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

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

Body

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

<a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Many have <a href="https://www.economist.com/leaders/2023/03/02/new-drugs-could-spell-an-end-to-the-worlds-obesity-epidemic">declared</a> drugs like Ozempic could “end obesity” by reducing the appetite and waistlines of millions of people around the world. When we look past the hype, this isn’t just untrue – it can also be harmful. The focus on weight, as opposed to health, is a feature of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0277539521001217">diet culture</a>. This frames the pursuit of thinness as more important than other aspects of physical and cultural wellbeing. The Ozempic buzz isn’t just rooted in health and medicine but plays into ideas of <a href="https://butterfly.org.au/weight-bias-fatphobia-diet-culture/#:%7E:text=Weight%20bias%2C%20sometimes%20also%20called,or%20being%20around%20fat%20people.">fat stigma and fat phobia</a>. This can perpetuate fears of fatness and fat people, and the behaviours that <a href="https://link.springer.com/article/10.1186/S12916-018-1116-5">harm people who live in larger bodies</a>. <h2>Not the first ‘miracle’ weight-loss drug</h2> This isn’t the first time we have heard that weight-loss drugs will change the world. Ozempic and <a href="https://www.ncbi.nlm.nih.gov/books/NBK551568/">its family</a> of GLP-1-mimicking drugs are the <a href="https://theconversation.com/ozempic-is-in-the-spotlight-but-its-just-the-latest-in-a-long-and-strange-history-of-weight-loss-drugs-209324">latest in a long line of weight loss drugs</a>. Each looked promising at the time. But none have lived up to the hype in the long term. Some have even been withdrawn from sale due to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126837/">severe side effects</a>. Science does improve <a href="https://www.thelancet.com/journals/lanmic/article/PIIS2666-5247(20)30028-8/fulltext">incrementally</a>, but diet culture also keeps us on a cycle of hope for the next <a href="https://sahrc.org/2022/04/diet-culture-a-brief-history/">miracle cure</a>. So drugs like Ozempic might not deliver the results individuals expect, continuing the cycle of hope and shame. <h2>Ozempic doesn’t work the same for everyone</h2> When we talk about the results of studies using Ozempic, we often <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719041/">focus on the average</a> (also known as the mean) results or the maximum (or peak) results. So, studies might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9486455/">show</a> those using the drug lost an average of 10.9% of their body weight, but some lost more than 20% and others less than 5% What we don’t talk about as much is that responses are variable. Some people are “<a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769">non-responders</a>”. This means not everyone loses as much weight as the average, and some don’t lose weight at all. For some people, the side-effects will outweigh the benefits. When people are on drugs like Ozempic, their blood sugar is better controlled by enhancing the release of insulin and reducing the levels of another hormone called glucagon. But there is greater variability in the amount of <a href="https://www.sciencedirect.com/science/article/pii/S2212877820301769#bib88">weight lost</a> than the variability in blood sugar control. It isn’t clear why, but is likely due to differences in genetics and lifestyles, and weight being more complex to regulate. <h2>Treatment needs to be ongoing. What will this mean?</h2> When weight-loss drugs do work, they are only effective while they’re being taken. This means that to keep the weight off people need to keep taking them long term. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542252/">One study found</a> an average weight loss of more than 17% after a year on Ozempic became an average net weight loss of 5.6% more than two years after stopping treatment. Short-term side effects of drugs like Ozempic include dizziness, nausea, vomiting and other gastrointestinal upsets. But because these are new drugs, we simply don’t have data to tell us if side effects will increase as people take them for longer periods. Nor do we know if <a href="https://www.medicalnewstoday.com/articles/why-weight-loss-drugs-stop-working-how-to-break-past-ozempic-plateau#:%7E:text=A%20lifetime%20commitment%20to%20Ozempic&text=By%20these%20standards%2C%20such%20drugs,long%2Dterm%20risk%20is%20unknown.">effectiveness will be reduced</a> in the long term. This is called <a href="https://www.cancer.gov/publications/dictionaries/cancer-terms/def/drug-tolerance#:%7E:text=A%20condition%20that%20occurs%20when,or%20different%20medicine%20is%20needed.">drug tolerance</a> and is documented for other long-term treatments such as antidepressants and chemotherapies. <h2>Biology is only part of the story</h2> For some people, using GLP-1-mimicking drugs like Ozempic will be validating and empowering. They will feel like their biology has been “normalised” in the same way that blood pressure or cholesterol medication can return people to the “normal” range of measures. But biologically, obesity <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202176/#:%7E:text=Obesity%20behaves%20as%20complex%20polygenic,about%2080%25%20(3).">isn’t solely about GLP-1 activity</a> with <a href="https://www.worldobesity.org/what-we-do/our-policy-priorities/the-roots-of-obesity">many other</a> hormones, physical activity, and even our gut microbes involved. Overall, <a href="https://www.ncbi.nlm.nih.gov/books/NBK278977/">obesity is complex and multifaceted</a>. Obesity isn’t just driven by personal biology and choice; it has social, cultural, political, environmental and economic determinants. <h2>A weight-centred approach misses the rest of the story</h2> The weight-centred approach <a href="https://butterfly.org.au/body-image/health-not-weight/#:%7E:text=Health%20and%20wellbeing%20are%20multi,on%20their%20size%20or%20appearance.">suggests that leading with thinness means health will follow</a>. But changing appetite is only part of the story when it comes to health. Obesity often <a href="https://www.sciencedirect.com/science/article/pii/S2667368123000335#:%7E:text=Obesity%20related%20malnutrition%20can%20also,%5D%2C%20%5B7%5D%5D.">co-exists with malnutrition</a>. We try to separate the effects in research using statistics, but focusing on the benefits of weight-loss drugs without addressing the underlying malnutrition means we aren’t likely to see the <a href="https://www.wsj.com/articles/ozempic-diet-exercise-healthy-43eee86c">improved health outcomes in everyone who loses weight</a>. <h2>Obesity isn’t an issue detached from people</h2> Even when it is well-intentioned, the rhetoric around the joy of “ending the obesity epidemic” can <a href="https://theconversation.com/ozempic-the-miracle-drug-and-the-harmful-idea-of-a-future-without-fat-211661">harm people</a>. Obesity doesn’t occur in isolation. It is people who are obese. And the celebration and hype of these weight-loss drugs can reinforce harmful fat stigma. The framing of these drugs as a “cure” exacerbates the binary view of thin versus fat, and healthy versus unhealthy. These are not binary outcomes that are good or bad. Weight and health exist on a spectrum. Ironically, while fat people are told they need to lose weight for their health, they are also <a href="https://www.dailytelegraph.com.au/news/nsw/ozempic-shame-why-users-are-embarrassed-to-admit-using-weight-loss-wonder-drug/news-story/ee52a819c69459afe6576d25988f9bd6">shamed for “cheating” or taking shortcuts</a> by using medication. <h2>Drugs are tools, not silver bullets</h2> The creation of these drugs is a start, but they remain expensive, and the hype has been followed by <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023#:%7E:text=Consumer%20Medicine%20Information%20.-,Why%20the%20Ozempic%20shortage%20happened,label%20prescribing%20for%20weight%20loss.">shortages</a>. Ultimately, complex challenges aren’t addressed with simple solutions. This is particularly true when people are involved, and even more so when there isn’t even an agreement on what the challenge is. Many organisations and individuals see obesity is a disease and believe this framing helps people to seek treatment. Others think it’s unnecessary to attach medical labels to body types and <a href="https://www.forbes.com/sites/geoffreykabat/2013/07/09/why-labeling-obesity-as-a-disease-is-a-big-mistake/?sh=5ca95cc2103b">argue</a> it confuses risk factors (things that are linked to increased risk of illness) with illness itself. Regardless, two things will always remain true. Drugs can only ever be tools, and those tools need to be applied in a context. To use these tools ethically, we need to remain mindful of who this application harms along the way. <hr /> Read the other articles in The Conversation’s <a href="https://theconversation.com/au/topics/ozempic-series-154673">Ozempic series</a> here.<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/219309/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/emma-beckett-22673">Emma Beckett</a>, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation - School of Health Sciences, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drugs-like-ozempic-wont-cure-obesity-but-they-might-make-us-more-fat-phobic-219309">original article</a>.

Body

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

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

Body

Might we see child-free zones on flights?

Ah, the joys of air travel. The excitement of jetting off to exotic locales, the thrill of new adventures, and of course, the endless possibilities for unexpected entertainment. And what's more exhilarating than finding yourself seated next to a rowdy toddler or an inconsolable infant? It's the stuff of dreams, truly. Picture this: you're settling into your seat, envisioning a serene journey ahead, perhaps catching up on your favourite Netflix series or finally finishing that novel you've been meaning to read. But wait, what's this? A couple with a baby approaching your row. You can already hear the distant wails of despair echoing through the cabin. Your heart sinks as you realise that your peaceful flight just took a nosedive before it even began. Yes, it's the age-old dilemma of child-free travellers everywhere. Whether it's the cacophony of a crying baby or the rhythmic drumming of tiny feet on the back of your seat, flying with children nearby can be an experience like no other. And let's not forget the classic game of "Will they or won't they?" as you anxiously await to see if the parents will be able to tame their pint-sized companions or if chaos will reign supreme at 30,000 feet. But fear not, dear passengers, for there may be a solution on the horizon. Could child-free zones be the answer to our airborne woes? According to a <a href="https://travel.nine.com.au/latest/planes-should-there-be-child-free-zones/d463b299-5258-418f-831c-f5fb218f1d77" target="_blank" rel="noopener">recent poll conducted by Nine News</a>, a whopping 73 per cent of respondents were in favour of such a proposition. Finally, a sanctuary where one can escape the unpredictable antics of tiny humans and bask in the tranquility of uninterrupted inflight bliss. Of course, implementing such a scheme may prove to be a tad challenging. After all, how does we go about segregating the child-rearing masses from the child-free elite without inciting a riot at the boarding gate? It's a logistical nightmare that even the most seasoned airline execs would hesitate to tackle. So, for now, it seems we child-free flyers will have to make do with our trusty noise-cancelling headphones, our steadfast eye masks, and a healthy dose of empathy for our fellow passengers. After all, parenting is no easy feat, especially at 35,000 feet. Image: Getty

Travel Trouble

We talked to dozens of people about their experience of grief. Here’s what we learned (and how it’s different from what you might think)

<a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Have you ever felt a sudden pang of sadness? A bird seems to stop and look you in the eye. A photo drops out of a messy drawer from long ago, in the mundanity of a weekend spring clean. Your day is immediately derailed, unsettled. You are pulled into something you thought was past. And yet, in being pulled back, you are grateful, reconnected, and grief-stricken all over again. “You’ll get over it”. “Give it time”. “You need time to move on”. These are common cultural refrains in the face of loss. But what if grief doesn’t play by the rules? What if grief is a different thing altogether? We talked to 95 people about their experiences of grief surrounding the loss of a loved one, and <a href="https://journals.sagepub.com/doi/10.1177/00380261241228412">their stories</a> provided a fundamentally different account of grief to the one often presented to us culturally. <h2>Disordered grief?</h2> Grief is often imagined as a time-bound period in which one processes the pain of loss – that is, adjusts to absence and works toward “moving on”. The bereaved are expected to process their pain within the confines of what society deems “normal”. The <a href="https://theconversation.com/explainer-what-is-the-dsm-and-how-are-mental-disorders-diagnosed-9568">DSM-5 psychiatric manual</a> says if grief drags on too long, in fact, it becomes a pathology (a condition with a medical diagnosis). “Prolonged grief disorder” is the name given to “persistent difficulties associated with bereavement that exceeded expected social, cultural, or religious expectations”. While there can be <a href="https://theconversation.com/why-prolonged-grief-should-be-listed-as-a-mental-disorder-4262">value</a> in clinical diagnostic categories such as this, the danger is they put artificial boundaries around emotions. The pathologisation of grief can be deeply alienating to those experiencing it, for whom the pressure to “move on” can be hurtful and counterproductive. The stories we gathered in our research were raw, complex and often fraught. They did not sit comfortably with commonsense understandings of how grief “should” progress. As bereaved daughter Barbara told us: "Grief is not in the little box, it doesn’t even come close to a little box." <h2>Grief starts early</h2> The tendency is to think of grief as something that happens post death. The person we love dies, we have a funeral, and the grief sets in. Then it slowly subsides with the steady march of time. In fact, grief often begins earlier, often in a clinical consultation where the words “terminal” or “nothing more we can do” are used. Or when a loved one is told “go home and get your life in order”. Grief can begin months or even years before bereavement. As the people we interviewed experienced it, loss was also cumulative. The gradual deterioration of a loved one’s health in the years or months before their death imposed other painful losses: the loss of chosen lifestyles, the loss of longstanding relational rhythms, the loss of shared hopes and anticipated futures. Many participants felt their loved ones – and, indeed, the lives they shared with them – slipping away long before their physical deaths. <h2>Living with the dead</h2> Yet the dead do not simply leave us. They remain with us, in memories, rituals and cultural events. From <a href="https://theconversation.com/what-ancient-cultures-teach-us-about-grief-mourning-and-continuity-of-life-86199">Mexico’s Dia de los Muertos</a> to <a href="https://theconversation.com/japans-obon-festival-how-family-commemoration-and-ancestral-worship-shapes-daily-life-179890">Japan’s Opon</a>, festivals of the dead play a key role in cultures around the world. In that way, remembering the dead remains a critical aspect of living. So too does <a href="https://theconversation.com/theres-not-always-closure-in-the-never-ending-story-of-grief-3096">the ongoing experience of grief</a>. Events of this kind are not merely celebratory. They are critical forms through which life and death, joy and grief, are brought together and integrated. The absence of remembering can hold its own trouble, as our participants’ accounts revealed. As bereaved wife Anna explained: "I just find it really frustrating and I do get quite angry and upset sometimes. I know that life goes on. I’d be talking to girlfriends and stuff like that and it’s like they’ve forgotten that I’ve lost my husband. They haven’t, but nothing really changed in their life. But for me, and my family, it has." Part of the problem, here, is the ambivalent role grief plays in advanced industrialised societies like ours. Many of our participants felt pressure to perform resilience or (in clinical terms) to <a href="https://journals.sagepub.com/doi/full/10.1177/1363459317724854">“recover” quickly after loss</a>. But whose interests does a swift recovery serve? An employer’s? Friends who just want to get on with a death-free life? And, even more importantly, mightn’t ongoing connections with the dead enable better living? Might bringing the dead along with us actually make for better deaths and better lives? Many of our participants felt their loved ones remained with them, and experienced their “absent presence” as a source of comfort. Grieving, in this context, involved spending time “with” the dead. Anna described her practice as follows: "I had a diary, so I just write stuff in it about how I’m feeling or something happened and I’ll say to [my deceased husband], it’s all to [my deceased husband], “Do you remember, blah, blah, blah.” I’ll just talk about that memory that I have of that particular time and I find that that helps." <h2>Caring for those who grieve</h2> Grief does not begin at death, but neither do relationships end there. To rush the bereaved through grief – to usher them towards “recovery” and the more comfortable territories of happiness and productivity – is to do them a disservice. And, perhaps more critically, ridding our lives of the dead and grief may, in the end, make for more limited and muted emotional lives.<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/223848/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, Research Fellow, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-talked-to-dozens-of-people-about-their-experience-of-grief-heres-what-we-learned-and-how-its-different-from-what-you-might-think-223848">original article</a>.

Caring

‘Self-love’ might seem selfish. But done right, it’s the opposite of narcissism

<a href="https://theconversation.com/profiles/ian-robertson-1372650">Ian Robertson</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> “To love what you are, the thing that is yourself, is just as if you were embracing a glowing red-hot iron” <a href="https://archive.org/details/jungsseminaronni0000jung">said psychonalyst Carl Jung</a>. Some may argue this social media generation does not seem to struggle with loving themselves. But is the look-at-me-ism so easily found on TikTok and Instagram the kind of self-love we need in order to flourish? The language of <a href="https://theconversation.com/teaching-positive-psychology-skills-at-school-may-be-one-way-to-help-student-mental-health-and-happiness-217173">positive psychology</a> can be – and often is – appropriated for all kinds of self-importance, as well as cynical marketing strategies. Loving yourself, though, psychological experts stress, is not the same as behaving selfishly. There’s a firm line between healthy and appropriate forms of loving yourself, and malignant or <a href="https://theconversation.com/how-many-types-of-narcissist-are-there-a-psychology-expert-sets-the-record-straight-207610">narcissistic</a> forms. But how do we distinguish between them? In 2023, researchers Eva Henschke and Peter Sedlmeier conducted <a href="https://www.researchgate.net/publication/355152846_What_is_self-love_Redefinition_of_a_controversial_construct">a series of interviews</a> with psychotherapists and other experts on what self-love is. They’ve concluded it has three main features: self-care, self-acceptance and self-contact (devoting attention to yourself). But as an increasingly individualistic society, are we already devoting too much attention to ourselves? <h2>Philosophy and self-love</h2> Philosophers and psychology experts alike have considered the ethics of self-love. Psychology researcher Li Ming Xue and her colleagues, <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2021.585719/full">exploring the notion of self-love in Chinese culture</a>, claim “Western philosophers believe that self-love is a virtue”. But this is a very broad generalisation. In the Christian tradition and in much European philosophy, <a href="https://www.tandfonline.com/doi/full/10.1080/10848770.2020.1839209">says philosopher Razvan Ioan</a>, self-love is condemned as a profoundly damaging trait. On the other hand, <a href="https://www.jstor.org/stable/2107991">many of the great Christian philosophers</a>, attempting to make sense of the instruction to love one’s neighbour as oneself, admitted certain forms of self-love were virtuous. In order to love your neighbour as yourself, you must, it would seem, love yourself. In the Western philosophical context, claim Xue and her colleagues, self-love is concerned with individual rights – “society as a whole only serves to promote an individual’s happiness”. This individualistic, self-concerned notion of self-love, they suggest, might come from the Ancient Greek philosophers. In particular, Aristotle. But <a href="https://www.psychologytoday.com/intl/blog/philosophy-stirred-not-shaken/201502/love-yourself-love-your-character">Aristotle thought only the most virtuous</a>, who benefited the society around them, should love themselves. By making this connection, he avoided equating self-love with self-centredness. We should love ourselves not out of vanity, he argued, but in virtue of our capacity for good. Does Aristotle, then, provide principled grounds for distinguishing between proper and improper forms of self-love? <h2>Bar too high?</h2> Aristotle might set the bar too high. If only the most virtuous should try to love themselves, this collides head-on with the idea loving yourself can help us improve and become more virtuous – as <a href="https://link.springer.com/chapter/10.1057/9781137383310_6">philosophers Kate Abramson and Adam Leite have argued</a>. Many psychologists claim self-love is important for adopting the kind and compassionate self-perception crucial for overcoming conditions that weaponise self-criticism, like <a href="https://theconversation.com/clinical-perfectionism-when-striving-for-excellence-gets-you-down-43704">clinical perfectionism</a> and <a href="https://theconversation.com/how-many-people-have-eating-disorders-we-dont-really-know-and-thats-a-worry-121938">eating disorders</a>. More broadly, some argue compassion for oneself is necessary to support honest insights into your own behaviour. They believe we need warm and compassionate self-reflection to avoid the defensiveness that comes with the fear of judgement – even if we’re standing as our own judge. For this reason, a compassionate form of self-love is often necessary to follow Socrates’ advice to “know thyself”, says <a href="https://link.springer.com/article/10.1007/s10677-015-9578-4">philosopher Jan Bransen</a>. Positive self-love, by these lights, can help us grow as people. <h2>Self-love ‘misguided and silly’</h2> But not everyone agrees you need self-love to grow. The late philosopher <a href="https://www.theguardian.com/news/2005/nov/29/guardianobituaries.obituaries">Oswald Hanfling</a> was deeply sceptical of this idea. In fact, he argued the notion of loving oneself was misguided and silly. His ideas are mostly rejected by philosophers of love, but pointing out where they go wrong can be useful. When you love someone, he said, you’re prepared to sacrifice your own interests for those of your beloved. But he thought the idea of sacrificing your own interests made no sense – which shows, he concluded, we can’t love ourselves. <a href="https://www.jstor.org/stable/3751159">He wrote</a>: "I may sacrifice an immediate satisfaction for the sake of my welfare in the future, as in the case of giving up smoking. In this case, however, my motive is not love but self-interest. What I reveal in giving up smoking is not the extent of my love for myself, but an understanding that the long-term benefits of giving it up are likely to exceed the present satisfaction of going on with it." We often have conflicting interests (think of someone who is agonising over two different career paths) – and it’s not at all strange to sacrifice certain interests for the sake of others. This is not just a question of sacrificing short-term desires in favour of a long-term good, but a matter of sacrificing something of value for your ultimate benefit (or, so you hope). <h2>Self-compassion</h2> Hanfling fails to consider the role of compassionate self-love. While we might understand it’s in our interests to do something (for instance, repair bridges with someone we’ve fallen out with), it might take a compassionate and open disposition towards ourselves to recognise what’s in our best interests. We might need this self-compassion, too, in order to admit our failures – so we can overcome our defensiveness and see clearly how we’re failing to fulfil <a href="https://link.springer.com/article/10.1007/s10677-015-9578-4">these interests</a>. Self-acceptance in this context does not mean giving ourselves licence to run roughshod over the interests of those around us, nor to justify our flaws as “valid” rather than work on them. Self-love, as promoted by contemporary psychologists, means standing in a compassionate relationship to ourselves. And there’s nothing contradictory about this idea. Just as we strive to develop a supportive, kind relationship to the people we care about – and just as this doesn’t involve uncritical approval of everything they do – compassionate self-love doesn’t mean abandoning valid self-criticism. In fact, self-compassion has the opposite effect. It promotes comfort with the kind of critical self-assessment that helps us grow – which leads to resilience. It breeds the opposite of narcissistic self-absorption.<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/205938/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ian-robertson-1372650">Ian Robertson</a>, PhD Candidate (Teaching roles at Macquarie & Wollongong), <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/self-love-might-seem-selfish-but-done-right-its-the-opposite-of-narcissism-205938">original article</a>.

Mind

Your skin is a mirror of your health – here’s what yours might be saying

<a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> <a href="https://pubmed.ncbi.nlm.nih.gov/12095893/">Skin accounts for around 15% of our body mass</a>. It is the largest and most visible organ in the human body. Yet many of the skin’s functions are often overlooked. It’s a sunscreen, a shield from germs, a reservoir of <a href="https://pubmed.ncbi.nlm.nih.gov/28994020/">vitamin D</a> and a means of tightly regulating our body temperature. Being the most visible of our organs, the skin also offers us a view into the body tissues that it protects. So don’t think of your skin merely aesthetically – think of it as a reflection of your health. Disorders of the gut, blood, hormones and even the heart might first be seen on the skin in the form of a rash. Here are a few to look out for. <h2>Bullseye</h2> Ticks are pesky creatures that no one will want to return home from a country walk with. But while the vast majority of tick bites <a href="https://pubmed.ncbi.nlm.nih.gov/36116831/">won’t make you ill</a>, there is one rash that should prompt a visit to your doctor if you spot it. Erythema migrans, a rash named for its ability to rapidly expand across the skin, is a hallmark of <a href="https://www.bmj.com/content/369/bmj.m1041.long">Lyme disease</a>, a potentially severe bacterial illness. This rash forms a classic target pattern, like a bullseye on a dartboard. Be vigilant for a few weeks after being bitten to check this rash doesn’t make an appearance – especially if you noticed a red lump that wasn’t there before or if you had to remove a tick from your skin. You should also keep an eye out for other associated symptoms of Lyme disease – such as swinging temperatures, muscle and joint pains and headache. The condition is treated with antibiotics, which can prevent long-term complications, including chronic fatigue symptoms. <h2>Purpura</h2> Some rashes are given a <a href="https://linkinghub.elsevier.com/retrieve/pii/S1538-7836(22)01880-3">colourful namesake</a> – purpura is one such example. This rash’s name is derived from a mollusc which was used to make purple dye. Purpura refers to a rash of small purple or red dots. The cause is pooling of blood into a deeper layer of the skin (dermis). When pressed with a finger – or even better, the side of a glass – it refuses to blanch away. Purpura signals an issue with either the walls of the tiny blood vessels that feed the skin or the blood within them. This might be from a deficiency in platelets, the tiny cell fragments that allow blood to clot – perhaps from bone marrow failure, or an autoimmune condition where the body turns on itself and attacks its own cells. At worst, purpura may signal the life-threatening condition <a href="https://www.magonlinelibrary.com/doi/full/10.12968/hmed.2017.78.8.468">septicaemia</a>, where an infection has spread into the bloodstream – perhaps from the lungs, kidneys or even from the skin itself. <h2>Skin spiders</h2> Skin rashes can also take on <a href="https://pubmed.ncbi.nlm.nih.gov/32513406/">recognisable shapes</a>. Spider naevi represent an issue within skin arterioles (small arteries which supply the skin with blood). Arterioles open and close to control the loss of heat from the body’s surface. But sometimes they can get stuck open – and a spider-like pattern will appear. The open arteriole is the spider’s body, and the even tinier capillaries fanning out in all directions are the thready legs. Crush the body under a fingertip and the whole thing disappears, as your touch temporarily stops the blood flow. Often, these are benign and not associated with any specific condition – especially if you only have one or two. However, more than three suggest higher circulating levels of the <a href="https://dermnetnz.org/topics/spider-telangiectasis">hormone oestrogen</a>, often due to liver disease or from the hormonal changes seen in pregnancy. Treat the underlying cause, and the spiders often vanish with time – though they may persist or reappear later. <h2>Black velvet</h2> Changes to the folds of your skin (usually around the armpits or neck) – especially if it becomes thickened and velveteen to the touch – may suggest a condition known as <a href="https://onlinelibrary.wiley.com/doi/10.1111/jocd.13544">acanthosis nigricans</a>. This “black velvet” skin appearance is more commonly seen in darker skins. Usually, the condition is associated with <a href="https://pubmed.ncbi.nlm.nih.gov/29241752/">disorders of the metabolism</a> – namely type 2 diabetes and polycystic ovary syndrome. If either of these conditions are successfully treated, the rash may fade. In rare cases, it can also be a sign of <a href="https://www.hkmj.org/abstracts/v29n4/355.htm">stomach cancer</a>, which should be considered in patients with few or none of the key signs of metabolic disease (obesity and high blood pressure). <h2>Butterfly rashes</h2> Even disorders of the heart can be visible on the skin. Cardiac valves have the important role of correctly directing the journey of blood through the heart and preventing backflow. The valve between the chambers on the left side of the heart (the mitral valve – so called because of its resemblance to a bishop’s hat, or mitre) can sometimes become narrowed, causing the heart’s function to deteriorate. The body’s natural response is to preserve core blood volume, shutting off flow towards the skin. The net effect can produce a purple-red rash, high across the cheeks and the bridge of the nose, like the outstretched wings of a butterfly. We call this <a href="https://journals.sagepub.com/doi/10.1177/2050313X231200965?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">mitral facies</a> which, depending on the extent of damage to the heart and great vessels, may persist despite treatment. It’s important to pay heed to your skin. It’s constantly talking to you, and any changes in its texture, colour or if new marks or patterns appear, may indicate something is going on beneath the surface.<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/221937/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-skin-is-a-mirror-of-your-health-heres-what-yours-might-be-saying-221937">original article</a>.

Body

How much weight do you actually need to lose? It might be a lot less than you think

<a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> If you’re one of the <a href="https://www.finder.com.au/new-years-resolutions-statistics">one in three</a> Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards. But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers. Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range. Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight. Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits. <h2>Using BMI to define our target weight is flawed</h2> We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio. BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening. But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is <a href="https://theconversation.com/using-bmi-to-measure-your-health-is-nonsense-heres-why-180412">because</a> it: <ul> <li> fails to consider two critical factors related to body weight and health – body fat percentage and distribution </li> <li> does not account for significant differences in body composition based on gender, ethnicity and age. </li> </ul> <h2>How does losing weight benefit our health?</h2> Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways. 1. Reducing cholesterol Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy. Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke. But <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4987606/">research</a> shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss. 2. Lowering blood pressure Our blood pressure is considered high if it reads more than 140/90 on at least two occasions. Excess weight is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">linked to</a> high blood pressure in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082272/">several ways</a>, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure. Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke. Like the improvements in cholesterol, a 5% weight loss <a href="https://onlinelibrary.wiley.com/doi/10.1002/oby.21358">improves</a> both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number). A <a href="https://www.ahajournals.org/doi/10.1161/01.hyp.0000094221.86888.ae">meta-analysis of 25 trials</a> on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point. 3. Reducing risk for type 2 diabetes Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat). Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels. Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system. <a href="https://www.nejm.org/doi/full/10.1056/nejmoa012512">Research</a> shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%. 4. Reducing joint pain and the risk of osteoarthritis Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis. <a href="https://pubmed.ncbi.nlm.nih.gov/21425246/">Observational studies</a> show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold. Small amounts of weight loss alleviate this stress on our joints. <a href="https://pubmed.ncbi.nlm.nih.gov/15986358/">In one study</a> each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities. <h2>Focus on long-term habits</h2> If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone. An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/">analysis</a> of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%. When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several <a href="https://pubmed.ncbi.nlm.nih.gov/25896063/">physiological responses</a> to defend our body weight and “survive” starvation. Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to: <ul> <li> losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight </li> <li> making gradual changes to your lifestyle to ensure you form habits that last a lifetime. </li> </ul> Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits. At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can <a href="https://redcap.sydney.edu.au/surveys/?s=RKTXPPPHKY">register here</a> to express your interest.<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/217287/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nick-fuller-219993">Nick Fuller</a>, Charles Perkins Centre Research Program Leader, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-weight-do-you-actually-need-to-lose-it-might-be-a-lot-less-than-you-think-217287">original article</a>.

Body

Squats and lunges might help you avoid knee surgery

Whether it’s another round of squats and lunges, or a longer wall sit, researchers say working those quads could help lower your risk of a knee replacement. <div> In Australia, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis" target="_blank" rel="noopener">about 9% of the population</a> has osteoarthritis, a condition known to lead to hip and knee surgery in severe cases. About 14 million Americans suffer from knee osteoarthritis, about half are expected to face knee replacement surgery. But new research offers hope, finding stronger quadricep muscles could play a role in avoiding knee replacement surgery. A study presented to <a href="https://press.rsna.org/timssnet/media/rsna/newsroom2023.cfm" target="_blank" rel="noopener">annual meeting</a> of the Radiological Society of North America, offers hope to people with arthritis, finding stronger quadriceps could help in avoiding a knee replacement. The two most important muscles in the knee are the extensors or quadriceps, and the hamstrings. Quads are the strong muscles located at the front of the thigh, which play a key role in gait. Hammies at the back of the thigh, are essential for hip and knee flexibility. The two muscles act as opposing forces, allowing physical activity while also protecting the knee. An imbalance can change the body’s biomechanics, and may progress to osteoarthritis. Using MRI scans – from the time of surgery as well as 2 and 4 years prior – researchers analysed thigh muscle volume in 134 participants from a national study called the Osteoarthritis Initiative. Using artificial intelligence to compute muscle volume from the MRI scans, the researchers compared 67 of the cohort who had a total, single knee replacement with 67 control participants who had not undergone knee replacement surgery. They found patients who had a higher ratio of quadricep to hamstring volume had significantly lower odds of a total knee replacement. Higher volume hamstrings were also associated with lower odds of surgery. The results suggest strength training – focusing on the quadriceps – may be beneficial, both in people with arthritis as well as the general population.  <img id="cosmos-post-tracker" src="https://syndication.cosmosmagazine.com/?id=289325&title=Squats+and+lunges+might+help+you+avoid+knee+surgery" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" />Image credits: Getty Images</div> <div> </div> <div><a href="https://cosmosmagazine.com/health/body-and-mind/squats-and-lunges-might-help-you-avoid-knee-surgery/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </div>

Body

Trying to spend less on food? Following the dietary guidelines might save you $160 a fortnight

<a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> A rise in the <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/pubs/BriefingBook47p/CostOfLiving#:%7E:text=Consumer%20Price%20Index%20over%20time,but%205.1%25%20in%20the%20second">cost of living</a> has led many households to look for ways to save money. New research suggests maintaining a healthy diet, in line with the <a href="https://www.eatforhealth.gov.au/guidelines/guidelines">Australian Dietary Guidelines</a>, is cheaper than an unhealthy diet and <a href="https://southwesthealthcare.com.au/wp-content/uploads/SWH-HP-Healthy-Diets-ASAP-Protocol-Warrnambool-Report-2023.pdf">could save A$160</a> off a family of four’s fortnightly shopping bill. Poor diet is the most common preventable risk factor contributing to chronic disease in <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30752-2/fulltext">Australia</a>. So improving your diet can also be an important way to reduce the chance of developing chronic disease. <h2>First, what are the dietary guidelines?</h2> The guidelines provide information on the quantity and types of foods most Australians should consume to promote overall health and wellbeing. Recommendations include eating a wide variety of nutritious foods from the main five food groups: <ul> <li>vegetables and legumes</li> <li>fruit</li> <li>grains</li> <li>lean meats and meat alternatives such as tofu, nuts and legumes</li> <li>dairy products.</li> </ul> The guidelines recommend limiting our intake of foods high in saturated fat, added salt, added sugars and alcohol. <h2>What are Australians eating?</h2> Fewer than <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/dietary-behaviour/latest-release">7%</a> of Australians eat sufficient vegetables, in line with the Australian Dietary Guidelines. In fact, Australians have an average healthy diet score of <a href="https://www.csiro.au/-/media/News-releases/2023/Total-Wellbeing-Diet-Health-Score/Diet-score-2023-Report_September.pdf">55 out of 100</a> – barely passing. Foods that aren’t part of a food group are known as “discretionary” items, which includes alcohol, cakes, biscuits, chocolate and confectionery and most takeaway foods. Because they’re typically high in kilojoules, saturated fat, sodium and added sugars, the Australian Dietary Guidelines recommend they only be eaten occasionally and in small amounts (ideally zero serves). For many households, discretionary items make up a big portion of their grocery shop. Australians consume an average of <a href="https://www.csiro.au/-/media/News-releases/2023/Total-Wellbeing-Diet-Health-Score/Diet-score-2023-Report_September.pdf">28 serves</a> of discretionary choices per week (equal to 28 doughnuts, 28 slices of cake, or 28 cans of soft drink or beer). This is an increase of ten serves since 2015. One recent <a href="https://link.springer.com/article/10.1186/s12966-022-01389-8">study</a> estimated 55% of Australians’ total energy intake was from discretionary items. <h2>What did the researchers find?</h2> Researchers from the Health Promotion Team at South West Healthcare <a href="https://southwesthealthcare.com.au/wp-content/uploads/SWH-HP-Healthy-Diets-ASAP-Protocol-Warrnambool-Report-2023.pdf">recently</a> visited four local supermarkets and takeaway stores in Warrnambool, Victoria, and purchased two baskets of groceries. One basket met the Australian Dietary Guidelines (basket one), the other aligned with the typical dietary intake of Australians (basket two). They compared prices between the two and found basket one would cost approximately $167 less per fortnight for a family of four at the most affordable supermarket. That’s equal to $4,342 a year. Basket one was sufficient to supply a family of four for a fortnight, and aligned with the Australian Dietary Guidelines. It cost $724 and included: <ol> <li>fruit and vegetables (made up 31% of the fortnightly shop)</li> <li>grains and cereals (oats, cornflakes, bread, rice, pasta, Weet-bix)</li> <li>lean meats and alternatives (mince, steak, chicken, tuna, eggs, nuts)</li> <li>milk, yoghurt and cheese</li> <li>oils and spreads (olive oil).</li> </ol> Basket two reflected the current average Australian fortnightly shop for a family of four. In the project, the team spent over half of the fortnightly shop on processed and packaged foods, of which 21% was spent on take-away. This is based on actual dietary intake of the general population reported in the 2011-2012 <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/australian-health-survey-nutrition-first-results-foods-and-nutrients/latest-release#:%7E:text=Food%20consumption,across%20the%20major%20food%20groups.">Australian Health Survey</a>. Basket two cost $891 and included: <ol> <li>fruit and vegetables (made up 13% of the fortnightly shop)</li> <li>grains and cereals (oats, cornflakes, bread, rice, pasta, Weet-bix)</li> <li>lean meats and alternatives (mince, steak, chicken, tuna, eggs, nuts)</li> <li>milk, yogurt and cheese</li> <li>oils and spreads (olive oil, butter)</li> <li>drinks (soft drink, fruit juice)</li> <li>desserts and snacks (muffins, sweet biscuits, chocolate, ice cream, potato chips, muesli bars)</li> <li>processed meats (sausages, ham)</li> <li>convenience meals</li> <li>fast food (pizza, meat pie, hamburger, fish and chips)</li> <li>alcohol (beer, wine).</li> </ol> <h2>But a healthy basket is still unaffordable for many</h2> While this piece of work, and other <a href="https://www.mdpi.com/1660-4601/15/11/2469">research</a>, suggests a healthy diet is less expensive than an unhealthy diet, affordability is still a challenge for many families. The Warrnambool research found basket one (which aligned with guidelines) was still costly, requiring approximately 25% of a median household income. This is unaffordable for many. For a household reliant on welfare, basket one would require allocating 26%-38% of their income. This highlights how the rising cost of living crisis is affecting those already facing financial difficulties. Around 3.7 <a href="https://reports.foodbank.org.au/foodbank-hunger-report-2023/">million</a> Australian households did not have access to enough food to meet their basic needs at some point in the last 12 months. Policy action is needed from the Australian government to make recommended diets more affordable for low socioeconomic groups. This means lowering the costs of healthy foods and ensuring household incomes are sufficient. <h2>What else can you do to cut your spending?</h2> To help reduce food costs and support your health, reducing discretionary foods could be a good idea. Other ways to reduce your grocery bill and keep your food healthy and fresh include: <ul> <li> planning for some meatless meals each week. Pulses (beans, lentils and legumes) are nutritious and cheap (a can is <a href="https://coles.com.au/product/coles-chick-peas-420g-8075852?uztq=46abcbb7e16253b0cdc3e6c5bbe6a3f0&cid=col_cpc_Generic%7cColesSupermarkets%7cPLA%7cCatchAll%7cAustralia%7cBroad&s_kwcid=AL!12693!3!675842378376!!!g!326304616489!&gad_source=1&gclid=CjwKCAjwkY2qBhBDEiwAoQXK5SceYhU2VtKepNLXWN218GH8Cp8Vs9cnYynCBwRqQPaW3UYNX2SVIBoC_6EQAvD_BwE&gclsrc=aw.ds">less than $1.50</a>. Here are some great pulse recipes to <a href="https://nomoneynotime.com.au/healthy-easy-recipes/filter/keywords--vegetarian/p2">try</a> </li> <li> checking the specials and buy in bulk (to store or freeze) when items are cheaper </li> <li> making big batches of meals and freezing them. Single-serve portions can help save time for lunches at work, saving on takeaway </li> <li> Australian supermarkets are <a href="https://www.theguardian.com/australia-news/datablog/2023/jul/27/cost-of-living-grocery-store-price-rises-cheapest-fresh-produce-australia-woolworths-coles#:%7E:text=The%20results%20showed%20independent%20and,best%20place%20for%20affordable%20groceries">almost never</a> the cheapest place for fresh produce, so shop around for farmers markets or smaller local grocery shops </li> <li> buying generic brands when possible, as they are <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/streamlined-datagathering-techniques-to-estimate-the-price-and-affordability-of-healthy-and-unhealthy-diets-under-different-pricing-scenarios/872EA6396533166E0C6FA94C809D9CAC#r">notably cheaper</a>. Supermarkets usually <a href="https://theconversation.com/the-science-that-makes-us-spend-more-in-supermarkets-and-feel-good-while-we-do-it-23857">promote</a> the items they want you to buy at eye-level, so check the shelves above and below for cheaper alternatives.<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/216749/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian & Academic, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/trying-to-spend-less-on-food-following-the-dietary-guidelines-might-save-you-160-a-fortnight-216749">original article</a>.

Food & Wine

Do you think you have a penicillin allergy? You might be wrong

<a href="https://theconversation.com/profiles/winnie-tong-1468274">Winnie Tong</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jacqueline-loprete-1468275">Jacqueline Loprete</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Penicillins are the most prescribed class of antibiotics in Australia. Originally derived from a fungus, penicillin antibiotics such as amoxicillin are used to treat common infections, including chest, sinus, ear, urinary tract and skin infections. Penicillins are effective against a wide range of bacteria that cause common infections. But their activity is not so broad as to impact on good bacteria in our gut like other antibiotic classes do. They’re also cheap and readily accessible. Up to <a href="https://www.sciencedirect.com/science/article/pii/S2772829322000376#bib1">20%</a> of Australians admitted in hospital say they have a penicillin allergy. But not everyone who thinks they’re allergic to penicillin actually is. Research from <a href="https://www.sciencedirect.com/science/article/pii/S2772829322000376?via%3Dihub">our team</a> and others suggests that if we assess all these patients, up to 90% are not allergic to it. <h2>Why does it matter?</h2> People who mistakenly think they’re allergic to penicillin may not get the most effective or safest antibiotics to treat their infection. They are also at greater risk of developing <a href="https://www.sciencedirect.com/science/article/abs/pii/S009167491301467X">multidrug-resistant infections</a> or “superbugs”. This is because the antibiotic will kill off the bacteria that are susceptible to it, but the resistant bacteria are left behind to proliferate and cause further infection. People who receive second-line antibiotics are more likely to have complications, such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S009167491301467X">antibiotic-induced gut infections</a>. Second-line antibiotics tend to have a wider range of activity, killing both the bacteria causing infection, and the good bacteria required to keep our gut in balance. This allows bugs like Clostridium difficile, which normally lives in our gut but is controlled by other bacteria, to overgrow and cause inflammation. For the health system, using second-line antibiotics means longer, more complicated hospital stays. Hospital stays for patients with penicillin allergies cost up to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2222.2003.01638.x">63% more</a> more than those without. It also results in greater costs for medications and greater resources required to treat the patient. <h2>Why do people think they’re allergic?</h2> People incorrectly believe they are allergic to penicillin for a number of reasons. They may have experienced side effects from penicillin, such as nausea or diarrhoea. But though unpleasant, this doesn’t mean an allergy. Others had a rash as a child, but this could have been due to the illness itself or an interaction between the virus and the antibiotic. An Epstein-Barr viral infection treated with amoxicillin, for example, <a href="https://pubmed.ncbi.nlm.nih.gov/23589810/">causes</a> a fine, red rash. Some believe a family history of reactions to penicillin means they cannot take them. But there is no evidence penicillin allergy is inherited. If some time has passed between exposure, people can lose the allergic response. This is typically seen in adults who had a mild allergy as a child, but lose the response with time, so are said to have “grown out” of their allergy. Then there are people who have had a genuine and serious reaction to penicillin. This includes anaphylaxis, with profound swelling, breathing difficulties and low blood pressure, and severe life-threatening reactions such as <a href="https://www.ncbi.nlm.nih.gov/books/NBK459323/#:%7E:text=Stevens%2DJohnson%20syndrome%2Ftoxic%20epidermal,in%20over%2080%25%20of%20cases.">Steven-Johnson’s syndrome</a>, which causes widespread blisters and wounds that resemble burns. <h2>Testing for penicillin</h2> When someone says they have a penicillin allergy, we first get them to explain what happened with the reaction, including to what antibiotic, in what context and how severe it was. Then we perform skin tests to further assess the person’s risk of reaction. If skin tests are negative, we can then give the patient the penicillin in question under supervision (a “challenge”) to see if they react. Some people can skip the skin tests altogether and go straight to the challenge if the history tells us they are at low risk of reacting. <a href="https://www.sciencedirect.com/science/article/pii/S2772829322000376?via%3Dihub">Our study</a> followed 195 patients who reported a penicillin allergy across six Sydney hospitals. In the first phase, we assessed 85 people and found 82% weren’t allergic to penicillin. In the second phase, we assessed 110 people, of whom 69% weren’t allergic. This is slightly lower than research on the population as a whole, because we only looked at people who were referred for an allergy assessment. Many more patients carry an allergy label than those referred for testing. In our study, eight weeks after their test, just 54% of participants in phase one correctly knew their penicillin allergy status. Some allergic people believed they were not allergic, and many non-allergic people believed they were allergic. For phase two, we ensured people received a standardised letter outlining their results in addition to having a doctor or nurse explain them. This time, 92% were correct in their understanding when contacted eight weeks later. <h2>Reducing long waits for allergy tests</h2> Ruling out allergies among people who think they can’t have penicillin is time- and labour-intensive. The wait time from someone first being referred to an allergy clinic to having testing can be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026071/">up to two years</a>. And it’s usually not available outside major metropolitan hospitals. We need to improve access to testing and also look at when people can access allergy services. When a person is sick in hospital with a serious infection, it’s not the right time for testing. We also need to ensure the results of allergy tests translate to the real world so people know their true allergy status. The fragmentation of our medical records are a barrier to clear and effective communication of a patient’s true allergy status, and urgently need to be improved. <a href="https://theconversation.com/profiles/winnie-tong-1468274">Winnie Tong</a>, Clinical Immunologist & Allergist, Immunopathologist and Senior Lecturer, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jacqueline-loprete-1468275">Jacqueline Loprete</a>, Postdoctoral fellow, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-think-you-have-a-penicillin-allergy-you-might-be-wrong-212874">original article</a>.

Body

All the reasons you might be having night sweats – and when to see a doctor

<a href="https://theconversation.com/profiles/siobhan-banks-18473">Siobhan Banks</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/linda-grosser-1461631">Linda Grosser</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> You’ve finished a workout, so you’re hot and drenched with perspiration – but soon you begin to feel cool again. Later, it’s a sweltering summer evening and you’re finding it hard to sleep, so you kick off the covers. Sweating is a normal part of the body’s cooling system, helping to release heat and maintain optimal body temperature. But regularly waking up during the night, soaked through from excessive sweating is not. Night sweats are <a href="https://www.mayoclinic.org/symptoms/night-sweats/basics/definition/sym-20050768">repeated episodes</a> of excessive or intense sweating at night. They are an unpleasant part of life for many people. Many conditions and factors can trigger night sweats by changing the body’s tightly regulated temperature set point, at which the body attempts to maintain its <a href="https://www.tandfonline.com/doi/full/10.4161/temp.29702">core temperature</a>. Some triggers are harmless (a hot bedroom) or even related to positive lifestyle changes (exercise). Others have an underlying cause like menopause, infection, disease or medication. <h2>Temperature control and sweating</h2> The hypothalamus, located in the brain, is part of the <a href="https://www.hormones-australia.org.au/the-endocrine-system/">endocrine system</a> and the temperature control centre for the body. It contains <a href="https://www.statpearls.com/point-of-care/29920#ref_19631766">temperature sensors</a> that receive information from nerve cells (thermoreceptors) located centrally (in the organs) and peripherally in the skin. Thermoreceptors detect changes in body temperature, sending signals back to the hypothalamus. These <a href="https://www.sciencedirect.com/science/article/pii/S1876034111000256">signals</a> will either activate sweating to cool the body or shivering to warm the body. <h2>Hormones and night sweats</h2> Anyone, regardless of age or gender, can experience night sweats. But women experience night sweats more often than men, largely because menopause and associated changing hormone levels are <a href="https://www.tandfonline.com/doi/abs/10.3109/13697137.2011.608596">a leading cause</a>. Approximately 80% of women experience <a href="https://link.springer.com/article/10.1007/s00737-007-0209-5">hot flashes</a> (also called hot flushes) or night sweats after <a href="https://www.menopause.org.au/hp/information-sheets/what-is-menopause">menopause</a> (when periods have ceased for 12 months) and during <a href="https://www.healthdirect.gov.au/perimenopause">perimenopause</a> (the time leading up to it). While both hot flashes and night sweats produce a feeling of overheating, they are different experiences associated with menopause. Hot flashes occur during the day, are transient episodes of flushing and may involve sweating. Night sweats occur at night and involve an intense period of <a href="https://www.proquest.com/docview/2821423865?accountid=14649">sweating</a>. Changing oestrogen levels are thought to impact norepinephrine and serotonin levels, two neurotransmitters that influence <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/#:%7E:text=%5B21%5D%20Estrogens%20stimulate%20the%20production,norepinephrine%20which%20disturbs%20hypothalamic%20thermostat">temperature regulation</a> in the hypothalamus. Hormones also influence night sweats in men, particularly those with low <a href="https://www.healthdirect.gov.au/testosterone">testosterone</a> levels, known as <a href="https://www.hormones-australia.org.au/endocrine-diseases/hypogonadism/">hypogonadism</a>. Around 38% of men aged 45 years or older have low testosterone <a href="https://www.scielo.br/j/ibju/a/RZqqfTn5tY6BFpV6rp3GMxJ/">levels</a> but it can affect men at any age. <h2>Infections, disease and medications</h2> When fighting infection, our body temperature often <a href="https://europepmc.org/article/nbk/nbk562334">rises</a>. This can stimulate sweating to cool and decrease body <a href="https://www.sciencedirect.com/science/article/pii/S1876034111000256">temperature</a>. Minor infections like the common cold can cause night sweats. They are also a symptom of serious infections such as human immunodeficiency virus (HIV) and diseases such as <a href="https://www.aafp.org/pubs/afp/issues/2020/0101/p34.html">Hodgkin’s</a> and <a href="https://link.springer.com/article/10.2165/00002018-200831020-00002">non-Hodgkin’s lymphoma</a>. However, night sweats are rarely the only symptom present. Medications such as selective serotonin reuptake inhibitors (SSRIs), corticosteroids, thyroid hormone replacement and methadone can cause night sweats. These medications affect parts of the <a href="https://link.springer.com/article/10.2165/00002018-200831020-00002">brain</a> and neurotransmitters that control and stimulate sweating. Regular alcohol (particularly alcohol dependence) and recreational drug use can also <a href="https://link.springer.com/article/10.2165/00002018-200831020-00002">increase the risk</a> of night sweats. <h2>Stress, snoring and strenuous exercise</h2> Night sweats are commonly reported by people with <a href="https://karger.com/spp/article-abstract/26/2/92/295722/Psychological-Sweating-A-Systematic-Review-Focused?redirectedFrom=fulltext">anxiety</a>. Psychological stress activates the body’s fight or flight system releasing neurotransmitters that increase heart rate, respiration, and blood pressure. This causes the body to heat up, at which point it starts sweating to cool the body back down. Night sweats may also increase anxiety, causing more sweating which in turn leads to less sleep and more anxiety. If anxiety causes night sweats and this causes distress, it’s best to get up, move around and engage in a <a href="https://www.calmclinic.com/anxiety/symptoms/night-sweats">calming routine</a>, preferably in a dark or dimly lit room. Night sweats have similarly been connected with sleep disorders like <a href="https://www.healthdirect.gov.au/obstructive-sleep-apnoea">obstructive sleep apnoea</a>, where the airway is repeatedly blocked during sleep and there is loud snoring. About one third of people with obstructive sleep apnoea regularly <a href="https://link.springer.com/article/10.1007/s11325-011-0502-4">experience night sweats</a>. The exact cause is undetermined but research shows it is linked with low blood oxygen levels (<a href="https://link.springer.com/article/10.1007/s11325-022-02701-3">hypoxemia</a>) and/or <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2869.2009.00743.x">high blood pressure</a>. People can experience night sweats after high-intensity workouts. Vigorous exercise can stimulate the thyroid, <a href="https://www.ncbi.nlm.nih.gov/books/NBK500006/#:%7E:text=Thyroid%20hormone%20increases%20the%20basal,respiration%20rate%2C%20and%20body%20temperature">increasing basal metabolic rate</a> and body temperature for up to <a href="https://journals.lww.com/acsm-msse/Fulltext/2011/09000/A_45_Minute_Vigorous_Exercise_Bout_Increases.6.aspx">14 hours post exercise</a>. So night sweats can occur even after a vigorous morning workout. Night sweats can indicate overtraining and/or under-fuelling. If not enough calories are consumed to support the increase in training, blood sugar could drop and you could experience <a href="https://www.aafp.org/pubs/afp/issues/2003/0301/p1019.pdf">hypoglycaemia</a>, which can cause night sweats. <h2>When to seek help and 5 things to try</h2> There are <a href="https://www.aafp.org/pubs/afp/issues/2020/1001/p427.html">numerous</a> health conditions and medications that can cause night sweats and interfere with sleep. If night sweats are regular, distressing, interfere with sleep or are accompanied by symptoms such as fatigue or weight loss (not related to lifestyle or diet changes) talk to a doctor to help determine the cause. They might suggest alternative medications to any you’re taking or recommend tests or investigations. In the meantime, you can try the following ideas: 1. sleep in a cool room and use a fan if needed 2. don’t overdress for bed. Wear breathable cotton or linen pyjamas 3. choose lightweight bedding you can kick off. Avoid synthetic fibres and flannel bedding 4. consider a cooling mattress or pillow and avoid those (such as foam ones) that can limit airflow 5. avoid spicy foods, caffeine or alcohol before bed.<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/211436/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/siobhan-banks-18473">Siobhan Banks</a>, Research professor, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/linda-grosser-1461631">Linda Grosser</a>, , <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/all-the-reasons-you-might-be-having-night-sweats-and-when-to-see-a-doctor-211436">original article</a>.

Body

Do stress and depression increase the risk of Alzheimer’s disease? Here’s why there might be a link

<a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Dementia affects more than <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">55 million people</a> around the world. A number of factors can increase a person’s risk of developing dementia, <a href="https://link.springer.com/article/10.14283/jpad.2023.119">including</a> high blood pressure, poor sleep, and physical inactivity. Meanwhile, keeping cognitively, physically, and socially active, and limiting alcohol consumption, can <a href="https://www.thelancet.com/article/S0140-6736(20)30367-6/fulltext">reduce the risk</a>. Recently, a <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01308-4">large Swedish study</a> observed that chronic stress and depression were linked to a higher risk of developing <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638">Alzheimer’s disease</a>, the most common form of dementia. The researchers found people with a history of both chronic stress and depression had an even greater risk of the disease. Globally, around <a href="https://www.who.int/news-room/fact-sheets/detail/depression">280 million people</a> have depression, while roughly <a href="https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders">300 million people</a> experience anxiety. With so many people facing mental health challenges at some stage in their lives, what can we make of this apparent link? <h2>What the study did and found</h2> This study examined the health-care records of more than 1.3 million people in Sweden aged between 18 and 65. Researchers looked at people diagnosed with chronic stress (technically chronic stress-induced exhaustion disorder), depression, or both, between 2012 and 2013. They compared them with people not diagnosed with chronic stress or depression in the same period. Participants were then followed between 2014 and 2022 to determine whether they received a diagnosis of mild cognitive impairment or dementia, in particular Alzheimer’s disease. <a href="https://alz-journals.onlinelibrary.wiley.com/doi/10.1016/j.jalz.2016.07.151">Mild cognitive impairment</a> is often seen as the precursor to dementia, although not everyone who has mild cognitive impairment will progress to dementia. During the study period, people with a history of either chronic stress or depression were around twice as likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. Notably, people with both chronic stress and depression were up to four times more likely to be diagnosed with mild cognitive impairment or Alzheimer’s disease. <h2>Important considerations</h2> In interpreting the results of this study, there are some key things to consider. First, the diagnosis of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9438479/">chronic stress-induced exhaustion disorder</a> is unique to the Swedish medical system. It is characterised by at least six months of intensive stress without adequate recovery. Symptoms include exhaustion, sleep disturbance and concentration difficulties, with a considerable reduction in ability to function. Mild stress may not have the same effect on dementia risk. Second, the number of people diagnosed with dementia in this study (the absolute risk) was very low. Of the 1.3 million people studied, 4,346 were diagnosed with chronic stress, 40,101 with depression, and 1,898 with both. Of these, the number who went on to develop Alzheimer’s disease was 14 (0.32%), 148 (0.37%) and 9 (0.47%) respectively. These small numbers may be due to a relatively young age profile. When the study began in 2012–2013, the average age of participants was around 40. This means the average age in 2022 was around 50. Dementia is typically diagnosed in <a href="https://www.health.gov.au/topics/dementia/about-dementia">people aged over 65</a> and diagnosis <a href="https://karger.com/dem/article-abstract/34/5-6/292/99009/Overdiagnosis-of-Dementia-in-Young-Patients-A?redirectedFrom=fulltext">in younger ages</a> may be less reliable. Finally, it’s possible that in some cases stress and depressive symptoms may reflect an awareness of an already declining memory ability, rather than these symptoms constituting a risk factor in themselves. This last consideration speaks to a broader point: the study is observational. This means it can’t tell us one thing caused the other – only that there is an association. <h2>What does other evidence say?</h2> <a href="https://link.springer.com/article/10.14283/jpad.2023.119">Many studies</a> indicate that significant symptoms of depression, anxiety and stress are related to higher dementia risk. However, the nature of this relationship is unclear. For example, are depressive and anxiety symptoms a risk factor for dementia, or are they consequences of a declining cognition? It’s likely to be a bit of both. High <a href="https://pubmed.ncbi.nlm.nih.gov/32082139/">depressive and anxiety symptoms</a> are commonly reported in people with mild cognitive impairment. However, studies in middle-aged or younger adults suggest they’re important dementia risk factors too. For example, similar to the Swedish study, other <a href="https://www.sciencedirect.com/science/article/pii/S0165032719323031">studies</a> have suggested people with a history of depression are twice as likely to develop dementia than those without this history. In addition, in middle-aged adults, high anxiety symptoms are associated with <a href="https://pubmed.ncbi.nlm.nih.gov/34648818/">poorer cognitive function</a> and <a href="https://bmjopen.bmj.com/content/8/4/e019399">greater dementia risk</a> in later life. <h2>Why the link?</h2> There are several potential pathways through which stress, anxiety and depression could increase the risk of dementia. Animal studies suggest cortisol (a hormone produced when we’re stressed) can increase risk of Alzheimer’s disease by causing the accumulation of key proteins, <a href="https://pubmed.ncbi.nlm.nih.gov/34159699/">amyloid and tau</a>, in the brain. The accumulation of these proteins can result in increased <a href="https://www.mdpi.com/1422-0067/23/18/10572">brain inflammation</a>, which affects the brain’s nerves and supporting cells, and can ultimately lead to brain volume loss and memory decline. Another potential pathway is through <a href="https://www.sciencedirect.com/science/article/pii/S1087079217300114?via%3Dihub">impaired sleep</a>. Sleep disturbances are common in people with chronic stress and depression. Similarly, people with Alzheimer’s disease commonly report sleep disturbances. Even in people with <a href="https://pubmed.ncbi.nlm.nih.gov/34668959/">early Alzheimer’s disease</a>, disturbed sleep is related to poorer memory performance. Animal studies suggest poor sleep can also enhance accumulation of <a href="https://pubmed.ncbi.nlm.nih.gov/31408876/">amyloid and tau</a>. We still have a lot to learn about why this link might exist. But evidence-based strategies which target chronic stress, anxiety and depression may also play a role in reducing the risk of dementia.<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/215065/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yen-ying-lim-355185">Yen Ying Lim</a>, Associate Professor, Turner Institute for Brain and Mental Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/ivana-chan-1477100">Ivana Chan</a>, PhD candidate, clinical psychology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-stress-and-depression-increase-the-risk-of-alzheimers-disease-heres-why-there-might-be-a-link-215065">original article</a>.

Mind

You’ve heard of long COVID, but did you know there might also be a long cold?

<a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> At least <a href="https://www.nature.com/articles/s41579-022-00846-2">10% of people</a> infected with SARS-CoV-2, the virus that causes COVID, have symptoms that last more than four weeks after the infection. With more than <a href="https://covid19.who.int/">770 million infections</a> to date, this translates to tens of millions of people living with the long-term consequences of COVID, known as “long COVID”. <a href="https://www.nature.com/articles/s41579-022-00846-2">More than 200 symptoms</a> of long COVID have been studied, with some of the most common being fatigue, breathlessness and cognitive difficulties, such as memory problems or “brain fog”. The condition can be debilitating – many people have to <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00387-5/fulltext">reduce their working hours</a> or are <a href="https://ifs.org.uk/publications/long-covid-and-labour-market">unable to work entirely</a>. But COVID may not be alone in causing long-lasting symptoms. In a <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00428-5/fulltext">new paper</a>, my colleagues and I report the findings of a study comparing long-term symptoms reported by people who experienced different types of acute respiratory infection. We asked more than 10,000 people to report on 16 symptoms commonly found in long COVID, such as fatigue, breathlessness, aches and pains, and dizziness. We then compared how common these symptoms were among three groups: people who had reported COVID, those who had reported another acute respiratory infection (but had tested negative for COVID), and those who had not reported either infection. We focused on long-term symptoms by only including people who had been infected more than four weeks earlier. We also took into account people’s general health before they were infected, and whether they had any existing respiratory conditions. Our study showed that all the symptoms considered were more common in people with previous COVID than in people with no infections, regardless of whether they reported long COVID. But this finding wasn’t unique to COVID. Almost all the symptoms we looked at were also more common in people with non-COVID respiratory infections than in those with no infection. In other words, our findings hinted towards the existence of a “long cold”: long-lasting health effects from other respiratory infections, such as colds, flu, or pneumonia, that are currently going unrecognised. Some of the most common symptoms of the long cold include coughing, stomach pain, and diarrhoea. These symptoms were reported an average of 11 weeks after the infection. While a severe initial infection seems to increase the risk of long-term symptoms, our research does not yet tell us why some people suffer extended symptoms while others do not. <h2>Important differences</h2> Importantly, we have no evidence that symptoms of the long cold have the same severity or duration as long COVID. In fact, we saw some important differences in the symptoms reported in the two groups, with those recovering from COVID more likely to experience light-headedness or dizziness and problems with taste and smell. These findings shine a light not only on the impact of long COVID on people’s lives, but also other respiratory infections. A lack of awareness, or even the lack of a common term, such as “long cold” or “long flu”, prevents both reporting and diagnosis of these conditions. And people who do report their long cold may still struggle to get a diagnosis, owing to the wide range of symptoms and <a href="https://www.nature.com/articles/s41591-022-01810-6">lack of diagnostic tests</a>. Long-lasting symptoms after respiratory infections are not a new phenomenon. Studies in survivors of two previous coronavirus outbreaks – the severe acute respiratory syndrome (Sars) pandemic and the Middle East respiratory syndrome (Mers) outbreak – have found long-term impacts on <a href="https://www.rcpjournals.org/content/clinmedicine/21/1/e68">lung function, quality of life and mental health</a>. And some people hospitalised with influenza A have experienced <a href="https://www.nature.com/articles/s41598-017-17497-6">respiratory and psychological problems</a> at least two years after being discharged from hospital. But most of the research so far has focused on people with severe disease, often severe enough to be hospitalised. Little is known about the long-term effects respiratory infections might have among people whose acute disease episode is less severe. Long COVID has bucked this trend, being studied in people with all levels of severity of the initial infection. This is in large part due to <a href="https://www.sciencedirect.com/science/article/pii/S0277953620306456">strong patient advocacy</a>, showing that it can affect even those with mild initial symptoms. In demanding recognition of their condition, people with long COVID have cast a much-needed spotlight on post-infection syndromes more generally. Now is the time to improve our understanding, diagnosis and treatment of these conditions. Let’s not wait for another pandemic.<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/214995/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giulia-vivaldi-1476903">Giulia Vivaldi</a>, , <a href="https://theconversation.com/institutions/queen-mary-university-of-london-1745">Queen Mary University of London</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/youve-heard-of-long-covid-but-did-you-know-there-might-also-be-a-long-cold-214995">original article</a>.

Body

Got no COVID-19 symptoms? A gene mutation might be the reason

<div> <div class="copy"> A global study has unearthed a possible genetic reason why some people infected with the virus that causes COVID-19 show no symptoms. Human leukocyte antigens – or HLAs – are important genes that support immune function in the human body, particularly in identifying viral pathogens. And a particular variation in the HLA-B complex has been found to at least double the likelihood that a person infected with SARS-CoV-2 will be asymptomatic. For people who inherit a copy of the HLA-B15 variant from one parent, there was a 2.4 times greater chance of avoiding symptoms. Homozygous carriers — born with copies of the variant from each parent — were 8.5 times more likely to avoid symptoms. It’s a somewhat common variant among certain ethnicities – about 1 in 10 people with European ancestry are potential carriers – but having the gene is not a guaranteed protector against coronavirus symptoms. The findings, <a href="https://doi.org/10.1038/s41586-023-06331-x" target="_blank" rel="noreferrer noopener" data-type="URL" data-id="https://doi.org/10.1038/s41586-023-06331-x">published</a> in Nature, have emerged from a joint study between researchers at the University of California San Fransisco and Australian institutions including Latrobe University, Monash University and the QIMR Berghofer Centre. The research came about almost by accident. <div class="in-content-area content-third content-right"><a href="https://cosmosmagazine.com/health/covid/link-between-blood-type-and-risk-of-covid-19-infection/"> </a></div> Co-lead authors Professor Stephanie Gras from Latrobe and Jill Hollenbach from UCSF first met at a research conference in May 2022 and pooled their resources to track the association of possible gene variations with COVID-19 symptoms. Their teams narrowed a group of 30,000 people with high-quality HLA data to a cohort of about 1,500 unvaccinated people who tested positive for the virus. They then focussed on five locations of interest in the HLA genes while monitoring the emergence of symptoms to determine which variants, if any, might have a greater linkage to being COVID asymptomatic. “The [SARS-CoV-2] virus gets inside cells and ‘presents’ some small part of the virus on the surface via the HLA molecule,” Gras explains. “Those act as a red flag for T cells. The cell sends the signal to the T cell that it has been infected with the virus, and the T cells get activated and kill that [infected] cell. “HLA-B15 can actually present a small part of the spike protein that is very similar between SARS-CoV-2 and seasonal coronaviruses… [that] circulate every year in the population and give us the common cold during winter most of the time. They share some similarities.” The understanding provides a possible application for future treatments. Now an association between the variant and asymptomatic cases has been identified, the Gras and Hollenbach teams have begun to study the interaction between HLA-B15 and the SARS-CoV-2 spike protein at the atomic level. That research is already underway, including at the Australian Synchrotron at the Australian Nuclear Science and Technology Organisation. “We’re doing atomic-level models of proteins to understand the interaction,” Gras says. “We want to compare the T cells within people who are asymptomatic with HLA-B15 and people who are not asymptomatic with HLA-B15. Actually, HLA-B15 is not a magic bullet, you can have it and still have severe COVID.” Image credits: Getty Images </div> <div id="contributors"> <a href="https://cosmosmagazine.com/health/covid/got-no-covid-19-symptoms-a-gene-mutation-might-be-the-reason/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/matthew-agius">Matthew Ward Agius</a>. </div> </div>

Body

Should you register with a GP? What is MyMedicare and how might it change the care you get?

<a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> <a href="https://www.health.gov.au/our-work/mymedicare">MyMedicare</a> is a new voluntary scheme that allows patients to register with their usual GP, in an attempt to improve continuity of care and health outcomes. From October 1, the scheme will give registered patients access to longer telehealth consultations. Then, from next year, GP clinics with patients who are frequently admitted to hospital or are aged care residents will be able to access additional “blended” funding, which sits outside Medicare’s usual fee-for-service. MyMedicare was announced in the May budget, with A$19.7 million of funding over four years, alongside a range of <a href="https://www.health.gov.au/sites/default/files/2023-05/building-a-stronger-medicare-budget-2023-24_0.pdf">other health reforms</a>, including funding for practice nurses to improve team-based care, as well as new incentives to increase bulk billing rates. We’re still waiting on a lot of detail about how the scheme will function. But here’s what we know so far – and what it might mean for patients and GPs. <h2>What do we know about MyMedicare?</h2> The scheme is voluntary for GPs and patients. In addition to patients opting in, GPs will also need to sign up, and have been able to do so since the start of July. There will be a gradual roll out and it will take three years to cover all of Australia. Though details are yet to be confirmed, from mid-2024 individual GPs will receive “<a href="https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/understanding-capitation">capitation</a>” payments for patients who have more than ten hospital admissions per year. These patients are likely to have complex needs and multiple conditions and, for various reasons, may not be able to access a GP as much as they should. Though not yet confirmed, GPs are likely to <a href="https://www.ausdoc.com.au/news/the-mymedicare-enrolment-scheme-is-open-for-gp-practices-should-you-sign-up-now/">receive</a> $2,000 per patient per year, plus a $500 bonus for keeping patients out of hospital. The funding provides incentives for the GP to coordinate their care and provide the patient with access to nursing and allied health if required. It’s hoped this will stop patients going to hospital as often. There will also be similar payments for providing regular visits to patients in residential aged care facilities. <h2>Will MyMedicare make a difference to patients?</h2> Let’s consider four key areas patients are concerned about: 1) Continuity of care Research shows greater <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2753.2009.01235.x">continuity of care</a> – developing a relationship with and seeing the same provider or team for your care – improves patient outcomes and reduces costs to the health system. People who use MyMedicare to get a regular GP may see some of these benefits. But many patients already see the same GP or visit the same practice, especially those with chronic conditions. So registration with a practice may not make much difference for this group of patients. What are the other benefits of registration? 2) Reducing hospital admissions Avoiding hospitals can be beneficial – in hospitals, there are no home comforts, they are inconvenient for you and relatives, there is little privacy, and they can be costly. Patients with ten or more hospital admissions in a year have been targeted as they have more complex chronic conditions and may be from vulnerable populations. Better access to a GP could prevent patients visiting the emergency department or prevent overnight hospital admissions. Research shows financial incentives for GPs to better manage chronic disease <a href="https://journals.sagepub.com/doi/full/10.1177/01410768211005109">can reduce hospital admissions</a>. However, <a href="https://bmjopen.bmj.com/content/5/4/e007342?cpetoc=&int_source=trendmd&int_medium=trendmd&int_campaign=trendmd">hospital admissions could also increase</a> if the scheme identifies significant levels of previous unmet need. 3) Reducing barriers to care MyMedicare does not directly address many of the <a href="https://link.springer.com/article/10.1186/1475-9276-12-18">barriers to accessing GP services</a>. If GPs are getting paid more and still getting fee for service payments, will MyMedicare patients be guaranteed to be bulk billed? This has not yet been mentioned, but could be an important part of the scheme to attract patients. People with chronic disease have <a href="https://grattan.edu.au/report/not-so-universal-how-to-reduce-out-of-pocket-healthcare-payments/">two to three times higher</a> out-of-pocket costs than those who do not, and <a href="https://healthsystemsustainability.com.au/the-voice-of-australian-health-consumers/">30%</a> of patients with chronic disease would find it difficult to pay for care if they became seriously ill. Unfortunately MyMedicare will not directly reduce out-of-pocket costs, which may be the real reason why people use “free” emergency department care. 4) Making it clear and easy to sign up It is also unclear how the process of registration will work for patients. Will patients be offered a choice of alternative GPs? If chosen, will GPs be obliged to take them? At the moment, there are no public data about out-of-pocket costs and quality of care provided by different GPs, and so it will be impossible for patients to make an informed choice. Information to inform choice on a website would be useful, as is the case for <a href="https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder">specialists</a>. It’s also unclear if patients who chose to register will find it harder to move GPs or continue to see other GPs if they wish to. The advantages to patients of MyMedicare need to be made clear to encourage them to register and be supported to exercise informed choice if they wish. <h2>Will it make a difference for GPs?</h2> Patient registration can mean a more secure and predictable stream of future income for some patients and also less competition (in terms of “losing” patients to other GPs) and more continuity of care. Moving away from fee for service towards a blended payment model is <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011865.pub2/full">widely recognised</a> to support higher value health care. Yet GPs are wary of moving from fee for service to capitation payment. Capitation payments are fixed, so GPs take on more financial risk if they have more complex patients who are more costly to treat and manage in terms of time and effort. Whether the $2,000, plus $500 bonus, plus normal fee for service payments are sufficient to cover the costs of treating very complex patients is unclear. Overall, GPs will get more money, and along with the other announcements in the budget, will receive a significant investment of resources invested in primary care. Our previous <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3572">research</a> has shown a 5% increase in earnings for GPs is predicted to reduce the total number of GPs by up to 1% (equivalent to around 310 GPs in 2021) at a time of significant GP shortages. If they get paid more, they would prefer to work less. But this could also be offset because the increase in funding will hopefully make general practice more attractive as a career and so there will be more postgraduate doctors <a href="https://www.sciencedirect.com/science/article/pii/S0167629612000902">choosing to be a GP</a>. Voluntary patient registration under MyMedicare has potential to strengthen the relationship between patients and their GP, and focuses on keeping patients out of hospital and properly cared for in residential aged care. But the devil is in the detail and we will need a proper evaluation to determine the impacts on health outcomes, costs and access to health care. <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/206183/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-you-register-with-a-gp-what-is-mymedicare-and-how-might-it-change-the-care-you-get-206183">original article</a>.

Caring

Silent signs of acid reflux you might be ignoring

Sore throat or hoarseness A sore throat that doesn’t go away and isn’t accompanied by typical cold symptoms (like a runny nose) may in fact be a symptom of acid reflux. “Your throat feels sore because a little bit of acid is coming up from the oesophagus and irritating the throat,” says gastroenterologist Dr Gina Sam. Unexplained hoarseness may be caused by stomach acid moving up to your larynx, or voice box, and tends to be more noticeable in the mornings when it’s had all night to travel while you were lying down. Persistent cough or wheezing “Wheezing or a cough that mimics asthma or bronchitis can be caused by acid reflux moving from the stomach to the lungs,” says Dr Evan Dellon, from the Center for Esophageal Diseases and Swallowing. On the other hand, wheezers and coughers can sometimes make themselves more prone to reflux because these actions put pressure on the belly and push stomach acid upwards. You're having dental problems If you’re a dedicated brusher and flosser but your dentist is still filling cavities and tells you your tooth enamel is eroding or notices discolouration, acid reflux may be to blame. “Even a small amount of acid reflux making its way up from the oesophagus to your throat or mouth while lying down can impact tooth enamel,” says Dr Dellon. Ringing in your ears If your ears always ring (a condition known as tinnitus), especially after a meal, it may be caused by reflux getting into the sinuses and even the interior of the ear, says Dr Sam. “A lot of patients see their ENT to get consults about sinus pain and ear ringing, but it’s often acid reflux,” she says. You have trouble swallowing Food getting stuck when you swallow, liquid that just won’t go down, or the sensation that something is stuck in your throat could all be signs of acid reflux, says Dr Sam. Chronic reflux can irritate the throat, and scar tissue can develop in the oesophagus and narrow it. See your doctor if you have difficulty swallowing, as this can also be a symptom of other more serious conditions. Nasal congestion Nasal congestion that comes and goes may be caused by acid reflux. “If you’ve tried cutting down on reflux-producing foods and eating late at night and the symptom doesn’t go away, it’s probably just congestion,” says Dr Sam. “But if it goes away and comes back, and then goes away again, it’s probably acid reflux.” Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/silent-signs-of-acid-reflux-you-might-be-ignoring" target="_blank" rel="noopener">Reader's Digest</a>.

Body

Marine species are being pushed towards the poles. From dugong to octopuses, here are 8 marine species you might spot in new places

<a href="https://theconversation.com/profiles/gretta-pecl-128477">Gretta Pecl</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/curtis-champion-1373045">Curtis Champion</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a>, and <a href="https://theconversation.com/profiles/zoe-doubleday-393169">Zoe Doubleday</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> If you take a plunge in the sea this winter, you might notice it’s warmer than you expect. And if you’re fishing off Sydney and catch a tropical coral trout, you might wonder what’s going on. The reason is simple: hotter water. The ocean has absorbed the vast majority of the extra heat trapped by carbon dioxide and other greenhouses gases. It’s no wonder heat in the oceans is building up rapidly – and this year is <a href="https://theconversation.com/ocean-heat-is-off-the-charts-heres-what-that-means-for-humans-and-ecosystems-around-the-world-207902">off the charts</a>. That’s even without the likely arrival of El Niño, where the Pacific Ocean gets warmer than usual and affects weather all over the world. Our coastal waters <a href="http://www.bom.gov.au/oceanography/oceantemp/sst-outlook-map.shtml">are forecast</a> to be especially warm over the coming months, up to 2.5℃ warmer than usual in many places. <figure class="align-center "><img src="https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=482&fit=crop&dpr=1 600w, https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=482&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=482&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=605&fit=crop&dpr=1 754w, https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=605&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/533327/original/file-20230622-27-cqb9j1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=605&fit=crop&dpr=3 2262w" alt="" /><figcaption>Oceans around Australia are forecast to be much warmer than usual. SSTA stands for projected Sea Surface Temperature Anomaly, the difference between forecast ocean temperatures and a historical baseline period encompassing 1990–2012. Bureau of Meteorology</figcaption></figure> Many marine species live within a narrow temperature range. If the water heats up, they have to move, and if they don’t, they might die. So those that can move, are moving. In Australia, at least 200 marine species have <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/gcb.15634">shifted distributions</a> since 2003, with 87% heading south. This pattern is happening all around the world, both on land and <a href="https://theconversation.com/thousands-of-photos-captured-by-everyday-australians-reveal-the-secrets-of-our-marine-life-as-oceans-warm-189231">in the ocean</a>. This year, the warmer ocean temperatures during winter mean Australia’s seascapes are likely to be more like summer. So, the next time you go fishing or diving or beachcombing, keep your eyes peeled and your camera ready. You may glimpse the enormous disruption happening underwater for yourself. <h2>Here are eight species on the move</h2> 1. Moorish idol (Zanclus cornutus) Historic range: northern Australia Now: This <a href="https://www.redmap.org.au/species/1/204/">striking fish</a> can now be seen south of Geraldton in Western Australia and Eden in New South Wales. This is a great fish for divers to spot on hard-bottomed habitats. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/533373/original/file-20230622-21-6g6xk8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="moorish idol" /></a><figcaption>Moorish Idols are heading south to escape the heat. Shutterstock</figcaption></figure> 2. Branching coral (Pocillopora aliciae) Historic range: northern NSW Now: Look out for this <a href="https://www.redmap.org.au/species/2/255">pale pink beauty</a> south of Port Stephens, not far from Sydney. Seemingly immovable species like coral are fleeing the heat too. They’re already providing habitat for a range of other shifting species like tropical fish and crab species. 3. Eastern rock lobster (Sagmariasus verreauxi) Historic range: common in NSW Now: South, as far as <a href="https://www.redmap.org.au/species/2/167">it can get.</a> It’s now found in Tasmania and even in <a href="https://www.cambridge.org/core/journals/journal-of-the-marine-biological-association-of-the-united-kingdom/article/westward-range-expansion-of-the-eastern-rock-lobster-sagmariasus-verreauxi-in-australia/8DE945E58E1DDA1A2BB7431065AAC8EC">South Australia</a>. This tasty greenish crustacean <a href="https://www.int-res.com/abstracts/meps/v624/p1-11/">doesn’t like heat</a> and has moved south into the territory of red southern rock lobsters (Jasus edwardsii). 4. Gloomy octopus (Octopus tetricus) Previous range: common in NSW Now: As far south as Tasmania. Look out for this slippery, smart invertebrate in <a href="https://www.redmap.org.au/species/2/127">Tasmanian waters</a> this winter. You might even spot the octopus nestled down with some eggs, as this looks to be a <a href="https://www.publish.csiro.au/mf/mf14126">permanent sea change</a>. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=462&fit=crop&dpr=1 600w, https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=462&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=462&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=581&fit=crop&dpr=1 754w, https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=581&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/533376/original/file-20230622-17-lf2y8r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=581&fit=crop&dpr=3 2262w" alt="gloomy octopus" /></a><figcaption>The gloomy octopus is also known as the common Sydney octopus. Niki Hubbard, Wikimedia, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> 5. Whitetip reef shark (Triaenodon obesus) Previous range: northern Australia Now: <a href="https://www.redmap.org.au/species/3/185">South of K'gari</a> (formerly known as Fraser Island). Classed as vulnerable in parts of the world, this tropical shark is a slow swimmer and never sleeps. It poses very little danger to humans. 6. Dugongs (Dugong dugon) Previous range: northern Australia Now: As far south as Shark Bay in WA and <a href="https://www.abc.net.au/news/2023-05-17/tweed-river-dugong-sighting-boaties-warned/102355438">Tweed River</a> in New South Wales. Our waters are home to the largest number of dugong in the world. But as waters warm, they’re heading south. That means more of us may see these elusive sea-cows as they graze on seagrass meadows. Some of the most adventurous have gone way out of their normal range – in 2014, a kitesurfer <a href="https://www.redmap.org.au/articles/2021/07/26/are-dugongs-hitching-a-ride-south/">reported</a> passing a dugong at City Beach, Perth. As a WA wildlife expert says, dugongs may occasionally stray further south of Shark Bay but “given the recent warming trend […] more dugong sightings might be expected in the future” 7. Red emperor (Lutjanus sebae) and other warm water game fish Previous range: northern Australia Now: Appearing much further south – especially in WA. Look for <a href="https://www.redmap.org.au/species/1/108/">red</a>, threadfin, and redthroat emperors in southwest WA as the Leeuwin current carries these <a href="https://www.redmap.org.au/articles/2021/07/26/game-fish-follow-warm-route-south/">warm water species</a> south. As WA fisheries expert Gary Jackson has said, this current is a warming hotspot, acting like a warm water highway for certain marine species. These fish are highly <a href="https://goodfish.org.au/species/red-emperor/">sought after</a> by fishers. 8. Long-spined sea urchin (Centrostephanus rodgersii) Historic range: NSW and Victoria Now: Tasmania Look out for these <a href="https://www.redmap.org.au/species/2/34/">spiky critters</a> in southern and western Tasmania. The larvae of these urchins have crossed the Bass Strait and found a new home, due to warming waters. Urchins are grazers and can scrape rocks clean, creating urchin barrens where nothing grows. That’s bad news for kelp forests and the species which depend on them. In response, Tasmanian authorities are working to create a <a href="https://fishing.tas.gov.au/community/long-spined-sea-urchin-management/long-spined-sea-urchin-strategy#:%7E:text=%E2%80%8B%E2%80%8B%E2%80%8BTackling%20the%20longspined%20sea%20urchin&text=Unchecked%2C%20the%20urchin's%20presence%20is,at%20around%2020%20million%20individuals.">viable urchin fishery</a> to keep numbers down. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/533379/original/file-20230622-33216-7lslyr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" alt="long spined sea urchins" /></a><figcaption>Long-spiked sea urchins are voracious eaters of seaweed. <a class="source" href="https://www.flickr.com/photos/johnwturnbull/32131133496/in/photostream/">John Turnbull/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></figcaption></figure> <h2>You can help keep watch</h2> For years, fishers, snorkellers, spearfishers and the general public have contributed their unusual marine sightings to <a href="https://www.redmap.org.au/">Redmap</a>, the Australian citizen science project aimed at mapping range extensions of species. If you spot a creature that wouldn’t normally live in the waters near you, you can upload a photo to log your sighting. For example, avid spearfisher Derrick Cruz logged a <a href="https://www.redmap.org.au/sightings/1624/">startling discovery</a> with Redmap in 2015: A coral trout in Sydney’s waters. As he told us: “I’ve seen plenty of coral trout in tropical waters, where they’re at home within the coral. But it was surreal to see one swimming through a kelp forest in the local waters off Sydney, much further south than I’ve ever seen that species before!” How does tracking these movements help scientists? Many hands make light work. These vital observations from citizen scientists <a href="https://data-blog.gbif.org/post/gbif-citizen-science-data">have helped</a> researchers gain deeper understanding of what climate change is doing to the natural world in many places, from bird migrations to flowering plants to marine creatures. So, please keep an eye out this year. The heat is on in our oceans, and that can mean sudden change. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/207115/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gretta-pecl-128477">Gretta Pecl</a>, Professor, ARC Future Fellow & Director of the Centre for Marine Socioecology, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a>; <a href="https://theconversation.com/profiles/curtis-champion-1373045">Curtis Champion</a>, Research Scientist, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a>, and <a href="https://theconversation.com/profiles/zoe-doubleday-393169">Zoe Doubleday</a>, Marine Ecologist and ARC Future Fellow, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/marine-species-are-being-pushed-towards-the-poles-from-dugong-to-octopuses-here-are-8-marine-species-you-might-spot-in-new-places-207115">original article</a>. Images: Getty

International Travel

Australia's top earners revealed – and it might be you

A new report has found Australians are the third most wealthy citizens in the world, with a surprising way to make the cut as one of the richest. A six figure salary will qualify an Aussie to be among the top 10 per cent richest in the world, while homeowners in Sydney are included among the global elite. The top 10 per cent of earners in Australia make $122,664 or more, with some of the highest paid incomes in the country including miners who earn $124,550 on average, school principals who rake in $130,142 and dentists that receive $131,773. Prestige property company Frank Knight’s report revealed anyone with $1.5 million in assets was classified as a “high-net-worth individual”, which would qualify plenty of Sydney homeowners. Meanwhile, the net worth required to be in the top one per cent of Australia’s rich was the third highest figure globally, behind Monaco and Switzerland. However, to be considered in Australia’s highest percentage of wealth, you must have a total net worth of an eye-watering US%5.5 million ($A8.26 million). Its annual Wealth Populations report as part of its Wealth Report Series found that wealth levels across every country analysed had seen an increase since 2021, despite experiencing a “dip” the following year. Australia has almost doubled its 2021 wealth figure, revealing that the rich got richer during the pandemic. In 2021, Australia was number seven, with $US2.8 million as the baseline. Monaco reportedly has the world’s “densest population of super-rich individuals” which saw it at the top of the list out of 25 countries analysed. To be considered one of the top earners in Monaco, people must have income and assets that equate to US$12.4 million in overall net worth. Switzerland calls for just half of Monacos, coming in at $US6.6 million. New Zealand earned a spot right behind their neighbour at number four, with a $US5.2 million net worth qualifying an individual to be in the country’s top percentile. The US rounded out the top five, at US$5.1 million. Ireland, Singapore, France, Hong Kong and the UK made it into the top 10 on the “One per cent club” respectively. China was number 15 on the list, with US$960,000 marking out the number its top one per cent exceeds. In a staggering comparison, having a net worth of more than US$20,000 in Kenya would make you one of the richest in the African nation, which saw itself last on the list. Despite the remarkable wealth of the people detailed in the report, the authors pointed out that every country still fell “well short” of an “ultra high net individual”. The elite must have a net worth that exceeds US$30 million to earn the title. After a tumultuous financial year, the filthy rich remained unaffected with their number increasing by 2 per cent to almost 70 million nationwide. The report’s authors said the Middle East was “the standout region” regarding adding mega rich individuals to their list, with a 16.9 per cent growth. However, during that time, the number of billionaires dropped by five per cent to 2,629. It is expected over the next five years that another 750,000 people will join the exclusive club of remarkably high net worth individuals. Image credit: Shutterstock

Money & Banking

What made rents soar? It might have been COVID, and pairing off

So, you think you know why rents climbed. You probably think was skyrocketing interest rates and a tsunami of migration. It’s true that interest rates have jumped more over the past year than at any time on record, and it’s true that migration has roared back – in the six months to September 2022 (the latest month for which we’ve official figures) arrivals exceeded departures by <a href="https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/sep-2022">170,000</a>. But here’s the thing. Advertised rents began climbing sharply in <a href="https://www.realestate.com.au/insights/where-rents-prices-are-really-skyrocketing-in-some-cases-by-600-a-week-more/">late 2021</a> – six months before the Reserve Bank began pushing up interest rates, and at a time <a href="https://theconversation.com/top-economists-expect-rba-to-hold-rates-low-in-2022-as-real-wages-fall-175054">when it was forecast not to</a>. And “net migration” was <a href="https://www.abs.gov.au/statistics/people/population/national-state-and-territory-population/sep-2021">negative</a> back when rents were taking off – meaning the number of arrivals didn’t even match the number of departures. <h2>It’s supply and demand</h2> Something else made rents move. As it happens, there’s no particular reason to think interest rates would have quickly affected rents even if they had been climbing. If higher rates force some landlords to sell, and they sell to other landlords, the number of properties for rent won’t change. If those landlords sell to owner occupiers who would otherwise rent, they cut both the number of rental properties and the number of renters. What matters for rents, as for any price, is the demand for and the supply of the product being priced. More demand (more renters wanting properties) and the price climbs. More supply (more properties available for rent) and the price falls. On the face of it, neither demand nor supply was changing much during COVID as rents started climbing. Australia’s population was growing more slowly than at any time <a href="https://www.rba.gov.au/speeches/2023/sp-gov-2023-04-05.html">in modern history</a>. And, as best as we can tell, the number of properties available for rent was climbing, <a href="https://www.abs.gov.au/statistics/industry/building-and-construction/building-activity-australia/latest-release">albeit weakly</a>. What did change during COVID, according to the research department of the Reserve Bank, was the <a href="https://www.rba.gov.au/publications/bulletin/2023/mar/renters-rent-inflation-and-renter-stress.html">average number of people per household</a>. The change doesn’t sound big – the average fell from a bit above 2.6 residents per household to a bit below 2.55 – but applied to millions of households it meant about <a href="https://www.rba.gov.au/speeches/2022/sp-ag-2022-05-25.html">140,000</a> more houses and apartments were needed than would have been. <h2>Average household size (capital cities)</h2> The sudden change was awfully for hard for the building industry to respond to, especially when it was laid low by COVID. Why did we suddenly want to live with fewer people? The head of the Bank’s economic division, Luci Ellis, thinks it was COVID itself, and lockdowns. We suddenly became more precious about sharing space. <h2>‘Love the one you’re with’</h2> Ellis says proportion of Australians living in group houses declined and stayed low. Faced with the choice of living with a large number of housemates and just one other person, perhaps a romantic partner, a lot of renters left group houses and <a href="https://www.rba.gov.au/speeches/2022/sp-ag-2022-05-25.html">shacked up with each other</a>. As she put it last year, "On the question of who you would rather be locked down with, at least some Australians have voted with their removalists’ van, by moving out of their share house and in with their partner." There’s more to it of course, but where the supply and demand for anything are roughly in balance (rents had been increasing by <a href="https://theconversation.com/rent-crisis-average-rents-are-increasing-less-than-you-might-think-189154">less than 1% per year</a> in the four years before COVID, and fell in the first year of COVID) any sudden change in either supply or demand can move prices quickly. <h2>Advertised rents aren’t typical …</h2> Having said that, for most renters prices are still moving slowly. Advertised capital city rents are up <a href="https://www.realestate.com.au/insights/where-rents-prices-are-really-skyrocketing-in-some-cases-by-600-a-week-more/">13%</a> over the past year, and advertised regional rates up 9%. But average rents (the average of what all renters pay) are up only 4.8%. The rents charged to ongoing tenants climb <a href="https://theconversation.com/rent-crisis-average-rents-are-increasing-less-than-you-might-think-189154">much more slowly</a>than the rents charged to new tenants, in part because landlords often like their tenants, and in part because for the first year renters are usually on fixed contracts. But over time as renters move home, and landlords become less squeamish, more and more renters tend to pay the rents advertised. It makes the increase in advertised rents an unwelcome sign of what’s to come. <h2>… but they’re a sign of rents ahead</h2> And it might get worse. Reserve Bank Governor Philip Lowe says population growth is set to climb to <a href="https://www.rba.gov.au/speeches/2023/sp-gov-2023-04-05.html">2%</a> – near the peak reached during the resources boom. We won’t be able to build houses anything like that fast. Lowe says the last time Australia’s population surged it took about <a href="https://www.rba.gov.au/speeches/2023/sp-gov-2023-04-05.html">five years</a> for housing supply to fully respond to housing demand. We’ve ways of dealing with it of course. One is to re-embrace group homes, another is to delay moving out of our partents’ homes, or to move back in. But even if this does happen, Lowe says, with typical understatement, that rent inflation – ultra-low before COVID – is likely to stay “quite high” for some time. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/what-made-rents-soar-it-might-have-been-covid-and-pairing-off-203542" target="_blank" rel="noopener">The Conversation</a>.

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

Drugs like Ozempic won’t ‘cure’ obesity but they might make us more fat-phobic

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

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