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What’s the difference between ADD and ADHD?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>Around <a href="https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd#:%7E:text=Around%201%20in%20every%2020,have%20symptoms%20as%20an%20adult.">one in 20 people</a> has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.</p> <p>ADHD is <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">diagnosed</a> when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.</p> <p>Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?</p> <p>In short, what was previously called ADD is now known as ADHD. So how did we get here?</p> <h2>Let’s start with some history</h2> <p>The <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">first clinical description</a> of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still <a href="https://pubmed.ncbi.nlm.nih.gov/26740929/">presented</a> a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.</p> <p>Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.</p> <p>The first DSM, published in 1952, did not include a specific related child or adolescent category. But the <a href="https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420355.dsm-ii">second edition</a>, published in 1968, <a href="https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1009310">included a section</a> on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.</p> <p>In the early 1980s, the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">third DSM</a> added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder <em>with</em> hyperactivity (ADDH) and attention deficit disorder as the subtype <em>without</em> the hyperactivity.</p> <p>However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:</p> <ul> <li>predominantly inattentive</li> <li>predominantly hyperactive-impulsive</li> <li>combined.</li> </ul> <h2>Why change ADD to ADHD?</h2> <p>ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.</p> <p>First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">initially named</a>, little research had been done to determine the similarities and differences between the two sub-types.</p> <p>The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?</p> <p>Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours <a href="https://academic.oup.com/shm/article/30/4/767/2919401">may not necessarily be</a> disruptive and challenging but are more likely to be forgetful and daydreamers.</p> <h2>Why do some people use the term ADD?</h2> <p>There was a <a href="https://academic.oup.com/shm/article/30/4/767/2919401">surge of diagnoses</a> in the 1980s. So it’s understandable that some people still hold onto the term ADD.</p> <p>Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.</p> <p>Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.</p> <h2>How is ADHD currently diagnosed?</h2> <p>The three sub-types of ADHD, outlined in the DSM-5 are:</p> <ul> <li> <p>predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions</p> </li> <li> <p>predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control</p> </li> <li> <p>combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.</p> </li> </ul> <p>ADHD diagnoses <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/children-mental-illness">continue to rise</a> among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.</p> <p>However, some international experts <a href="https://academic.oup.com/shm/article/30/4/767/2919401">contest</a> the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.</p> <p>Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.<!-- 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/225162/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/kathy-gibbs-1392051">Kathy Gibbs</a>, Program Director for the Bachelor of Education, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith 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/whats-the-difference-between-add-and-adhd-225162">original article</a>.</em></p> </div>

Mind

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How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<p><a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">La<em>wson R. Wulsin</em></a><em>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a></em></p> <p>COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others.</p> <p>So how much stress is too much, and what can you do about it?</p> <p>I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues.</p> <p>I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.”</p> <p>A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging.</p> <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</span></figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> <p>Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit.</p> <p>Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.”</p> <p>The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface.</p> <p>When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions.</p> <p>For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors.</p> <h2>‘Treating’ stress</h2> <p>Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan.</p> <p>Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure.</p> <p>Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>.</p> <p>Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress.</p> <p>Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses.</p> <h2>Suffering from toxic stress</h2> <p>Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood.</p> <p>Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be.</p> <p>And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all.</p> <p>Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress.</p> <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption><span class="caption">Exercise, meditation and a healthy diet help fight toxic stress.</span></figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> <p>The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>.</p> <p>The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate.</p> <p>Adopting these lifestyle changes is not quick or easy, but it works.</p> <p>The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits.</p> <p>There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<!-- 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/222245/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/lawson-r-wulsin-1493655"><em>Lawson R. Wulsin</em></a><em>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</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/how-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.</em></p>

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What’s the difference between autism and Asperger’s disorder?

<p><em><a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a></em></p> <p>Swedish climate activist Greta Thunberg describes herself as having <a href="https://www.theguardian.com/environment/2019/sep/02/greta-thunberg-responds-to-aspergers-critics-its-a-superpower">Asperger’s</a> while others on the autism spectrum, such as Australian comedian Hannah Gatsby, <a href="https://www.theguardian.com/stage/2022/mar/19/hannah-gadsby-autism-diagnosis-little-out-of-whack">describe</a> themselves as “autistic”. But what’s the difference?</p> <p>Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.</p> <p>Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.</p> <p>When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of <a href="https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder">autism spectrum disorder</a> is made.</p> <h2>Where do the definitions come from?</h2> <p>The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.</p> <p>Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.</p> <p>In 2013, the DSM-5 collapsed both diagnoses into one <a href="https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">autism spectrum disorder</a>.</p> <h2>How did we used to think about autism?</h2> <p>The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.</p> <p>Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.</p> <p>Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.</p> <p>The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.</p> <p>Today, as a legacy of the recognition of the autism itself, the <a href="https://www.aihw.gov.au/reports/disability/autism-in-australia/contents/autism">majority of people</a> diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.</p> <h2>What changed with ‘autism spectrum disorder’?</h2> <p>The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.</p> <p>It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.</p> <p>The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.</p> <p>The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.</p> <h2>Why do some people prefer the old terminology?</h2> <p>Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.</p> <p>The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, <a href="https://xminds.org/resources/Documents/Web%20files/Aspie%20Criteria%20by%20Attwood.pdf">Tony Attwood and Carol Gray</a>, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.</p> <h2>What about identity-based language?</h2> <p>A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.</p> <p>The neurodiversity rights movement describes its aim to <a href="https://researchonline.jcu.edu.au/71531/1/JCU_71531_AAM.pdf">push back</a> against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.</p> <p>The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.</p> <p>However the social model contrasts itself against a very outdated medical or clinical model.</p> <p>Current clinical thinking and practice focuses on <a href="https://www.collegianjournal.com/article/S1322-7696(22)00122-6/fulltext">targeted</a> supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.</p> <p>A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.<!-- 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/223643/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/andrew-cashin-458270">Andrew Cashin</a>, Professor of Nursing, School of Health and Human Sciences, <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/whats-the-difference-between-autism-and-aspergers-disorder-223643">original article</a>.</em></p>

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Supermarket worker finds 2000 Olympics relic between the shelves

<p dir="ltr">A worker at an Aussie supermarket has discovered a relic of Australian culture that is over two decades old. </p> <p dir="ltr">While moving some old shelves in the grocery store as they prepared for renovations, the supermarket worker was shocked to discover a long-expired chocolate bar that was released for the 2000 Sydney Olympics. </p> <p dir="ltr">Posting about the discovery on a Facebook page called Old Shops Australia, a man posted about his wife’s unusual find. </p> <p dir="ltr">“My wife works in a supermarket and they were moving the shelving around and this was stuck between two shelves. Still wrapped up with chocolate inside,” the man said. </p> <p dir="ltr">The 'Sydney 2000 Games Story Block' had the three characters, Syd the platypus, Millie the echidna and Olly the Kookaburra on the front. </p> <p dir="ltr">It also had one of six collectable Olympic Games story book inside the wrapper, with the chocolate expiring on July 30th 2001. </p> <p dir="ltr">Images of the almost-forgotten treat have been circulating online triggering old memories in thousands of Aussies. </p> <p dir="ltr">One person noted the wrapper was made out of paper and foil rather than the plastic used today. </p> <p dir="ltr">Others pointed out the generous size of the chocolate block which is 250g compared to the 180g bars available now. </p> <p dir="ltr">“Oh wow!! This brings back memories!! A near 24 year old block of chocolate!! Would anyone be up for tasting it?! Wonder how much it's worth?! How long since the supermarket had a good clean and update?! So many questions!” one woman asked. </p> <p dir="ltr">“Partly want this to go to a museum, partly just wanna see it unwrapped,” a second wrote.    </p> <p dir="ltr">“Oof, right in the nostalgia,” a third said and another chimed in, “Mouldy as hell. I wonder what the story book looks like.”</p> <p dir="ltr"><em>Image credits: Facebook</em></p>

Food & Wine

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What’s the difference between memory loss and dementia?

<p dir="ltr">When it comes to memory loss, it's normal to become a little more forgetful as we age. </p> <p dir="ltr">However, it’s important to know the difference between a standard level of memory loss, and the early signs of dementia. </p> <p dir="ltr">Researchers at the University of New South Wales (UNSW) say it is crucially important to distinguish between the physical decline of ageing, and the more sinister reality of cognitive decline. </p> <p dir="ltr">Associate Professor Simone Reppermund from the Centre for Healthy Brain Ageing says, “As we age, we get more frail, and it may be difficult to walk longer distances or to have the range of motion to drive a car.”</p> <p dir="ltr">“But that's unrelated to cognitive decline, and this is where dementia or cognitive impairment comes in. A person with dementia at some point will not be able to do the things they once could do without thinking, such as drive a car, because they get confused and are no longer able to process the sensory information required to do this.”</p> <p dir="ltr">Prof. Brodaty went on to say that some cognitive decline is part of normal ageing.</p> <p dir="ltr">“As we age, we become slower in our processing speed. We’re not as good at remembering things, particularly when they’re not able to be logically sorted and connected.”</p> <p dir="ltr">But it’s not all bad for older folks, as some things are known to improve with age.</p> <p dir="ltr">“As we age our vocabulary improves, our judgement improves, our ability to organise things improves. In everyday tests where we can sort, say, 10 grocery items into different categories, we do just as well as the younger person because we can use those strategies to compensate. There is also evidence that we become wiser as we get older.”</p> <p dir="ltr">According to <a href="https://www.dementia.org.au" target="_blank" rel="noopener">Dementia Australia</a>, it’s when people encounter difficulties with the following on a regular basis that there could be some underlying cognitive cause worth investigating. </p> <p dir="ltr">These difficulties include:</p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Trouble remembering recent events</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Trouble finding the right word</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Trouble remembering the day and date</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Forgetting where things are usually kept</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Difficulty adjusting to changes in routine</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Trouble understanding written content or a story on television</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Difficulty following conversations in groups</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Problems handling finances</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Difficulty with everyday activities</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Losing interest in activities that were previously enjoyable</p> </li> </ul> <p dir="ltr">Researchers and medical experts say that even if encountering these difficulties has not become a huge hurdle, it is important to be assessed by a doctor. </p> <p dir="ltr">Some conditions can cause symptoms similar to illnesses of cognitive decline, and can be reversed and prevented if caught early enough. </p> <p dir="ltr">While Professor Brodaty says there is no cure for most types of dementia and no known way to prevent it, we can certainly delay the onset of it. </p> <p dir="ltr">“There are certain risk factors that make it more or less likely to develop cognitive decline and dementia, including physical and social inactivity. Being inactive, not engaging in social activities, a poor diet and too much alcohol are all risk factors.”</p> <p dir="ltr">Even then, Professor Brodaty says, “it’s never too late to start, and never too early to start” making changes that maintain and protect your brain health into old age.</p> <p dir="ltr"><em>Image credits: Getty Images</em></p> <p> </p>

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Heated argument between economy passengers reignites plane etiquette debate

<p>A 12-second clip of two passengers arguing on a plane has reignited the age-old debate of whether it is acceptable to recline your seat on a plane. </p> <p>The viral video which was originally posted on TikTok and then re-shared on X, has racked up over 8 million views since Thursday. </p> <p>In the video, a frustrated woman was calling out another female passenger for pushing her seat the entire flight, right after they landed. </p> <p>“The whole trip she pushed my seat,” the woman said to a male passenger seated next to the female passenger accused of kicking her seat. </p> <p>“You seen it. You know she did.”</p> <p>“I’m allowed to put my seat back," she yelled repeatedly. </p> <p>Ian Miles Cheong, the user who posted the video on X, defended the woman saying: “She’s allowed to put her seat back. You don’t get to kick it repeatedly just because you want more space.”</p> <p>A few were on the woman's side and praised her for standing up for herself. </p> <p>“You are allowed! Period! You want space in front of you instead of pushing the seat, buy a seat with extra space or get your a** to business class. Reclining was put there for a reason,” one person wrote. </p> <p>“She was patient enough to wait till flight landed," they added. </p> <p>“If the seat is reclinable, recline it,” another commented. </p> <p>"What she’s saying is right. The woman has a right to put her seat back without someone kicking it," a third agreed.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">She’s allowed to put her seat back. You don’t get to kick it repeatedly just because you want more space. <a href="https://t.co/WELD7Qh4Re">pic.twitter.com/WELD7Qh4Re</a></p> <p>— Ian Miles Cheong (@stillgray) <a href="https://twitter.com/stillgray/status/1719881310351863952?ref_src=twsrc%5Etfw">November 2, 2023</a></p></blockquote> <p>However, others claimed that there was an unwritten rule that you shouldn't recline your seat, especially on a short-haul flight, adding that the recline feature should be scrapped from airplanes. </p> <p>“Putting your seat back in coach is an unspoken thing most people don’t do. It’s really the airline’s fault because they’ve made coach so cramped and tight that putting the seat back shouldn’t even be an option,” one commented. </p> <p>“Airline seats simply shouldn’t be able to recline. It intrudes on the already very little space a person has on the plane for the person behind them,” another added. </p> <p>“Really it’s the airline’s fault for cramming so many people in such a small space. They don’t call it cattle class for nothing,” a third wrote. </p> <p>One user understood both sides of the argument, and blamed the airlines for making the seats so cramped. </p> <p>"It can be annoying sometimes to be behind someone with their seat all the way, but if the airlines didn't want to allow that, it wouldn't happen," they wrote.</p> <p>"You don't kick the seat like a baby. Blame the airline, not the person doing what the airline says is fine." </p> <p><em>Images: Twitter</em></p>

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How biological differences between men and women alter immune responses – and affect women’s health

<p><a href="https://theconversation.com/profiles/helen-mcgettrick-1451122">Helen McGettrick</a>, <em><a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a></em> and <a href="https://theconversation.com/profiles/asif-iqbal-1451123">Asif Iqbal</a>, <em><a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a></em></p> <p>Most people will have heard the term “man flu”, which refers to men’s perceived tendency to exaggerate the severity of a cold or a similar minor ailment.</p> <p>What most people may not know is that, generally speaking, women mount stronger <a href="https://pubmed.ncbi.nlm.nih.gov/36121220/">immune responses</a> to infections than men. Men are <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005374">more susceptible</a> to infections from, for example, HIV, hepatitis B, and <em>Plasmodium falciparum</em> (the parasite responsible for malaria).</p> <p>They can also have more severe symptoms, with evidence showing they’re more likely to be <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005374">admitted to hospital</a> when infected with hepatitis B, tuberculosis, and <em>Campylobacter jejuni</em> (a bacteria that causes gastroenteritis), among others.</p> <p>While this may be positive for women in some respects, it also means women are at <a href="https://www.nature.com/articles/nri2815">greater risk</a> of developing chronic diseases driven by the immune system, known as immune-mediated inflammatory diseases.</p> <p>Here we will explore how biological factors influence immune differences between the sexes and how this affects women’s health. While we acknowledge that both sex and gender may affect immune responses, this article will focus on biological sex rather than gender.</p> <h2>Battle of the sexes</h2> <p>There are differences <a href="https://www.nature.com/articles/nri.2016.90">between the sexes</a> at every stage of the immune response, from the number of immune cells, to their degree of activation (how ready they are to respond to a challenge), and beyond.</p> <p>However, the story is more complicated than that. Our immune system evolves throughout our lives, learning from past experiences, but also responding to the physiological challenges of getting older. As a result, <a href="https://www.nature.com/articles/nri.2016.90">sex differences</a> in the immune system can be seen from birth through puberty into adulthood and <a href="https://academic.oup.com/jleukbio/advance-article/doi/10.1093/jleuko/qiad053/7190870">old age</a>.</p> <p>Why do these differences occur? The first part of answering this question involves the X chromosome. Females have two X chromosomes, while males have one X and one Y chromosome. The <a href="https://pubmed.ncbi.nlm.nih.gov/20651746/">X chromosome</a> contains the largest number of immune-related genes.</p> <p>The X chromosome also has <a href="https://link.springer.com/article/10.1007/s00018-020-03526-7">around 118 genes</a> from a gene family that are able to stop the expression of other genes, or change how proteins are made, including those required for immunity. These gene-protein regulators are known as microRNA, and there are only <a href="https://pubmed.ncbi.nlm.nih.gov/24808907/">two microRNA genes</a> on the Y chromosome.</p> <p>The X chromosome has <a href="https://www.genome.gov/about-genomics/fact-sheets/X-Chromosome-facts">more genes overall</a> (around 900) than the Y chromosome (around 55), so female cells have evolved to switch off one of their X chromosomes. This is not like turning off a light switch, but more like using a dimmer.</p> <p>Around <a href="https://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-019-5507-6">15-25% of genes</a> on the silenced X chromosome are expressed at any given moment in any given cell. This means female cells can often express more immune-related genes and gene-protein regulators than males. This generally means a faster clearance of pathogens in females than males.</p> <p>Second, men and women have <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2020.604000/full">varying levels</a> of different sex hormones. Progesterone and testosterone are broadly considered to limit immune responses. While both hormones are produced by males and females, progesterone is found at higher concentrations in non-menopausal women than men, and testosterone is much higher in men than women.</p> <p>The role of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533072/">oestrogen</a>, one of the main female sex hormones, is more complicated. Although generally oestrogen <a href="https://www.sciencedirect.com/science/article/abs/pii/S000887491500026X?via%3Dihub">enhances immune responses</a>, its levels vary during the menstrual cycle, are high in pregnancy and low after menopause.</p> <p>Due in part to these genetic and hormonal factors, pregnancy and the years following are associated with heightened immune responses to external challenges such as infection.</p> <p>This has been regarded as an <a href="https://www.nature.com/articles/nri.2016.90">evolutionary feature</a>, protecting women and their unborn children during pregnancy and enhancing the mother’s survival throughout the child-rearing years, ultimately ensuring the survival of the population. We also see this pattern in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628977/">other species</a> including insects, lizards, birds and mammals.</p> <h2>What does this all mean?</h2> <p>With women’s heightened immune responses to infections comes an increased risk of certain diseases and prolonged immune responses after infections.</p> <p>An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328995/">estimated 75-80%</a> of all immune-mediated inflammatory diseases <a href="https://pubmed.ncbi.nlm.nih.gov/32542149/">occur in females</a>. Diseases more common in women include multiple sclerosis, <a href="https://www.nature.com/articles/nri2815">rheumatoid arthritis</a>, lupus, Sjogren’s syndrome, and <a href="https://www.nature.com/articles/nri.2016.90">thyroid disorders</a> such as Graves disease.</p> <p>In these diseases, the immune system is continuously fighting against what it sees as a foreign agent. However, often this perceived threat is not a foreign agent, but cells or tissues from the host. This leads to tissue damage, pain and immobility.</p> <p>Women are also prone to chronic inflammation following infection. For example, after infections with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818468/">Epstein Barr virus</a> or <a href="https://www.liebertpub.com/doi/10.1089/jwh.2008.1193">Lyme disease</a>, they may go on to develop <a href="https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/">chronic fatigue syndrome</a>, another condition that affects more women than men.</p> <p>This is one possible explanation for the heightened risk among <a href="https://www.frontiersin.org/articles/10.3389/fresc.2023.1122673/full">pre-menopausal women</a> of developing long COVID following infection with SARS-CoV-2, the virus that causes COVID.</p> <p>Research has also revealed the presence of auto-antibodies (antibodies that attack the host) in patients with long COVID, suggesting it might be an <a href="https://www.sciencedirect.com/science/article/pii/S1568997221000550">autoimmune disease</a>. As women are more susceptible to autoimmune conditions, this could potentially explain the sex bias seen.</p> <p>However, the exact causes of long COVID, and the reason women may be at greater risk, are yet to be defined.</p> <p>This paints a bleak picture, but it’s not all bad news. Women typically mount <a href="https://pubmed.ncbi.nlm.nih.gov/24966191/">better vaccine responses</a> to several common infections (for example, influenza, measles, mumps, rubella, hepatitis A and B), producing higher antibody levels than men.</p> <p>One study showed that women vaccinated with half a dose of flu vaccine produced the same amount of antibodies compared to men vaccinated with <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/773453">a full dose</a>.</p> <p>However, these responses <a href="https://www.nature.com/articles/nri.2016.90">decline as women age</a>, and particularly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954964/">after menopause</a>.</p> <p>All of this shows it’s vital to consider sex when designing studies examining the immune system and treating patients with immune-related diseases.<!-- 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/208802/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/helen-mcgettrick-1451122">Helen McGettrick</a>, Reader in Inflammation and Vascular Biology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> and <a href="https://theconversation.com/profiles/asif-iqbal-1451123">Asif Iqbal</a>, Associate Professor in Inflammation Biology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</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/how-biological-differences-between-men-and-women-alter-immune-responses-and-affect-womens-health-208802">original article</a>.</em></p>

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How a garden hose dispute between neighbours ended with a 30-year jail sentence

<p>An Aussie man has been sentenced to 30 years in jail after shooting two of his neighbours, in a months-long dispute that began over a disagreement over a garden hose. </p> <p>Rodney John Lee, a 74-year-old from Melbourne's south-east, was sentenced to 30 years behind bars in court on Monday, after showing little remorse for pulling out a shotgun and murdering Saumoto Gasio and Tibor Laszlo, who lived in the same unit block. </p> <p>The dispute between the neighbours began several months ago, with tensions escalating quickly in the lead up to the shooting, which occurred on January 13th 2022. </p> <p>Lee had accused one neighbour's grandson of being a drug dealer, and was angry others would turn off a hose he used to water a communal garden.</p> <p>On the day of the killings, Lee left the hose running and went inside his apartment, later screaming in anger when he realised that the water had been shut off.</p> <p>According to court documents, Lee yelled to his neighbours, "You turn the hose off again you bastards, I'll f***ing kill you."</p> <p>Later that night, Lee confronted residents in the garden when he got into an argument with Mr Gasio, who told him he would ignore demands about the hose because he was wasting water by leaving the hose running unattended.</p> <p>Lee then went back to his apartment and armed himself with his grandfather's shotgun, before he headed back to the group and from close range fired at Mr Gasio, who was sitting on a bench.</p> <p>Other residents of the building fled the scene looking for safety, while a badly injured Mr Gasio stumbled into a neighbour's unit. </p> <p>As neighbours tried to help Mr Gasio, Lee came through the door and fired the shotgun again, this time hitting Mr Laszlo.</p> <p>Both men died at the scene.</p> <p>Before handing down the sentencing, Justice James Elliott described the killer's actions as "senseless and brutally violent".</p> <p>"Nothing could justify the disproportionate, senseless and brutally violent way in which you responded," Justice Elliott said.</p> <div data-component="EmphasisedText"> <p>"You murdered two people in their places of residence, where they were entitled to feel safe, in the presence of other residents of the unit complex."</p> </div> <p>"Both victims were completely defenceless against you."</p> <p>Lee is likely to die in jail,  as h<span style="font-family: abcsans, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size: 16px;">e will be aged 97 by the time he is eligible for parole in early 2046.</span></p> <p class="paragraph_paragraph__3Hrfa" style="font-size: 16px; box-sizing: border-box; font-family: abcsans, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif;">"You'll almost certainly be imprisoned for the remainder of your life," Justice Elliott said.</p> <p class="paragraph_paragraph__3Hrfa" style="font-size: 16px; box-sizing: border-box; font-family: abcsans, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif;"><em>Image credits: ABC News</em></p>

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Bees have appeared on coins for millennia, hinting at an age-old link between sweetness and value

<p><em><a href="https://theconversation.com/profiles/adrian-dyer-387798">Adrian Dyer</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>In 2022, the Royal Australian Mint issued a $2 coin decorated with honeybees. Around 2,400 years earlier, a mint in the kingdom of Macedon had the same idea, creating a silver obol coin with a bee stamped on one side.</p> <p>Over the centuries between these two events, currency demonstrating a symbolic link between honey and money is surprisingly common.</p> <p>In a recent study in <a href="https://s3.ap-southeast-2.amazonaws.com/assets.mmxgroup.com.au/ACR/Bee+Article.pdf">Australian Coin Review</a>, I trace the bee through numismatic history – and suggest a scientific reason why our brains might naturally draw a connection between the melliferous insects and the abstract idea of value.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&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/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">A Royal Australian Mint 2022 two-dollar coin representing 200 years since the introduction of the honeybee to Australia.</span></figcaption></figure> <h2>What is currency and why is it important?</h2> <p>Money is a store of value, and can act as a medium of exchange for goods or services. Currency is a physical manifestation of money, so coins are a durable representation of value.</p> <p>Coins have had central role in many communities to enable efficient trade since ancient times. Their durability makes them important time capsules.</p> <p>Ancient Malta was famous for its honey. The modern 3 Mils coin (<a href="https://en.numista.com/catalogue/pieces1775.html">1972-81</a>) celebrates this history with images of a bee and honeycomb. According to the information card issued with the coin set,</p> <blockquote> <p>A bee and honeycomb are shown on the 3 Mils coin, symbolising the fact that honey was used as currency in Ancient Malta.</p> </blockquote> <figure class="align-center "><img src="https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&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/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=582&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=582&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=582&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=732&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=732&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=732&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">A circulating 3 Mils coin from Malta showing a honeybee on honeycomb.</span></figcaption></figure> <p>In ancient Greece, bees were used on some of the earliest coins made in Europe. A silver Greek obol coin minted in Macedon between 412 BCE and 350 BCE, now housed in the British Museum, shows a bee on one side of the coin.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&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/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=293&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=293&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=293&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=368&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=368&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=368&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">An ancient obol from Macedon, dated between 412 BCE and 350 BCE, shows a bee one side.</span></figcaption></figure> <p>Bees also feature on coins minted elsewhere in the ancient Greek world, such as a bronze coin minted in Ephesus dated between 202 BCE and 133 BCE.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&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/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=546&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=546&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=546&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=686&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=686&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=686&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">A bronze coin minted in Ephesus, dated between 202BCE and 133BCE, featuring a honeybee.</span></figcaption></figure> <p>The use of bees on ancient coins extended for many centuries including widely circulated bronze coins, and new varieties <a href="https://coinweek.com/bee-all-that-you-can-bee-honeybees-on-ancient-coins/">continue to be discovered</a>.</p> <h2>Why we might like bees on coins</h2> <p>Why have bees appeared so often on coins? One approach to this question comes from the field of neuro-aesthetics, which seeks to understand our tastes by understanding the basic brain processes that underpin aesthetic appreciation.</p> <p>From this perspective, it seems likely the sweet taste of honey – which indicates the large amount of sugar it delivers – promotes positive neural activity <a href="https://brill.com/view/journals/artp/10/1/article-p1_2.xml">associated with bees and honey</a>.</p> <p>Indeed, primatologist Jane Goodall once proposed that obtaining high-calorie nutrition from bee honey may have been <a href="https://www.sciencedirect.com/science/article/abs/pii/S0066185668800032">an important step</a> in the cognitive development of primates.</p> <p>Our brain may thus be pre-adapted to liking bees due to their association with the sweet taste of honey. Early usage of bees on coins may have been a functional illustration of the link between a known value (honey) and a new form of currency: coins as money.</p> <h2>The bee on modern coins</h2> <figure class="align-center "><img src="https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&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/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=588&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=588&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=588&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=738&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=738&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=738&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">A 1920 Italian bronze ten-centesimi coin featuring featuring an Italian honeybee on a flower.</span></figcaption></figure> <p>The use of bees as a design feature has persisted from ancient to modern times. A honeybee visiting a flower is shown on a series of ten-centesimi bronze coins issued in Italy from <a href="https://en.numista.com/catalogue/pieces1960.html">1919 to 1937</a>.</p> <p>(As an aside, the world’s last stock of pure Italian honeybees is found in Australia, on Kangaroo Island, which was declared a sanctuary for Ligurian bees by an <a href="https://www.legislation.sa.gov.au/home/historical-numbered-as-made-acts/1885/0342-Lingurian-Bees-Act-No-342-of-48-and-49-Vic,-1885.pdf">act of parliament</a> in 1885.)</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&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/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=586&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=586&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=586&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=737&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=737&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=737&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">A coin from Tonga showing 20 honeybees emerging from a hive.</span></figcaption></figure> <p>More recently, a 20-seniti coin from the Pacific nation of Tonga shows 20 honeybees flying out of a hive. This coin was part of a series initiated by the Food and Agriculture Organization of the United Nations to promote sustainable agricultural and cultural development around the world.</p> <p>Bees are relevant here because their pollinating efforts contribute to about one-third of the food required to feed the world, with a value in excess of <a href="https://zenodo.org/record/2616458">US$200 billion per year</a>, and they are threatened by climate change and other environmental factors.</p> <h2>Bees on coins, today and tomorrow</h2> <p>Public awareness of bees and environmental sustainability may well be factors in the current interest in bee coins. The diversity of countries using bees as a design feature over the entire history of coins suggests people have valued the relationship with bees as essential to our own prosperity for a long time.</p> <p>In Australia, the 2022 honeybee $2 coin is part of a series developed by the <a href="https://www.ramint.gov.au/about-mint">Royal Australian Mint</a>. In 2019, the Perth Mint in Western Australia also released coins and stamps celebrating native bees.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&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/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=373&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=373&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=373&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=469&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=469&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=469&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">Australian native bee coin and stamps released in 2019 by the Perth Mint.</span></figcaption></figure> <p>Despite the decline of cash, bee coins still appear to be going strong. The buzzing companions of human society are likely to be an important subject for coin design for as long as coins continue to be used.<!-- 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/208912/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/adrian-dyer-387798">Adrian Dyer</a>, Associate Professor, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Australian Royal Mint / NZ Post Collectables</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/bees-have-appeared-on-coins-for-millennia-hinting-at-an-age-old-link-between-sweetness-and-value-208912">original article</a>.</em></p>

Money & Banking

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Bombshell twist in split between Australia's richest couple

<p>Just days after announcing their separation, there has been a bombshell twist in the split between Australia's richest couple Andrew and Nicola Forrest. </p> <p>The couple, who were married for 31 years and have a shared fortune of $32 billion, <a href="https://oversixty.com.au/lifestyle/relationships/australia-s-richest-couple-call-it-quits" target="_blank" rel="noopener">confirmed their separation</a> in a joint statement on Wednesday after living apart for months.</p> <p>During those months apart, it has been revealed that Andrew's own mining company investigated allegations he had a secret relationship with an employee.</p> <p>The board of Mr Forrest's company Fortescue Metals Group became aware of an anonymous letter that made allegations against the mining billionaire while the Forrests were figuring out their separation. </p> <p>The board contacted an outside law firm to investigate claims made in the letter about the behaviour of the executive chairman towards a lower level employee. </p> <p>The Australian Financial Review reported the investigation included a review of whether he had a relationship with an employee at the mining company, with the investigation concluding that the allegations were unsubstantiated.</p> <p>"The directors of Fortescue became aware of an anonymous letter concerning the behaviour of the executive chairman," Fortescue Metals said in a statement.</p> <p>"The board immediately met and engaged Seyfarth Shaw LLP, to independently investigate the letter and provide a report. Seyfarth Shaw LLP provided a full report to the board."</p> <p>"The investigation concluded that none of the matters in the letter were substantiated. There were no adverse findings."</p> <p>It added that Mr Forrest was excluded from the investigation as "it related to him".</p> <p>Fortescue went on to say that the report in full would not be released to shareholders or to the public.  </p> <p>The revelations the investigation emerged just days after Andrew and Nicola announced their separation. </p> <p>"After 31 years of marriage, we have made the decision to live apart," the couple said in a joint statement.</p> <p>"Our friendship and commitment to our family remains strong."</p> <p><em>Image credits: Getty Images </em></p>

Legal

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What is the difference between the laws of cricket and the ‘spirit’ of cricket?

<p><em><a href="https://theconversation.com/profiles/vaughan-cruickshank-396715">Vaughan Cruickshank</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a></em></p> <p>The second Ashes Test ended in tense scenes on Sunday following the controversial dismissal of English batsman Jonny Bairstow. His stumping infuriated a pro-England crowd at the famous Lord’s ground and divided the cricketing world.</p> <p>While the Australians would no doubt have preferred to win with less controversy, did they actually do anything wrong?</p> <p>In answer to that question, it’s widely accepted, even by the English team, that his dismissal was within the laws of cricket. But critics then invoked the “spirit of cricket” to suggest the Australians should not have asked for the dismissal to be upheld. So what is the difference?</p> <p>The <a href="https://www.lords.org/mcc/the-laws-of-cricket">laws of cricket</a> detail the rules of the game of cricket worldwide. They have been owned and maintained by the Marylebone Cricket Club (MCC) in London for over 200 years.</p> <p>The rules are clear and the many English fans and past players, along with the <a href="https://www.foxsports.com.au/cricket/the-ashes/ashes-2023-jonny-bairstow-stumped-by-alex-carey-cricket-rule-explained-was-he-out-was-the-decision-right-second-test-at-lords-reaction-news/news-story/41f36dc48a1515effb69a5c18acccf5a">current captain and coach</a>, have acknowledged the umpires were correct according to those laws.</p> <p>That’s when we get to the “spirit”. Since the late 1990s, the laws of cricket have also had an introductory statement or preamble. It states that cricket should be played not only according to the laws, <a href="https://www.lords.org/mcc/the-laws-of-cricket/spirit-of-cricket">but also in the “spirit of cricket”</a>“.</p> <p>This preamble is aimed at reminding players and officials of their responsibility for ensuring cricket is played <a href="https://www.lords.org/mcc/the-laws-of-cricket/spirit-of-cricket">in a truly sportsmanlike manner</a>.</p> <p>The two captains have the main responsibility for ensuring the spirit of fair play is upheld. This primarily involves making sure players show respect for other players, officials and the traditional values of cricket. It is against the spirit of the game to do things such as dispute an umpire’s decision, verbally or physically abuse a player or umpire, or cheat.</p> <p>The problem is the "spirit of cricket” is a subjective and slightly hazy concept. Respected English cricket writers have even suggested it has not existed since 1882, using an <a href="https://www.telegraph.co.uk/cricket/2023/07/04/the-ashes-cheating-bairstow-spirit-of-cricket-tradition/">example of conduct</a> by the “father of cricket”, W.G. Grace himself.</p> <p>While cricket is united under its laws, cricket is a global game and the idea of the “spirit” differs around the world. Consequently, opinions about Bairstow’s dismissal have been highly polarised. Many English players and fans are very angry at what has occurred, accusing Australia of going against the “spirit of cricket”. The fact they narrowly lost the match no doubt intensified this feeling.</p> <p>Their anger is reflected in the front-page stories in <a href="https://twitter.com/cric_blog/status/1675808745656573954">numerous English newspapers</a> and in social media posts. Twitter has had tens of thousands of tweets under trending hashtags such as #Ashes, #Bairstow and #SpiritofCricket.</p> <p>Interestingly, a look at these hashtags also reveal numerous accusations of hypocrisy by the English, backed up with <a href="https://www.nzherald.co.nz/sport/ashes-cricket-2023-eight-times-england-broke-the-spirit-of-cricket-as-bairstow-incident-ignites/52QFZT4ES5FG5OUBZMUKGJHEYI/">examples</a> of England’s questionable, and sometimes very similar, conduct. These examples have included central figures such as English players <a href="https://twitter.com/BigOtrivia/status/1675643613689311232">Stuart</a> <a href="https://twitter.com/MitchellGlenn/status/1675685369898242048">Broad</a>, <a href="https://twitter.com/1116sen/status/1676076294306689026">Jonny</a> <a href="https://twitter.com/TonyIKnow/status/1676246531387846657">Bairstow</a> and coach <a href="https://www.foxsports.com.au/cricket/the-ashes/cant-reward-stupidity-brendan-mccullums-words-come-back-to-bite-him/news-story/b4f114547671fa325b11a3acef806ae2">Brendon McCullum</a>.</p> <p>Additionally, the only player who has been fined for displaying <a href="https://www.icc-cricket.com/media-releases/3542860">conduct contrary</a> to the spirit of the game in this Ashes series is English player Moeen Ali.</p> <p>Former Australian captain Ricky Ponting noted that a key part of the spirit of cricket was <a href="https://www.foxsports.com.au/cricket/the-ashes/ashes-2023-cricket-news-ricky-ponting-hits-out-at-ben-stokes-response-to-lords-furore/news-story/cd9859c2dfc32c007e6e9c76a22136be">respecting the umpire’s decision</a>, which in this instance he said the English players, fans and press had not. Indeed, several MCC members have been <a href="https://www.bbc.com/sport/cricket/66082409">suspended</a> over their abuse of Australian cricketers returning to their dressing room.</p> <figure><iframe src="https://www.youtube.com/embed/Yiuo50uCL9s?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>Perhaps the key lesson that both sides could learn can be encapsulated in the old saying that people who live in glass houses shouldn’t throw stones, particularly in the modern age when evidence can be quickly <a href="https://www.thechronicle.com.au/sport/cricket/jonny-bairstow-footage-all-but-silences-englands-spirit-of-the-game-debate/news-story/4a4b6d8f9ce801fb23169e6d8c87a5f3">found on the internet</a>.</p> <p>Neither country has a clean slate when it comes to the “spirit of cricket”. Both should be careful about trying to take the moral high ground. Trevor Chappell’s <a href="https://www.heraldsun.com.au/sport/cricket/icc-world-cup-2015/when-trevor-chappell-rolled-the-ball-down-the-pitch-to-brian-mckechnie-he-did-the-kiwis-a-favour/news-story/9e6cdec155f23674f3abf0629a96abaa">underarm bowl</a> is one of the most infamous Australian examples, still remembered over 40 years later.</p> <p>Bairstow’s dismissal is the most recent controversy and unlikely to be the last.</p> <p>As the Australian team heads to Leeds for the third Test starting on Thursday, there are concerns tensions could boil over, on and off the field. Leeds is known for its raucous atmosphere. Cricket Australia has <a href="https://www.theage.com.au/national/australia-news-live-rba-interest-rates-joko-widodo-pwc-scandal-20230704-p5dlpf.html?post=p54ztv">increased security</a> for the Australian team and reportedly told players to remain <a href="https://au.sports.yahoo.com/cricket-ashes-jonny-bairstow-stumping-controversy-exposes-worrying-aussie-truth-014432845.html">extra vigilant</a> when dining out in restaurants during the remaining weeks of the Ashes.</p> <p>We may never get complete agreement on the “spirit of cricket” and whether the Australians breached it on this occasion. Perhaps the closest we can get is to agree with former Australian bowler and Yorkshire coach Jason Gillespie, who <a href="https://www.dailymail.co.uk/sport/cricket/article-12256795/Mail-Sports-experts-weigh-controversial-stumping-Englands-second-Test-defeat.html">believes</a> that "by playing within the laws of the game you are playing within the spirit of the game."</p> <p>Let’s hope the remainder of the series sees a cooling of tensions and more focus on the last three Tests being <a href="https://www.lords.org/mcc/the-laws-of-cricket/preamble-to-the-laws-spirit-of-cricket">played hard but fair</a>, without reigniting “spirit of cricket” debates that no one wins.<!-- 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/209124/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/vaughan-cruickshank-396715">Vaughan Cruickshank</a>, Program Director – Health and Physical Education, Maths/Science, Faculty of Education, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</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/what-is-the-difference-between-the-laws-of-cricket-and-the-spirit-of-cricket-209124">original article</a>.</em></p>

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Between nostalgia and amnesia: the legacy of Julia Gillard as PM, 10 years after her ousting

<p><em><a href="https://theconversation.com/profiles/joshua-black-729708">Joshua Black</a>, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National University</a></em></p> <p>On June 26 2013, as she fronted the press gallery in Canberra after her removal as leader of the Labor Party, Julia Gillard was determined not to cry. In her prime ministerial <a href="https://www.youtube.com/watch?v=G0uhHuEw8LY">resignation speech</a>, she asked not for pity, but rather for a meaningful national conversation about gender and politics, specifically the politics of her demise.</p> <p>"It doesn’t explain everything; it doesn’t explain nothing. It explains some things. And it is for the nation to think in a sophisticated way about those shades of grey."</p> <p>Ten years after the fact, that conversation is ongoing. At times, it has been a progressive and sophisticated one. The events of recent weeks, including the puerile debate about Katy Gallagher’s <a href="https://www.theage.com.au/national/gallagher-faces-censure-motion-20230622-p5dirm.html">prior knowledge</a> of Brittany Higgins’ sexual assault allegations, and the <a href="https://www.abc.net.au/news/2023-06-15/peter-dutton-dumps-senator-david-van-from-liberal-party-room/102481814">allegations</a> against Senator David Van, remind us there is still a long way to go.</p> <p>However, it is worth pausing to reflect on what has happened to Gillard’s reputation over the decade. Why has it thrived? Is it all about gender? And if we have forgotten key aspects of the Gillard years, what does that partial amnesia say about us?</p> <h2>From ‘Juliar’ to feminist icon</h2> <p>For much of her premiership, Gillard was singularly unpopular among Australian voters. Her efforts to put a price on carbon (damned by critics as a broken promise not to introduce a carbon tax) proved electorally damaging, as did her failure to end the deadlock over asylum-seeker policy. <a href="https://www.smh.com.au/politics/federal/a-line-has-been-crossed-gillard-acts-on-thomson-and-slipper-20120429-1xsiz.html">Controversies</a> surrounding Labor MP Craig Thompson and Speaker Peter Slipper (selected for the role by Gillard) further undermined her standing.</p> <p>There was much sexism at play. Her critics incessantly argued this was a woman not to be trusted. Critics of carbon pricing infamously dubbed her “Juliar” on their angry placards. Her body was objectified in the public domain, and the shock jocks of commercial radio questioned the sexuality of her then partner.</p> <p>One commentator, the irascible Alan Jones, <a href="https://www.youtube.com/watch?v=hsaVpepMyA8">even suggested</a> the prime minister ought to be “put in a chaff bag” and drowned at sea. The shocking thing is not that these things were said, but rather that they were accepted as legitimate contributions to public debate by the community at large.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&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/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=399&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=399&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=399&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=502&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=502&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/533611/original/file-20230623-24-4cz05p.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=502&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">The language used to criticised Gillard was often deeply sexist, and opposition politicians often did little to discourage it.</span> <span class="attribution"><span class="source">Alan Porritt/AAP</span></span></figcaption></figure> <p>Stories about Gillard’s <a href="https://www.theguardian.com/australia-news/2014/oct/31/julia-gillard-did-not-commit-any-inquirys-counsel-assisting-says">alleged corruption</a> as a lawyer in Perth in the early 1990s also proved a distraction from the government’s agenda. Not until 2014 – in the witness box of a royal commission, no less – was Gillard finally able to clear her name.</p> <h2>The misogyny speech</h2> <p>The passage of time can make things seem as if they always were as they are now. But Gillard’s renowned <a href="https://www.youtube.com/watch?v=ihd7ofrwQX0">misogyny speech</a> was not an instant sensation in Australia. The context – a censure motion on the disgraced speaker Peter Slipper – was unpropitious, and when Gillard made her speech, the conservative press called her a hypocrite who now played the <a href="https://www.smh.com.au/politics/federal/gillard-reveals-true-nature-in-playing-gender-card-20121010-27cnq.html">“gender card”</a> for political expediency.</p> <p>The speech’s global impact was immediate, but only after Gillard’s removal from power did it capture the hearts and minds of some Australians. New developments – the sexist attacks on US presidential candidate Hillary Clinton in 2016, the #MeToo movement beginning in 2017, and latterly the backlash against gendered discrimination and abuse in parliament house – gave it further acuity in the following years.</p> <p><iframe title="YouTube video player" src="https://www.youtube.com/embed/ihd7ofrwQX0" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></p> <p>A decade after its muted reception in Canberra, the speech is circulated on TikTok, featured in stage productions, and in 2020 it was even voted Australia’s most <a href="https://www.theguardian.com/tv-and-radio/2020/feb/07/julia-gillard-misogyny-speech-voted-most-unforgettable-moment-in-australian-tv-history">“unforgettable” television moment</a>.</p> <p>Though not always enamoured with the way it dominated her political legacy, Gillard ultimately leaned in to it, as the saying goes. She started a podcast called A Podcast of One’s Own (a clear nod to Virginia Woolf), published two books about women and leadership, and established the Global Institute for Women’s Leadership at King’s College London, and latterly the Australian National University.</p> <h2>Star status</h2> <p>As prime minister, Gillard was regularly criticised for her “wooden” media appearances and her cautious approach to public engagement. It is ironic, then, that her transformation from untrustworthy politician to venerable feminist advocate depended on the media and celebrity industries.</p> <p>It began with a series of ticketed <a href="https://www.youtube.com/watch?v=ZoCpHkPr8lE">public talks</a> in venues such as the Sydney Opera House with longstanding feminist advocate, author and historian Anne Summers. Gillard’s memoir, <a href="https://www.penguin.com.au/books/my-story-9781760893330">My Story</a>, and a high-profile book tour followed in 2014.</p> <p>In her advocacy work as chair of the Global Partnership for Education she also rubbed shoulders with celebrities such as <a href="https://www.vogue.com.au/celebrity/interviews/rihanna-and-julia-gillard-the-unlikely-friendship-between-a-global-superstar-and-our-former-prime-minister/news-story/3263d3e95e6d9780c0535b8cfea8840d">Rihanna</a>.</p> <h2>The policy legacy</h2> <p>Several of the Rudd-Gillard government’s policy initiatives were unravelled by their successors. The <a href="https://www.abc.net.au/news/2011-07-10/gillard-reveals-carbon-price-scheme/2788842">$23-per-tonne carbon price</a> was repealed by Tony Abbott’s government, as was the (clearly deficient) <a href="https://treasury.gov.au/sites/default/files/2019-03/FOI_2247.pdf">Minerals Resource Rent Tax</a>. The National Broadband Network, the rollout of which began under Gillard, was dramatically reimagined by Malcolm Turnbull as communications minister and then as prime minister.</p> <p>Some of the less-savoury aspects of Gillard policy legacy have been forgotten for more convenient reasons. Gillard herself has not often discussed her government’s revival of mandatory offshore processing for asylum seekers in Australia. The cutting of the <a href="https://theconversation.com/how-julia-gillard-forever-changed-australian-politics-especially-for-women-138528">single parents’ benefit</a>, on the very same day as Gillard’s misogyny speech, has earned perhaps not enough discussion. It is her <a href="https://www.abc.net.au/news/2023-05-16/julia-gillard-same-sex-marriage-feminism-debate/102290962">failure to support</a> same-sex marriage as prime minister that now draws the most condemnation from pundits.</p> <p>But policy legacies have also played a huge part in the revival of Gillard’s public standing. The Royal Commission into Child Sexual Abuse in Institutional Settings was a hugely important initiative. It earned Gillard significant credit across the political spectrum when its findings proved so damning.</p> <p>The NDIS, largely overlooked in media coverage in favour of “carbon tax” and “deficit”, has become a sacred element in Australian social and welfare policy. The subsequent policy debate has not hinged on the design of the scheme, but rather how best to fund it.</p> <h2>Between nostalgia and amnesia</h2> <p>There is a dissonance in the way Australians talk about Gillard today. Her magnanimity is respected, her embrace of a life after politics admired. Above all else, Gillard’s status as Australia’s first woman prime minister and now a global women’s ambassador prevails. As a rule, she does not parade her views on contemporary politics before the public, except at a conceptual level. (Her memoir was perhaps the exception.)</p> <p>But when commentators refer to the decade of egos, ambitions and failed leaders, they are increasingly likely to elide her name entirely. It is a disservice to the historical record, and to Gillard herself. She was a fierce combatant in parliament, and endured a period of intense conflict within the Labor Party. Her victory over Kevin Rudd in February 2012 – one of their many spills and shadow contests – was larger than any ballot that Rudd, Abbott or Turnbull ever contested.</p> <p>People have been quick to wipe their hands clean of yesterday’s sexism in order to make Gillard yesterday’s heroine. But they ought to be careful that, in the process, they do not erase her from other political histories.</p> <p>To segregate her story as one of women’s leadership while neglecting it in wider histories of Australian politics and policy would, in its own way, be an act of sexism.<!-- 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/208283/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/joshua-black-729708">Joshua Black</a>, PhD Candidate, School of History, National Centre of Biography, <a href="https://theconversation.com/institutions/australian-national-university-877">Australian National 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/between-nostalgia-and-amnesia-the-legacy-of-julia-gillard-as-pm-10-years-after-her-ousting-208283">original article</a>.</em></p>

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Eerie link between OceanGate pilot and Titanic disaster

<p>A chilling link has been discovered between pilot Stockton Rush, who was onboard the OceanGate submersible, and the Titanic disaster in 1912. </p> <p>Mr Rush, who was at the helm of the vehicle bound for the Titanic wreckage, has a personal connection to two of the victims who were onboard the Titanic when it sank over 100 years ago. </p> <p>His wife, Wendy Rush, is the great-great-granddaughter of Isador Straus, who co-founded Macy’s department store, and Ida Straus, who were among the wealthiest people aboard the Titanic’s ill-fated transatlantic voyage, according to archived records obtained by the New York Times.</p> <p>The Strauses have long been remembered for their display of love and affection when the ocean liner hit the iceberg before infamously sinking in the North Atlantic, claiming the lives of more than 1500 people. </p> <p>Survivors of the disaster reported seeing Ida refuse a place on the lifeboats, which were reserved largely for women and children, and decided to stay onboard the sinking vessel with her husband of more than 40 years. </p> <p>Their tragic love story was depicted in James Cameron’s fictionalised version of the tragedy, his 1997 blockbuster <em>Titanic</em>, which features a scene showing an elderly couple holding on to each other in bed as waters rise around them. </p> <p>Wendy Rush is descended from one of the couple’s daughters, Minnie Strauss, who married Dr. Richard Weil in 1905, and their son, Richard Weil Jr., served as president of Macy’s New York,</p> <p>His son, Dr. Richard Weil III, is Wendy Rush’s father, Joan Adler, the executive director of the Straus Historical Society. </p> <p>Isador’s body was found at sea weeks after the Titanic sank, but his wife’s body was never recovered.</p> <p>Wendy also worked for OceanGate as their communications director, with her LinkedIn indicating she had been on several trips to the wreckage of the Titanic herself. </p> <p>The OceanGate submersible <a href="https://oversixty.com.au/news/news/surprising-cause-of-death-revealed-for-missing-titan-sub-crew" target="_blank" rel="noopener">reportedly imploded</a> hours after it went missing, with all five people on board believed to be dead. </p> <p><em>Image credits: OceanGate / Wikimedia</em></p>

Family & Pets

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Why does my back get so sore when I’m sick? The connection between immunity and pain

<p><em><a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a></em></p> <p>Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID?</p> <p>This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”.</p> <p>A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats.</p> <h2>Immunology basics</h2> <p>Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing.</p> <p>When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology.</p> <p>This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual.</p> <h2>Invisibly small changes</h2> <p>Part of this self-protective response is a change in how we perceive threats, including sensory stimuli.</p> <p>When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain.</p> <p>Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>.</p> <h2>Immune memories</h2> <p>This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>.</p> <p>Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are.</p> <p>After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>.</p> <p>Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>.</p> <h2>When to worry and what to do</h2> <p>If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves.</p> <p>While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain.</p> <p>Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>.</p> <p>Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse.</p> <p>Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness.</p> <p>Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications.</p> <h2>All in the mind?</h2> <p>Is this all mind over matter? A little of yes and a lot of no.</p> <p>The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level.</p> <p>But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<!-- 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/207222/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/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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/why-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.</em></p>

Caring

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There’s a growing gap between countries advancing LGBTQ+ rights, and those going backwards

<p>Prime Minister Anthony Albanese and Foreign Minister Penny Wong joined 50,000 people to march in support of queer rights across the Sydney Harbour Bridge for World Pride in early March. A week earlier, Albanese became the first sitting prime minister to march in Sydney’s Mardi Gras, something he’s done over several decades.</p> <p>And yet at the same time, in another part of the world, Uganda’s parliament passed <a href="https://theconversation.com/ugandas-new-anti-lgbtq-law-could-lead-to-death-penalty-for-same-sex-offences-202376">a string of draconian measures</a> against homosexuality, including possible death sentences for “aggravated homosexuality”. Any “promotion” of homosexuality is also outlawed.</p> <p>Seven years ago, I co-wrote a book with Jonathan Symons called Queer Wars. Back then, we suggested there was <a href="https://researchers.mq.edu.au/en/publications/queer-wars-the-new-global-polarization-over-gay-rights">a growing gap </a>between countries in which sexual and gender diversity was becoming more acceptable, and those where repression was increasing. </p> <p>Sadly, that analysis seems even more relevant today.</p> <h2>A growing gap</h2> <p>Some countries have been unwinding criminal sanctions around homosexuality, which are often the legacy of colonialism. This includes, in recent years, former British colonies <a href="https://www.hrw.org/news/2022/08/22/singapore-decriminalize-gay-sex">Singapore</a> and <a href="https://www.theguardian.com/world/2018/sep/06/indian-supreme-court-decriminalises-homosexuality">India</a>.</p> <p>But others have been imposing new and more vicious penalties for any deviation from stereotypical assumptions of heterosexual masculine superiority (what Australian sociologist Raewyn Connell <a href="https://journals.sagepub.com/doi/abs/10.1177/0891243205278639">terms</a> “hegemonic masculinity”).</p> <p>Anti-gay legislation is currently pending in Ghana, which led US Vice President Kamala Harris to <a href="https://www.bbc.com/news/world-43822234">express concerns</a> on a recent visit.</p> <p>These moves echo the deep homophobia of Russian President Vladimir Putin, who has <a href="https://www.bostonreview.net/articles/putins-anti-gay-war-on-ukraine/">bizarrely linked</a> intervention in Ukraine to protecting traditional values against LGBTQ+ infiltration.</p> <p>Meanwhile, reports from Afghanistan suggest that anyone identified as “LGBT” is <a href="https://www.hrw.org/news/2022/01/26/afghanistan-taliban-target-lgbt-afghans">in danger of being killed</a>.</p> <p>Indonesia recently passed legislation <a href="https://www.theguardian.com/world/2022/dec/06/indonesia-passes-legislation-banning-sex-outside-marriage">penalising all sex outside marriage</a>. This follows <a href="https://www.tandfonline.com/doi/full/10.1080/13639811.2022.2038871">years of anti-queer rhetoric</a> from Indonesian leaders and crackdowns in regional areas.</p> <p>And while the Biden administration is supportive of queer rights globally, the extraordinary hysteria <a href="https://www.theguardian.com/us-news/2023/mar/07/cpac-anti-trans-rhetoric">around trans issues in the Republican Party</a> reminds us the West has no inherent claim to moral superiority.</p> <h2>Where to next?</h2> <p>Speaking at the World Pride Human Rights Conference, both Wong and Attorney General Mark Dreyfus made it clear Australia would press for recognition of sexuality and gender identity as deserving protection, as part of <a href="https://www.foreignminister.gov.au/minister/penny-wong/speech/sydney-worldpride-human-rights-conference-opening-statement">our commitment to human rights</a>.</p> <p>Wong also announced a <a href="https://www.themandarin.com.au/213443-wong-announces-international-fund-for-lgbt-rights/">new Inclusion and Equality Fund</a> to support queer community organisations within our region.</p> <p>Australian governments have usually been wary of loud assertions of support for queer rights. This is partly due to a reasonable fear this merely reinforces the perception that such language reflects <a href="https://www.cambridge.org/core/journals/african-studies-review/article/abs/locating-neocolonialism-tradition-and-human-rights-in-ugandas-gay-death-penalty/33A06F4F33CF586E20E208BE790E71E0">a sense of Western superiority</a>, unwilling to acknowledge other societies may have very different attitudes towards gender and sexuality.</p> <p>Australia is part of the Equal Rights Coalition, an intergovernmental body of 42 countries dedicated to the protection of the rights of LGBTQ+ people, and has supported sexual and gender rights in the <a href="https://humanrights.gov.au/our-work/rights-and-freedoms/australias-second-universal-periodic-review-human-rights">country reviews</a> undertaken by the United Nations Human Rights Commission.</p> <p>Australia has a minimal presence in Uganda, and direct representations are unlikely to have much effect. Uganda is a member of the Commonwealth, as are Ghana, Kenya and Zambia, where official homophobia appears to be increasing. But there’s little evidence the Australian government sees this as a significant foreign policy forum, or is prepared to push for sexual rights through its institutions.</p> <p>As persecution on the basis of sexuality and gender identity increases, more people will seek to flee their countries. Queer refugees face double jeopardy: they’re not safe at home, but they’re often equally unsafe in their diasporic communities, which have inherited the <a href="https://www.weforum.org/agenda/2018/01/lgbt-refugees-untold-story/">deep prejudices of their homelands</a>.</p> <p>The UN’s refugee agency <a href="https://www.unhcr.org/lgbtiq-persons.html">reports</a> that most people seeking asylum because of their sexuality are unwilling to disclose this, because of discrimination within their own ethnic communities. This makes it impossible to have accurate numbers. But a clear signal from Australia would be a powerful statement of support – that it understands the situation and welcomes people who need flee because of their sexuality or gender expression.</p> <p>An official Canadian government document <a href="https://www.canada.ca/en/immigration-refugees-citizenship/services/refugees/canada-role/2slgbtqi-plus.html">states</a>: "Canada has a proud history of providing protection to and helping to resettle the world’s most vulnerable groups. That includes those in the Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, and additional sexually and gender diverse community."</p> <p>Theirs is a model worth following.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/theres-a-growing-gap-between-countries-advancing-lgbtq-rights-and-those-going-backwards-203329" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Caring

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Global review shows link between social media use, body image and eating disorders

<p>Body image has remains a <a href="https://www.missionaustralia.com.au/what-we-do/research-impact-policy-advocacy/youth-survey" target="_blank" rel="noopener">top personal concern</a> for young people in Australia, with 76% concerned about the issue. </p> <p>Social media use by teens is rising at the same time – with <a href="https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Social-Media-and-Teens-100.aspx" target="_blank" rel="noopener">more than 90% on platforms</a> like Facebook, YouTube, Instagram, Snapchat, WeChat and TikTok.</p> <p>While there have long been concerns about the association between social media, body image and eating disorders the connection remains relatively unexplored as a public health issue.</p> <p>Now, researchers from University College London in the UK have undertaken a systematic review of 50 scientific studies across 17 countries showing  clear links between social media use and body image concerns.</p> <p>The paper, <a href="https://doi.org/10.1371/journal.pgph.0001091" target="_blank" rel="noopener">published</a> in PLOS Global Public Health, analyses the relationship between body image or eating disorders in young people and social media use. </p> <p>The researchers identify specific aspects of social media – platforms with an emphasis on photos, and engaging with “fitspiration” and “thinspiration” trends – as the factors most closely linked to body image concerns, disordered eating and poor mental health.</p> <p>Other key risk factors included female gender, high body-mass-index and pre-existing body image concerns. </p> <p>The researchers note further studies are needed into the direction of causality. </p> <p>“For example, do body image dissatisfaction and disordered eating occur because of social media usage, or do these pre-exist, encourage engagement in certain online activities, and result in unfavourable clinically significant outcomes?” they ask.</p> <p>Eating disorders involve disturbed attitudes to body image, pre-occupation with weight and body shape and are associated with significant negative outcomes such as cardiovascular disease, reduced bone density, and psychiatric conditions.</p> <p>In Australia, the <a href="https://butterfly.org.au/" target="_blank" rel="noopener">Butterfly Foundation</a> reports eating disorders affect around one million people, with the conditions causing more people die each year than the road toll. </p> <p><em>Image credits: Getty Images  </em></p> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/social-media-use-body-image/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Petra Stock. </em></p>

Technology

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Music and mental health: the parallels between Victorian asylum treatments and modern social prescribing

<p>Music has a powerful effect on the listener. It is linked to <a href="https://www.nature.com/articles/s41398-021-01483-8">better mental health</a>, and it has been shown to <a href="https://journals.sagepub.com/doi/abs/10.1177/0305735617703811?journalCode=poma">alleviate loneliness, pain, anxiety and depression</a>. </p> <p>For this reason, it is increasingly being prescribed by doctors as a form of medicine. This practice – where patients are referred to various activities such as running groups, art classes and choirs – is known as <a href="https://www.england.nhs.uk/personalisedcare/social-prescribing/">social prescribing</a>.</p> <p>Music-based activities may be prescribed to <a href="https://link.springer.com/article/10.1186/s13612-016-0048-0">help support</a> patients’ <a href="https://www.tandfonline.com/doi/abs/10.1080/08098131.2018.1432676">mental health</a>, <a href="https://link.springer.com/chapter/10.1007/978-3-319-76240-1_9">combat isolation</a>, encourage <a href="https://www.tandfonline.com/doi/full/10.1080/17482631.2020.1732526">physical activity</a>, and <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2021.693791/full">keep an active brain</a>.</p> <p>While social prescribing is a relatively new practice, the use of music as a therapeutic tool is not. The first widespread use of music as a therapeutic tool can be traced back to the 19th century, where it was used in Victorian asylums to support patients’ treatment. </p> <h2>Music in asylums</h2> <p>Victorian asylums are usually associated with poor sanitation, overcrowding, <a href="https://www.tandfonline.com/doi/abs/10.1179/0308018813Z.00000000063">danger</a> and patients held against their will. Indeed, the Victorians had little understanding of mental illness and the brain, which meant <a href="https://journals.sagepub.com/doi/10.1177/030802269005301009">many treatments </a>considered barbaric today were used on patients – including bleeding, leeching, shaving the head and bathing in ice.</p> <p>From the end of the 18th century, however, practitioners moved away from the worst types of physical restraint. A new practice emerged, known as “<a href="https://www.sciencemuseum.org.uk/objects-and-stories/medicine/victorian-mental-asylum#:%7E:text=The%20Victorian%20mental%20asylum%20has,humane%20attitude%20towards%20mental%20healthcare.">moral management</a>”, which placed a focus on using employment, diet, surroundings and recreational activities as <a href="https://historicengland.org.uk/research/inclusive-heritage/disability-history/1832-1914/daily-life-in-the-asylum/">forms of therapy</a>.</p> <p>When state-run asylums were first introduced in Britain in the <a href="https://www.bloomsbury.com/uk/cure-comfort-and-safe-custody-9780718500948/">early 19th century</a>, music soon became included as a <a href="https://link.springer.com/book/10.1007/978-3-030-78525-3">form of moral management</a> to distract patients outside of working hours and keep them occupied. Both music and dance were efficient ways of entertaining large numbers of patients. </p> <p>By the middle of the 19th century, almost all the larger asylums in the UK had their own band and would often organise dances, attended by over a hundred patients. Asylums also hosted concerts by travelling performers, from comic sketches to solo singers and amateur choirs. Dances and concerts were usually the only opportunities for patients to meet in a large group, providing important social interaction.</p> <p>Among the <a href="https://www.cambridge.org/core/journals/royal-musical-association-research-chronicle/article/music-as-therapy-for-the-exceptionally-wealthy-at-the-nineteenthcentury-ticehurst-asylum/CBB82DA05DAB7A9D47636BCE2DF9DBB7">smaller asylums</a>, chiefly catering for wealthier patients, patients had more options to create music as part of their treatment. They would often bring instruments with them. And small concerts put on by patients and staff were common.</p> <h2>The benefits of music</h2> <p>Much of the therapeutic value of music was attached to its social function. Accounts suggest that patients benefited from the anticipation of these social engagements and that events were used to reward good behaviour. Music was also used to break up the monotony of asylum life.</p> <p>For example, <a href="https://link.springer.com/chapter/10.1007/978-3-030-78525-3_11">at one private asylum</a>, Dr Alfred Wood, wrote, "These entertainments involved a great amount of trouble in their preparation and arrangement and, I may add, considerable expense; but they are invaluable as a relief to the monotony of life in an Asylum. The pleasure they afford as well in anticipation as in reality, is ample to compensate for the efforts made to present them …"</p> <p>Dances, in particular, offered exercise and enjoyment, and even patients who were unable to dance enjoyed the music and watching fellow patients. </p> <p>Musical events also carried strict expectations of behaviour. Patients needed a good deal of self-control to participate and behave appropriately. It was this process of conforming to expectations that formed an important part of rehabilitation. William A.F. Browne, one of the most noteworthy asylum doctors of the era, wrote in 1841 about the <a href="https://wellcomecollection.org/works/dkxnvx35/items?canvas=91">self-control</a> needed before, during and after amusements. </p> <p>Others suggested that music would help <a href="https://wellcomecollection.org/works/vmmq4wv8/items?canvas=216">remind patients of happier days</a> and give them hope and pleasure during their treatment. Browne also cited the “powers of music to soothe, enliven, rouse, or melt”. He suggested that even difficult patients may benefit from music, <a href="https://wellcomecollection.org/works/far6jdph/items?canvas=26">writing</a>: “There is or may be a hidden life within him which may be reached by harmony.”</p> <p>The writer James Webster <a href="https://www.bmj.com/content/s1-5/114/197.2">recorded in 1842</a> that: “In many, the effect produced by the music upon their countenances and behaviour was often quite apparent.” Records include many stories of patients seemingly cured by music. </p> <p>Webster cites the example of a young girl, previously “morose” and “stupefied”, who under the influence of music, seemed “pleased” and “cheerful” – appearing “altogether a changed creature”. Browne also wrote in one of his books of the <a href="https://wellcomecollection.org/works/far6jdph/items?canvas=26">miraculous effect</a> music had on one patient who awoke, cured, the morning after listening to a performance of Scottish traditional melodies. </p> <h2>Music as treatment</h2> <p>In the 1890s, many doctors carried out experiments on the relationship between music and mental illness. Herbert Hayes Newington, medical superintendent of one of the era’s most prestigious asylums, used music to diagnose patients and <a href="https://www.cambridge.org/core/journals/journal-of-mental-science/article/abs/some-mental-aspects-of-music/A87C190163A86070D4445A830E656557">help develop theories</a> on how the brain works. Reverend Frederick Kill Harford, who campaigned to provide music in public hospitals during the early 1890s, believed music could <a href="https://www.bmj.com/content/2/1603/667">treat depression</a>, alleviate physical pain and help with sleep. </p> <p>Although music remained in asylums as a form of <a href="https://theconversation.com/what-life-was-like-in-mental-hospitals-in-the-early-20th-century-119949">therapy</a>, interest in it as a large-scale treatment waned as innovations such as <a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2020.160103">electroconvulsive therapy</a> emerged in the 20th century.</p> <p>For patients in Victorian asylums, therefore, music was an important part of mental health treatment – not only providing an opportunity for creative engagement but also fulfilling a range of social, emotional and intellectual needs. Given what we know now about the <a href="https://www.nature.com/articles/s41398-021-01483-8">benefit of music on mental health</a>, it’s no wonder doctors are making use of it again.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/music-and-mental-health-the-parallels-between-victorian-asylum-treatments-and-modern-social-prescribing-200576" target="_blank" rel="noopener">The Conversation</a>. </em></p>

Music

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Pat Rafter delves into “rift” between Ash Barty and US player

<p>Aussie great Pat Rafter has opened up about the tension during Ash Barty’s match against her 2022 Australian Open final opponent, Danielle Collins.</p> <p>The now retired tennis star smashed the American 6-3 7-6 (7-2) which saw Barty claim her first home slam and the third of her career.</p> <p>Almost 12 months later, Rafter has opened up about the tension the pair had in which Barty didn’t want to lose to the American star and vice versa.</p> <p>“I knew with her and Danielle, they had a bit of a … what’s the word? There was no love lost anyway,” Rafter told reporters ahead of the United Cup.</p> <p>“Danielle’s pretty feisty. And Ash didn’t want to lose to her.”</p> <p>He said that there was a bit of worry when he saw Barty get “rattled” on court before getting out of her head and smashing the game.</p> <p>“It was pretty funny, I don’t know how much you can pick up on the on-court subtleties of it but I’m pretty aware of Ash and I understand where her mind’s at and I can see all her little movements and ticks,” Rafter continued.</p> <p>“I was going, ‘oh no, she’s getting rattled, she’s not good’. But she was able to pull it out which was pretty important.</p> <p>“I would have hated to see her get to the final and lose because she was the dominant player. I like seeing the best players win.”</p> <p>After her successful win, the now 26-year-old shocked the tennis world by announcing her retirement from the game.</p> <p>She recently got married to her longtime partner Garry Kissick and is currently working at Optus.</p> <p><em>Image: Getty</em></p>

News

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This is the difference between dementia and Alzheimer’s

<p>There are around 50 million people living with dementia worldwide, according to the World Health Organization. While dementia and Alzheimer's disease are often used interchangeably, there are important differences between them. Here’s what you need to know.</p> <p><strong>Dementia vs. Alzheimer’s</strong></p> <p>Here’s the first thing you need to know: how to tell the difference between dementia and Alzheimer’s disease. Dementia is an umbrella term for symptoms like impaired memory and thinking that interferes with daily living; Alzheimer’s disease is a specific type of dementia. Other types of dementia include vascular dementia, dementia with Lewy bodies, frontotemporal dementia, Parkinson’s disease, and Huntington’s disease.</p> <p>“Alzheimer’s is the most common form of dementia – about 60 to 70 per cent of the time, a patient with dementia has Alzheimer’s,” says Dr Richard Isaacson, Director of the Alzheimer’s Prevention Clinic at NewYork-Presbyterian/Weill Cornell Medical Center. The reason you hear about Alzheimer’s most often is not only because it is the most common type of dementia, but also because the science behind Alzheimer’s is the most advanced across all dementias,” explains Dr Isaacson.</p> <p><strong>Causes of dementia are vastly different</strong></p> <p>A medical illness, metabolic issue (like a nutritional or thyroid problem), vascular disease (like a stroke), or, rarely, infectious diseases can affect brain cells, causing dementia. Even mad cow disease, which is very rare, can contribute to dementia, says Dr Isaacson. A condition called depressive “pseudo” dementia is another possible source. As he explains, when levels of the neurotransmitter serotonin run low, you may have trouble paying attention. And when you’re distracted, you have trouble remembering things, which can manifest as dementia.</p> <p>On the other hand, Alzheimer’s has its own origins. It’s a brain disease marked by deposits of beta-amyloid plaques and proteins called tau that damage cells in brain regions that control functions like thinking, memory, and reasoning.</p> <p><strong>Multiple factors can be at play</strong></p> <p>There’s also what’s called mixed dementia, meaning there are multiple conditions that can come together to cause dementia. “Thirty percent of the time, patients who have Alzheimer’s also have a vascular disease that makes cognitive symptoms worse,” says Dr Isaacson. Alzheimer’s and dementia with Lewy bodies (in this disease, clumps of alpha-synuclein proteins develop in the brain) have also been found to occur together.</p> <p><strong>Symptoms can look very similar</strong></p> <p>Losing your keys – again – and forgetting where you parked are basic memory problems, so how do you know when it crosses the line to dementia or Alzheimer’s? According to the Alzheimer’s Association, in order for a person to be diagnosed with dementia, two of the following must be “significantly impaired”: memory, communication and language, the ability to focus and pay attention, reasoning and judgment, and visual perception. When it comes to Alzheimer’s, you may forget new information or find that you have to ask family members to remember important facts you should be able to keep track of yourself. (It’s not those little brain blips where you can’t remember the name of your second cousin and then it comes to you later – that’s normal). Research published in the <em>Journal of Alzheimer’s Disease</em> in 2016 also indicates that difficulty using a map may be one of the earliest warning signs of Alzheimer’s.</p> <p><strong>You may be able to prevent Alzheimer’s</strong></p> <p>“We have the Alzheimer’s Prevention Clinic, and the fact that you can talk about those words together is advanced,” says Dr Isaacson. The clinic investigates how lifestyle choices – a healthy diet, exercise, social and mentally stimulating activities, as well as everyday habits, and ample sleep can markedly reduce your risk of Alzheimer’s. In fact, in a study in 2014 published in the Lancet Neurology, reducing certain risk factors can decrease the risk of Alzheimer’s by 33 per cent. The most important ways to prevent Alzheimer’s: Control diabetes and high blood pressure, reduce weight if obese, stay active, treat depression, don’t smoke, and stay in school. The Lancet, in a 2017 article, also notes that staying social (spending time with friends and family members) and managing hearing loss have been shown to be among the controllable factors that may help prevent dementia.</p> <p><strong>Treatment options depend on the type of dementia</strong></p> <p>There are virtually no FDA-approved therapies for dementia (only one approved drug for Parkinson’s dementia), but there are four medications that target Alzheimer’s, according to Dr Isaacson. And while these drugs don’t stall disease progression (or cure the disease), they can help control symptoms. Patients of Dr Isaacson’s say these drugs may help for six to nine months, but many stay on them for the long haul because they help with behavioural symptoms such as agitation and aggression. “When you stop the medications, the psychological symptoms get worse,” he says.</p> <p>As for other types of dementia, lifestyle changes may be the best option. Treatment for vascular dementia relies on doing things that are healthy for your arteries and heart: reducing blood pressure and cholesterol, and controlling diabetes. “Managing other chronic conditions is important,” says Dr Isaacson. “Those are a great way to press the fast-forward button on dementia.”</p> <p><strong>You can find out if you’re at an increased risk of Alzheimer’s now</strong></p> <p>If you get evaluated for Alzheimer’s, your doctor can make a diagnosis based on symptoms, a clinical history, and medical tests (to rule out causes like thyroid issues or nutritional deficiencies). Brain imaging tests like a cat scan or MRI can look for beta amylase plaques gunking up brain regions.</p> <p><strong>You don’t have to be scared</strong></p> <p>Forgetting how to work the remote in your home, being afraid to leave your neighbourhood out of fear you might not get home, or misplacing your belongings so often that it hurts your ability to get out the door can all be particularly worrisome – especially if a loved one expresses concern. If you’re worried, see your doctor, says Dr Issacson. “Get educated, get informed, get evaluated,” he says. “The earlier the diagnosis, the earlier you can be treated. And the earlier you’re treated, the better you’ll do.”</p> <p><em><span id="docs-internal-guid-439d99b3-7fff-2e74-36b4-a8ac764e0b4c">Written by Jessica Migala. This article first appeared in <a href="https://www.readersdigest.com.au/healthsmart/this-is-the-difference-between-dementia-and-alzheimers" target="_blank" rel="noopener">Reader’s Digest</a>. For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.innovations.com.au/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA87V" target="_blank" rel="noopener">here’s our best subscription offer.</a></span></em></p> <p><em>Image: Getty Images</em></p>

Mind

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What’s the connection between cosmetic procedures and mental health?

<p>Although we cannot be sure of the exact numbers of Australians undergoing cosmetic procedures, as there is no requirement for health professionals to report their statistics, there is a consensus demand is on the rise. </p> <p>In 2015, the <a href="https://cpca.net.au/wp-content/uploads/2016/05/31-05-2016_AUSTRALIAS_SPEND_ON_COSMETIC_TREATMENTS_TOPS_1_BILLION.pdf">Cosmetic Physicians College of Australasia</a> found Australians were spending more than $1 billion a year on non-invasive cosmetic procedures like Botox and fillers. This is more than 40% higher, per capita, than in the United States.</p> <p>In the US, where procedure <a href="https://cdn.theaestheticsociety.org/media/statistics/2021-TheAestheticSocietyStatistics.pdf">statistics are reported</a>, there was a 42% increase in the number of filler procedures and a 40% increase in Botox procedures performed in the last year alone. </p> <p>Rates of mental health issues in this group may be higher than the general population, but seemingly not enough is being done to ensure the psychological safety of people requesting cosmetic procedures.</p> <h2>Body dysmorphic disorder</h2> <p>Body image concerns are generally the main motivator for seeking cosmetic procedures of all kinds. These concerns are <a href="https://www.sciencedirect.com/science/article/pii/S1740144518305552">usually focused on the body part</a> where the cosmetic intervention is sought, such as the nose for a rhinoplasty. </p> <p>Severe body image concerns are a key feature of several mental health conditions. The most prevalent in people seeking cosmetic procedures is body dysmorphic disorder. In the general community, around 1-3% of people will experience body dysmorphic disorder, but in populations seeking cosmetic surgery, this <a href="https://pubmed.ncbi.nlm.nih.gov/35715310/">rises to 16-23%</a>.</p> <p><a href="https://bdd.iocdf.org/professionals/diagnosis/">Body dysmorphic disorder</a> involves a preoccupation or obsession with one or more perceived flaws in physical appearance which are not visible or seem minor to other people. In response to the distress regarding the flaw, the person with body dysmorphic disorder will perform repetitive behaviours (such as excessively checking body parts in the mirror) and mental acts (such as comparing their appearance with other people). </p> <p>These concerns can have a significant negative impact on the person’s daily life, with some people too distressed to leave their home or even eat dinner with family members out of fear of being seen by others. </p> <p>With the distress associated with body dysmorphic disorder seemingly stemming from physical appearance issues, it makes sense someone with body dysmorphic disorder is far more likely to turn up at a cosmetic clinic for treatment than a mental health clinic.</p> <p>The problem is, cosmetic intervention usually makes the person with body dysmorphic disorder feel the <a href="https://link.springer.com/article/10.1007/s00266-017-0819-x">same or worse</a> after the procedure. They may become even more preoccupied with the perceived flaw and seek further cosmetic procedures. </p> <p>Patients with body dysmorphic disorder are also <a href="https://academic.oup.com/asj/article/22/6/531/204131">more likely</a> to take legal action against their treating cosmetic practitioner after believing they have not received the result they wanted.</p> <p>For these reasons, body dysmorphic disorder is generally considered by health professionals to be a “red flag” or contraindication (a reason not to undergo a medical procedure) for cosmetic procedures.</p> <p>However, this is not entirely clear-cut. <a href="https://academic.oup.com/asj/advance-article/doi/10.1093/asj/sjac243/6678852?searchresult=1">Some studies</a> have shown people with body dysmorphic disorder can improve their symptoms after cosmetic intervention, but the obsession may just move to another body part and the body dysmorphic disorder diagnosis remain.</p> <h2>What about other mental health conditions?</h2> <p>Body dysmorphic disorder is by far the most well-studied disorder in this area, but is not the only mental health condition that may be associated with poorer outcomes from cosmetic procedures.</p> <p>According to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034989/">recent systematic review</a>, the rates of depression (5-26%), anxiety (11-22%) and personality disorders (0-53%) in people seeking cosmetic surgery may be higher than the general population (which are estimated to be 10%, 16% and 12% respectively).</p> <p>However, these rates should be interpreted with some caution as they depend greatly on how the mental health diagnosis was made – clinician-led interview (higher rates) versus mental health questionnaire (lower rates). Some interview approaches can suggest higher rates of mental health issues as they may be quite unstructured and thus have questionable validity compared with highly structured questionnaires. </p> <p>Besides body dysmorphic disorder, the research investigating other mental health conditions is limited. This may just be due to the fact body image focus is at the core of body dysmorphic disorder, which makes it a logical focus for cosmetic surgery research compared with other types of psychiatric disorders.</p> <h2>So what should happen?</h2> <p>Ideally, all cosmetic surgeons and practitioners should receive sufficient training to enable them to conduct a brief routine assessment of all prospective patients. Those with signs indicating they are unlikely to derive psychological benefit from the procedure should undergo a further assessment by a mental health professional before undergoing the procedure. </p> <p>This could include an in-depth clinical interview about motivations for the procedure, and completing a range of standard mental health questionnaires. </p> <p>If a person was found to have a mental health issue in the assessment process, it does not necessarily mean the mental health professional would recommend against pursuing the procedure. They may suggest a course of psychological therapy to address the issue of concern and then undergo the cosmetic procedure. </p> <p>At the moment, assessments are only recommended rather than mandated for cosmetic surgery (and not at all for injectables like Botox and fillers). The <a href="https://plasticsurgery.org.au/wp-content/uploads/2020/08/2.5-AHPRA-MBA-Guidelines-for-Registered-Medical-Practitioners-Who-Perform-Cosmetic-Medical-and-Surgical-Procedures-2016.pdf">guidelines</a> say evaluation should be undertaken if there are signs the patient has “significant underlying psychological problems”.</p> <p>This means we are relying on the cosmetic medical practitioner being capable of detecting such issues when they may have received only basic psychological training at medical school, and when their business may possibly benefit from not attending to such diagnoses.</p> <p>An August 2022 <a href="https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Cosmetic-surgery-review.aspx">independent review</a> by the Australian Health Practitioner Regulation Agency and the Medical Board of Australia recommended the guidelines around mental health assessment should be “strengthened” and emphasised the importance of medical practitioners receiving more training in the detection of psychiatric disorders. </p> <p>Ultimately, as cosmetic practitioners are treating patients who are seeking treatment for psychological rather than medical reasons, they must have the wellbeing of the patient front-of-mind, both out of professional integrity and to protect themselves from legal action. Mandatory evaluation of all patients seeking any kind of cosmetic procedure would likely improve patient satisfaction overall.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/whats-the-connection-between-cosmetic-procedures-and-mental-health-190841" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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