of age as they survive myriad abuses. It’s watchable, if not particularly memorable. Finally, Wicked is, well … Wicked. If you like the musical you may like the film (although the live aspect of musicals makes this one play better on the stage than on the screen, unlike The Wizard of Oz, which was made for the screen). In any case, it’s not ridiculously bad, even though it is too long. <h2>A few top contenders</h2> Walter Salles’ I’m Still Here – which traces the struggle of an activist in Brazil after the forced disappearance of her husband in 1970 – works well in its evocation of place and time, and should soften the heart of even the most cynical viewer. Based on Marcelo Rubens Paiva’s 2015 memoir, the entire film is washed over with a faint scent of nostalgia that complements the idea of failing to find, and then remembering, that which is missing. <figure><iframe src="https://www.youtube.com/embed/gDunV808Yf4?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Conclave, adapted from Robert Harris’ novel, is another solidly made affair. It follows the political machinations of the Vatican as the Dean of Cardinals sets up a conclave to elect a new pope after the previous one dies of a heart attack. Ralph Fiennes is as effective and sombre as usual in the lead role as Cardinal Lawrence and various twists and turns keep us watching throughout. But one suspects the primary pleasure of the film is that it seems to offer an insider’s view of the Vatican, including all the fetishistic processes and rituals. Despite its serious tone, Conclave is a fun romp. And what a pleasure it is to watch Isabella Rossellini on the big screen once again. <h2>The strongest nominee</h2> The film that is most classically like a best picture nominee is The Brutalist – an epic, visually-magnificent study of the struggles of (fictional) architect László Toth, a Hungarian Jew who moves to America following the Holocaust. <figure><iframe src="https://www.youtube.com/embed/GdRXPAHIEW4?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Testament to the technical accomplishments of the film, and its superb creation of a coherent world, The Brutalist runs close to four hours (thankfully with an intermission) without becoming tedious. It chugs along with the relentless momentum of a steam engine. Adrien Brody is charming as Toth, endowing the character with a roguish and playful quality, and the supporting cast are solid. Akin to one of Toth’s constructions (as we hear in the epilogue section), the film neither indicates nor tells us anything beyond itself. There may be conclusions to be drawn regarding the relationship between art, power and capitalism, but the film gives you the space to devise these yourself. The film is, in a sense, beautifully mute. Out of all the nominations, The Brutalist is the only one that feels like a genuine best picture contender (with something of the grandeur of classical Hollywood cinema about it). Although many critics <a href="https://www.hollywoodreporter.com/movies/movie-features/oscars-2025-who-will-win-should-win-1236146220/">are</a> <a href="https://variety.com/lists/2025-oscars-predictions/">predicting</a> Anora will win, The Brutalist is the strongest of the nominees. That said, my pick for the best film of 2024 goes to a production that didn’t get a best picture nomination (as usual). Magnus von Horn’s The Girl With the Needle is a stunning Danish expressionistic nightmare that seamlessly integrates formal experimentation with a thrilling and horrific true crime narrative. It is absolutely sensational – the kind of thing you never forget. Thankfully, it has been recognised through its nomination for best international feature film.<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/250783/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <figure><iframe src="https://www.youtube.com/embed/NdjhUNH5v3Q?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <a href="https://theconversation.com/profiles/ari-mattes-97857">Ari Mattes</a>, Lecturer in Communications and Media, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a> Image credits: Brookstreet Pictures 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/oscars-2025-who-will-likely-win-who-should-win-and-who-barely-deserves-to-be-there-250783">original article</a>. </div>

Movies

"Dropping like flies": Cruise passengers ravaged by severe virus

A dream holiday has turned into a floating nightmare for passengers onboard a P&O Cruise after the vessel was ravaged with a severe strain of novovirus. The luxury ship, Iona, was sailing through Northern Europe when the virus struck, affecting over 5000 guests and nearly 2000 staff onboard. Sky News UK reported that the onslaught of the virus has caused hundreds of passengers to fall ill with the company releasing statements providing updates as the situation grows worse aboard the ship. The ship, which is currently located off shore near Belgium, is continuing on with the itinerary as planned, with staff attempting to isolate the affected passengers and restrict their movements both aboard the ship and land-based stopovers. “People were throwing up in restaurants, on decks, outside cabins,” one of the passengers told Sky News. “A large number of guests and staff are experiencing the virus symptoms. They're dropping like flies." Norovirus is the most common cause of gastroenteritis and causes diarrhoea, vomiting, and severe stomach pain. The symptoms usually develop 12 to 48 hours after being exposed and can take three days for a person to fully flush the virus from their system. P&O Cruises confirmed that some guests have reported symptoms of gastrointestinal illness but refused to provide an update on the health of cruise staffers. “P&O Cruises works with global, national and regional public health authorities on approved and proven protocols across our ships in order to protect the health and wellbeing of all on board,” a P&O spokesperson said. Image credits: Shutterstock

Travel Trouble

"Like a bolt out of the blue": Ray Hadley shares sad family news

Veteran broadcaster Ray Hadley has shared heartbreaking news about his three-year-old granddaughter, Lola, who has been diagnosed with leukaemia. In a deeply emotional video posted to Facebook, the 70-year-old former 2GB radio host revealed that Lola was diagnosed on January 6, describing the moment as "like a bolt out of the blue". Having spent years supporting charity events as an auctioneer, Hadley is no stranger to the hardships families endure when faced with childhood illness. Now, he and his family are experiencing those challenges firsthand. “The journey we’ve endured over the last seven weeks has been... I guess, in many parts, agonising, and in other parts, enlightening – enlightening because of the courage and bravery shared by my granddaughter, Lola,” Hadley said in the video. The toddler faces a tough two-year battle ahead, undergoing intense treatment. “It’s a two-year battle... this little baby girl has had a lumbar puncture yesterday, that’ll be her seventh, she’s had a biopsy and bone marrow six times all under general anaesthetic,” he explained. Hadley went on to describe the physical toll on his granddaughter, who is receiving four chemotherapy treatments a week. “She’s got tubes coming out of her left, right and centre... they attacked the leukaemia and the tests came back a week ago which weren’t as good as we hoped, so now they’ve really doubled down,” he said. As a grandfather of seven, Hadley is fully devoted to supporting Lola through her fight. Reflecting on his retirement from radio late last year, he now believes the timing was meant to be: “I don’t think I believe in fate … but I think that something must have pre-empted my retirement so that I can do what I’m doing now in relation to my granddaughter and my family. Because if I was still working, I wouldn’t have been able to do it.” Hadley <a href="https://www.oversixty.com.au/lifestyle/retirement-life/the-time-has-come-ray-hadley-announces-retirement" target="_blank" rel="noopener">announced his departure from 2GB</a> on December 13, bringing a 43-year career to a close. With his daughter and son-in-law balancing the demands of caring for three children, Hadley has stepped in to help bring some joy to Lola’s days. “I was with her yesterday …. and she’s got this thing where she likes to trick me,” he said, recounting their playful interactions. “Her favourite thing is (to say) ‘Poppy, you’ve got a spider in your hair’ and I sort of brush my hair, and I say, ‘Where is it? Where is it? Get the spider out’ and then she laughs. “I don’t know how she handles it, she’s only three.” For now, Hadley remains focused on what matters most – his family, and ensuring Lola has all the love and support she needs in the fight ahead. Images: Facebook

Caring

Readers response: What does ‘self-care’ look like for you now compared to earlier years?

We asked our readers what self-care looks like for them during their retirement years. Here's what you said. Anne Henderson - More time and focus on my strength and fitness, and all of those things that will help with independence in old age. More saying no to society’s expectations … (including whether my 70 year old face and my clothing are acceptable to others)…. my routine has become simpler for this reason, not more complicated. Self care in older age to me is liberation from the shackles of all of the above. Marie Jones - Definitely focusing on strength and balance hence exercise class and walking. Happy with my grey hair but always moisturising and have toned down make-up. I wear what's comfortable for me. Dawn Dominick - Endless moisturising of my entire body not just my face any more. Margie Buckingham - Love having long baths to relax in. Going to the podiatrist every month. Moisturising twice daily. Not wearing makeup unless it’s a special occasion. Wearing comfortable clothes. Considering stopping the every 5 week hair colouring. <div dir="auto" style="font-family: system-ui, -apple-system, BlinkMacSystemFont, '.SFNSText-Regular', sans-serif; caret-color: #080809; color: #080809; font-size: 15px;">Image credits: Shutterstock </div>

Beauty & Style

Man reveals what it's like to spend 25 years at sea

Mario Salcedo has mastered life at sea, living on cruise ships for 25 years and completing his 1,000th voyage with Royal Caribbean. Salcedo, also known as "Super Mario" in cruise circles revealed that he spends around $101,000 on on cruises per year for a cabin with a balcony. The senior funds his ocean-bound lifestyle through investment management work. His loyalty to Royal Caribbean has earned him some recognition among the crew, with some ships creating makeshift offices for him on deck, complete with cordoned-off tables, chairs and signs reading "Super Mario's Office". Salcedo spoke about his love for cruising in an interview with allthingscruise.com. "Cruising never gets old," he began. "I'm so used to being on ships that it feels more comfortable to me than being on land." The full-time cruiser began his life at sea after "tiring of the suit-and-tie business world and the long flights to international clients." The Cuban-born businessman went on his first cruise in 1997 and became hooked since then. In 2000 he began living on Royal Caribbean ships, spending only a few days per year on land, and taking a short 15 month break during the Covid pandemic. Salcedo said he spends about five hours a day working and "has fun" for the rest of it. "It's zero stress," he said. "The best lifestyle I can find." Image: Wayleebird / Shutterstock.com

International Travel

Readers response: What is one fictional place you would like to visit?

We asked our readers what fictional place from a movie, TV or book world they would love to travel to. Here's what they said. Ann Sigley - Hogwarts and Diagon Alley. Alison Jane - The Magic Faraway Tree. Peta Alto - The Secret Garden. Graham Moss - The Shire from Lord of the Rings. Kath Wilkinson - Robinson Crusoe’s island. Ken Harris - Emerald City. Betty Howarth - Marigold hotel. Matilda Jambour - Camelot. Joy Gardner - Narnia. Jean Rose Paoli - The garden of Eden. Jennifer Halemba - Brigadoon. Regina Johnson - Pemberley. Image credits: Shutterstock

International Travel

Airline worker reveals the kind of suitcase most likely to get lost

An airline worker has warned passengers of the type of suitcases he believes are "more likely" to get lost. The airport maintenance worker, who is based in the US, shared in a Reddit thread some advice to travellers to avoid losing their luggage during a holiday. The worker pointed out that one airline alone can have "3,000 to 5,000" bags per hour passing through the airport at peak flight times, and one simple design choice can make a huge difference on where your luggage ends up. While he suggests a hard shell suitcase as the best choice for luggage to protect your belongings, the worker warns the colour or pattern of your bag could be a cause for it to be lost. "Mirrored colours and paint schemes with a metallic flake act like reflectors and send the beam back to the sensor. Basically turning the bag invisible," he wrote. "Once that happens, it can't be diverted to its assigned location to be loaded on the plane it belongs on.” "We only see it when it passes through the tag scanners again, but with the sheer volume of bags, it gets hard to catch them." The worker also warned against using coloured ribbons, ropes or scarves, as well as decorative bag covers, to identify your luggage, as they can cause widespread delays. "While helpful to identify your bag, it can get caught downstairs and can delay bags," he wrote, adding he once had to cut a bungee cord off a bag that had gotten caught in a roller and affecting operation. "Do what you feel is best to help identify your bag, but just be warned some items can help cause delays." Image credits: Shutterstock

Travel Tips

Forget Bob Geldof: this is why you don’t like Mondays

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/leon-lack-1142">Leon Lack</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Feeling sluggish? Grouchy even? Difficulties getting out of bed? Mondayitis can happen to the best of us. But rest assured: it’s a phenomenon science can actually explain. In fact, there are a range of explanations: perhaps you hate your job and/or are bullied at work; or maybe you <a href="http://www.youtube.com/watch?v=wmin5WkOuPw">live it large at the weekends</a> and come down with a crash on Mondays. But perhaps the most common cause involves our body clock – i.e. our circadian rhythms – and how our weekend sleeping habits throw our normal rhythms out of whack. <h2>Blue Monday</h2> As Sally Ferguson of the University of South Australia explained in <a href="https://theconversation.com/keeping-time-how-our-circadian-rhythms-drive-us-17">a recent article for The Conversation</a>, your circadian rhythm is your “natural pacemaker”. It controls a range of bodily cycles including the 24-hour cycle that regulates your degree of alertness at various times of day. Normally, our rhythm helps sustain our wakefulness until the end of the day and sustain our sleep until we’re ready to arise in the morning. <figure class="align-center "><img src="https://images.theconversation.com/files/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&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/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=291&fit=crop&dpr=1 600w, https://images.theconversation.com/files/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=291&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=291&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=365&fit=crop&dpr=1 754w, https://images.theconversation.com/files/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=365&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/1062/original/mondayitis.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=365&fit=crop&dpr=3 2262w" alt="" /><figcaption>Image courtesy of Leon Lack.</figcaption></figure> The above image shows how the normally-timed circadian “bed” (approximately 11pm to 7am) is surrounded by periods of low sleepiness (or alertness): this is also known as the “sleep forbidden zone” and the “wake-up zone”. In both, your body “wants” you to be awake: in the “sleep forbidden zone” you’ll find it hard to get to sleep, and in the “wake-up zone”, your body will “try” to wake you up. If the timing of your body clock changes – by partying till the wee hours, for example – these two zones can shift, making it harder to get to sleep at certain hours. In practice, this means that if you stay up a couple of hours later than normal one night, the “sleep forbidden zone” will drift to between 8pm and midnight, making it very difficult to get to sleep until after midnight. If this drifting occurs when it is necessary to get up early – e.g. on weekdays – you’ll lose sleep and be tired the next day. If this happens most days of the week, you’ll build up a sleep debt over the week that you will probably want to “pay off” when you have the opportunity to do so – on the weekend for most of us. <h2>Sleep-in, and pay the price</h2> How do you catch up on sleep on the weekend? You could go to bed earlier on Friday or Saturday night or you could sleep in later on Saturday and Sunday mornings. Ah, the luxury of the weekend sleep-in! Isn’t that what weekends are for? Unfortunately, though, that long-awaited weekend lie-in can cause problems come Monday. By sleeping in, you actively delay your body clock again, which can make it hard to get to sleep on Sunday night and leave you not feeling properly awake until later on Monday morning. <h2>I don’t like Mondays (tell me why!)</h2> Thanks to your weekend lie-in(s), your circadian rhythms have drifted away from their normal position and so, when that alarm clock starts bleating, you’re still at your lowest body temperature (see image above). You are expected to be up and out into the world while still in your “circadian bed”. Sure, you’ll probably feel better by noon with the help of the circadian “wake-up zone” (and maybe a stiff coffee or two) but the bad start to Monday has put you behind and you spend the rest of the week in catch-up mode. This vicious cycle is a problem for many, particularly <a href="http://en.wikipedia.org/wiki/Night_owl_(person)">“night owls”</a> whose rhythms are delayed even more than normal. So what can be done? Minimising the number of late bedtimes you have is a good start, as this will reduce your need for catch-up sleep. And if you do need to have catch-up sleep on the weekend, don’t sleep in late: get up about the same time you normally would and, if you need it, have a siesta instead. You’ll feel better for it come Monday morning. <a href="https://theconversation.com/profiles/leon-lack-1142">Leon Lack</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</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/forget-bob-geldof-this-is-why-you-dont-like-mondays-828">original article</a>. </div>

Body

British royal considering moving to Australia

A member of the British royal family is considering relocating to Australian shores after finding love with an Aussie. Lady Louise Windsor, the late Queen Elizabeth’s granddaughter, found love with Australian student Felix Robert da Silva-Clamp and is reportedly planning to move Down Under for her partner. Lady Windsor is the daughter of King Charles’ youngest brother Prince Edward and his wife Sophie, Duchess of Edinburgh. She and Felix, who attended Melbourne Grammar School from 2017 to 2022, first met at St Andrew’s University in Scotland. Felix is the son of British solicitor, Charles William da Silva-Clamp, while his mother, Kendall Clamp, lives in Melbourne, and holds a master’s degree in epidemiology. Royal commentator Victoria Arbiter joined Nat Barr on Sunrise on Thursday, where she explained that Lady Windsor was interested in taking classes at Macquarie University in Sydney. “Both of their degrees allow for a study abroad semester — Louise at the moment is in her third semester. If she is likely to do a semester of study abroad, it would likely be in her fourth year,” Arbiter said. “She is interested in studying at Macquarie University in Sydney. So, this time next year, you could be welcoming a royal down under.” Felix is also said to have met Lady Windsor’s parents, as Arbiter said, “Certainly in royal circles that’s not a thing until it is quite serious — Felix is only 20 and Lady Louise is 21, so they have a lot of time ahead of them, but it would seem things are going well.” “I think the royals would definitely welcome an Aussie to the royal family.” Image credits: Thomas Krych/ZUMA Press Wire/Shutterstock Editorial

Relationships

New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels. However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>. Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes. Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked? <h2>Osteoarthritis and obesity</h2> Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis. Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation. For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>. Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help. But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten. Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness. <h2>Semaglutide for osteoarthritis?</h2> The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight. They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight. As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group. The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group. This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale. The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>. Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test. <h2>How could semaglutide reduce knee pain?</h2> It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain. But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>. While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not. The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity. It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue. There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this. Further, it can be difficult to access. <h2>I have knee osteoarthritis, what should I do?</h2> Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<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/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstocl 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/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>. </div>

Body

Don’t like drinking plain water? 10 healthy ideas for staying hydrated this summer

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Have you heard the saying “water is life?” Well, it’s true. Water is an <a href="https://www.hsph.harvard.edu/nutritionsource/water/">essential nutrient</a>. Our body cannot produce sufficient water to live, so we need to consume water through food and fluids to survive. Maintaining hydration is one of the most fundamental components of good health. But lots of people don’t like drinking plain water much. The good news is there are many other healthy ways to help you stay hydrated. <h2>Why hydration is important</h2> Water is vital for many aspects of body functioning. About half our blood is “blood plasma”, which is over 90% water. Blood plasma is essential for carrying energy, nutrients and oxygen to the cells in the body that need it most. Water helps to remove waste products via the kidneys. It also helps keep joints lubricated, the digestive system functioning, the body’s temperature controlled and skin plump and strong. If you don’t consume enough water, you may experience symptoms of dehydration such as headaches, dizziness, tiredness, low concentration, constipation and a dry mouth. Being severely dehydrated increases the risk of <a href="https://www.kidney.org/atoz/content/kidneystones">kidney stones</a> and <a href="https://www.healthdirect.gov.au/urinary-tract-infection-uti">urinary tract infections</a>. If you feel thirsty, it means your body is already <a href="https://my.clevelandclinic.org/health/treatments/9013-dehydration#:%7E:text=If%20you're%20thirsty%2C%20you,life%2Dthreatening%20illnesses%20like%20heatstroke.">mildly dehydrated</a>, so make sure you pay attention to what your body is telling you. <h2>How much fluid do you need?</h2> The amount of fluid we need changes as we age. Relative to our body weight, our needs decrease. So, a newborn baby has higher fluid needs (per kilogram body weight) than their parent, and older adults have lower fluid needs than younger adults. Fluid requirements are related to metabolic needs and vary from person-to-person. The normal turnover of water in adults is approximately 4% of total body weight per day. So, for example, if you weigh 70 kilograms, you’ll lose about 2.5 to 3 litres of water a day (not including sweating). This means you will need to consume that amount of water from food and drinks to maintain your hydration. Eight cups (or two litres) a day is often <a href="https://www.npr.org/2022/09/21/1124371309/busting-common-hydration-water-myths?utm_source=npr_newsletter&utm_medium=email&utm_content=20221016&utm_term=7386723&utm_campaign=health&utm_id=31926817&orgid=&utm_att1=">mentioned</a> as the amount of water we should aim for and a nice way to track your intake. But it doesn’t account for individual variation based on age, gender, body size and activity levels. Alcohol is a diuretic, which means it dehydrates the body by promoting water loss through urine. This fluid loss is a key factor that contributes to the severity of a hangover. Always have a glass of water in between alcoholic drinks to help stay hydrated. Caffeinated drinks (like tea and coffee) only have a mild diuretic effect. For most healthy adults, it’s okay to consume up to 400 mg of caffeine a day – that’s about four cups of coffee or eight cups of tea. If you drink more than this, it may impact your hydration levels. To check your specific requirements, check out the Australian <a href="https://www.nrv.gov.au/nutrients/water">guidelines</a> for fluid intake. <h2>People who should take extra care</h2> Some people are at greater risk of the harmful health effects from dehydration and need to pay special attention to their fluid intake. The highest priority groups are babies, young kids, pregnant women, and older adults. These groups are at greater risk for many reasons, including relatively higher water needs per kilo of body weight, reduced ability to detect and respond to symptoms of dehydration, and barriers to consuming fluids regularly. Family and friends can play an important role in <a href="https://www.agedcareguide.com.au/information/hydration-for-elderly-people-and-the-dangers-of-dehydration">supporting loved ones</a> to maintain hydration, especially during warm weather. <h2>Ten ideas for keeping fluids up this summer</h2> <ol> <li> Download a water reminder app on your phone This will help keep you on track during the day and give you digital “high fives” when you hit your water goals. </li> <li> Add sugar-free flavouring Try a sugar-free fruit infusion in your water to make it more appealing. Prepare a jug in the refrigerator and infuse it overnight so it’s chilled for you the next day. Fill it up and take it everywhere with you! </li> <li> Add some fresh fruit Add some slices of lime, lemon, berries, pineapple or orange to your water bottle for some natural flavouring. If the bottle is kept in a fridge, the fruit will stay fresh for about three days. </li> <li> Make a jug of iced tea (not the bottled stuff) There are many great sugar-free recipes online. Tea contributes to fluid intake too. For green and black teas, brew in boiling water then cool overnight on the bench before refrigerating. Fruit teas can be made using cold water immediately. </li> <li> Add a dash of cordial to your water A small amount of cordial in your water is a healthier alternative to drinking a sugar-sweetened soft drink or fruit juice. Diet cordials have less added sugar again. </li> <li> Make a fruit ‘slushie’ Combine fresh fruit, ice and water at home in the morning and sip to increase your fluid intake for the day. </li> <li> Buy a soda maker for your home Some people find plain water tastes better with bubbles. Sparkling mineral water is great too, as long as there is no added sugar or sweeteners. </li> <li> Before you eat anything, have a glass of water Make it a rule with yourself to have a glass of water before every snack or meal. </li> <li> Eat water-rich fruits and vegetables Many fruits and vegetables have a high water content. Some of the best include berries, oranges, grapes, carrots, lettuce, cabbage, spinach and melons. Keep a container full of cut-up fruit to snack on in your fridge. </li> <li> Use a water bottle Take it with you during the day and keep it by your bed overnight. </li> </ol> <h2>A tip on water bottles</h2> Water bottles are everywhere and sometimes seem to offer <a href="https://www.refinery29.com/en-au/emotional-support-water-bottle-girlies-tiktok-trend">emotional support</a> as well as hydration. Having a water bottle you enjoy using can go a long way in helping you keep up your fluids during the day. Pay attention to the material of the water bottle and use one that helps you form good habits. Some people prefer metal water bottles as they can keep water cooler for longer (others feel like they are camping). Some prefer glass bottles because the water isn’t affected by any flavours from the container (others fear breaking the glass). Consider the practical aspects, too: Will it fit in your bag? Will it be light enough to carry with you? Can you “chug” on it when you’re exceptionally thirsty? Does the lid require screwing? How durable is it in preventing leaks? Do some <a href="https://www.marthastewart.com/7842071/best-water-bottles-hydration">homework</a> on your water bottle, an essential accessory! <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian and Researcher, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</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/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">original article</a>. </div>

Body

Filling the silences in family stories − how to think like a historian to uncover your family’s narrative

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/andrea-kaston-tange-1417052">Andrea Kaston Tange</a>, <a href="https://theconversation.com/institutions/macalester-college-2632">Macalester College</a> Great-grandmothers. We all have them. But most of us will never know them except through glimpses of fading bits of paper: sepia photographs, recipe cards, letters in handwriting traced by a fountain pen dispensing cocoa-colored ink. What does it take to build coherent stories out of such tantalizing fragments of lives? I face this question routinely in my career as a <a href="https://www.macalester.edu/english/facultystaff/andreakastontange/">professor of 19th-century literature and culture</a>. Recently, I’ve turned that experience to writing a book about my own family. When I inherited my great-grandmother’s diary, a repurposed teacher’s planner in which she chronicled the family’s 1926 move from Michigan to Miami, I found a wedding portrait tucked inside. The angled profile showcases her youthful skin and a dress too elaborate for a Midwestern schoolteacher’s daily wear. It is easy to imagine that she took pleasure in inscribing her new name on the picture’s reverse: Faith Avery. I stared at her beautiful image for years, as if details of her satin gown could explain why a woman widowed in 1918 would, for the rest of her life, refuse to admit to having had that first husband and yet carefully preserve this portrait. And then, because archives have been at the center of my scholarly work, I turned to research. I located marriage records and draft cards, pored over maps, found family members in censuses and obituaries. Within those documents lay answers both surprising and poignant. What did I look for? How might anyone with a half-told family story begin to uncover more truths? And what does it take to make sense of them? <h2>The digging</h2> Questions that begin with “why” can rarely be answered easily. Researchers thus often prefer to start with “who” and “when” and “how,” locating a person in one spot and then tracing them through time. This adventure down a rabbit hole follows a method. Make a list of unknowns. These may be facts or enticing tidbits of incomplete family lore. My mother, trying to be helpful, told me things like, “Faith always said there was a horse thief in the family, but she was too mortified to reveal his name” and “I think Aunt Harriette (Faith’s sister) was married once briefly.” Do precise, not general, searches. Typing “horse thief Avery” into Google yields nothing useful, but many other sources contain rich information about old-fashioned exploits. The New York Public Library’s <a href="https://www.nypl.org/blog/2019/03/25/genealogy-guide-books">guide for family research</a> introduces some options. The <a href="https://www.loc.gov/pictures/">Library of Congress print and photograph collection</a> can also help you envision your ancestors’ world. Physical libraries contain historic photographs, maps, local records and digitized newspapers not available online. Historical societies and state universities typically allow free, in-person use of their collections. Know that sometimes you will fail and need to change course. I spent several days looking for the horse thief to no avail, much to my mother’s disappointment. But when I turned to Aunt Harriette’s marriage, I found a character no less fascinating, one I now think of as “Four Wives Frank.” Read old documents knowing they were produced by a patchwork of individuals who took information on trust. The handwritten birth, death, marriage and <a href="https://www.archives.gov/research/census/about">census records</a> of past centuries relied on self-reported data that required no verification. They can be plagued by carelessness in the name of efficiency. One hurried census-taker recorded Faith’s mother Cara as “Cora,” another renamed her brother Horace “Harris.” Frank offered up a variety of birth years, countries of origin and maiden names for his mother as he worked his way west. He must have been charming. Who but a charming man could have convinced woman after woman to marry him, each thinking she was, at most, his second wife? Marriage register officers and census-takers, not to mention his trail of brides, were none the wiser. Which leads me to this: Cross-check information. I knew I had the right Frank because he had the same three sons in multiple records. Inconsistencies across those records, in conjunction with the trajectory of his life, made this conclusion inevitable: The man purposefully reinvented himself. <h2>The assembly</h2> My academic work has taught me that most <a href="https://doi.org/10.2979/victorianstudies.63.2.02">archival answers lead to more questions</a>. As a result, I expect multiple phases of collecting. I gathered everything I could find about Faith’s early life, in hopes something might explain her reticence about her first marriage. As her story emerged, I periodically hit holes in the narrative that sent me back for more digging. Understanding people is easier if you are familiar with their world. For background, I read histories of Miami in the 1920s and researched details in Faith’s diary that might reveal her personality or motivations. Exploring her reading lists showed me a woman who enjoyed popular entertainment, such as 1926’s blockbuster “<a href="https://www.imdb.com/title/tt0016598/">Aloma of the South Seas</a>.” Primers of <a href="https://libraryguides.missouri.edu/pricesandwages/1920-1929">1920s wages and prices</a> explained the family’s economic worries. As I got to know Faith, I revisited documents with new questions. To figure out whether Harriette’s husband Frank had anything to do with Faith, I made timelines for both sisters. To ponder the emotional underpinnings of those events, I reread Faith’s diary, paying particular attention to entries about Harriette and about Faith’s second husband. Because every pile of documents contains multiple stories, the key to a coherent narrative is locating a through line that addresses the biggest conundrums while identifying the tangents. I let go of the horse thief. <h2>The results</h2> The detective-style plots of what I call “<a href="https://www.writersdigest.com/be-inspired/lilly-dancyger-memoir-as-detective-novel">investigative memoir</a>” may inspire you to do your own family research. Genealogy sites such as <a href="https://www.ancestry.com/">Ancestry.com</a> and <a href="https://www.familysearch.org/en/united-states/">FamilySearch.org</a> can help. But it’s worth remembering that secondary reading will add richness to any family story. And local librarians are extraordinary at helping patrons navigate the search process. Improbable as it might seem, Four Wives Frank helped me understand the extent of Faith’s secrets and that she harbored them in hopes that her children’s lives would be easier. Such self-sacrifices are common for mothers. And yet, their particulars are as individual as the faintly silvered portrait of the soft young woman who married Harold Avery in 1911, and whose story requires an entire book to tell properly.<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/234341/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrea-kaston-tange-1417052">Andrea Kaston Tange</a>, Professor of English, <a href="https://theconversation.com/institutions/macalester-college-2632">Macalester College</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/filling-the-silences-in-family-stories-how-to-think-like-a-historian-to-uncover-your-familys-narrative-234341">original article</a>. </div>

Family & Pets

What does a good death look like when you’re really old and ready to go?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/naomi-richards-182120">Naomi Richards</a>, <a href="https://theconversation.com/institutions/university-of-glasgow-1269">University of Glasgow</a> <a href="https://www.huffingtonpost.co.uk/entry/hawaii-legalizes-assisted-suicide_us_5ac6c6f5e4b0337ad1e621fb">Hawaii</a> recently joined the growing number of states and countries where doctor-assisted dying is legal. In these jurisdictions, help to die is rarely extended to those who don’t have a terminal illness. Yet, increasingly, very old people, without a terminal illness, who feel that they have lived too long, are arguing that they also have a right to such assistance. Media coverage of <a href="https://www.washingtonpost.com/news/to-your-health/wp/2018/05/09/this-104-year-old-plans-to-die-tomorrow-and-hopes-to-change-views-on-assisted-suicide/?utm_term=.b00a9036f9bc">David Goodall</a>, the 104-year-old Australian scientist who travelled to Switzerland for assisted dying, demonstrates the level of public interest in ethical dilemmas at the <a href="https://www.bmj.com/content/361/bmj.k1891.full">extremities of life</a>. Goodall wanted to die because he no longer enjoyed life. Shortly before his death, he told reporters that he spends most of his day just sitting. “What’s the use of that?” he asked. <a href="https://www.sciencedirect.com/science/article/pii/S0277953615002889?via%3Dihub">Research</a> shows that life can be a constant struggle for the very old, with social connections hard to sustain and health increasingly fragile. <a href="https://www.ncbi.nlm.nih.gov/pubmed/25982088">Studies</a> looking specifically at the motivation for assisted dying among the very old show that many feel a deep sense of loneliness, tiredness, an inability to express their individuality by taking part in activities that are important to them, and a hatred of dependency. Of the jurisdictions where assisted dying is legal, some make suffering the determinant (Canada, for example). Others require a prognosis of six months (California, for example). Mainly, though, the focus is on people who have a terminal illness because it is seen as less of an ethical problem to hasten the death of someone who is already dying than someone who is simply tired of life. <h2>Why give precedence to physical suffering?</h2> Assisted dying for people with psychological or existential reasons for wanting to end their life is unlikely to be supported by doctors because it is not objectively verifiable and also potentially remediable. In the Netherlands, despite the legal power to offer assistance where there is no life-limiting illness, doctors are <a href="https://www.ncbi.nlm.nih.gov/pubmed/25693947">seldom convinced</a> of the unbearable nature of non-physical suffering, and so will rarely administer a lethal dose in such cases. Although doctors may look to a physical diagnosis to give them confidence in their decision to hasten a patient’s death, physical symptoms are often not mentioned by the people they are assisting. Instead, the most common reason given by those who have received help to die is <a href="https://www.nejm.org/doi/full/10.1056/NEJMms1700606">loss of autonomy</a>. Other common reasons are to avoid burdening others and not being able to enjoy one’s life – the exact same reason given by Goodall. This suggests that requests from people with terminal illness, and from those who are just very old and ready to go, are not as different as both the law – and doctors’ interpretation of the law – claim them to be. <h2>Sympathetic coverage</h2> It seems that the general public does not draw a clear distinction either. Most of the media coverage of Goodall’s journey to Switzerland was sympathetic, to the dismay of <a href="http://www.carenotkilling.org.uk/press-releases/centenarians-assisted-suicide/">opponents</a> of assisted dying. Media reports about <a href="https://www.theguardian.com/tv-and-radio/2014/sep/02/mary-berry-great-british-bake-off-centenarian-assisted-dying">ageing celebrities</a> endorsing assisted dying in cases of both terminal illness and very old age, blur the distinction still further. One of the reasons for this categorical confusion is that, at root, this debate is about what a good death looks like, and this doesn’t rely on prognosis; it relies on <a href="https://www.tandfonline.com/doi/full/10.1080/01459740.2016.1255610">personality</a>. And, it’s worth remembering, the personalities of the very old are as diverse as those of the very young. Discussion of assisted suicide often focuses on concerns that some older people may be exposed to coercion by carers or family members. But older people also play another role in this debate. They make up the rank and file <a href="http://www.ep.liu.se/ej/ijal/2012/v7/i1/a01/ijal12v7i1a01.pdf">activists</a> of the global right-to-die movement. In this conflict of rights, protectionist impulses conflict with these older activists’ demands to die on their own terms and at a time of their own choosing. In light of the <a href="https://www.nih.gov/news-events/news-releases/worlds-older-population-grows-dramatically">unprecedented ageing</a> of the world’s population and increasing longevity, it is important to think about what a good death looks like in deep old age. In an era when more jurisdictions are passing laws to permit doctor-assisted dying, the choreographed death of a 104-year-old, who died listening to Ode to Joy after enjoying a last fish supper, starts to look like a socially approved good death.<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/96589/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/naomi-richards-182120">Naomi Richards</a>, Lecturer in Social Science (End of Life Studies), <a href="https://theconversation.com/institutions/university-of-glasgow-1269">University of Glasgow</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-does-a-good-death-look-like-when-youre-really-old-and-ready-to-go-96589">original article</a>. </div>

Caring

Why hurricanes like Milton in the US and cyclones in Australia are becoming more intense and harder to predict

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/andrew-dowdy-119002">Andrew Dowdy</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/liz-ritchie-tyo-1509061">Liz Ritchie-Tyo</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/savin-chand-1351050">Savin Chand</a>, <a href="https://theconversation.com/institutions/federation-university-australia-780">Federation University Australia</a> Tropical cyclones, known as hurricanes and typhoons in other parts of the world, have caused huge damage in many places recently. The United States has just been hit by <a href="https://www.nhc.noaa.gov/graphics_at4.shtml?start">Hurricane Milton</a>, within two weeks of <a href="https://theconversation.com/how-hurricane-helene-became-a-deadly-disaster-across-six-states-240522">Hurricane Helene</a>. Climate change <a href="https://www.worldweatherattribution.org/climate-change-key-driver-of-catastrophic-impacts-of-hurricane-helene-that-devastated-both-coastal-and-inland-communities/">likely made their impacts worse</a>. In Australia, the tropical cyclone season (November to April) is approaching. The Bureau of Meteorology this week released its <a href="http://www.bom.gov.au/climate/cyclones/australia/">long-range forecast</a> for this season. It predicts an average number of tropical cyclones, 11, are likely to form in the region. Four are expected to cross the Australian coast. However, the risk of severe cyclones is higher than average. So what does an average number actually mean in our rapidly changing climate? And why is there a higher risk of intense cyclones? The bureau’s forecast is consistent with scientific evidence suggesting climate change is likely to result in fewer but more severe tropical cyclones. They are now more likely to bring stronger winds and <a href="https://hess.copernicus.org/articles/28/1251/2024/hess-28-1251-2024.pdf">more intense rain and flooding</a>. <h2>Climate change is making prediction harder</h2> Our knowledge of tropical cyclones and climate change is based on multiple lines of evidence <a href="https://doi.org/10.1175/BAMS-D-18-0189.1">globally</a> and for the Australian region. This work includes our studies based on <a href="https://www.nature.com/articles/s41558-022-01388-4">observations</a> and <a href="https://link.springer.com/article/10.1007/s00382-018-4497-4">modelling</a>. The bureau’s seasonal outlook in recent years has assumed an average of 11 tropical cyclones occurring in our region (covering an area of the southern tropics between longitudes 90°E and 160°E). It’s based on the average value for all years back to 1969. However, for the past couple of decades the annual average is below nine tropical cyclones. In earlier decades, it was over 12. This long-term downward trend adds to the challenge of seasonal predictions. The most recent above-average season (assuming an average of 11) was almost 20 years ago, in the <a href="http://www.bom.gov.au/cyclone/tropical-cyclone-knowledge-centre/history/climatology/">2005–06 summer with 12 tropical cyclones</a>. Since then, any prediction of above-average tropical cyclone seasons has not eventuated. <h2>El Niño and La Niña influences may be changing too</h2> Historical observations suggest more tropical cyclones tend to occur near Australia during La Niña events. This is a result of warm, moist water and air near Australia, compared with El Niño events. The shifting between El Niño and La Niña states in the Pacific region is known as the El Niño-Southern Oscillation (ENSO). Such events can be predicted with a useful degree of accuracy several months ahead in some cases. For example, the US National Oceanic and Atmospheric Administration (NOAA) has <a href="https://www.cpc.ncep.noaa.gov/products/analysis_monitoring/lanina/enso_evolution-status-fcsts-web.pdf">forecast</a>: <blockquote> La Niña is favored to emerge in September–November (71% chance) and is expected to persist through January–March 2025. </blockquote> Based on that, one might expect a higher-than-average number of tropical cyclones for the Australian region. However, the <a href="https://rmets.onlinelibrary.wiley.com/doi/abs/10.1002/asl2.502">ENSO influence on tropical cyclones has weakened</a> in our region. It’s another factor that’s making long-range predictions harder. The <a href="http://www.bom.gov.au/climate/enso/outlook/">bureau’s ENSO outlook</a> is somewhat closer to neutral ENSO conditions, based on its modelling, compared to NOAA’s leaning more toward La Niña. The bureau says: <blockquote> Should La Niña form in the coming months, it is forecast to be relatively weak and short-lived. </blockquote> The bureau’s prediction of an average number of tropical cyclones this season is broadly consistent with its prediction of close-to-average ENSO conditions. <h2>So what does this all mean for this cyclone season?</h2> If we end up getting an average Australian season for the current climate, this might actually mean fewer tropical cyclones than the historical average. The number might be closer to eight or nine rather than 11 or 12. (Higher or lower values than this range are still possible.) However, those that do occur could have an increased chance of being <a href="http://www.bom.gov.au/cyclone/tropical-cyclone-knowledge-centre/understanding/categories/">category 4 or 5 tropical cyclones</a>. These have stronger winds, with gusts typically exceeding 225km per hour, and are more likely to cause severe floods and coastal damage. If we end up getting more than the recent average of eight to nine tropical cyclones, which could happen if NOAA predictions of La Niña conditions eventuate, that increases the risk of impacts. However, there is one partially good news story from climate change relating to this, if the influence of La Niña is less than it used to be on increasing tropical cyclone activity. Another factor is that the <a href="http://www.bom.gov.au/climate/ocean/sst/#/anom/global/weekly/20241006">world’s oceans are much warmer than usual</a>. Warm ocean water is one of several factors that provide the energy needed for a tropical cyclone to form. Many ocean heat <a href="https://climatereanalyzer.org/clim/sst_daily/?dm_id=world2">records have been set</a> recently. This means we have been in “uncharted waters” from a temperature perspective. It adds further uncertainty if relying on what occurred in the past when making predictions for the current climate. <h2>Up-to-date evidence is vital as climate changes</h2> The science makes it clear we need to plan for tropical cyclone impacts in a different way from what might have worked in the past. This includes being prepared for potentially fewer tropical cyclones overall, but with those that do occur being more likely to cause more damage. This means there are higher risks of damaging winds, flooding and coastal erosion. Seasonal prediction guidance can be part of improved planning. There’s also a need for enhanced design standards and other climate change adaptation activities. All can be updated regularly to stay consistent with the best available scientific knowledge. Increased preparedness is more important than ever to help reduce the potential for disasters caused by tropical cyclones in the current and future climate. <hr /> The authors acknowledge the contribution of CSIRO researcher <a href="https://theconversation.com/profiles/hamish-ramsay-19549">Hamish Ramsay</a> during the writing of this article.<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/241000/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-dowdy-119002">Andrew Dowdy</a>, Principal Research Scientist in Extreme Weather, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/liz-ritchie-tyo-1509061">Liz Ritchie-Tyo</a>, Professor of Atmospheric Sciences, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/savin-chand-1351050">Savin Chand</a>, Associate Professor, Applied Mathematics and Statistics, <a href="https://theconversation.com/institutions/federation-university-australia-780">Federation University Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-hurricanes-like-milton-in-the-us-and-cyclones-in-australia-are-becoming-more-intense-and-harder-to-predict-241000">original article</a>. </div>

Travel Trouble

An unbroken night’s sleep is a myth. Here’s what good sleep looks like

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> What do you imagine a good night’s sleep to be? Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep. Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">the same belief</a>. In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like. <h2>Sleep cycles are a roller-coaster</h2> As an adult, our sleep moves through <a href="https://www.sleepfoundation.org/stages-of-sleep">different cycles</a> and brief awakenings during the night. Sleep cycles last roughly 90 minutes each. We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming. If sleeping well, we get most of our deep sleep in the first half of the night, with <a href="https://www.nhlbi.nih.gov/health/sleep/stages-of-sleep#:%7E:text=During%20REM%20sleep%2C%20your%20eyes,from%20acting%20out%20your%20dreams">REM sleep</a> more common in the second half of the night. Adults usually move through five or six sleep cycles in a night, and it is entirely <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">normal</a> to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief. <h2>What does getting a ‘good’ sleep actually mean?</h2> You’ll often hear that adults <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need#:%7E:text=Sleep%20requirements%20stabilise%20in%20early,their%20best%20the%20next%20day">need between seven and nine hours</a> of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality. For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day. You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb). But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons. <h2>Common issues</h2> Sleep disorders are common. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/35478719/">25% of adults</a> have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like. Rates of common sleep disorders such as insomnia and <a href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631">sleep apnoea</a> – where your breathing can partially or completely stop many times during the night – also increase with age, affecting <a href="https://pubmed.ncbi.nlm.nih.gov/32280974/">20% of early adults</a> and 40% of people in <a href="https://pubmed.ncbi.nlm.nih.gov/35082023/">middle age</a>. There are effective treatments, so asking for help is important. Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0012369218311139">pain</a> – and by <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13075">certain medications</a>. There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “<a href="https://www.tandfonline.com/doi/full/10.1080/07420528.2021.2003375">forced awakenings</a>” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause. A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help. We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own <a href="https://www.sleephealthfoundation.org.au/sleep-categories/circadian-rhythm-disorders#:%7E:text=The%20circadian%20rhythms%20throughout%20the,regulation%20of%20our%20sleeping%20patterns">internal clock</a>, which can influence the time your body prefers to sleep. If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern. <h2>Can my smart watch help?</h2> It is important to remember sleep-tracking devices can <a href="https://www.nature.com/articles/s41746-024-01016-9">vary in accuracy</a> for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure. In-laboratory <a href="https://pubmed.ncbi.nlm.nih.gov/31277862/">polysomnography</a>, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep. Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time. <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8356">Understanding your sleep patterns</a> may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment. And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.<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/238069/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, Associate Professor in Clinical Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, Research Associate, Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, Postdoctoral Research Fellow, Clinical Psychologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, Research Fellow in Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, Associate Professor, Adelaide Institute for Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</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/an-unbroken-nights-sleep-is-a-myth-heres-what-good-sleep-looks-like-238069">original article</a>. </div>

Body

Lost touch with someone? Reach out – your friend will likely appreciate it more than you think

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/peggy-liu-818769">Peggy Liu</a>, <a href="https://theconversation.com/institutions/university-of-pittsburgh-854">University of Pittsburgh</a> and <a href="https://theconversation.com/profiles/lauren-min-1354136">Lauren Min</a>, <a href="https://theconversation.com/institutions/university-of-kansas-1588">University of Kansas</a> <h2>The big idea</h2> The next time you wonder whether to reach out to a friend, family member, classmate or other person who’s been out of touch for a long time, go ahead and do it. According to <a href="https://doi.org/10.1037/pspi0000402">our just-published research</a>, it’s likely they’ll appreciate it more than you think. In a series of 13 experiments involving over 5,900 participants, we – along with colleagues <a href="https://scholar.google.com/citations?user=0Stzf1cAAAAJ&hl=en">SoYon Rim</a> and <a href="https://scholar.google.com/citations?user=TZQefJAAAAAJ&hl=en">Kate Min</a> – wanted to investigate whether people accurately predict <a href="https://doi.org/10.1037/pspi0000402">how much their social contacts appreciate being reached out to</a>. In one experiment we conducted, college students wrote a note “to check in and say hello” to a classmate they hadn’t interacted with in a while. Then we asked them how much they thought their classmate would appreciate receiving this note. Next, we delivered these notes to their classmates and asked the recipients how much they appreciated receiving them. We found that the students who received the notes were much more appreciative of the gesture than the students who wrote them had anticipated. Other experiments varied the scenario by involving older adults as participants rather than college students, switching the written message to a small gift – such as cookies or coffee – and comparing how much the sender underestimated the appreciation that an emotionally distant contact would feel compared with a close contact. Overall they yielded the same basic finding: People tended to underestimate how much others appreciated hearing from them. What drives this underestimation? Our results suggest that it’s related to how little the people reaching out factor in the surprise felt by those being contacted. When we asked recipients what they focused on when indicating how appreciative they felt, they reported paying a lot of attention to their positive feelings of surprise, which were linked to how appreciative they felt. Comparatively, potential senders did not report focusing much on recipients’ positive feelings of surprise. It also mattered whether the two parties were already in a close relationship. People’s underestimations were even greater when their contact was a distant acquaintance because these recipients were especially surprised at being contacted. <h2>Why it matters</h2> Many people can name at least one person with whom they would like to reconnect. Taking a new job, moving to a different city, becoming a parent, or the busyness of everyday life – these are just some of the life events and circumstances that can cause people to lose touch. Then, if the desire to reconnect arises on one side, doubts may arise about whether the other person may appreciate being contacted out of the blue. When people consider taking the initiative to reach out, especially after a prolonged period of no contact, they may worry about being rejected. This worry might keep them from reaching out in the first place. Our research lessens this challenge by showing that often, these gestures will be much more appreciated than one might expect. <h2>What other research is being done</h2> Our findings fit within a growing stream of research examining the tendency to underestimate others’ appreciation of various social exchanges. For example, other researchers have found that people underestimate how much <a href="https://doi.org/10.1037/pspa0000277">others appreciate receiving compliments</a> or <a href="https://doi.org/10.1177/0956797618772506">expressions of gratitude</a>. Our work adds to this area by broadening the scope of the contexts in which people underestimate how much social exchanges are appreciated. Reaching out could but need not require giving compliments or expressing gratitude – the gesture can be as simple as checking in with someone to show that one is thinking about them.<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/185001/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peggy-liu-818769">Peggy Liu</a>, Ben L. Fryrear Chair in Marketing and Associate Professor of Business Administration, <a href="https://theconversation.com/institutions/university-of-pittsburgh-854">University of Pittsburgh</a> and <a href="https://theconversation.com/profiles/lauren-min-1354136">Lauren Min</a>, Assistant Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-kansas-1588">University of Kansas</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/lost-touch-with-someone-reach-out-your-friend-will-likely-appreciate-it-more-than-you-think-185001">original article</a>. </div>

Relationships

Young homeowners are more likely to use their home as an ‘ATM’ than their Boomer parents. Here’s why

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> For many Australians, the family home is their largest financial asset. With an increasing variety of ways to tap into home equity, the temptation to access this wealth is ever growing. Homeowners increase the debt owed on their home when they borrow against their <a href="https://doi.org/10.1080/02673037.2013.783202">equity</a>. Standard mortgage home loans now provide facilities for relatively cheap or free withdrawals of equity from the home. This turns the <a href="https://theconversation.com/your-home-as-an-atm-home-equity-a-risky-welfare-tool-22000">home into an ATM</a>, which borrowers can access when they choose. Our new <a href="https://doi.org/10.1080/02673037.2024.2400158">study</a> asks what motivates Australians to tap into their home equity, and how does this behaviour change with age? Surprisingly, despite having much lower housing equity levels, younger homeowners borrow often, and borrow more, than their Boomer parents. <h2>How common is equity borrowing?</h2> Using 15 years of data from the government-funded <a href="https://melbourneinstitute.unimelb.edu.au/hilda">Household, Income and Labour Dynamics in Australia </a>(HILDA) survey, we tracked the mortgage debt and repayments of homeowners aged 35 and over. The chart below shows younger owners are far more likely to engage in equity borrowing. In 2006, nearly 39% of the youngest homeowners, aged 35–44, borrowed against their home equity. By 2021, this number had dropped to 29%. Despite the decline, it’s still 24 percentage points more common than those aged 65 and over. The older group has remained steady at about 5% over the years. <hr /> <iframe id="Ll9Cw" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Ll9Cw/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How much do equity borrowers withdraw from their home?</h2> Among those who use their home like an ATM, younger borrowers now withdraw larger amounts than older borrowers. In 2006–07, equity borrowers aged 35–44 and 45–54 withdrew on average $43,000 and $57,000, respectively (expressed in real values set at 2022 price levels). By 2021, the amount withdrawn by these two age groups had climbed to $70,000 and $100,000. On the other hand, the amount withdrawn by borrowers aged 55 or older fell from more than $50,000 to less than $40,000. <hr /> <iframe id="ujq3S" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/ujq3S/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>What motivates equity borrowing?</h2> Young homeowners’ equity borrowing behaviours are sensitive to changes in house prices and debt values, and their financial risk preferences. Among those aged 35–44, a $10,000 increase in the primary home value raises the likelihood of equity borrowing by ten percentage points. Every $10,000 in debt against the primary home reduces the likelihood by 2.8% percentage points. Those willing to take substantial financial risk are eight percentage points more likely to borrow against their home than those who are risk-averse. Those aged 65+ are not inclined to borrow, and exhibit little change in equity borrowing behaviour with variations in asset, debt, income or financial risk preferences. <h2>Why borrowing practices differ between age groups</h2> As well as being more likely than older homeowners to borrow against equity, the younger group also withdraws higher amounts than their Boomer parents. This is despite younger borrowers already carrying much higher debt against their primary home. Among those in our study who engaged in equity borrowing in 2021, the median debt before borrowing was $401,000 for 35-44 year-olds compared to $0 for those aged 65+. As real house prices have risen over decades, the current generation of young homeowners has had to invest more money into purchasing their first home than previous generations. It’s therefore not surprising the primary home is now widely viewed as a financial resource to be <a href="https://theconversation.com/your-home-as-an-atm-home-equity-a-risky-welfare-tool-22000">tapped into to meet spending needs</a>. On the other hand, most Baby Boomers bought their first home at more affordable prices than their children, and at lower levels of debt. Now they don’t appear to be spending their kids’ inheritance by drawing down housing wealth. In fact, older parents may shy away from equity borrowing to <a href="https://www.pc.gov.au/research/completed/wealth-transfers/wealth-transfers.pdf">bequeath wealth to children</a>. Some also <a href="https://doi.org/10.1017/S0047279417000058">dislike passing debt</a> on to their children. Older people may also avoid equity borrowing due to concerns about <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150.pdf">aged care costs</a>. Some may be hampered by <a href="https://doi.org/10.1016/j.jue.2013.08.003">poor financial literacy</a>. <h2>More debt ahead without policy changes</h2> Present trends suggest young homeowners will remain indebted for longer periods, and more and more will <a href="https://theconversation.com/more-of-us-are-retiring-with-mortgage-debts-the-implications-are-huge-115134">retire with mortgage debt</a>. For indebted retirees, there are real prospects of <a href="https://theconversation.com/fall-in-ageing-australians-home-ownership-rates-looms-as-seismic-shock-for-housing-policy-120651">drawing down of superannuation</a> to pay off mortgages in retirement. This may impose extra burdens on the age pension system. Another unwelcome consequence, which may add to health costs, is the prospect of <a href="https://www.ahuri.edu.au/sites/default/files/migration/documents/AHURI-Final-Report-319-Mortgage-stress-and-precarious-home-ownership-implications-for-older-Australians.pdf">debt-related psychological distress</a> among those who can’t pay off their mortgage in old age. If the current trends continue, the <a href="https://www.afr.com/policy/economy/what-happens-when-australia-s-boomers-hand-5-trillion-to-their-heirs-20240515-p5jdvf">great wealth transfer</a> that has already begun looks set to <a href="https://theconversation.com/not-everyone-wins-from-the-bank-of-mum-and-dad-73842">further entrench inequality</a> between those who have access to the bank of mum and dad and those who do not. Encouraging older people to use their housing equity to fund their needs in old age may lighten fiscal burdens on younger generations. But policy reforms will be needed to relieve concerns about the risks of equity borrowing in old age.<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/238924/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, ARC Future Fellow & Professor of Economics, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, Research Fellow, School of Accounting, Economics and Finance, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</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/young-homeowners-are-more-likely-to-use-their-home-as-an-atm-than-their-boomer-parents-heres-why-238924">original article</a>. </div>

Money & Banking

I’m feeling run down. Why am I more likely to get sick? And how can I boost my immune system?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> It has been a long winter, filled with many viruses and cost-of-living pressures, on top of the usual mix of work, study, life admin and caring responsibilities. Stress is an inevitable part of life. In short bursts, our stress response has evolved as a survival mechanism to help us be more alert in <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">fight or flight situations</a>. But when stress is chronic, it weakens the immune system and makes us more vulnerable to illnesses such as the <a href="https://www.healthline.com/health/can-stress-make-you-sick#:%7E:text=The%20common%20cold&text=Inflammation%20has%20been%20linked%20to,to%20the%20cold%2Dcausing%20germs.">common cold</a>, <a href="https://journals.lww.com/psychosomaticmedicine/abstract/1999/03000/psychological_stress,_cytokine_production,_and.9.aspx">flu</a> and <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/smi.3017">COVID</a>. <h2>Stress makes it harder to fight off viruses</h2> When the immune system starts to break down, a virus that would normally have been under control starts to flourish. Once you begin to feel sick, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/">stress response</a> rises, making it harder for the immune system to fight off the disease. You may be sick more often and for longer periods of time, without enough immune cells primed and ready to <a href="https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6">fight</a>. In the 1990s, American psychology professor Sheldon Cohen and his colleagues conducted a number of <a href="https://www.cmu.edu/common-cold-project/">studies</a> where healthy people were exposed to an upper respiratory infection, through drops of virus placed directly into their <a href="https://www.nejm.org/doi/full/10.1056/NEJM199108293250903">nose</a>. These participants were then quarantined in a hotel and monitored closely to determine who became <a href="https://theconversation.com/stress-less-it-might-protect-you-from-covid-153361">ill</a>. One of the most important factors predicting who got sick was prolonged psychological <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">stress</a>. <h2>Cortisol suppresses immunity</h2> “Short-term stress” is stress that lasts for a period of minutes to hours, while “chronic stress” persists for several hours per day for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964013/#:%7E:text=Therefore%2C%20a%20major%20distinguishing%20characteristic,weeks%20or%20months%20%5B9%5D.">weeks or months</a>. When faced with a perceived threat, psychological or physical, the hypothalamus region of the brain sets off an alarm system. This signals the release of a surge of hormones, including adrenaline and <a href="https://www.embopress.org/doi/full/10.15252/msb.20209510">cortisol</a>. <figure class="align-center "><img src="https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&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/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=472&fit=crop&dpr=1 600w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=472&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=472&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=593&fit=crop&dpr=1 754w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=593&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/616892/original/file-20240903-18-blrqoz.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=593&fit=crop&dpr=3 2262w" alt="Human brain illustration" /><figcaption>The hypothalamus sets off an alarm system in response to a real or perceived threat. <a class="source" href="https://www.shutterstock.com/image-illustration/hypothalamus-causes-vasoconstriction-illustration-medical-brain-435142264">stefan3andrei/Shutterstock</a></figcaption></figure> In a typical stress response, <a href="https://www.sciencedirect.com/science/article/abs/pii/S147149060300173X">cortisol levels</a> quickly increase when stress occurs, and then rapidly drop back to normal once the stress has subsided. In the short term, cortisol suppresses inflammation, to ensure the body has enough energy available to respond to an <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2019.00245/full">immediate threat</a>. But in the longer term, chronic stress can be harmful. A Harvard University study <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">from 2022</a> showed that people suffering from psychological distress in the lead up to their COVID infection had a greater chance of experiencing long COVID. They <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">classified</a> this distress as depression, probable anxiety, perceived stress, worry about COVID and loneliness. Those suffering distress had close to a <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097">50% greater risk</a> of long COVID compared to other <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">participants</a>. Cortisol has been shown to be high in the most severe cases of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102614/">COVID</a>. <h2>Stress causes inflammation</h2> <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">Inflammation</a> is a short-term reaction to an injury or infection. It is responsible for trafficking immune cells in your body so the right cells are present in the right locations at the right times and at the right <a href="https://link.springer.com/article/10.1007/s12026-014-8517-0">levels</a>. The immune cells also store a memory of that threat to respond faster and more effectively the next <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">time</a>. Initially, circulating immune cells detect and flock to the site of <a href="https://www.nature.com/articles/ni1275">infection</a>. Messenger proteins, known as pro-inflammatory cytokines, are released by immune cells, to signal the danger and recruit help, and our immune system responds to neutralise the <a href="https://stories.uq.edu.au/imb/the-edge/inflammation/what-is-inflammation/index.html">threat</a>. During this response to the infection, if the immune system produces too much of these inflammatory chemicals, it can trigger symptoms such as nasal congestion and runny <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">nose</a>. <h2>What about chronic stress?</h2> Chronic stress causes persistently high cortisol secretion, which remains high even in the absence of an immediate <a href="https://theconversation.com/no-you-cant-blame-all-your-health-issues-on-high-cortisol-heres-how-the-hormone-works-203162">stressor</a>. The immune system becomes desensitised and unresponsive to this <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043661816307435">cortisol suppression</a>, increasing low-grade “silent” inflammation and the production of pro-inflammatory cytokines (the messenger proteins). Immune cells become exhausted and start to <a href="https://www.fxmedicine.com.au/blog-post/adrenal-immune-connection">malfunction</a>. The body loses the ability to turn down the inflammatory <a href="https://journals.sagepub.com/doi/full/10.1177/1745691620942516">response</a>. Over time, the immune system changes the way it responds by reprogramming to a “<a href="https://www.unimelb.edu.au/newsroom/news/2021/april/how-stress-can-stop-immune-cells-in-their-tracks">low surveillance mode</a>”. The immune system misses early opportunities to destroy threats, and the process of recovery can take <a href="https://theconversation.com/being-stressed-out-before-you-get-covid-increases-your-chances-of-long-covid-heres-why-190649">longer</a>. <h2>So how can you manage your stress?</h2> We can actively strengthen our immunity and natural defences by managing our <a href="https://theconversation.com/stuck-in-fight-or-flight-mode-5-ways-to-complete-the-stress-cycle-and-avoid-burnout-or-depression-218599">stress levels</a>. Rather than letting stress build up, try to address it early and frequently by: 1) Getting enough sleep Getting enough sleep reduces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132857/">cortisol levels</a> and inflammation. During sleep, the immune system <a href="https://link.springer.com/chapter/10.1007/978-1-4939-6578-6_12">releases</a> <a href="https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674">cytokines</a>, which help fight infections and inflammation. 2) Taking regular exercise Exercising helps the lymphatic system (which balances bodily fluids as part of the immune system) circulate and allows immune cells to monitor for threats, while sweating flushes <a href="https://www.healthline.com/nutrition/does-exercise-boost-immune-system">toxins</a>. Physical activity also lowers stress hormone levels through the release of positive brain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387807/">signals</a>. 3) Eating a healthy diet Ensuring your diet contains enough nutrients – such as the B vitamins, and the full breadth of minerals like magnesium, iron and zinc – during times of stress has a positive impact on overall stress <a href="https://www.ncbi.nlm.nih.gov/pubmed/22782571">levels</a>. Staying hydrated helps the body to flush out <a href="https://theconversation.com/a-strong-immune-system-helps-ward-off-colds-and-flus-but-its-not-the-only-factor-99512">toxins</a>. 4) Socialising and practising meditation or mindfulness These activities increase endorphins and serotonin, which improve mood and have <a href="https://www.sciencedirect.com/science/article/pii/S2949834123000351">anti-inflammatory effects</a>. Breathing exercises and meditation stimulate the parasympathetic nervous system, which calms down our stress responses so we can “reset” and reduce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940234/">cortisol levels</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/237456/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sathana-dushyanthen-1169328">Sathana Dushyanthen</a>, Academic Specialist & Lecturer in Cancer Sciences & Digital Health| Superstar of STEM| Science Communicator, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/im-feeling-run-down-why-am-i-more-likely-to-get-sick-and-how-can-i-boost-my-immune-system-237456">original article</a>. </div>

Body

What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes. Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>. More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it. So, what is type 1.5 diabetes? And how is it diagnosed and treated? <h2>There are several types of diabetes</h2> Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2. Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production. Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults. Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin. Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy. <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis. Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2. Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes. <h2>What are the symptoms, and how is it treated?</h2> The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>: <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day. When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes. <h2>Type 1.5 diabetes is often misdiagnosed</h2> Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>. There are a few possible reasons for this. First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them. Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults). Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin. Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2. <h2>We’re still learning about type 1.5</h2> Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers. Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition. A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road. Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<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/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>. </div>

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