Placeholder Content Image

What causes the itch in mozzie bites? And why do some people get such a bad reaction?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Are you one of these people who loathes spending time outdoors at dusk as the weather warms and mosquitoes start biting?</p> <p>Female mosquitoes <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-ento-120811-153618">need blood</a> to develop their eggs. Even though they take a tiny amount of our blood, they can leave us with itchy red lumps that can last days. And sometimes something worse.</p> <p>So why does our body react and itch after being bitten by a mosquito? And why are some people more affected than others?</p> <h2>What happens when a mosquito bites?</h2> <p>Mosquitoes are attracted to warm blooded animals, including us. They’re attracted to the <a href="https://www.cambridge.org/core/journals/bulletin-of-entomological-research/article/abs/role-of-carbon-dioxide-in-hostfinding-by-mosquitoes-diptera-culicidae-a-review/2506B86EF63852B2D02EC3FCEE1E3B8B">carbon dioxide</a> we exhale, our body temperatures and, most importantly, <a href="https://www.abc.net.au/news/2024-11-08/mosquitoes-climate-change-skin/104548122">the smell of our skin</a>.</p> <p>The <a href="https://www.cell.com/trends/parasitology/abstract/S1471-4922(21)00237-3">chemical cocktail</a> of odours from bacteria and sweat on our skin <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(23)00532-8">sends out a signal</a> to hungry mosquitoes.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S2667114X21000522">Some people’s</a> skin smells more appealing to mosquitoes, and they’re more likely to be bitten than others.</p> <p>Once the mosquito has made its way to your skin, things get a little gross.</p> <p>The mosquito pierces your skin with their “proboscis”, their feeding mouth part. But the proboscis isn’t a single, straight, needle-like tube. There are multiple tubes, <a href="https://www.npr.org/sections/health-shots/2016/06/07/480653821/watch-mosquitoes-use-6-needles-to-suck-your-blood">some designed</a> for sucking and some for spitting.</p> <p>Once their mouth parts have been inserted into your skin, the mosquito will inject some saliva. This contains a mix of chemicals that gets the blood flowing better.</p> <p>There has even been a suggestion that future medicines could be inspired by the <a href="https://www.sydney.edu.au/news-opinion/news/2018/03/29/mosquito-saliva-vital-to-the-discovery-of-future-drugs.html">anti-blood clotting properties</a> of mosquito saliva.</p> <p>It’s not the stabbing of our skin by the mosquito’s mouth parts that hurts, it’s the mozzie spit our bodies don’t like.</p> <h2>Are some people allergic to mosquito spit?</h2> <p>Once a mosquito has injected their saliva into our skin, a variety of reactions can follow. For the lucky few, nothing much happens at all.</p> <p>For most people, and irrespective of the type of mosquito biting, <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.1024559/full">there is some kind of reaction</a>. Typically there is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0161589023002304?via%3Dihub">redness and swelling of the skin</a> that appears within a few hours, but often more quickly, after just a few minutes.</p> <p>Occasionally, the reaction can cause pain or discomfort. Then comes the <a href="https://www.abc.net.au/news/health/2023-01-20/mosquito-bites-itchy-calamine-heat-ice-antihistamine-toothpaste/101652608">itchiness</a>.</p> <p>Some people do suffer severe reactions to mosquito bites. It’s a condition often referred to as “<a href="https://www.webmd.com/allergies/what-is-skeeter-syndrome">skeeter syndrome</a>” and is an allergic reaction caused by the protein in the mosquito’s saliva. This can cause large areas of swelling, blistering and fever.</p> <p>The chemistry of mosquito spit hasn’t really been well studied. But it has been shown that, for those who do suffer allergic reactions to their bites, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0091674904022183">reactions may differ</a> depending on the type of mosquito biting.</p> <p>We all probably get more tolerant of mosquito bites as we get older. Young children are certainly more likely to suffer more following mosquito bites. But as we get older, the reactions are less severe and may pass quickly without too much notice.</p> <h2>How best to treat the bites?</h2> <p>Research into treating bites <a href="https://linkinghub.elsevier.com/retrieve/pii/S0161589023002304">has yet to provide</a> a single easy solution.</p> <p>There are many <a href="https://www.healthline.com/health/outdoor-health/home-remedies-for-mosquito-bites">myths and home remedies</a> about what works. But there is little scientific evidence supporting their use.</p> <p>The best way to treat mosquito bites is by applying a cold pack to reduce swelling and to keep the skin clean to avoid any secondary infections. Antiseptic creams and lotions may also help.</p> <p>There is some evidence that <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10309056/">heat may alleviate</a> some of the discomfort.</p> <p>It’s particularly tough to keep young children from scratching at the bite and breaking the skin. This can form a nasty scab that may end up being worse than the bite itself.</p> <p>Applying an anti-itch cream may help. If the reactions are severe, <a href="https://www.healthdirect.gov.au/insect-bites-and-stings">antihistamine medications</a> may be required.</p> <h2>To save the scratching, stop the bites</h2> <p>Of course, it’s better not to be bitten by mosquitoes in the first place. Topical <a href="https://theconversation.com/insect-repellents-work-but-there-are-other-ways-to-beat-mosquitoes-without-getting-sticky-171805">insect repellents</a> are a safe, effective and affordable way to reduce mosquito bites.</p> <p>Covering up with loose fitted long sleeved shirts, long pants and covered shoes also provides a physical barrier.</p> <p><a href="https://theconversation.com/are-mosquito-coils-good-or-bad-for-our-health-88548">Mosquito coils and other devices</a> can also assist, but should not be entirely relied on to stop bites.</p> <p>There’s another important reason to avoid mosquito bites: millions of people around the world suffer from mosquito-borne diseases. More than <a href="https://www.who.int/news-room/fact-sheets/detail/malaria">half a million people die</a> from malaria each year.</p> <p>In Australia, <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005070">Ross River virus</a> infects more than 5,000 people every year. And in recent years, there have been cases of serious illnesses caused by <a href="https://www.science.org/content/article/how-rains-pigs-and-waterbirds-fueled-shocking-disease-outbreak-australia">Japanese encephalitis</a> and <a href="https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1256149/full">Murray Valley encephalitis</a> viruses.<!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, Clinical Associate Professor and Principal Hospital Scientist, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-causes-the-itch-in-mozzie-bites-and-why-do-some-people-get-such-a-bad-reaction-243044">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Balance declines with age, but exercise can help stave off some of the risk of falling

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a></em></p> <p>My wife and I were in the grocery store recently when we noticed an older woman reaching above her head for some produce. As she stretched out her hand, she lost her balance and began falling forward. Fortunately, she leaned into her grocery cart, which prevented her from falling to the ground.</p> <p>Each year, about <a href="https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm">1 in every 4 older adults experience a fall</a>. In fact, falls are the leading cause of injuries in adults ages 65 and older. Falls are the <a href="https://doi.org/10.1007/bf00298717">most common cause of hip fractures</a> and <a href="https://doi.org/10.1111/j.1553-2712.2000.tb00515.x">traumatic brain injuries</a>.</p> <p>Injuries like those are also <a href="https://doi.org/10.1056/NEJM199710303371806">risk factors for placement in a nursing home</a>, where the fall risk is <a href="https://doi.org/10.7326/0003-4819-121-6-199409150-00009">nearly three times higher than for people living in the community</a>.</p> <p>A number of physical changes with aging often go unseen preceding falls, including muscle weakness, decreased balance and changes in vision.</p> <p>I am a <a href="https://facultyprofiles.tufts.edu/evan-papa">physical therapist</a> and <a href="https://scholar.google.com/citations?user=T9B_dHQAAAAJ&amp;hl=en">clinical scientist focused on fall prevention</a> in older adults, commonly ages 65 and older. I’ve spent most of my career investigating why older adults fall and working with patients and their families to prevent falls.</p> <h2>Why aging leads to increased risk of falls</h2> <p>Aging is a process that affects the systems and tissues of every person. The rate and magnitude of aging may be different for each person, but overall physical decline is an inevitable part of life. Most people think aging starts in their 60s, but in fact we spend most of our life span <a href="https://doi.org/10.1093%2Fgeront%2Fgnv130">undergoing the process of decline</a>, typically beginning in our 30s.</p> <p>Older adults are more prone to falling for various reasons, including age-related changes in their bodies and vision changes that leave them vulnerable to environmental factors such as curbs, stairs and carpet folds.</p> <figure><iframe src="https://www.youtube.com/embed/ztPbKP68P2Q?wmode=transparent&amp;start=24" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Some straightforward measures to improve the safety of the home environment for older adults can significantly lower the risk of falls.</span></figcaption></figure> <p>Based on my experience, here are some common reasons older adults may experience falls:</p> <p>First, <a href="https://my.clevelandclinic.org/health/diseases/23167-sarcopenia">aging leads to a natural loss of muscle strength</a> and flexibility, making it more challenging to maintain balance and stability. The loss of strength and poor balance are two of the most common causes of falls.</p> <p>Second, older adults often have chronic conditions such as arthritis, Parkinson’s disease or diabetes that can affect their mobility, coordination and overall stability.</p> <p>In addition, certain medications commonly taken by older adults, <a href="https://doi.org/10.4088/jcp.18f12340">such as sedatives</a> or <a href="https://doi.org/10.1001/jamainternmed.2013.14764">blood pressure drugs</a>, can cause dizziness, drowsiness or a drop in blood pressure, leading to an increased risk of falls.</p> <p>Age-related vision changes, such as reduced depth perception and peripheral vision and difficulty in differentiating colors or contrasts, can make it harder to navigate and identify potential hazards. Hazards in the environment, such as uneven surfaces, slippery floors, inadequate lighting, loose rugs or carpets or cluttered pathways, can <a href="https://doi.org/10.1186/s12877-021-02499-x">significantly contribute to falls among older adults</a>.</p> <p>Older adults who lead a sedentary lifestyle or have limited physical activity may also experience reduced strength, flexibility and balance.</p> <p>And finally, such conditions as dementia or Alzheimer’s disease can affect judgment, attention and spatial awareness, leading to increased fall risk.</p> <h2>Theories of aging</h2> <p>There are numerous theories about why we age but there is no one unifying notion that explains all the changes in our bodies. A large portion of aging-related decline is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295054/">caused by our genes</a>, which determine the structure and function of bones, muscle growth and repair and visual depth perception, among other things. But there are also numerous lifestyle-related factors that influence our rate of aging including diet, exercise, stress and exposure to environmental toxins.</p> <p>A recent advance in scientific understanding of aging is that there is a difference between your <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">chronological age and your biological age</a>. Chronological age is simply the number of years you’ve been on the Earth. Biological age, however, refers to how old your cells and tissues are. It is based on physiological evidence from a blood test and is related to your physical and functional ability. Thus, if you’re healthy and fit, your biological age may be lower than your chronological age. However, the reverse can also be true.</p> <p>I encourage patients to focus on their biological age because it empowers them to take control over the aging process. We obviously have no control over when we are born. By focusing on the age of our cells, we can avoid long-held beliefs that our bodies are destined to develop cancer, diabetes or other conditions that <a href="https://doi.org/10.1016/j.cub.2012.07.024">have historically been tied to how long we live</a>.</p> <p>And by taking control of diet, exercise, sleep and other lifestyle factors you can actually <a href="https://doi.org/10.1111%2Facel.13538">decrease your biological age</a> and improve your quality of life. As one example, our team’s research has shown that moderate amounts of aerobic exercise <a href="https://doi.org/10.1371/journal.pone.0188538">can slow down motor decline</a> even when a person begins exercise in the latter half of the life span.</p> <h2>Fall prevention</h2> <p>Adopting lifestyle changes such as regular, long-term exercise can <a href="https://doi.org/10.1001/jamainternmed.2018.5406">reduce the consequences of aging</a>, including falls and injuries. Following a healthy diet, managing chronic conditions, reviewing medications with health care professionals, maintaining a safe home environment and getting regular vision checkups can also help reduce the risk of falls in older adults.</p> <p>There are several exercises that physical therapists use to improve balance for patients. It is important to note however, that before starting any exercise program, everyone should consult with a health care professional or a qualified physical therapist to determine the most appropriate exercises for their specific needs. Here are five forms of exercise I commonly recommend to my patients to improve balance:</p> <ol> <li> <p>Balance training can help improve coordination and <a href="https://www.sciencedirect.com/topics/neuroscience/proprioception">proprioception</a>, which is the body’s ability to sense where it is in space. By practicing movements that challenge the body’s balance, such as standing on one leg or walking heel-to-toe, the nervous system becomes better at coordinating movement and maintaining balance. A large research study analyzing nearly 8,000 older adults found that balance and functional exercises <a href="https://doi.org/10.1002/14651858.cd012424.pub2">reduce the rate of falls by 24%</a>.</p> </li> <li> <p>Strength training exercises involve lifting weights or using resistance bands to increase muscle strength and power. By strengthening the muscles in the legs, hips and core, older adults can improve their ability to maintain balance and stability. Our research has shown that strength training can also lead to <a href="https://doi.org/10.2147/cia.s104674">improvements in walking speed and a reduction in fall risk</a>.</p> </li> <li> <p>Tai chi is a gentle martial art that focuses on slow, controlled movements and shifting body weight. Research shows that it can improve balance, strength and flexibility in older adults. Several combined studies in tai chi have demonstrated a 20% reduction in the <a href="https://doi.org/10.1002/14651858.cd012424.pub2">number of people who experience falls</a>.</p> </li> <li> <p>Certain yoga poses can enhance balance and stability. Tree pose, warrior pose and mountain pose are examples of poses that can help improve balance. It’s best to <a href="https://theconversation.com/yoga-modern-research-shows-a-variety-of-benefits-to-both-body-and-mind-from-the-ancient-practice-197662">practice yoga</a> under the guidance of a qualified instructor who can adapt the poses to individual abilities.</p> </li> <li> <p>Flexibility training involves stretching the muscles and joints, which can improve range of motion and reduce stiffness. By improving range of motion, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990889/">older adults can improve their ability to move safely</a> and avoid falls caused by limitations in mobility.</p> </li> <li> <p>Use of assistive devices can be helpful when strength or balance impairments are present. Research studies involving the evaluation of canes and walkers used by older adults confirm that <a href="https://doi.org/10.1016/j.apmr.2004.04.023">these devices can improve balance and mobility</a>. Training from a physical or occupational therapist in the proper use of assistive devices is an important part of improving safety.</p> </li> </ol> <p>When I think back about the woman who nearly fell in the grocery store, I wish I could share everything we have learned about healthy aging with her. There’s no way to know if she was already putting these tips into practice, but I’m comforted by the thought that she may have avoided the fall by being in the right place at the right time. After all, she was standing in the produce aisle.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/204174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, Associate Professor of Physical Therapy and Rehabilitation Science, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/balance-declines-with-age-but-exercise-can-help-stave-off-some-of-the-risk-of-falling-204174">original article</a>.</em></p> </div>

Body

Placeholder Content Image

For some people dying alone is not such a bad thing – here’s why

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/glenys-caswell-142188">Glenys Caswell</a>, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a></em></p> <p>It seems so obvious that no one should die alone that we never talk about it, but people do often die when they are alone. Sometimes they die in a way that suggests they prefer to be alone as they are coming to the end of their lives. So is it really such a bad thing to be alone when you die?</p> <p>When a person is dying in a hospital or a care home it is common for the nurses caring for them to summon their family. Many people will have the experience of trying to <a href="http://journals.sagepub.com/doi/abs/10.2190/OM.55.3.d">keep vigil beside a family member</a>. It is hard – as everyday life goes on regardless – and it can be emotionally exhausting. Sometimes, the relative will die when their family have gone to make a phone call or get a cup of tea, leaving the family feeling distressed and guilty for not being there when they died.</p> <p>There is plenty of research literature, from many countries, devoted to trying to decide <a href="http://www.sciencedirect.com/science/article/pii/S0885392415001578">what makes a good death</a>. There are differences to be found between countries, but similarities too. One similarity is a belief that <a href="http://www.sciencedirect.com/science/article/pii/S106474811600138X?via%3Dihub">no one should die alone</a>.</p> <p>This idea sits well with the view of dying that can be found in many different places. When interviewed as research participants, health professionals – and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904589/">nurses in particular</a> – commonly say that no one should die alone. There are also many cultural references that suggest that to die alone is a bad thing. Consider, for example, the death of Ebenezer Scrooge in Dickens’s <a href="https://www.gutenberg.org/files/46/46-h/46-h.htm">A Christmas Carol</a>, or the death of Nemo, the law writer in <a href="http://www.gutenberg.org/files/1023/1023-h/1023-h.htm">Bleak House</a>. These are both sad, dark, lonely deaths of a kind to be avoided.</p> <p>Celebrity deaths, such as those of comedian and actress <a href="https://www.theguardian.com/culture/2016/apr/20/victoria-wood-dies-aged-62-comedian">Victoria Wood</a> or <a href="http://www.bbc.co.uk/news/entertainment-arts-35278872">David Bowie</a>, are described in the news as peaceful or good when they are surrounded by family. Ordinary people who die alone make the news when the person’s body is undiscovered for a long time. When this happens the death is likely to be described in <a href="http://www.sciencedirect.com/science/article/pii/S027795360300577X?via%3Dihub">negative terms</a>, such as shocking, lonely, tragic or as a sad indictment of society.</p> <h2>Some people prefer to be alone</h2> <p>Of course, it may be the case that many people would prefer to have their family around them when they are dying. But there is <a href="http://www.tandfonline.com/doi/full/10.1080/21582041.2015.1114663">evidence</a> that suggests that some people would <a href="http://www.sciencedirect.com/science/article/pii/S0277953615003482?via%3Dihub">prefer to be alone </a> as they are coming to the end of their lives.</p> <p>My own <a href="http://www.tandfonline.com/doi/full/10.1080/13576275.2017.1413542">research</a> found that while hospice-at-home nurses believe that no one should die alone, they had seen cases where a person died after their family members had left the bedside. The nurses believed that some people just want to be on their own when they are dying. They also thought that people may have a measure of control over when they die, and choose to do so when their family are not around.</p> <p>In the same study, I also talked to older people who were living alone to find out their views about dying alone. I was intrigued to learn that dying alone was not seen as something that is automatically bad, and for some of the older people it was to be preferred. For some people in this group, dying was not the worst thing that could happen – being trapped in a care home was considered to be far worse than dying alone.</p> <p>Cultural representations of dying suggest that being alone while dying is a dreadful thing. This view is supported by healthcare policy and the practices of health professionals, such as nurses. But we all know people who prefer to be left alone when they are ill. Is it so surprising then that some might wish to be alone when they are dying?</p> <p>It is time we began to talk about this and to accept that we want different things in our dying as we do in our living. Openness created through discussion might also help to remove some of the guilt that family members feel when they miss the moment of their relative’s death.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/90034/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/glenys-caswell-142188">Glenys Caswell</a>, Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/for-some-people-dying-alone-is-not-such-a-bad-thing-heres-why-90034">original article</a>.</em></p> </div>

Caring

Placeholder Content Image

Offering end of life support as part of home care is important – but may face some challenges

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p>Earlier this month, the government announced <a href="https://theconversation.com/the-government-has-a-new-plan-for-residential-aged-care-heres-whats-changing-238765">major changes</a> to aged care in Australia, including a A$4.3 billion <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">investment in home care</a>.</p> <p>Alongside a shake up of home care packages, the Support at Home program will include an important addition – an <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">end of life pathway</a> for older Australians.</p> <p>This pathway will allow access to a <a href="https://www.health.gov.au/our-work/support-at-home/features">higher level</a> of in-home aged care services to help Australians stay at home as they come to the end of their life. Specifically, it will provide an extra A$25,000 for palliative support when a person has three months or less left to live.</p> <p>This is a positive change. But there may be some challenges to implementing it.</p> <h2>Why is this important?</h2> <p>Older people have made clear their preference to remain in their homes as they age. For <a href="https://journals.sagepub.com/doi/10.1177/0269216313487940">most people</a>, home is where they would like to be during their last months of life. The space is personal, familiar and comforting.</p> <p>However, data from the <a href="https://www.abs.gov.au/statistics/research/classifying-place-death-australian-mortality-statistics">Australian Bureau of Statistics</a> shows most people who die between the ages of 65 and 84 die in hospital, while most people aged 85 and older die in residential aged care.</p> <p>This apparent gap may reflect a lack of appropriate services. Both palliative care services and GPs have an important role in providing medical care to people living at home with a terminal illness. However, being able to <a href="https://grattan.edu.au/wp-content/uploads/2014/09/815-dying-well.pdf">die at home</a> relies on the availability of ongoing support including hands-on care and assistance with daily living.</p> <p>Family members and friends often provide this support, but this is not always possible. Even when it is, carers may <a href="https://pubmed.ncbi.nlm.nih.gov/38533612/">lack confidence and skills</a> to provide the necessary care, and may not have enough support for and respite from their carer role.</p> <p>The palliative care funding offered within Support at Home should help an older person to remain at home and die at home, if that is their preference.</p> <p>Unless someone dies suddenly, care needs are likely to increase at the end of a person’s life. Supports at home may involve help with showering and toileting, assessing and addressing symptoms, developing care plans, managing medications, wound dressing, domestic tasks, preparing meals, and communicating with the person’s family.</p> <p>Occupational therapists and physiotherapists can assist with equipment requirements and suggest home modifications.</p> <p>End of life supports may also involve clarifying goals of care, contacting services such as pharmacists for medications or equipment, liaising with organisations about financial matters, respite care or funeral planning, as well as acknowledging grief and offering spiritual care.</p> <p>But we don’t know yet exactly what services the $25,000 will go towards.</p> <h2>What do we know about the scheme so far?</h2> <p>The Support at Home program, including the end of life pathway, is scheduled to start from <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">July 1 2025</a>.</p> <p>We know the funding is linked to a prognosis of three months or less to live, which will be determined <a href="https://www.abc.net.au/news/2024-09-15/new-payment-aims-to-make-it-easier-for-people-to-die-at-home/104347984">by a doctor</a>.</p> <p>Further information has indicated that an older person can be referred to a <a href="https://www.health.gov.au/our-work/support-at-home/features">high-priority assessment</a> to access the end of life pathway. We don’t know yet what this means, however they don’t need to be an existing Support at Home participant to be eligible.</p> <p>The pathway will allow 16 weeks to use the funds, possibly to provide some leeway around the three-month timeline.</p> <p>Although more details are coming to light, there are still some things which remain unclear.</p> <p>Home care providers will be looking for details on what can be covered by this funding and how they will work alongside primary care providers and health-care services.</p> <p>Older people and their families will want to know the processes to apply for this funding and how long applications will take to be reviewed.</p> <p>Everyone will want to know what happens if the person doesn’t die within three months.</p> <h2>Some challenges</h2> <p>Ready availability of appropriate supports and services will be crucial for older people accessing this pathway. Home care providers will therefore need to assess how an end of life pathway fits into their operational activities and how they can build the necessary skills and capacity.</p> <p>Demand for nurses with palliative care skills and allied health professionals is likely to increase. Providing end of life care can be <a href="https://pubmed.ncbi.nlm.nih.gov/33096682/">especially taxing</a> so strategies will be needed to prevent staff burnout and encourage self-care.</p> <p>How pathways are implemented in rural and remote areas and in different cultural and community groups will need to be monitored to ensure all older people benefit.</p> <p>Effective coordination and communication between home care, primary care and specialist palliative providers care will be key. Digital health systems that connect the sectors could be helpful. Family engagement will also be very important.</p> <p>Escalation pathways and referral pathways should be established to enable appropriate responses to emergencies, unexpected deterioration, and family distress.</p> <p>Finally, <a href="https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-023-01155-y">accurately determining</a> when someone will die can be difficult. Knowing when the last three months of life starts may not be easy, particularly where frailty, cognitive issues and multiple health concerns may be present.</p> <p>This might mean some people are not seen as being ready for this pathway. Others may not be willing to accept this prognosis. An older person may also be expected to live with a terminal illness for many months or years. Their palliative care needs would not be met under this pathway.</p> <p>Despite these challenges, the announcement of an end of life pathway within the home care program is timely and welcome. As a population we are living longer and dying older. More details will help us be better prepared to implement this scheme.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239296/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, Matthew Flinders Professor and Director of the Research Centre for Palliative Care, Death and Dying, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/offering-end-of-life-support-as-part-of-home-care-is-important-but-may-face-some-challenges-239296">original article</a>.</em></p> </div>

Retirement Life

Placeholder Content Image

Why do I need to take some medicines with food?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p>Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?</p> <p>There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.</p> <p>To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.</p> <p>Different brands of the same medicine may also have different recommendations when it comes to taking it with food.</p> <h2>Food impacts drug absorption</h2> <p>Food can affect how fast and how much a drug is absorbed into the body in up to <a href="https://academic.oup.com/jpp/article-abstract/71/4/510/6122024?login=false">40% of medicines</a> taken orally.</p> <p>When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.</p> <p>Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505616/">gastric emptying</a>. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.</p> <p>Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.</p> <p>But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.</p> <h2>Food can make medicines more tolerable</h2> <p>Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.</p> <p>Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452716/">one in four users affected</a>. To combat these side effects, it is generally recommended to be taken with food.</p> <p>The same <a href="https://amhonline.amh.net.au/auth">advice</a> is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).</p> <p>Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.</p> <h2>Can food make medicines safer?</h2> <p>Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/medications/latest-release">within a two-week period</a>.</p> <p>While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of <a href="https://www.tandfonline.com/doi/full/10.1586/14737175.6.11.1643#d1e212">bleeding, ulceration and perforation</a> with long-term use.</p> <p>But there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">isn’t enough research</a> to show taking ibuprofen with food reduces this risk.</p> <p>Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.</p> <p>The <a href="https://amhonline.amh.net.au/auth">Australian Medicines Handbook</a>, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">A systematic review published in 2015</a> found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.</p> <p>To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs">non-steroidal anti-inflammatory medicines</a> at the same time.</p> <p>For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a <a href="https://australianprescriber.tg.org.au/articles/peptic-ulcer-disease-and-non-steroidal-anti-inflammatory-drugs.html">proton pump inhibitor</a>, a medicine that reduces stomach acid and protects the stomach lining.</p> <h2>How much food do you need?</h2> <p>When you need to take a medicine with food, how much is enough?</p> <p>Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.</p> <p>However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.</p> <p>Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Associate Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-take-some-medicines-with-food-235782">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Why are some people happy when they are dying?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/mattias-tranberg-941050">Mattias Tranberg</a>, <a href="https://theconversation.com/institutions/lund-university-756"><em>Lund University</em></a></em></p> <p>Simon Boas, who wrote a candid account of living with cancer, passed away on July 15 at the age of 47. In a recent <a href="https://www.bbc.co.uk/news/articles/clmykzrdnljo">BBC interview</a>, the former aid worker told the reporter: “My pain is under control and I’m terribly happy – it sounds weird to say, but I’m as happy as I’ve ever been in my life.”</p> <p>It may seem odd that a person could be happy as the end draws near, but in my experience as a clinical psychologist working with people at the end of their lives, it’s not that uncommon.</p> <p>There is quite a lot of research suggesting that fear of death is at the unconscious centre of being human. William James, an American philosopher, called the knowledge that we must die <a href="https://www.penguinrandomhouse.com/books/170217/the-worm-at-the-core-by-sheldon-solomon-jeff-greenberg-and-tom-pyszczynski/">“the worm at the core”</a> of the human condition.</p> <p>But a <a href="https://www.jstor.org/stable/44577785">study</a> in Psychological Science shows that people nearing death use more positive language to describe their experience than those who just imagine death. This suggests that the experience of dying is more pleasant – or, at least, less unpleasant – than we might picture it.</p> <p>In the BBC interview, Boas shared some of the insights that helped him come to accept his situation. He mentioned the importance of enjoying life and prioritising meaningful experiences, suggesting that acknowledging death can enhance our appreciation for life.</p> <p>Despite the pain and difficulties, Boas seemed cheerful, hoping his attitude would support his wife and parents during the difficult times ahead.</p> <p>Boas’s words echo the Roman philosopher Seneca who <a href="https://en.wikisource.org/wiki/Moral_letters_to_Lucilius/Letter_61">advised that</a>: “To have lived long enough depends neither upon our years nor upon our days, but upon our minds.”</p> <p>A more recent thinker expressing similar sentiments is the psychiatrist <a href="https://www.viktorfrankl.org/">Viktor Frankl</a> who, after surviving Auschwitz, wrote <a href="https://www.penguin.co.uk/books/347571/mans-search-for-meaning-by-viktor-e-frankl/9781846046384">Man’s Search for Meaning</a> (1946) in which he lay the groundwork for a form of existential psychotherapy, with the focus of discovering meaning in any kind of circumstance. Its most recent adaptation is meaning-centred psychotherapy, which offers people with cancer a way to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861219/">improve their sense of meaning</a>.</p> <h2>How happiness and meaning relate</h2> <p>In two recent studies, in <a href="https://doi.org/10.1017/S1478951521000262">Palliative and Supportive Care</a> and the <a href="https://doi.org/10.1177/1049909120939857">American Journal of Hospice and Palliative Care</a>, people approaching death were asked what constitutes happiness for them. Common themes in both studies were social connections, enjoying simple pleasures such as being in nature, having a positive mindset and a general shift in focus from seeking pleasure to finding meaning and fulfilment as their illness progressed.</p> <p>In my work as a clinical psychologist, I sometimes meet people who have – or eventually arrive at – a similar outlook on life as Boas. One person especially comes to mind – let’s call him Johan.</p> <p>The first time I met Johan, he came to the clinic by himself, with a slight limp. We talked about life, about interests, relationships and meaning. Johan appeared to be lucid, clear and articulate.</p> <p>The second time, he came with crutches. One foot had begun to lag and he couldn’t trust his balance. He said it was frustrating to lose control of his foot, but still hoped to cycle around Mont Blanc.</p> <p>When I asked him what his concerns were, he burst into tears. He said: “That I won’t get to celebrate my birthday next month.” We sat quietly for a while and took in the situation. It wasn’t the moment of death itself that weighed on him the most, it was all the things he wouldn’t be able to do again.</p> <p>Johan arrived at our third meeting supported by a friend, no longer able to grip the crutches. He told me that he had been watching films of him cycling with his friends. He had concluded that he could watch YouTube videos of others cycling around Mont Blanc. He had even ordered a new, expensive mountain bike. “I’ve wanted to buy it for a long time, but was tightfisted,” he said. “I may not be able to ride it, but thought it would be cool to have in the living room.”</p> <p>For the fourth visit, he arrived in a wheelchair. It turned out to be the last time we met. The bike had arrived; he had it next to the couch. There was one more thing he wanted to do.</p> <p>“If by some miracle I were to get out of this alive, I would like to volunteer in domestic care services – one or two shifts a week,” Johan said. “They work hard and it gets crazy sometimes, but they make such an incredible contribution. I wouldn’t have been able to get out of the apartment without them.”</p> <p>My experience of patients with life-threatening disease is that it’s possible to feel happiness alongside sadness, and other seemingly conflicting emotions. Over a day, patients can feel gratitude, remorse, longing, anger, guilt and relief – sometimes all at once. Facing the limits of existence can add perspective and help a person appreciate life more than ever.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/mattias-tranberg-941050">Mattias Tranberg</a>, Postdoctoral Research Associate, The Institute of Palliative Care, <a href="https://theconversation.com/institutions/lund-university-756">Lund University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-are-some-people-happy-when-they-are-dying-234309">original article</a>.</em></p> </div>

Caring

Placeholder Content Image

Cancer diagnosis can be devastating, but for some it gives permission to live more radically

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/kevin-dew-577291">Kevin Dew</a>, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/chris-cunningham-1534054">Chris Cunningham</a>, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/elizabeth-dennett-1532423">Elizabeth Dennett</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>; <a href="https://theconversation.com/profiles/kerry-chamberlain-103714">Kerry Chamberlain</a>, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/richard-egan-400188">Richard Egan</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a></em></p> <p>A diagnosis of life-limiting cancer can be overwhelming and cause feelings of panic and anxiety. But for some people, it provides a license to live life differently, including quitting toxic jobs and becoming more adventurous.</p> <p>In our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13797">recently published research</a>, we sought to understand the impact of a cancer diagnosis and subsequent experiences for cancer survivors.</p> <p>We talked with 81 New Zealanders (23 Māori and 58 non-Māori) who had lived longer than expected with a life-limiting or terminal diagnosis of cancer (four to 32 years since first diagnosis), and 25 people who were identified as their supporters.</p> <p>We found there are vastly different ways in which people experience and respond to a cancer diagnosis, but for some it’s a prompt to make significant changes. Of the 81 participants, 26 expressed the view, unsolicited, that cancer had some positive impact on their lives – without downplaying the negative impacts it could have as well.</p> <h2>A licence to change</h2> <p>Being told you only have limited time left to live can undoubtedly be a shock. But it can lead to profound change.</p> <p>It’s not uncommon for people who receive a serious diagnosis to draw up a “<a href="https://theconversation.com/paris-in-spring-bali-in-winter-how-bucket-lists-help-cancer-patients-handle-life-and-death-225682">bucket list</a>”. Some people in our study took the opportunity to travel or move to a new home.</p> <p>For others, the diagnosis provided a chance to rethink their lives and make more significant changes to the way they lived. They decided to be culturally more adventurous and to take up new skills.</p> <p>Many of these people quit their jobs or changed to jobs that suited them better. Many changed their relationships with the people around them. One talked about showing more affection for his children, another was kinder and stopped fretting over small things.</p> <p>Some decided to be more selective and no longer be around people who were negative. Others took up new hobbies or crafts which they felt were healing. For one person, the cancer diagnosis provided the impetus to look at things and people differently, which they thought would not have happened otherwise.</p> <p>Individuals could also undergo a transformation to become what they felt they were meant to be in life. One person, given two months to live, embraced rongoā (Māori traditional healing), including its spiritual side. They now love their “journey” and feel this was what they were “supposed to do”.</p> <p>For many, a diagnosis of cancer gave them license to be different people and to resist conforming to social norms, including having a job, being thrifty or not taking risks.</p> <h2>Disrupting diagnoses</h2> <p>One person, given only months to live, moved out of her flat, gave away her possessions, quit her job that she described was toxic, and returned home to say goodbye to her family.</p> <p>Most importantly for her, she worked on experiencing “joy” – after receiving the diagnosis, she realised she had lost it. But she continues to live many years later. After a while, she had to find a new flat, get a new job and the recovery of her joy was challenged:</p> <blockquote> <p>I had to start working again. And, of course, with working again, joy goes down, time goes down, rest goes down, spirituality goes down.</p> </blockquote> <p>But not everyone has the opportunity to change. Some peoples’ lives were limited because of the physical effects of the cancer, its treatment, or because of their personal, social or financial resources.</p> <p>Some go to great lengths to ensure their lives change as little as possible after diagnosis to maintain a sense of normality.</p> <h2>Why we need to know</h2> <p>Given the fear a cancer diagnosis can elicit, it is important to see there are different ways of responding.</p> <p>It is also worth knowing there are people who live longer than expected. Many people in our study were given just months to live, but one woman was still alive 12 years after being told she had a year left.</p> <p>Beyond that, this research documents how the disruption produced by a cancer diagnosis can prompt people to breach social norms. Where people have the capacity and resources to change, those around them and their health professionals can support them in taking opportunities to live life differently.</p> <p>We heard people say they think of their cancer as a friend or an amazing opportunity. Some even felt thankful.</p> <p>The possibility of cancer providing opportunities for some in no way diminishes the grief or a sense of loss, fear and anxiety that can accompany such diagnoses.</p> <p>Our research supports a reframing of cancer narratives, to consider ways of tempering the negative impacts of a diagnosis – while remaining cognisant of the struggle that can follow such news, and the variability in people’s capacity to engage with that struggle.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kevin-dew-577291">Kevin Dew</a>, Professor of Sociology, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology &amp; Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/chris-cunningham-1534054">Chris Cunningham</a>, Professor of Maori &amp; Public Health, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/elizabeth-dennett-1532423">Elizabeth Dennett</a>, Associate Professor in Surgery, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>; <a href="https://theconversation.com/profiles/kerry-chamberlain-103714">Kerry Chamberlain</a>, Professor of Social and Health Psychology, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/richard-egan-400188">Richard Egan</a>, Associate Professor in Health Promotion, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/cancer-diagnosis-can-be-devastating-but-for-some-it-gives-permission-to-live-more-radically-233782">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Poor sleep is really bad for your health. But we found exercise can offset some of these harms

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>Despite the well-known links between poor sleep and poorer health, getting enough good quality sleep has become a luxury in modern society.</p> <p>Many of us struggle to improve our sleep, while amid the COVID pandemic and recurring lock-downs, <a href="https://theconversation.com/were-sleeping-more-in-lockdown-but-the-quality-is-worse-155797">our sleep has deteriorated</a>.</p> <p>But <a href="https://doi.org/10.1136/bjsports-2021-104046">our new study</a>, published today in the British Journal of Sports Medicine, bears some encouraging news.</p> <p>We found doing enough physical activity (including exercise such as running or going to the gym) may counter some of the adverse health effects of unhealthy sleep patterns.</p> <p>Let us explain.</p> <h2>Does poor sleep really harm our health?</h2> <p>Unhealthy sleep patterns include:</p> <ul> <li> <p>not sleeping for long enough (less than seven hours per night for adults)</p> </li> <li> <p>sleeping for too long (more than nine hours per night for adults)</p> </li> <li> <p>snoring</p> </li> <li> <p>insomnia</p> </li> <li> <p>being a night owl, also known as “late chronotype”. This is people who naturally feel most awake and motivated in the evening, and are sluggish in the morning.</p> </li> </ul> <p>They are <a href="https://doi.org/10/ggjqrt">all associated</a> with poorer health.</p> <p>Recent research shows poor sleep may:</p> <ul> <li> <p>cause <a href="https://doi.org/10.1038/s41577-019-0190-z">inflammation</a></p> </li> <li> <p>impair the metabolism of glucose (also known as blood sugar) and reduce the number of calories burned, thereby increasing the risk of <a href="https://theconversation.com/why-sleep-is-so-important-for-losing-weight-145058">obesity</a></p> </li> <li> <p>increase the risk of <a href="https://doi.org/10/gg6x87">heart disease</a> and <a href="https://doi.org/10/ggnw5h">premature death</a>.</p> </li> </ul> <p>However, very few studies have examined how sleep and physical activity interact and impact our health.</p> <p>We set out to answer the question: if I have poor sleep but I do quite a lot of physical activity, can that offset some of the harms of my poor sleep in the long-term? Or would this not make any difference?</p> <h2>What did we do?</h2> <p>We analysed the information provided by 380,055 middle-aged adults in the UK Biobank study, recruited between 2006 and 2010. Participants reported their level of physical activity and five aspects of their sleep.</p> <p>We grouped people based on their sleep behaviour into healthy, intermediate or poor.</p> <p>We categorised people’s level of physical activity based on <a href="https://bjsm.bmj.com/content/54/24/1451">the World Health Organization (WHO) guidelines</a>. People who met the upper bounds of the guidelines did 300 minutes of moderate intensity physical activity a week, or 150 minutes of vigorous exercise, or a combination of both. Those who met the lower bound did 150 minutes of moderate intensity exercise a week, or 75 minutes of vigorous exercise, or a combination.</p> <p>Moderate intensity physical activity usually makes you slightly out of breath if sustained for a few minutes and includes brisk walking or cycling at a leisurely pace.</p> <p>Vigorous exercise usually makes you breath hard and can include running, swimming, and playing sports like tennis, netball, soccer or footy.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=409&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=409&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=409&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=515&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=515&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=515&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">Doing at least 150 minutes of moderate intensity physical activity a week, or 75 minutes of vigorous exercise, can offset some of the health harms of poor sleep.</span> <span class="attribution"><a class="source" href="https://apps.who.int/iris/bitstream/handle/10665/336656/9789240015128-eng.pdf?sequence=1&amp;isAllowed=y">World Health Organization, CC BY-NC-SA 3.0 IGO</a></span></figcaption></figure> <h2>What did we find?</h2> <p>We followed up with the participants after 11 years. By May 2020, 15,503 participants had died, of which 4,095 died from heart disease and 9,064 died from cancer.</p> <p><a href="https://doi.org/10.1136/bjsports-2021-104046">We found</a> that, compared to healthy sleepers, people with poor sleep had a 23% higher risk of premature death, a 39% higher risk of dying from heart disease, and a 13% higher risk of dying from cancer.</p> <p>We then compared the data of people who slept well with those who slept poorly, and how much they exercised. We found people who had the highest risk of dying from heart disease and cancer were those who had poor sleep and didn’t meet the WHO physical activity guidelines. On the other hand, those who had poor sleep but did enough physical activity to meet the WHO guidelines didn’t have as high a risk of dying from heart disease or cancer, compared to those who slept poorly and didn’t meet the physical activity guidelines.</p> <p>For example, let’s look at the risk of dying from cancer. Those who had poor sleep and did no physical activity had a 45% higher risk of dying from cancer compared to those who had healthy sleep and exercised a lot. But among those who met the physical activity guidelines, despite poor sleep, they didn’t really have a higher risk of dying from cancer any more.</p> <p>We found physical activity levels which met at least the bottom threshold of the WHO guidelines could reduce or eliminate some of the health harms of poor sleep. So people who did at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week were to some extent protected against the detrimental health effects of poor sleep.</p> <p>Those who had both poor sleep and did no moderate-to-vigorous intensity physical activity had the highest risks of premature death.</p> <p>Our study wasn’t designed to find out how and why physical activity may counteract some of the bad physiological impacts of poor sleep. But other research provides theories. For example, adequate physical activity may <a href="https://doi.org/10.1249/MSS.0000000000001179">reduce inflammation, help maintain a healthy glucose metabolism</a>, and <a href="https://doi.org/10.1016/j.pcad.2018.07.014">increase the number of calories burned</a>.</p> <p>It’s important to note our study was what’s called an “observational study”. It shows an association between adequate physical activity and reduced harms from poor sleep, but we must be careful in interpreting causation. It can’t conclusively say adequate physical activity <em>causes</em> the reduction of harms from poor sleep, though there’s strong evidence for an association in the right direction.</p> <p>Our study offers a hopeful message, that even if you haven’t been able to improve your sleep, you can still offset some of the health harms by doing enough exercise. <a href="https://www.sciencedirect.com/science/article/abs/pii/S009174352030339X">Our previous research</a> has also shown physical activity may help improve poor sleep patterns, which are a serious health problem across the world.</p> <p>In addition to combating some of the negative outcomes of poor sleep, physical activity can also provide many other health benefits and extend our lives. For example, a 2019 study found people who met WHO’s physical activity target above <a href="https://doi.org/10.1186/s12916-019-1339-0">lived three years longer on average</a> than those who didn’t.</p> <p>During lockdowns, access to parks, gyms, and swimming pools might be limited in many places. But there are still many ways to <a href="https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine">to stay fit and active at home during the coronavirus</a>.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/163270/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/poor-sleep-is-really-bad-for-your-health-but-we-found-exercise-can-offset-some-of-these-harms-163270">original article</a>.</em></p> </div>

Body

Placeholder Content Image

We finally know why some people got COVID while others didn’t

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p>Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times.</p> <p>Through a collaboration between University College London, the Wellcome Sanger Institute and Imperial College London in the UK, we set out to answer this question using the world’s first controlled <a href="https://www.nature.com/articles/s41591-022-01780-9">“challenge trial” for COVID</a> – where volunteers were deliberately exposed to SARS-CoV-2, the virus that causes COVID, so that it could be studied in great detail.</p> <p>Unvaccinated healthy volunteers with no prior history of COVID were exposed – via a nasal spray – to an extremely low dose of the original strain of SARS-CoV-2. The volunteers were then closely monitored in a quarantine unit, with regular tests and samples taken to study their response to the virus in a highly controlled and safe environment.</p> <p>For our <a href="https://www.nature.com/articles/s41586-024-07575-x">recent study</a>, published in Nature, we collected samples from tissue located midway between the nose and the throat as well as blood samples from 16 volunteers. These samples were taken before the participants were exposed to the virus, to give us a baseline measurement, and afterwards at regular intervals.</p> <p>The samples were then processed and analysed using single-cell sequencing technology, which allowed us to extract and sequence the genetic material of individual cells. Using this cutting-edge technology, we could track the evolution of the disease in unprecedented detail, from pre-infection to recovery.</p> <p>To our surprise, we found that, despite all the volunteers being carefully exposed to the exact same dose of the virus in the same manner, not everyone ended up testing positive for COVID.</p> <p>In fact, we were able to divide the volunteers into three distinct infection groups (see illustration). Six out of the 16 volunteers developed typical mild COVID, testing positive for several days with cold-like symptoms. We referred to this group as the “sustained infection group”.</p> <p>Out of the ten volunteers who did not develop a sustained infection, suggesting that they were able to fight off the virus early on, three went on to develop an “intermediate” infection with intermittent single positive viral tests and limited symptoms. We called them the “transient infection group”.</p> <p>The final seven volunteers remained negative on testing and did not develop any symptoms. This was the “abortive infection group”. This is the first confirmation of abortive infections, which were previously <a href="https://www.nature.com/articles/s41586-021-04186-8">unproven</a>. Despite differences in infection outcomes, participants in all groups shared some specific novel immune responses, including in those whose immune systems prevented the infection.</p> <p>When we compared the timings of the cellular response between the three infection groups, we saw distinct patterns. For example, in the transiently infected volunteers where the virus was only briefly detected, we saw a strong and immediate accumulation of immune cells in the nose one day after infection.</p> <p>This contrasted with the sustained infection group, where a more delayed response was seen, starting five days after infection and potentially enabling the virus to take hold in these volunteers.</p> <p>In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the “interferon” response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly.</p> <h2>Protective gene</h2> <p>Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection and could hence be used as a marker of protection. Therefore, we might be able to use this information and identify those who are probably going to be protected from severe COVID.</p> <p>These findings help us fill in some gaps in our knowledge, painting a much more detailed picture regarding how our bodies react to a new virus, particularly in the first couple of days of an infection, which is crucial.</p> <p>We can use this information to compare our data to other data we are currently generating, specifically where we are “challenging” volunteers to other viruses and more recent strains of COVID. In contrast to our current study, these will mostly include volunteers who have been vaccinated or naturally infected – that is, people who already have immunity.</p> <p>Our study has significant implications for future treatments and vaccine development. By comparing our data to volunteers who have never been exposed to the virus with those who already have immunity, we may be able to identify new ways of inducing protection, while also helping the development of more effective vaccines for future pandemics. In essence, our research is a step towards better preparedness for the next pandemic.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233063/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/marko-nikolic-1543289">Marko Nikolic</a>, Principal Research Fellow/Honorary consultant Respiratory Medicine, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> and <a href="https://theconversation.com/profiles/kaylee-worlock-1543639">Kaylee Worlock</a>, Postdoc Research Fellow, Molecular and Cellular Biology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-finally-know-why-some-people-got-covid-while-others-didnt-233063">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Do you have a mental illness? Why some people answer ‘yes’, even if they haven’t been diagnosed

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/jesse-tse-1429151">Jesse Tse</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nick-haslam-10182">Nick Haslam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722"><em>The University of Melbourne</em></a></em></p> <p>Mental illnesses such as depression and anxiety disorders have become more prevalent, especially among <a href="https://www.aihw.gov.au/mental-health/overview/prevalence-and-impact-of-mental-illness#changeovertime">young people</a>. Demand for treatment is surging and prescriptions of some <a href="https://pubmed.ncbi.nlm.nih.gov/35176912/">psychiatric medications</a> have climbed.</p> <p>These upswinging prevalence trends are paralleled by rising public attention to mental illness. Mental health messages saturate traditional and social media. Organisations and governments are developing awareness, prevention and treatment initiatives with growing urgency.</p> <p>The mounting cultural focus on mental health has obvious benefits. It increases awareness, reduces stigma and promotes help-seeking.</p> <p>However, it may also have costs. Critics worry <a href="https://www.bacp.co.uk/bacp-journals/therapy-today/2023/april-2023/the-big-issue/">social media</a> sites are incubating mental illness and that ordinary unhappiness is being pathologised by the overuse of diagnostic concepts and “<a href="https://www.bustle.com/wellness/is-therapy-speak-making-us-selfish">therapy speak</a>”.</p> <p>British psychologist <a href="https://www.psych.ox.ac.uk/team/lucy-foulkes">Lucy Foulkes</a> argues the trends for rising attention and prevalence are linked. Her “<a href="https://www.sciencedirect.com/science/article/pii/S0732118X2300003X">prevalence inflation hypothesis</a>” proposes that increasing awareness of mental illness may lead some people to diagnose themselves inaccurately when they are experiencing relatively mild or transient problems.</p> <p>Foulkes’ hypothesis implies that some people develop overly broad concepts of mental illness. Our research supports this view. In a new study, <a href="https://www.sciencedirect.com/science/article/pii/S2666560324000318?via%3Dihub">we show</a> that concepts of mental illness have broadened in recent years – a phenomenon we call “<a href="https://www.tandfonline.com/doi/full/10.1080/1047840X.2016.1082418">concept creep</a>” – and that <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05152-6">people differ</a> in the breadth of their concepts of mental illness.</p> <h2>Why do people self-diagnose mental illnesses?</h2> <p>In our new <a href="https://doi.org/10.1016/j.ssmmh.2024.100326">study</a>, we examined whether people with broad concepts of mental illness are, in fact, more likely to self-diagnose.</p> <p>We defined self-diagnosis as a person’s belief they have an illness, whether or not they have received the diagnosis from a professional. We assessed people as having a “broad concept of mental illness” if they judged a wide variety of experiences and behaviours to be disorders, including relatively mild conditions.</p> <p>We asked a nationally representative sample of 474 American adults if they believed they had a mental disorder and if they had received a diagnosis from a health professional. We also asked about other possible contributing factors and demographics.</p> <p>Mental illness was common in our sample: 42% reported they had a current self-diagnosed condition, a majority of whom had received it from a health professional.</p> <p>Unsurprisingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress.</p> <p>The second most important factor after distress was having a broad concept of mental illness. When their levels of distress were the same, people with broad concepts were substantially more likely to report a current diagnosis.</p> <p>The graph below illustrates this effect. It divides the sample by levels of distress and shows the proportion of people at each level who report a current diagnosis. People with broad concepts of mental illness (the highest quarter of the sample) are represented by the dark blue line. People with narrow concepts of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with broad concepts were much more likely to report having a mental illness, especially when their distress was relatively high.</p> <p>People with greater mental health literacy and less stigmatising attitudes were also more likely to report a diagnosis.</p> <p>Two interesting further findings emerged from our study. People who self-diagnosed but had not received a professional diagnosis tended to have broader illness concepts than those who had.</p> <p>In addition, younger and politically progressive people were more likely to report a diagnosis, consistent with some <a href="https://www.sciencedirect.com/science/article/pii/S2666560321000438">previous research</a>, and held broader concepts of mental illness. Their tendency to hold these more expansive concepts partially explained their higher rates of diagnosis.</p> <h2>Why does it matter?</h2> <p>Our findings support the idea that expansive concepts of mental illness promote self-diagnosis and may thereby increase the apparent prevalence of mental ill health. People who have a lower threshold for defining distress as a disorder are more likely to identify themselves as having a mental illness.</p> <p>Our findings do not directly show that people with broad concepts over-diagnose or those with narrow concepts under-diagnose. Nor do they prove that having broad concepts <em>causes</em> self-diagnosis or results in <em>actual</em> increases in mental illness. Nevertheless, the findings raise important concerns.</p> <p>First, they suggest that rising mental health awareness may <a href="https://www.newscientist.com/article/mg25934573-900-why-being-more-open-about-mental-health-could-be-making-us-feel-worse/">come at a cost</a>. In addition to boosting mental health literacy it may increase the likelihood of people incorrectly identifying their problems as pathologies.</p> <p>Inappropriate self-diagnosis can have adverse effects. Diagnostic labels may become identity-defining and self-limiting, as people come to believe their problems are enduring, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0165032724002489?via%3Dihub">hard-to-control</a> aspects of who they are.</p> <p>Second, unwarranted self-diagnosis may lead people experiencing relatively mild levels of distress to seek help that is unnecessary, inappropriate and ineffective. Recent <a href="https://pubmed.ncbi.nlm.nih.gov/37844607/">Australian research</a> found people with relatively mild distress who received psychotherapy worsened more often than they improved.</p> <p>Third, these effects may be particularly problematic for young people. They are most liable to hold broad concepts of mental illness, in part due to <a href="https://www.sciencedirect.com/science/article/pii/S0010440X22000682?via%3Dihub">social media</a> <a href="https://www.tandfonline.com/doi/full/10.1080/10810730.2023.2235563">consumption</a>, and they experience mental ill health at relatively high and rising rates. Whether expansive concepts of illness play a role in the youth mental health crisis remains to be seen.</p> <p>Ongoing cultural shifts are fostering increasingly expansive definitions of mental illness. These shifts are likely to have mixed blessings. By normalising mental illness they may help to remove its stigma. However, by pathologising some forms of everyday distress, they may have an unintended downside.</p> <p>As we wrestle with the mental health crisis, it is crucial we find ways to increase awareness of mental ill health without inadvertently inflating it.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231687/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jesse-tse-1429151">Jesse Tse</a>, PhD Candidate at Melbourne School of Psychological Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nick-haslam-10182">Nick Haslam</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-have-a-mental-illness-why-some-people-answer-yes-even-if-they-havent-been-diagnosed-231687">original article</a>.</em></p> </div>

Mind

Placeholder Content Image

I watched some 40 films at this year’s Sydney Film Festival. Here are my top five picks – and one hilarious flop

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ari-mattes-97857">Ari Mattes</a>, <em><a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a></em></p> <p>This year’s <a href="https://www.sff.org.au/">Sydney Film Festival’s</a> rich offerings of films more than compensated for the minor technical issues that led to some screenings being interrupted.</p> <p>Out of the 40-odd films I saw, here are my top five, along with some notable mentions and three disappointments (including a genuine <em>dud</em>).</p> <h2>1. The Girl with the Needle</h2> <p>Cowritten and directed by Swedish filmmaker Magnus von Horn, <a href="https://en.wikipedia.org/wiki/The_Girl_with_the_Needle">The Girl with the Needle</a> is loosely based on the story of notorious early-20th century serial killer Dagmar Overbye.</p> <p>But this is no procedural true crime film, painstakingly attempting to recreate crimes with historical accuracy. It’s a stylish Danish nightmare dazzling with cinematic acrobatics right from the opening sequence, in which black and white faces hideously morph, looking at the viewer like deranged figures from a hellish circus. It is, indeed, one of the most terrifying films I’ve seen.</p> <p>The narrative follows the struggles of new mother Karoline (Vic Carmen Sonne) as she gives her baby to Dagmar’s informal adoption agency and begins working with her as a wet nurse, unaware of what’s really going on.</p> <p>Sonne is as self-assured as ever – and none of the actors put a foot wrong here. Seasoned Danish film star Trine Dyrholm is exceptional in bringing nuance to what could have become a caricaturishly evil role as Dagmar. And Besir Zeciri endows Peter, a war-wounded veteran who can only find employment in a circus freakshow, with an unexpected warmth and tenderness.</p> <figure><iframe src="https://www.youtube.com/embed/VlyW-z1xbO4?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The Girl with the Needle features some of the most distressing sequences one could find in a commercial film. Its meticulously rendered shades of German expressionism never distract from its smorgasbord of horrors, offering an almost unbearably bleak vision of the world in the aftermath of the Great War. If only all films were this good!</p> <h2>2. Dying</h2> <p>I’d normally suppress a yawn if you told me I had to sit through a three-hour social realist drama about the everyday difficulties of a bourgeois German conductor and his family. Yet writer-director Matthias Glasner’s <a href="https://en.wikipedia.org/wiki/Dying_(2024_film)">Dying</a> is a near perfect film (no surprise it won <a href="https://www.screendaily.com/news/matthias-glasners-dying-wins-german-lola-for-best-film/5193046.article">four prizes</a> at the German Film Awards).</p> <p>The film is complex and engrossing – deeply sad in places and hysterical in others – formally controlled, but underpinned by an anarchic sensibility. It is life-affirming without any skerrick of sentimentality.</p> <figure><iframe src="https://www.youtube.com/embed/kagVqEfPxFw?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Lars Eidinger is astonishingly good as maestro Tom, who is trying to keep his career on track as his family life crumbles around him. He is matched by Lilith Stangenberg, mesmerising as his unhinged sister Ellen. Robert Gwisdek is equally exceptional as the highly strung composer and friend Bernard, while Corinna Harfouch anchors the film’s first section as Tom’s far from maternal mother, Lissy.</p> <p>At one point, Ingmar Bergman’s 1982 period film <a href="https://en.wikipedia.org/wiki/Fanny_and_Alexander">Fanny and Alexander</a> is playing on the TV (Tom watches it every Christmas). Even though Dying feels like a contemporary film committed to interrogating the difficulties of being in the modern world, there’s something of late Bergman here as it unfolds across its epic length.</p> <p>It is a three-hour film about middle-class life, but like a great 19th-century novel, it never feels long. The fact that nothing particularly extraordinary happens is testament to how well-made the film is.</p> <h2>3. Kill</h2> <p>Director Nikhil Nagesh Bhat’s Indian action film <a href="https://www.rottentomatoes.com/m/kill_2023_2">Kill</a> is cheesy, sentimental and at first seems remarkably silly.</p> <p>Commando Amrit, played by beefy TV star Lakshya, is travelling to New Delhi by train with his buddy, fellow commando Viresh (Abhishek Chauhan). His true love Tulika (Tanya Maniktala) is also on board and has recently become engaged to another man through an arrangement by her wealthy father, Baldev Singh Thakur (Harsh Chhaya), who happens to own the train company. When a group of 30-plus bandits led by the charming but ice-cold Fani (Raghav Juyal) move to rob the train, Amrit must defend Tulika, her family and the rest of the passengers.</p> <p>When the title card appears 40 minutes into the film, suddenly emblazoned on the screen, it seems like a distracting quirk at first. But it begins to make sense as the train rolls on. All of the violence and bone-crushing action of the first section is mere preamble, leading to a point of transition from an extremely violent but fun action film, to a much darker – and bloodier – revenge film.</p> <figure><iframe src="https://www.youtube.com/embed/da7lKeeS67c?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Kill is an exceptionally well-wrought genre film. The kinetic and balletic action recalls the golden era of Hong Kong action cinema, but with hammers, daggers and sickles instead of guns and the frenetic staging of hand-to-hand combat instead of poetic slow-motion footage. It is also a great example of a film being more than the sum of its parts. No element is perfect, yet they come together to transcend these limitations, its flow reaching sublime levels by the end.</p> <p>There’s also an undercurrent of sadness throughout. We see an India of haves and have-nots, of families of bandits struggling to survive and of the supreme violence sustaining the social and political order. As Fani says to Amrit near the end: “Who kills like this? I killed four of your people. You finished off 40 of my family. You’re not a protector. You’re a monster. A fucking monster.” The title says it all.</p> <h2>4. Super/Man: The Christopher Reeve Story</h2> <p>Biographical films about celebrities inevitably feel gossipy. Ian Bonhôte and Peter Ettedgui’s <a href="https://en.wikipedia.org/wiki/Super/Man:_The_Christopher_Reeve_Story">Super/Man: The Christopher Reeve Story</a> is no exception. But it is so well made (and well-resourced, one would imagine, as it’s produced by DC) that it moves beyond its tabloid-like qualities.</p> <p>Interviews with Reeve’s friends and colleagues, including Susan Sarandon, Glenn Close and Jeff Daniels, are interspersed with home footage shot by Reeve and his family throughout his career and during his recovery from the near-fatal riding accident that left him paralysed and breathing through a respirator for the rest of his life.</p> <p>Reeve’s close friendship with “brother” Robin Williams assumes central importance, with the film implying the two men were so emotionally dependent on each other that Williams would probably still be alive if Reeve hadn’t died in 2004.</p> <p>But the most interesting parts of the film involve carefully assembled archival footage looking at how Reeve’s decision to play Superman negatively impacted his career and personal life. He never starred in another profitable film, and his father and colleagues such as William Hurt loathed his decision to play a comic book character.</p> <p>This is counterpointed with his post-accident career as a director and disability advocate. Interviews with Reeve’s children add a genuinely tragic sense of pathos to this slick, well-made and emotionally exhausting “true Hollywood” story. It’s everything one could want from such a documentary.</p> <h2>5. Kneecap</h2> <p>Cowriter-director Rich Peppiatt’s Kneecap is a riotous, irreverent biopic following the career of Belfast drug-dealers Móglaí Bap and Mo Chara as they team up with high school music teacher DJ Próvai to become the first Irish-language rap group, Kneecap.</p> <p>The real <a href="https://www.bbc.com/news/uk-northern-ireland-66408560">Kneecappers</a> cowrote the film and play themselves and, given none of them are actors, do so remarkably well. They’re joined by Irish heavyweights Josie Walker, playing the detective who has it in for them, and Michael Fassbender, playing Móglaí’s father, an old-school Irish radical who has been on the run for the past few decades.</p> <p>The film depicts their hedonistic drug use and anarchic disregard for the law in the context of their radical political motivation to speak Irish against the colonial English. And while it may be a bit cartoonish in its presentation of Belfast’s history and the struggle to keep Gaelic alive, it is a music biopic after all.</p> <figure><iframe src="https://www.youtube.com/embed/FFYfp-hKxZQ?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Kneecap is violent, coarse and laced with infectiously good humour – a genuinely fun film, buoyed by its charismatic stars and lively style. Only the most stringent moralist wouldn’t enjoy this one!</p> <h2>Notable mentions</h2> <p>It’s extremely difficult to pick a top five when 15 or so of the films I saw were standouts. And this is testament to the quality of the festival’s selection.</p> <p>It was a pleasure watching heavyweight Sean Penn go head-to-head with Dakota Johnson in writer-director Christy Hall’s <a href="https://en.wikipedia.org/wiki/Daddio_(film)">Daddio</a>, even if the story takes an uninteresting turn in the final third. Despite the banality of the premise – a New York cabbie chats with a passenger – and the inanity of some of the dialogue, this romantic ode to urban life in all its alienated, fluoro-lit techno glory is so well crafted that we happily go along for the ride.</p> <p>Equally affective is the melancholic and beautifully performed <a href="https://en.wikipedia.org/wiki/Puan_(film)">Puan</a>, a restrained comedy set in a University faculty in Buenos Aires. Puan could easily make my top five, as could André Téchiné’s <a href="https://en.wikipedia.org/wiki/My_New_Friends_(film)">My New Friends</a>), an offbeat French melodrama starring Isabelle Huppert as a disillusioned police officer who becomes friends with an anti-cop activist in the suburbs.</p> <figure><iframe src="https://www.youtube.com/embed/cnz-6h60tkk?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Poor performers</h2> <p>Of the lot, I only found three films disappointing.</p> <p>The first, Among the Wolves, is a Belgian-French documentary in which a photographer and illustrator lie waiting in a tiny, makeshift building to encounter wild wolves. While some of the footage is striking, the film is let down by its scientific inaccuracy, such as references to the “alpha male” wolf – a term and concept that has <a href="https://www.newyorker.com/science/elements/the-myth-of-the-alpha-wolf">long been discredited</a>. Such innacuracy is a cardinal sin for a documentary, which is supposed to inform the viewer.</p> <p>Though critically acclaimed, Hollywood horror film The Substance – a story of an ageing entertainer who turns to a mysterious substance to stay young (with unsurprisingly horrific ramifications) – feels neither new nor particularly interesting. And while it’s great to see Demi Moore and Dennis Quaid back on the big screen, their caricaturish characters make the whole thing seem like a boring joke: an inflated short film that is both irritatingly silly and painfully didactic.</p> <p>But rarely does a film so resolutely reaffirm a sense of the absurd hubris of humans as Francis Ford Coppola’s self-financed mega-flop, Megalopolis. This cartoonish, incoherent mess set in a dystopian version of the United States, “New Rome”, is howlingly bad in places.</p> <p>Imagine the worst parts of The Hunger Games and <a href="https://www.imdb.com/title/tt0064940/">Fellini Satyricon</a> (1969) crossed with Ayn Rand’s Atlas Shrugged and The Fountainhead and you begin to get a sense of the kind of self-indulgent, heavy-handed nonsense that is Megalopolis.</p> <p>Side-splittingly funny moments come courtesy of bad dialogue (“Utopias become dystopias,” actor Giancarlo Esposito says at one point with a straight face). And stilted acting by Adam Driver and Aubrey Plaza had the (remaining) audience in stitches. Megalopolis is like one of the great fiascos from days gone by – the 21st century’s Heaven’s Gate – and there is definitely something delightful about the existence of this <a href="https://variety.com/2022/film/news/francis-ford-coppola-funding-120-million-dollars-megalopolis-1235184765/">US$120 million</a> (roughly A$180 million) flop.</p> <figure><iframe src="https://www.youtube.com/embed/1FQzWD5xVKQ?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But as a dud, Megalopolis is the outlier. And in a year following Barbie, Oppenheimer, Napoleon and Poor Things (talk about heavy-handed cinema), much of the menu of this year’s Sydney Film Festival once again proves there are still good filmmakers out there making good films.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232706/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/ari-mattes-97857"><em>Ari Mattes</em></a><em>, Lecturer in Communications and Media, <a href="https://theconversation.com/institutions/university-of-notre-dame-australia-852">University of Notre Dame Australia</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-watched-some-40-films-at-this-years-sydney-film-festival-here-are-my-top-five-picks-and-one-hilarious-flop-232706">original article</a>.</em></p> <p><em>Image: IMDB</em></p> </div>

Movies

Placeholder Content Image

Why it’s still a scientific mystery how some can live past 100 – and how to crack it

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/richard-faragher-224976">Richard Faragher</a>, <a href="https://theconversation.com/institutions/university-of-brighton-942">University of Brighton</a> and <a href="https://theconversation.com/profiles/nir-barzilai-1293752">Nir Barzilai</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <p>A 35-year-old man <a href="https://pubmed.ncbi.nlm.nih.gov/18544745/">only has a 1.5% chance of dying in the next ten years</a>. But the same man at 75 has a 45% chance of dying before he reaches 85. Clearly, ageing is bad for our health. On the bright side, we have made unprecedented progress in understanding the fundamental mechanisms that control ageing and late-life disease.</p> <p>A few tightly linked biological processes, sometimes called the <a href="https://pubmed.ncbi.nlm.nih.gov/23746838/">“hallmarks of ageing”</a>, including our supply of stem cells and communication between cells, act to keep us healthy in the early part of our lives – with <a href="https://theconversation.com/the-secret-to-staying-young-scientists-boost-lifespan-of-mice-by-deleting-defective-cells-54068">problems arising as these start to fail</a>. <a href="https://pubmed.ncbi.nlm.nih.gov/34699859/">Clinical trials are ongoing</a> to see if targeting some of these hallmarks can improve <a href="https://pubmed.ncbi.nlm.nih.gov/31542391/">diabetic kidney disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29997249/">aspects of</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33977284/">immune function</a> and age-related <a href="https://pubmed.ncbi.nlm.nih.gov/30616998/">scarring of the lungs</a> among others. So far, so good.</p> <p>Unfortunately, big, unanswered questions remain in the biology of ageing. To evaluate what these are and how to address them, the <a href="https://www.afar.org/">American Federation For Aging Research</a>, a charity, recently convened a series of <a href="https://www.afar.org/imported/AFAR_GeroFuturesThinkTankReport_November2021.pdf">meetings for leading scientists and doctors</a>. The experts agreed that understanding what is special about the biology of humans who survive more than a century is now a key challenge.</p> <p>These centenarians <a href="https://www.statista.com/chart/18826/number-of-hundred-year-olds-centenarians-worldwide/">comprise less than 0.02% of the UK population</a> but have exceeded the life expectancy of their peers by almost 50 years (babies born in the 1920s typically had a life expectancy of less than 55). How are they doing it?</p> <p>We know that centenarians live so long because they are unusually healthy. They remain in good health for about 30 years longer than most normal people and when they finally fall ill, they are only sick for a very short time. This <a href="https://pubmed.ncbi.nlm.nih.gov/27377170/">“compression of morbidity”</a> is clearly good for them, but also benefits society as a whole. In the US, the medical care costs for a centenarian in their last two years of life <a href="https://www.cdc.gov/nchs/data/series/sr_10/sr10_198.pdf">are about a third of those of someone who dies in their seventies</a> (a time when most centenarians don’t even need to see a doctor).</p> <p>The children of centenarians are also much healthier than average, indicating they are inheriting something beneficial from their parents. But is this genetic or environmental?</p> <h2>Centenarians aren’t always health conscious</h2> <p>Are centenarians the poster children for a healthy lifestyle? For the general population, watching your weight, not smoking, drinking moderately and eating at least five servings of fruit and vegetables a day can <a href="https://pubmed.ncbi.nlm.nih.gov/27296932/">increase life expectancy by up to 14 years</a> compared with someone who does none of these things. This difference <a href="https://publications.parliament.uk/pa/ld5801/ldselect/ldsctech/183/18305.htm#_idTextAnchor012">exceeds that seen</a> between the least and most deprived areas in the UK, so intuitively it would be expected to play a role in surviving for a century.</p> <p>But astonishingly, this needn’t be the case. <a href="https://pubmed.ncbi.nlm.nih.gov/21812767/">One study</a> found that up to 60% of Ashkenazi Jewish centenarians have smoked heavily most of their lives, half have been obese for the same period of time, less than half do even moderate exercise and under 3% are vegetarians. The children of centenarians appear no more health conscious than the general population either.</p> <p>Compared to peers with the same food consumption, wealth and body weight, however, <a href="https://pubmed.ncbi.nlm.nih.gov/29050682/">they have half the prevalence of cardiovascular disease</a>. There is something innately exceptional about these people.</p> <h2>The big secret</h2> <p>Could it be down to rare genetics? If so, then there are two ways in which this could work. Centenarians might carry unusual genetic variants that extend lifespan, or instead they might lack common ones that cause late-life disease and impairment. Several studies, including our own work, <a href="https://pubmed.ncbi.nlm.nih.gov/32860726/">have shown</a> that centenarians have just as many bad genetic variants as the general population.</p> <p>Some even carry two copies of the largest known common risk gene for Alzheimer’s disease (APOE4), but still don’t get the illness. So a plausible working hypothesis is that centenarians carry rare, beneficial genetic variations rather than a lack of disadvantageous ones. And the best available data is consistent with this.</p> <p>Over 60% of centenarians have genetic changes that alter the genes which regulate growth in early life. This implies that these remarkable people are human examples of a type of lifespan extension observed in other species. Most people know that <a href="https://pubmed.ncbi.nlm.nih.gov/28803893/">small dogs tend to live longer than big ones</a> but fewer are aware that this is a general phenomenon across the animal kingdom. <a href="https://pubmed.ncbi.nlm.nih.gov/26857482/">Ponies can live longer than horses</a> and many strains of laboratory mice with dwarfing mutations <a href="https://pubmed.ncbi.nlm.nih.gov/29653683/">live longer than their full-sized counterparts</a>. One potential cause of this is reduced levels of a growth hormone called IGF-1 – although human centenarians <a href="https://pubmed.ncbi.nlm.nih.gov/28630896/">are not necessarily shorter than the rest of us</a>.</p> <p>Obviously, growth hormone is necessary early on in life, but there is increasing evidence that high levels of IGF-1 in mid to late life <a href="https://pubmed.ncbi.nlm.nih.gov/18316725/">are associated with increased late-life illness</a>. The detailed mechanisms underlying this remain an open question, but even among centenarians, women with the lowest levels of growth hormone <a href="https://pubmed.ncbi.nlm.nih.gov/24618355/">live longer than those with the highest</a>. They also have better cognitive and muscle function.</p> <p>That doesn’t solve the problem, though. Centenarians are also different from the rest of us in other ways. For example, they tend to have good cholesterol levels – hinting there may several reasons for their longevity.</p> <p>Ultimately, centenarians are “natural experiments” who show us that it is possible to live in excellent health even if you have been dealt a risky genetic hand and chose to pay no attention to health messages – but only if you carry rare, poorly understood mutations.</p> <p>Understanding exactly how these work should allow scientists to develop new drugs or other interventions that target biological processes in the right tissues at the right time. If these become a reality perhaps more of us than we think will see the next century in. But, until then, don’t take healthy lifestyle tips from centenarians.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/172020/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/richard-faragher-224976">Richard Faragher</a>, Professor of Biogerontology, <a href="https://theconversation.com/institutions/university-of-brighton-942">University of Brighton</a> and <a href="https://theconversation.com/profiles/nir-barzilai-1293752">Nir Barzilai</a>, Professor of Medicine and Genetics, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-its-still-a-scientific-mystery-how-some-can-live-past-100-and-how-to-crack-it-172020">original article</a>.</em></p> </div>

Retirement Life

Placeholder Content Image

The hen-some winners of Australia's next top chicken awards

<p>The winners of Australia's Next Top Chicken competition have been crowned, with the winners ranging from feathered and fluffy, to just utterly fabulous. </p> <p>The annual competition, run by <a href="https://www.thegoodlifebackyard.com.au/australias-next-top-chicken-competition/" target="_blank" rel="noopener">Good Life Backyard</a>, gives farm enthusiasts a chance to show off their feathered friends, with the competition receiving hundreds of entrants this year. </p> <p>Tens of thousands of votes were cast by the public, ultimately crowning a Buff Laced Polish Frizzle, named Little Bird, the top chook for 2024. </p> <p>The top award is given to a chicken that embodies all the qualities of a standout star, and will be featured in the coveted spot on the 2025 Top Chicken calendar. </p> <p>The winner of Australia's next top rooster is Big Boy McFuzzle, who rules the roost with presence and charisma.</p> <p>Awards were also handed out to the funniest picture, as well as two random prize winners. </p> <p>Each year competition organisers draw random entries "ensuring everyone has a shot at winning".</p> <p>"Every chicken deserves a chance," organisers said.</p> <p>"This year's event was such a wonderful display of all breeds, abilities, disabilities and dedication to raising healthy, happy chickens."</p> <p><em>Image credits: Good Life Backyard</em></p> <p style="box-sizing: border-box; margin: 0px 0px 16px; padding: 0px; border: 0px; font-stretch: inherit; font-size: 18px; line-height: 24px; font-family: proxima-nova, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; vertical-align: baseline; color: #333333; caret-color: #333333;"> </p>

Family & Pets

Placeholder Content Image

Are some routes more prone to air turbulence? Will climate change make it worse? Your questions answered

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/doug-drury-1277871">Doug Drury</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p>A little bit of turbulence is a common experience for air travellers. Severe incidents are rare – but when they occur they can be deadly.</p> <p>The recent Singapore Airlines flight SQ321 from London to Singapore shows the danger. An <a href="https://apnews.com/article/singapore-airlines-flight-turbulence-5a9a268e1a6a6fb9ece7e58b5ea9231b">encounter with extreme turbulence</a> during normal flight left one person dead from a presumed heart attack and several others badly injured. The flight diverted to land in Bangkok so the severely injured passengers could receive hospital treatment.</p> <p>Air turbulence can happen anywhere, but is far more common on some routes than on others.</p> <p>Climate change is expected to boost the chances of air turbulence, and make it more intense. In fact, <a href="https://www.nature.com/articles/s41586-019-1465-z">some research</a> indicates turbulence <a href="https://theconversation.com/aviation-turbulence-soared-by-up-to-55-as-the-world-warmed-new-research-207574">has already worsened</a> over the past few decades.</p> <h2>Where does turbulence happen?</h2> <p>Nearly every flight experiences turbulence in one form or another.</p> <p>If an aircraft is taking off or landing behind another aircraft, the wind generated by the engine and <a href="https://www.faa.gov/air_traffic/publications/atpubs/aim_html/chap7_section_4.html">wingtips</a> of the lead aircraft can cause “wake turbulence” for the one behind.</p> <p>Close to ground level, there may be turbulence due to strong winds associated with weather patterns moving through the area near an airport. At higher altitudes, there may be wake turbulence again (if flying close to another aircraft), or turbulence due to updraughts or downdraughts from a thunderstorm.</p> <p>Another kind of turbulence that occurs at higher altitudes is harder to predict or avoid. So-called “<a href="https://agupubs.onlinelibrary.wiley.com/doi/10.1029/2023gl103814">clear-air turbulence</a>” is invisible, as the name suggests. It is often caused by warmer air rising into cooler air, and is generally expected to get worse due to climate change.</p> <p>At the most basic level turbulence is the result of two or more wind events colliding and creating eddies, or swirls of <a href="https://www.nationalgeographic.com/travel/article/what-is-turbulence-explained">disrupted airflow</a>.</p> <p>It often occurs near mountain ranges, as wind flowing over the terrain accelerates upward.</p> <p>Turbulence also often occurs at the edges of the <a href="https://www.nationalgeographic.com/travel/article/what-is-turbulence-explained">jet streams</a>. These are narrow bands of strong, high-altitude winds circling the globe. Aircraft often travel in the jet streams to get a speed boost – but when entering or leaving the jet stream, there may be some turbulence as it crosses the boundary with the slower winds outside.</p> <h2>What are the most turbulent routes?</h2> <p>It is possible to <a href="https://turbli.com/maps/world-turbulence-map/">map turbulence patterns</a> over the whole world. Airlines use these maps to plan in advance for alternate airports or other essential contingencies.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.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/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=430&fit=crop&dpr=1 600w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=430&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=430&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=541&fit=crop&dpr=1 754w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=541&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/595676/original/file-20240522-21-ippmyt.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=541&fit=crop&dpr=3 2262w" alt="Map showing air turbulence." /></a><figcaption><span class="caption">A map of estimated clear-air turbulence around the world, current as of 3:00PM AEST (0500 UTC) on May 22 2024.</span> <span class="attribution"><a class="source" href="https://turbli.com/maps/world-turbulence-map/">Turbli</a></span></figcaption></figure> <p>While turbulence changes with weather conditions, some regions and routes are more prone to it than others. As you can see from the list below, the majority of the most turbulent routes travel close to mountains.</p> <p><iframe id="EktuH" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/EktuH/2/" width="100%" height="400px" frameborder="0"></iframe></p> <p>In Australia, the <a href="https://turbli.com/historical-data/most-turbulent-flight-routes-of-2023/">highest average turbulence in 2023</a> occurred on the Brisbane to Sydney route, followed by Melbourne to Sydney and Brisbane to Melbourne.</p> <h2>Climate change may increase turbulence</h2> <p>How will climate change affect the future of aviation?</p> <p>A <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2023GL103814">study published last year</a> found evidence of large increases in clear-air turbulence between 1979 and 2020. In some locations severe turbulence increased by as much as 55%.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.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/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=253&fit=crop&dpr=1 600w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=253&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=253&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=318&fit=crop&dpr=1 754w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=318&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/595683/original/file-20240522-17-p2zdrt.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=318&fit=crop&dpr=3 2262w" alt="A map of the world with different areas shaded in red." /></a><figcaption><span class="caption">A map showing changes in the chance of clear-air turbulence across the globe between 1979 and 2020. Darker red indicates a higher chance of turbulence.</span> <span class="attribution"><a class="source" href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2023GL103814">Prosser et al. (2023), Geophysical Research Letters</a></span></figcaption></figure> <p>In 2017, a <a href="https://agupubs.onlinelibrary.wiley.com/doi/10.1002/2017GL074618">different study used climate modelling</a> to project that clear-air turbulence may be four times as common as it used to be by 2050, under some climate change scenarios.</p> <h2>What can be done about turbulence?</h2> <p>What can be done to mitigate turbulence? <a href="https://safetyfirst.airbus.com/optimum-use-of-weather-radar/">Technology to detect turbulence</a> is still in the research and development phase, so pilots use the knowledge they have from weather radar to determine the best plan to avoid weather patterns with high levels of moisture directly ahead of their flight path.</p> <p>Weather radar imagery shows the pilots where the most intense turbulence can be expected, and they work with air traffic control to avoid those areas. When turbulence is encountered unexpectedly, the pilots immediately turn on the “fasten seatbelt” sign and reduce engine thrust to slow down the plane. They will also be in touch with air traffic control to find better conditions either by climbing or descending to smoother air.</p> <p>Ground-based meteorological centres can see weather patterns developing with the assistance of satellites. They provide this information to flight crews in real time, so the crew knows the weather to expect throughout their flight. This can also include areas of expected turbulence if storms develop along the intended flight route.</p> <p>It seems we are heading into more turbulent times. Airlines will do all they can to reduce the impact on planes and passengers. But for the average traveller, the message is simple: when they tell you to fasten your seatbelt, you should listen.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230666/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/doug-drury-1277871"><em>Doug Drury</em></a><em>, Professor/Head of Aviation, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-some-routes-more-prone-to-air-turbulence-will-climate-change-make-it-worse-your-questions-answered-230666">original article</a>.</em></p> </div>

Travel Trouble

Placeholder Content Image

Eye infections might seem like a minor complaint – but in some cases they can cause blindness and even death

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p>When you think of eye infections, what comes to mind? Puffy, swollen bruised feeling eyelids that get glued together with gunk overnight? That feeling of having grit in your eye that can’t be cleaned away? Eye infections may seem like a relatively minor – if unsightly and inconvenient – complaint, but they can also be far more serious.</p> <p>Take the deadly outbreak of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022785/">antibiotic resistant</a> bacteria <a href="https://www.cff.org/managing-cf/burkholderia-cepacia-complex-b-cepacia"><em>Burkholderia cepacia</em></a> in 2023-24, for example.</p> <p>Between January 2023 and February 2024, contaminated brands of lubricating eye gel were linked to the infection of at least 52 patients. <a href="https://www.independent.co.uk/news/health/contaminated-eye-gel-outbreak-death-b2523446.html">One person died</a> and at least 25 others suffered serious infections.</p> <p>The outbreak has now subsided and products are <a href="https://www.gov.uk/drug-device-alerts/specific-brands-of-carbomer-eye-gel-recall-of-aacarb-eye-gel-aacomer-eye-gel-and-puroptics-eye-gel-potential-risk-of-infection-dsi-slash-2023-slash-11#update-2-april-2024">back on the shelves</a> but it isn’t the first time that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8335909/">medicinal products</a> have led to outbreaks of <em>B cepacia</em>.</p> <p>The bacterium is an opportunistic pathogen known to pose a significant risk to people with cystic fibrosis, chronic lung conditions and weakened immune systems. The infection likely progresses from the mucous membranes of the eyelids to the lungs where it leads to pneumonia and septicaemia causing <a href="https://erj.ersjournals.com/content/17/2/295">death in days</a>.</p> <p>But it’s not just <em>B cepacia</em> that can threaten our health. Something as simple as rubbing our eyes can introduce pathogens leading to infection, blindness and, in the worst case, death.</p> <p>Bacteria account for up to <a href="https://pubmed.ncbi.nlm.nih.gov/16148850/">70% of eye infections</a> and globally <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032492/">over 6 million people</a> have blindness or moderate visual impairment from ocular infection. Contact lens wearers are at <a href="https://www.aao.org/eye-health/diseases/contact-lens-related-eye-infections">increased risk</a>.</p> <figure><iframe src="https://www.youtube.com/embed/pWsx8i1kaxs?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The eye is a unique structure. It converts light energy to chemical and then electrical energy, which is transmitted to the brain and converted to a picture. The eye uses about <a href="https://www.ncbi.nlm.nih.gov/books/NBK11556/">6 million cones and 120 million rods</a> which detect colour and light.</p> <p>Eye cells have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775779/">no ability to regenerate</a> so, once damaged or injured, cannot be repaired or replaced. The body tries its best to preserve the eyes by encasing them in a <a href="https://www.ncbi.nlm.nih.gov/books/NBK531490/">bony protective frame</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK482428/">limiting exposure</a> having eyelids to defend against the environmental damage and ensure the eyes are kept lubricated.</p> <p>Despite our bodies’ best efforts to shield the eyes from harm, there are a number of common eye infections that can result from introducing potential pathogens into the eyes.</p> <h2>Conjunctivitis</h2> <p>The outer-most layer of the eye, the sclera, bears the brunt of exposure and to help protect it, it is lined by a thin moist membrane called the <a href="https://my.clevelandclinic.org/health/body/24329-conjunctiva">conjunctiva</a>.</p> <figure><iframe src="https://www.youtube.com/embed/RZ4danuJwd0?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The conjunctiva is <a href="https://innovations.bmj.com/content/9/4/253">highly vascularised</a>, which means it has lots of blood vessels. When microbes enter the eye, it is this layer that mounts an immune response causing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328962/">blood vessels to dilate</a> in the conjunctiva. This results in <a href="https://www.cdc.gov/conjunctivitis/about/symptoms.html">“pink eye”</a>, a common form of conjunctivitis. Conjunctivitis can be caused by bacteria, allergens or viruses and typically heals by itself.</p> <h2>Blepharitis</h2> <p>Blepharitis is an inflammation of the eyelid and usually affects both sides. It can cause itchy eyes and dandruff-like flakes. It’s most commonly caused by <a href="https://www.tandfonline.com/doi/pdf/10.3109/09273948.2013.870214"><em>Staphylococcus</em> bacteria</a>, or the <a href="https://cks.nice.org.uk/topics/blepharitis/background-information/causes/">dysfunction of the glands</a> of the eyelids. It can be treated by <a href="https://www.nhs.uk/conditions/blepharitis/">cleaning the eyes</a> regularly.</p> <h2>Stye</h2> <p>A stye (also called <a href="https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines/hordeolum">hordeolum</a>) is a painful infection of the upper or lower eyelid. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370090/">Internal styes</a> are caused by infection of an oil-producing gland inside the eyelid, whereas <a href="https://pubmed.ncbi.nlm.nih.gov/28723014/">external styes</a> develop at the base of the eyelash because of an infection of the hair follicle. Both are caused by bacteria, typically <a href="https://jamanetwork.com/journals/jamaophthalmology/fullarticle/1874715">the <em>S aureus</em> form of the <em>Staphylococcus</em> species</a>.</p> <figure><iframe src="https://www.youtube.com/embed/INKrGOdy824?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Styes can be treated by holding a clean flannel soaked in warm water against the affected eye for five to ten minutes, three or four times a day. Do not try to burst styes – this could spread the infection.</p> <h2>Keratitis</h2> <p>Keratitis is the inflammation of the cornea, the transparent part of the eye that light passes through. The cornea is part of the eye’s main barrier against dirt, germs, and disease. Severe keratitis can cause ulcers, damage to the eye and even blindness.</p> <p>The most common type is bacterial keratitis; however, it can also be caused by <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998329/">amoeba</a>, which can migrate to other parts of the body – including the brain – and cause infection and <a href="https://theconversation.com/nasal-rinsing-why-flushing-the-nasal-passages-with-tap-water-to-tackle-hay-fever-could-be-fatal-225811">even death</a>.</p> <p>Noninfectious keratitis is most commonly caused by wearing contact lenses for too long, especially while sleeping. This can cause scratches, dryness and soreness of the cornea, which leads to inflammation.</p> <h2>Uveitis</h2> <p><a href="https://www.nhs.uk/conditions/uveitis/">Uveitis</a> is inflammation of the middle layer of the eye. Although relatively rare, it is a serious condition and usually results from viral infections such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8501150/">herpes simplex</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29023181/">herpes zoster</a> or <a href="https://link.springer.com/chapter/10.1007/978-3-319-09126-6_40">trauma</a>. Depending on where the inflammation is in the eye, the symptoms can be anything from redness, pain and floaters to blurred vision and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772296/">partial blindness</a>.</p> <h2>Exogenous endophthalmitis</h2> <p>This is a rare but serious infection caused by eye surgery complications, penetrating ocular trauma (being stabbed in the eye with a sharp object) or foreign bodies in the eye. Foreign bodies can be anything from dirt and dust to small projectiles such as shards of metal from drilling, explosives or soil from farm machinery and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286045/">many other sources</a>.</p> <h2>Dacryocystitis</h2> <p>Dacryocystitis is the inflammation of the nasolacrimal sac, which drains tears away from the eye into the nose. This condition can be <a href="https://pubmed.ncbi.nlm.nih.gov/8443113/">acute</a>, <a href="https://www.nature.com/articles/6700662">chronic</a> or <a href="https://www.jebmh.com/articles/a-study-of-congenital-dacryocystitis.pdf.pdf">acquired at birth</a>. Most cases are caused by <a href="https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-020-01792-4"><em>Streptococcus pneumoniae</em> and <em>Staphylococcus aureus</em></a> bacteria.</p> <p>The condition mainly affects newborns and those over 40. Seventy-five per cent of cases are women and it’s most commonly found in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039673/">white adults</a>. It can lead to the stagnation of tears, creating a breeding ground for microbes.</p> <h2>Careful with contacts</h2> <p>Proper eye hygiene reduces the risk of all these conditions – and this is even more important for contact lens wearers.</p> <figure><iframe src="https://www.youtube.com/embed/uENHAntJOIA?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Appropriate hygienic cleaning of lenses is paramount. <a href="https://pubmed.ncbi.nlm.nih.gov/30789440/">Non-sterile water</a>, <a href="https://www.aao.org/eye-health/glasses-contacts/contact-lens-care">spit</a> and other fluids can transfer <a href="https://www.science.org/content/article/bacteria-living-your-contact-lens-solution">potentially dangerous</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482476/">microbes</a> into the eye – a warm, moist environment that makes an ideal breeding ground for bacteria – leading to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542356/">localised infection</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3972779/">blindness</a> or progress to a more serious <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9835757/">systemic infection or death</a>.</p> <p>Any persistent and painful redness or swelling of eyes should be checked by a registered health professional.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227252/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/adam-taylor-283950">Adam Taylor</a>, Professor and Director of the Clinical Anatomy Learning Centre, <a href="https://theconversation.com/institutions/lancaster-university-1176">Lancaster University</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eye-infections-might-seem-like-a-minor-complaint-but-in-some-cases-they-can-cause-blindness-and-even-death-227252">original article</a>.</em></p> </div>

Body

Placeholder Content Image

Considering taking a weight-loss drug like Ozempic? Here are some potential risks and benefits

<p><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <em><a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>After weight-loss drugs like Ozempic exploded onto the market, celebrities and social media influencers were quick to spruik their benefits, leading to their rapid rise in use. In the last three months of 2022, clinicians in the United States alone wrote <a href="https://www.washingtonpost.com/business/2023/09/27/ozempic-prescriptions-data-analysis/">more than nine million prescriptions</a> for these drugs.</p> <p>As they’ve grown in popularity, we’ve also heard more about the potential side effects – from common gastrointestinal discomforts, to more serious mental health concerns.</p> <p>But what does the science say about how well Ozempic and Wegovy (which are both brand names of the drug semaglutide) work for weight loss? And what are the potential side effects? Here’s what to consider if you or a loved one are thinking of taking the drug.</p> <h2>Potential benefits</h2> <p><strong>1) It’s likely to help you lose weight</strong></p> <p>The largest, well-conducted <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">research study</a> of semaglutide was from United Kingdom in 2021. Some 1,961 people who were classified as “overweight” or “obese” were randomly assigned to have either semaglutide or a placebo and followed for 68 weeks (about 1.3 years). All participants also had free access to advice about healthy eating and physical activity.</p> <p>The study found those taking semaglutide lost weight – significantly more than people who had the placebo (-14.9% of their body weight compared with -2.4% of body weight).</p> <p>In another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">study</a> in the United States, one health-care clinic gave 408 people weekly injections of semaglutide. Over the first three months, those included in the final analysis (175 people) lost an average of 6.7kg. Over the first six months, they lost an average of 12.3kg.</p> <p>Large weight losses have been found in a more <a href="https://www.nature.com/articles/s41591-022-02026-4">recent trial</a> of semaglutide, suggesting weight loss is a very likely outcome of ongoing use of the medication.</p> <p><strong>2) It may reduce your chronic disease risk factors</strong></p> <p>When people in the overweight or obese weight categories lose <a href="https://www.sciencedirect.com/science/article/pii/S1550413116300535">at least 5%</a> of their body weight, physiological changes often occur beyond a change in weight or shape. This <a href="https://www.nih.gov/news-events/nih-research-matters/research-context-obesity-metabolic-health">might include</a> lowered cholesterol levels, lowered blood pressure and lowered blood glucose levels, which all reduce the risk of chronic diseases.</p> <p>In one of the semaglutide <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">trials</a>, most people (87.3%) lost at least 5% of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health conditions such as type 2 diabetes, metabolic health gains were <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">observed</a>, including lowered blood pressure, blood glucose levels and fasting blood lipid (fat) levels.</p> <p>In the UK <a href="https://pubmed.ncbi.nlm.nih.gov/33567185/">study</a> from 2021, people taking semaglutide had greater improvements in physical capabilities and risk factors for heart disease and diabetes, including reductions in waist circumference, markers of inflammation, blood pressure and blood glucose levels.</p> <p><strong>3) It might improve your quality of life, emotional wellbeing or sense of achievement</strong></p> <p>The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant <a href="https://www.tandfonline.com/doi/full/10.1080/00325481.2022.2150006">improvements</a> in their physical functioning and perceptions of their general health, social functioning and mental health.</p> <p>Anecdotally (not based on scientific research), people using semaglutide, such as <a href="https://people.com/oprah-winfrey-reveals-weight-loss-medication-exclusive-8414552">Oprah Winfrey</a>, report a reclaiming or turning point of their life, social situation and body image.</p> <h2>What about the risks?</h2> <p><strong>1) You may experience gastrointestinal symptoms</strong></p> <p>In the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">US clinical trial</a>, nearly half (48.6%) of people taking semaglutide reported experiencing adverse effects. Nausea and vomiting were the most frequently experienced (36.6%) followed by diarrhea (8.6%), fatigue (6.3%) and constipation (5.7%).</p> <p>In the UK study, nausea and diarrhoea were also commonly reported.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">another trial</a>, many participants (74.2%) using semaglutide reported gastrointestinal symptoms. However, nearly half (47.9%) using the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily living.</p> <p>Most gastrointestinal symptoms were mild to moderate in severity, and resolved for most people without the need to stop participating in the study.</p> <p><strong>2) You might feel fatigued</strong></p> <p>Fatigue was the second most common side effect for participants in the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, affecting 6.3% of participants.</p> <p><strong>3) You might be among the minority who don’t tolerate the drug</strong></p> <p>Australia’s Therapeutic Goods Administration (TGA) has <a href="https://www.tga.gov.au/news/safety-alerts/compounding-safety-information-semaglutide-products">approved</a> Ozempic as safe to use, for the treatment of type 2 diabetes but it has not yet been approved for weight loss. The TGA has also <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/wegovy-novo-nordisk-pharmaceuticals-pty-ltd">approved Wegovy</a> (a higher dose of semagtlutide) for weight loss, however it’s not yet available in Australia.</p> <p>In the US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">clinical trial</a>, no unexpected safety issues were reported. However, five patients (2.9%) had to stop taking the medication because they could not tolerate the adverse effects. Fifteen (8.6%) had to either reduce the dose or remain on the same dose to avoid the adverse effects.</p> <p>In <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">other studies</a>, some patients stopped the trial due to gastrointestinal symptoms being so severe they could not tolerate continuing.</p> <p>More severe safety concerns reported in <a href="https://www.nejm.org/doi/10.1056/NEJMoa2032183?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">studies</a> include gallbladder-related disorders (mostly cholelithiasis, also known as gallstones) in 34 patients (2.6%) and mild acute pancreatitis in three patients (0.2%). All people recovered during the trial period.</p> <p>A 2024 European <a href="https://link.springer.com/article/10.1007/s11096-023-01694-7">study</a> analysed psychiatric adverse events associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2% of the total reported) associated with these drugs. About half of these events were reported as depression, followed by anxiety (39%) and suicidal ideation (19.6%). Nine deaths and 11 life-threatening outcomes were reported during the study period.</p> <p>Due to the severity and fatal outcomes of some of these reports, <a href="https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type">the US Food and Drug Administration</a> investigated further but did not find evidence that use of these medicines caused suicidal thoughts or actions.</p> <p><strong>4) It might be difficult to access</strong></p> <p>Despite being considered safe, the TGA has <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/update-prescribers-advised-not-start-new-patients-ozempic#:%7E:text=Ozempic%27s%20TGA%2Dapproved%20indication%20is,consult%20the%20appropriate%20prescribing%20guidelines.">warned</a> significant Ozempic access barriers are likely to continue throughout 2024.</p> <p>To manage the shortage, pharmacists are instructed to give preference to people with type 2 diabetes who are seeking the medication.</p> <p><strong>5) You might not always get clear information from vested interests</strong></p> <p>Given the popularity of Ozempic and Wegovy, health organisations such as the World Obesity Federation have expressed <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">concern</a> about the medication’s marketing, PR and strong <a href="https://www.theguardian.com/australia-news/2023/jan/06/tga-investigates-influencers-after-diabetes-drug-ozempic-promoted-as-weight-loss-treatment">social media presence</a>.</p> <p>Some journalists have <a href="https://www.theguardian.com/society/2023/mar/12/orchestrated-pr-campaign-how-skinny-jab-drug-firm-sought-to-shape-obesity-debate">raised conflict of interest concerns</a> about the relationship between some obesity researchers and Novo Nordrisk, Ozempic and Wegovy’s manufacturer. The worry is that researchers might be influenced by their relationship with Novo Nordrisk to produce study results that are more favourable to the medications.</p> <h2>Bottom line</h2> <p>Ozempic is a medication that should be used in conjunction with your health care provider. But remember, weight is only one aspect of your health and wellbeing. It’s important to take a holistic view of your health and prioritise eating well, moving more and getting enough sleep.</p> <hr /> <p><em>Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-132745">Ozempic series</a> here.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219312/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/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>, Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">original article</a>.</em></p>

Body

Placeholder Content Image

Eating some chocolate really might be good for you – here’s what the research says

<p><em><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p>Although it always makes me scoff slightly to see Easter eggs making their first appearance in supermarkets at the end of December, there are few people who aren’t delighted to receive a bit of chocolate every year.</p> <p>It makes sense that too much chocolate would be bad for you because of the high fat and sugar content in most products. But what should we make of common claims that eating some chocolate is actually good for you?</p> <p>Happily, there is a fair amount of evidence that shows, in the right circumstances, chocolate may be both beneficial for your heart and good for your mental state.</p> <p>In fact, chocolate – or more specifically cacao, the raw, unrefined bean – is a medicinal wonder. It contains many different active compounds which can evoke pharmacological effects within the body, like medicines or drugs.</p> <p>Compounds that lead to neurological effects in the brain have to be able to cross the <a href="https://link.springer.com/chapter/10.1007/978-3-642-13443-2_7">blood-brain barrier</a>, the protective shield which prevents harmful substances – like toxins and bacteria – entering the delicate nervous tissue.</p> <p>One of these is the compound <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672386/">theobromine</a>, which is also found in tea and contributes towards its bitter taste. Tea and chocolate also contain caffeine, which theobromine is related to as part of the purine family of chemicals.</p> <p>These chemicals, among others, contribute to chocolate’s addictive nature. They have the ability to cross the blood-brain barrier, where they can influence the nervous system. They are therefore known as <a href="https://pubmed.ncbi.nlm.nih.gov/15549276/">psychoactive</a> chemicals.</p> <figure><iframe src="https://www.youtube.com/embed/HloqayQdR6M?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>What effects can chocolate have on mood? Well, <a href="https://academic.oup.com/nutritionreviews/article/71/10/665/1931144?login=false">a systematic review</a> looked at a group of studies which examined the feelings and emotions associated with consuming chocolate. Most demonstrated improvements in mood, anxiety, energy and states of arousal.</p> <p>Some noted the feeling of guilt, which is perhaps something we’ve all felt after one too many Dairy Milks.</p> <h2>Health benefits of cocoa</h2> <p>There are other organs, aside from the brain, that might benefit from the medicinal effects of cocoa. For centuries, chocolate has been used as a medicine to treat a <a href="https://pubmed.ncbi.nlm.nih.gov/10917925/">long list of diseases</a> including anaemia, tuberculosis, gout and even low libido.</p> <p>These might be spurious claims but there is evidence to suggest that eating cacao has a positive effect on the cardiovascular system. First, it can prevent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068178/">endothelial dysfunction</a>. This is the process through which arteries harden and get laden down with fatty plaques, which can in turn lead to heart attacks and strokes.</p> <p>Eating dark chocolate may also reduce <a href="https://www.sciencedirect.com/science/article/pii/S1537189115001135?via%3Dihub">blood pressure</a>, which is another risk factor for developing arterial disease, and prevent formation of clots which block up blood vessels.</p> <figure><iframe src="https://www.youtube.com/embed/8VUcPCbSSCY?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Some studies have suggested that dark chocolate might be useful in adjusting ratios of <a href="https://pubmed.ncbi.nlm.nih.gov/20968113/">high-density lipoprotein cholesterol</a>, which can help protect the heart.</p> <p>Others have examined insulin resistance, the phenomenon associated with Type 2 diabetes and weight gain. They suggest that the <a href="https://www.sciencedirect.com/science/article/pii/S0963996900000697#:%7E:text=Cocoa%20is%20rich%20in%20polyphenols%20particularly%20in%20catechins,and%20cocoa%20powder%20have%20been%20published%20only%20recently.">polyphenols</a> – chemical compounds present in plants – found in foodstuffs like chocolate may also lead to <a href="https://pubmed.ncbi.nlm.nih.gov/29993262/">improved control of blood sugars</a>.</p> <h2>Chocolate toxicity</h2> <p>As much as chocolate might be considered a medicine for some, it can be a poison for others.</p> <p>It’s well documented that the ingestion of caffeine and theobromine is highly toxic for domestic animals. Dogs are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801869/">particularly affected</a> because of their often voracious appetites and generally unfussy natures.</p> <p>The culprit is often dark chocolate, which can provoke symptoms of agitation, rigid muscles and even seizures. In certain cases, if ingested in high enough quantities, it can lead to comas and abnormal, even fatal heart rhythms.</p> <p>Some of the compounds found in chocolate have also been found to have potentially negative effects in humans. Chocolate is a source of oxalate which, along with calcium, is one of the main components of <a href="https://pubmed.ncbi.nlm.nih.gov/20301742/">kidney stones</a>.</p> <p>Some clinical groups have advised against consuming oxalate rich foods, such as spinach and rhubarb – and chocolate, for those who suffer from recurrent kidney stones.</p> <p>So, what should all this mean for our chocolate consumption habits? Science points in the direction of chocolate that has as high a cocoa solid content as possible, and the minimum of extras. The potentially harmful effects of chocolate are more related to fat and sugar, and may counteract any possible benefits.</p> <p>A daily dose of 20g-30g of plain or dark chocolate with cocoa solids above 70% – rather than milk chocolate, which contains fewer solids and white chocolate, which contains none – could lead to a greater health benefit, as well as a greater high.</p> <p>But whatever chocolate you go for, please don’t share it with the dog.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226759/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/dan-baumgardt-1451396"><em>Dan Baumgardt</em></a><em>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eating-some-chocolate-really-might-be-good-for-you-heres-what-the-research-says-226759">original article</a>.</em></p>

Body

Placeholder Content Image

"I have some very big news": Today host announces shock resignation

<p>In a shock announcement on Friday morning, beloved <em>Today </em>show presenter Brooke Boney revealed that she will be bidding farewell to the morning program.</p> <p>Boney, known for her vibrant presence and insightful reporting, has been an integral part of the show since 2019, captivating audiences with her charisma and professionalism. However, her journey is about to take a new turn as she embarks on a remarkable academic pursuit at Oxford University.</p> <p>“Guys, I have some very big news for you this morning," Boney said to her co-hosts on the panel. "I’ve been offered a place at Oxford University later this year, which means I’ll be leaving the show after the Olympics</p> <p>“I don’t want to go into too much right now, because there’ll be plenty of time for goodbyes and thank yous, but I just wanted to share that good-slash-bad news with you all this morning.</p> <p>“It’s been a dream of mine to be able to study at an overseas university, and it just felt like the right time to take that step.</p> <p>“I’m so grateful to come in here every day and I love you all so much. So it’s made the decision really difficult. But it just means that you’ll all have to plan trips to the UK to come and visit."</p> <p>The news of Boney's departure stirred a wave of emotions among fans and colleagues alike. With tears and heartfelt messages, the tight-knit morning show panel expressed their pride and support for her next endeavour. Co-hosts Karl Stefanovic and Sarah Abo showered Boney with words of encouragement, acknowledging her longstanding dream of studying at an overseas university.</p> <p>“We are very, very proud of you,” Stefanovic said. “So proud of you,” Abo added.</p> <p>Boney's journey to this pivotal moment has been marked by dedication and perseverance. Hailing from the Hunter Region of NSW, she discovered her passion for media at a young age, volunteering at a local community radio station. Her path led her to Sydney, where she pursued an advertising cadetship before delving into university education as a mature-age student. Graduating with a Bachelor of Arts in Journalism in 2013, Boney's career trajectory took her to various roles, from political correspondent to newsreader on Triple J's breakfast show.</p> <p>Now, as she prepares to embark on a Masters in Public Policy at Oxford University, Boney reflected on the significance of this opportunity. "I thought if I don't do this now, then I'm probably never going to," she shared.</p> <p>While bidding farewell to the <em>Today</em> show, Boney reassured viewers that her departure is not the end of her journey with Nine. Expressing her desire to explore future collaborations with the network, she remains optimistic about the possibilities that lie ahead.</p> <p>As Brooke Boney prepares to embark on her next chapter, her legacy as a trailblazing journalist and cherished presenter continues to inspire. As she bids adieu to the morning show, audiences eagerly await the next chapter in her remarkable journey.</p> <p><em>Images: Nine</em></p>

TV

Placeholder Content Image

Not all mourning happens after bereavement – for some, grief can start years before the death of a loved one

<p><em><a href="https://theconversation.com/profiles/lisa-graham-wisener-1247893">Lisa Graham-Wisener</a>, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> and <a href="https://theconversation.com/profiles/audrey-roulston-1512057">Audrey Roulston</a>, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a></em></p> <p>For many people, grief starts not at the point of death, but from the moment a loved one is diagnosed with a life-limiting illness.</p> <p>Whether it’s the diagnosis of an advanced cancer or a non-malignant condition such as dementia, heart failure or Parkinson’s disease, the psychological and emotional process of grief can begin many months or even years before the person dies. This experience of mourning a future loss is known as <a href="https://link.springer.com/referenceworkentry/10.1007/978-3-319-69892-2_1006-1">anticipatory grief</a>.</p> <p>While not experienced by everyone, anticipatory grief is a <a href="https://spcare.bmj.com/content/bmjspcare/early/2022/02/10/bmjspcare-2021-003338.full.pdf?casa_token=IWNMDFN5SoIAAAAA:2EybwyPcKu73VdrACTNk7jITor-mMIXK8rv76arXgdjV9cA2Y0MV0LyZLLwcYe1rZUAQymOzFYo">common</a> part of the grieving process and can include a range of conflicting, often difficult thoughts and emotions. For example, as well as feelings of loss, some people can experience guilt from wanting their loved one to be free of pain, or imagining what life will be like after they die.</p> <h2>Difficult to define, distressing to experience</h2> <p>Anticipatory grief has proved <a href="https://journals.sagepub.com/doi/full/10.1177/02692163221074540#bibr13-02692163221074540">challenging to define</a>. A <a href="https://journals.sagepub.com/doi/full/10.1177/02692163221074540#bibr13-02692163221074540">systematic review</a> of research studies on anticipatory grief identified over 30 different descriptions of pre-death grief. This lack of consensus has limited research progress, because there’s no shared understanding of how to identify anticipatory grief.</p> <p>Therese Rando, a <a href="https://www.taylorfrancis.com/chapters/edit/10.4324/9781315800806-9/grief-mourning-accommodating-loss-therese-rando">prominent theorist</a>, has proposed that anticipatory grief can help prepare for death, contributing to a more positive grieving experience post-bereavement. Rando also suggests that pre-death mourning can aid with adjustment to the loss of a loved one and reduce the risk of <a href="https://www.cruse.org.uk/understanding-grief/effects-of-grief/complicated-grief/">“complicated grief”</a>, a term that describes persistent and debilitating emotional distress.</p> <figure><iframe src="https://www.youtube.com/embed/AapGn60DZSA?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>But pre-death mourning doesn’t necessarily mean grief will be easier to work through once a loved one has died. Other <a href="https://www.sciencedirect.com/science/article/pii/S0277953621005724?casa_token=I9mbdSv3d3gAAAAA:MqxN5X_iWbcqa6BYj7IXmImUviheOQWAVA4UBy6795UDuS1uOHG9b245qMkyOiLcvjv_SU6yVA">research evidence</a> shows that it’s possible to experience severe anticipatory grief yet remain unprepared for death.</p> <h2>Carers should seek support</h2> <p>Carers of people with life-limiting illnesses may notice distressing changes in the health of their loved ones. Witnessing close-up someone’s deterioration and decline in independence, memory or ability to perform routine daily tasks, such as personal care, is a painful experience.</p> <p>It is essential, then, for carers to acknowledge difficult emotions and seek support from those around them – especially because caring for a loved one at the end of their life <a href="https://www.mind.org.uk/information-support/helping-someone-else/carers-friends-family-coping-support/your-mental-health/">can be an isolating time</a>.</p> <p>Where possible, it can also be beneficial for carers to offer their loved one <a href="https://compassionatecommunitiesni.com/our-programs/dying-to-talk/">opportunities to reflect</a> on significant life events, attend to unfinished business, and to discuss preferences for funeral arrangements. For some, this may involve supporting loved ones to reconnect with friends and family, helping them to put legal or financial affairs in order, talking about how the illness is affecting them, or making an <a href="https://www.england.nhs.uk/publication/universal-principles-for-advance-care-planning/">advance care plan</a>.</p> <figure><iframe src="https://www.youtube.com/embed/wrJaTXW1Xvk?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>Talking is key</h2> <p>Living with altered family dynamics, multiple losses, transition and uncertainty can be <a href="https://www.tandfonline.com/doi/full/10.1080/07481187.2021.1998935">distressing for all family members</a>. It may be difficult to manage the emotional strain of knowing death is unavoidable, to make sense of the situation, and to <a href="https://hospicefoundation.ie/i-need-help/i-am-seriously-ill/how-to-talk-to-those-you-care-about/">talk about dying</a>.</p> <p>However, talking is key in <a href="https://www.cruse.org.uk/about/blog/important-conversations-death/">preparing for an impending death</a>. Organisations who offer specialist palliative care have information and trained professionals to help with difficult conversations, including <a href="https://www.mariecurie.org.uk/help/support/diagnosed/talking-children/children">talking to children</a> about death and dying.</p> <p>Navigating anticipatory grief can involve self-compassion for both the patient and carer. This includes acknowledging difficult emotions and treating oneself with kindness. Open communication with the person nearing the end of their life can foster emotional connection and help address their concerns, alongside support from the wider circle of family and friends.</p> <p>Extending empathy and understanding to those nearing death – and those grieving their impending loss – will help contribute to a compassionate community that supports those experiencing death, dying and bereavement.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/221629/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/lisa-graham-wisener-1247893">Lisa Graham-Wisener</a>, Lecturer of Health Psychology, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a> and <a href="https://theconversation.com/profiles/audrey-roulston-1512057">Audrey Roulston</a>, Professor of Social Work in Palliative Care, <a href="https://theconversation.com/institutions/queens-university-belfast-687">Queen's University Belfast</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-mourning-happens-after-bereavement-for-some-grief-can-start-years-before-the-death-of-a-loved-one-221629">original article</a>.</em></p>

Caring

Placeholder Content Image

12 super simple ways to save some cash

<p>Saving money is a lot easier said than done. Whether you’ve got a holiday you’re thinking about taking, or you just want to make day to day life a little less stressful, there is a range of strategies you can employ to put a couple of dimes together. Here are 12 tips to cut costs:</p> <p>1. Don't buy luxury, sometimes the budget brands are just as good and save you heaps.</p> <p>2. Read the junk mail and compare offers because you can get a better deal where you didn't think you could.</p> <p>3. Cut unnecessary expenses and reduce, if possible, the necessary expenses as well.</p> <p>4. Buy used goods, it's cheaper and you can haggle.</p> <p>5. See if you can switch power companies. I'm aware of several people who are saving $250 a year.</p> <p>6. Borrow books and movies from the library or movie store - it's free or low cost compared to buying new and it's fast.</p> <p>7. Barter with family and friends, it's free and everyone wins.</p> <p>8. Take advantage of specials, sales and deals including buying in bulk, it can save you more than you realise.</p> <p>9. Walk, bike or car pool or use other public transport, it's good for the environment and saves you money.</p> <p>10. Shop around for the best deal, it might be better elsewhere.</p> <p>11. Follow insurance company advice: Don't smoke, do have alarms and do get multi policies - it protects you and saves cash.</p> <p>12. Have a savings account with all the savings from this and don't touch it, you will be amazed at what you have saved in a short time.</p> <p><em>Written by John Murphy. Republished with permission of <a href="http://www.stuff.co.nz/" target="_blank" rel="noopener"><strong><span style="text-decoration: underline;">Stuff.co.nz</span></strong></a>.</em></p> <p><em>Image credits: Getty Images </em></p>

Money & Banking

Our Partners