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It may be macabre, but dark tourism helps us learn from the worst of human history

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/dr-neil-robinson-1312179">Dr Neil Robinson</a>, <a href="https://theconversation.com/institutions/university-of-salford-878">University of Salford</a> Dark tourism has become a much more well-covered pasttime in recent years, in which a macabre fascination lead tourists to travel to various places not served by Thomas Cook: the sites of battles and genocides, war cemeteries, prisons, and even <a href="http://www.theatlantic.com/international/archive/2014/07/the-rise-of-dark-tourism/374432/">current warzones such as Syria</a>. The 20th century alone has provided such a <a href="http://www.therichest.com/expensive-lifestyle/location/10-great-places-to-visit-for-dark-tourism/">long list of places</a> at which catastrophes or great loss of life and suffering has occurred. Sites visited range from the spot from which JFK was assassinated, to prisons such as Alcatraz in San Francisco, through to battlefields of the World Wars, or the vestiges of genocides such at Auschwitz in Poland or Tuol Sleng in Phnom Penh, Cambodia. It’s not everybody’s cup of tea, but we shouldn’t condemn those for whom this is an interest. Dark tourism appears to be a manifestation of our media-rich society through which information found online may persuade us to see historical sites in person. But its origins can be traced back much further than the fascination with death and disasters of the 19th and 20th century. In the 11th century, people and pilgrims often visited places with religious significance such as Jerusalem, where the location of Christ’s crucifixion is a popular attraction; tourists visited Gettysburg, the site of the bloodiest battle of the American Civil War in 1863; and in more recent centuries, the Grand Tour offered an opportunity for the wealthy to experience Europe, with sites such as the classical ruins of the Colosseum in Rome – which in the name of entertainment saw execution, torture and death – one of the must-see attractions. Today, in parallel with the growth in popularity of dark tourism is the enormous growth of social media and the 24-hour news economy. The ease of access to such blanket coverage through the web, Facebook and Twitter has increased people’s awareness of, and fascination for, these historical sites of war, conflict and catastrophe. For example, the last decade has brought a surge in visitor numbers to <a href="https://theconversation.com/from-fiction-to-gallows-humour-how-chernobyl-survivors-are-still-coping-with-trauma-57923">Chernobyl</a>, where guides take visitors around the abandoned city of Pripyat (radiation levels permitting) which has been deserted since the nuclear power plant explosion on April 26, 1986. The 30th anniversary this year has in itself <a href="http://www.dailymail.co.uk/travel/travel_news/article-3526271/Chernobyl-tourists-pose-photos-eerie-sites.html">added to interest in visiting</a> the overgrown and crumbling city. As with tourism of any kind, this greater footfall brings benefits. In this case, not just the economic boost but also as a tool of education and even conflict resolution. For example, the <a href="http://www.belfasttours.com/package/belfast-political-mural-tour">taxi tours of Belfast’s murals</a>, which document Northern Ireland’s Troubles, offer visitors a way to understand the history and provide the communities involved a means to reflect and move on from the conflict. This model is <a href="http://www.h-net.org/reviews/showpdf.php?id=25852">viewed with interest</a> and hope by moderates on both sides of the Arab-Israeli divide searching for a peaceful solution for the long term. The tours of <a href="http://whc.unesco.org/en/list/916">Robin Island prison</a> in South Africa, where Nelson Mandela spent 18 years incarcerated among many others, starkly present how those imprisoned by a corrupt and discriminatory political regime can later engage in peace and reconciliation. The <a href="http://www.bruisedpassports.com/africa/5-reasons-you-must-go-for-a-township-tour-in-south-africa">Soweto township tours</a> in Johannesburg have acted in part as a means through which generations of South Africans can better understand their country’s dark past and help to establish truth and reconciliation for the future. Dark tourism should not in my opinion by viewed as unethical, repugnant or even a self-indulgent activity. Certainly some dark tourists may engage in their pursuits for all the wrong reasons, seeing death and destruction as a commodity to be consumed with little thought for those who caught up in its wake. But others visit such sites to pay their respects, to better understand the magnitude of death and destruction, and to inform the outside world of the details of terrible events – even in some case offering to help. These are positive effects that may come from so much pain and suffering. We should strive to better understand the origins of the terrible events of human history to be more able to prevent us repeating them. In this regard, that more people visit sites associated with dark tourism and learn about them should be seen as a positive.<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/60966/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dr-neil-robinson-1312179">Dr Neil Robinson</a>, Lecturer in Business, <a href="https://theconversation.com/institutions/university-of-salford-878">University of Salford</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/it-may-be-macabre-but-dark-tourism-helps-us-learn-from-the-worst-of-human-history-60966">original article</a>. </div>

Travel Trouble

Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Many people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">drinking less</a> sugary soft drink than in the past. This is a great win for public health, given the <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2749350">recognised risks</a> of diets high in sugar-sweetened drinks. But over time, intake of diet soft drinks has <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230225/">grown</a>. In fact, it’s so high that these products are now regularly <a href="https://www.sciencedirect.com/science/article/pii/S0160412020319188">detected in wastewater</a>. So what does the research say about how your health is affected in the long term if you drink them often? <h2>What makes diet soft drinks sweet?</h2> The World Health Organization (WHO) <a href="https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children">advises</a> people “reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (six teaspoons) per day would provide additional health benefits.” But most regular soft drinks contain <a href="https://www.actiononsugar.org/surveys/2014/sugar-sweetened-beverages/">a lot of sugar</a>. A regular 335 millilitre can of original Coca-Cola contains at least <a href="https://www.coca-cola.com/ng/en/about-us/faq/how-much-sugar-is-in-cocacola-original-taste">seven</a> teaspoons of added sugar. Diet soft drinks are designed to taste similar to regular soft drinks but without the sugar. Instead of sugar, diet soft drinks contain artificial or natural sweeteners. The artificial sweeteners include aspartame, saccharin and sucralose. The natural sweeteners include stevia and monk fruit extract, which come from plant sources. Many artificial sweeteners are much sweeter than sugar so less is needed to provide the same burst of sweetness. Diet soft drinks are marketed as healthier alternatives to regular soft drinks, particularly for people who want to reduce their sugar intake or manage their weight. But while surveys of Australian <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551593/">adults</a> and <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/adolescents-knowledge-and-beliefs-regarding-health-risks-of-soda-and-diet-soda-consumption/32F3E0FD6727F18F04C63F0390595131">adolescents</a> show most people understand the benefits of reducing their sugar intake, they often aren’t as aware about how diet drinks may affect health more broadly. <h2>What does the research say about aspartame?</h2> The artificial sweeteners in soft drinks are considered safe for consumption by food authorities, including in the <a href="https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food">US</a> and <a href="https://www.foodstandards.gov.au/consumer/additives/aspartame">Australia</a>. However, some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899993/">researchers</a> have raised concern about the long-term risks of consumption. People who drink diet soft drinks regularly and often are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446768/">more likely</a> to develop certain metabolic conditions (such as diabetes and heart disease) than those who don’t drink diet soft drinks. The link was found even after accounting for other dietary and lifestyle factors (such as physical activity). In 2023, the WHO announced reports had found aspartame – the main sweetener used in diet soft drinks – was “<a href="https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released">possibly carcinogenic to humans</a>” (carcinogenic means cancer-causing). Importantly though, the report noted there is not enough current scientific evidence to be truly confident aspartame may increase the risk of cancer and emphasised it’s safe to consume occasionally. <h2>Will diet soft drinks help manage weight?</h2> Despite the word “diet” in the name, diet soft drinks are not strongly linked with weight management. In 2022, the WHO conducted a <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">systematic review</a> (where researchers look at all available evidence on a topic) on whether the use of artificial sweeteners is beneficial for weight management. Overall, the randomised controlled trials they looked at suggested slightly more weight loss in people who used artificial sweeteners. But the observational studies (where no intervention occurs and participants are monitored over time) found people who consume high amounts of artificial sweeteners tended to have an increased risk of higher body mass index and a 76% increased likelihood of having obesity. In other words, artificial sweeteners may not directly help manage weight over the long term. This resulted in the WHO <a href="https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline">advising</a> artificial sweeteners should not be used to manage weight. <a href="http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30296-0">Studies</a> in animals have suggested consuming high levels of artificial sweeteners can signal to the brain it is being starved of fuel, which can lead to more eating. However, the evidence for this happening in humans is still unproven. <h2>What about inflammation and dental issues?</h2> There is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10817473/">some early evidence</a> artificial sweeteners may irritate the lining of the digestive system, causing inflammation and increasing the likelihood of diarrhoea, constipation, bloating and other symptoms often associated with irritable bowel syndrome. However, this study noted more research is needed. High amounts of diet soft drinks have <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-17223-0">also been</a> linked with liver disease, which is based on inflammation. The consumption of diet soft drinks is also <a href="https://link.springer.com/article/10.1007/s40368-019-00458-0#:%7E:text=Diet%20soft%20drinks%20often%20have,2006">associated</a> with dental erosion. Many soft drinks contain phosphoric and citric acid, which can damage your tooth enamel and contribute to dental erosion. <h2>Moderation is key</h2> As with many aspects of nutrition, moderation is key with diet soft drinks. Drinking diet soft drinks occasionally is unlikely to harm your health, but frequent or excessive intake may increase health risks in the longer term. Plain water, infused water, sparkling water, herbal teas or milks remain the best options for hydration.<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/233438/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/cheeky-diet-soft-drink-getting-you-through-the-work-day-heres-what-that-may-mean-for-your-health-233438">original article</a>. </div>

Food & Wine

What’s the difference between ‘man flu’ and flu? Hint: men may not be exaggerating

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> The term “man flu” takes a <a href="https://www.oxfordlearnersdictionaries.com/definition/english/man-flu">humorous poke</a> at men with minor respiratory infections, such as colds, who supposedly exaggerate their symptoms. According to the stereotype, a man lies on the sofa with a box of tissues. Meanwhile his female partner, also with a snotty nose, carries on working from home, doing the chores and looking after him. But is man flu real? Is there a valid biological reason behind men’s symptoms or are men just malingering? And how does man flu differ from flu? <h2>What are the similarities?</h2> Man flu could refer to a number of respiratory infections – a cold, flu, even a mild case of COVID. So it’s difficult to compare man flu with flu. But for simplicity, let’s say man flu is actually a cold. If that’s the case, man flu and flu have some similar features. Both are caused by viruses (but different ones). Both are improved with rest, fluids, and if needed painkillers, throat lozenges or decongestants to <a href="https://activities.nps.org.au/nps-order-form/Resources/NPS-Cold-and-Flu-Brochure-May-2014.pdf">manage symptoms</a>. Both <a href="https://www.cdc.gov/flu/symptoms/coldflu.htm">can share</a> similar symptoms. Typically, more severe symptoms such as fever, body aches, violent shivering and headaches are more common in flu (but sometimes occur in colds). Meanwhile sore throats, runny noses, congestion and sneezing are more common in colds. A cough is common in both. <h2>What are the differences?</h2> <a href="https://www.cdc.gov/flu/about/keyfacts.htm">Flu</a> is a more serious and sometimes fatal respiratory infection caused by the influenza virus. Colds are caused by various viruses such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553670/">rhinoviruses</a>, <a href="https://www.cdc.gov/adenovirus/about/?CDC_AAref_Val=https://www.cdc.gov/adenovirus/symptoms.html">adenoviruses</a>, and common cold <a href="https://journals.lww.com/pidj/citation/2022/03000/proving_etiologic_relationships_to_disease_.18.aspx">coronaviruses</a>, and are rarely serious. Colds tend to <a href="https://www.cdc.gov/flu/symptoms/coldflu.htm">start gradually</a> while flu tends to start abruptly. Flu can be <a href="https://www.cdc.gov/flu/professionals/diagnosis/overview-testing-methods.htm">detected</a> with laboratory or at-home tests. Man flu is not an official diagnosis. Severe flu symptoms may be prevented with <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm">a vaccine</a>, while cold symptoms cannot. Serious flu infections may also be <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/racf-antiviral-treatments-and-prophylaxis.aspx">prevented or treated</a> with antiviral drugs such as Tamiflu. There are no antivirals for colds. <h2>OK, but is man flu real?</h2> Again, let’s assume man flu is a cold. Do men really have worse colds than women? The picture is complicated. <a href="https://www.sciencedirect.com/science/article/pii/S0022399922003324?via%3Dihub">One study</a>, with the title “Man flu is not a thing”, did in fact show there were differences in men’s and women’s symptoms. This study looked at symptoms of acute rhinosinusitis. That’s inflammation of the nasal passages and sinuses, which would explain a runny or stuffy nose, a sinus headache or face pain. When researchers assessed participants at the start of the study, men and women had similar symptoms. But by days five and eight of the study, women had fewer or less-severe symptoms. In other words, women had recovered faster. But when participants rated their own symptoms, we saw a somewhat different picture. Women rated their symptoms worse than how the researchers rated them at the start, but said they recovered more quickly. All this suggests men were not exaggerating their symptoms and did indeed recover more slowly. It also suggests women feel their symptoms more strongly at the start. <h2>Why is this happening?</h2> It’s not straightforward to tease out what’s going on biologically. There are <a href="https://www.nature.com/articles/nri.2016.90">differences</a> in immune responses between men and women that provide a plausible reason for worse symptoms in men. For instance, women generally produce antibodies more efficiently, so they <a href="https://www.nature.com/articles/nri.2016.90">respond more effectively</a> to vaccination. Other aspects of women’s immune system also appear to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735332/">work more strongly</a>. So why do women tend to have <a href="https://www.nature.com/articles/nri.2016.90">stronger immune responses</a> overall? That’s probably partly because women have two X chromosomes while men have one. X chromosomes carry important <a href="https://www.nature.com/articles/nri.2016.90#Tab3">immune function genes</a>. This gives women the benefit of immune-related genes from two different chromosomes. Oestrogen (the female sex hormone) also seems to <a href="https://www.nature.com/articles/nri.2016.90">strengthen</a> the immune response, and as levels vary throughout the lifespan, so does <a href="https://www.science.org/doi/10.1126/sciimmunol.aan2946">the strength</a> of women’s immune systems. Men are certainly more likely to die from some infectious diseases, such as <a href="https://www.aihw.gov.au/reports/life-expectancy-deaths/deaths-in-australia/contents/covid-10-deaths">COVID</a>. But the picture is less clear with other infections such as the flu, where the incidence and mortality between men and women <a href="https://iris.who.int/bitstream/handle/10665/44401/9789241500111_eng.pdf?sequence=1&isAllowed=y">varies widely</a> between countries and particular flu subtypes and outbreaks. Infection rates and outcomes in men and women can also depend on the way a virus is <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.712688/full">transmitted</a>, the person’s age, and social and behavioural factors. For instance, women seem to be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077589/#R20">practice protective behaviours</a> such as washing their hands, wearing masks or avoiding crowded indoor spaces. Women are also <a href="https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-016-0440-0">more likely</a> to seek medical care when ill. <h2>So men aren’t faking it?</h2> Some evidence suggests men are not over-reporting symptoms, and may take longer to clear an infection. So they may experience man flu more harshly than women with a cold. So cut the men in your life some slack. If they are sick, gender stereotyping is unhelpful, and may discourage men from seeking medical advice.<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/231161/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, Professor, Nursing, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-man-flu-and-flu-hint-men-may-not-be-exaggerating-231161">original article</a>. </div>

Body

Breast cancer screening in Australia may change. Here’s what we know so far

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The way women are screened for breast cancer in Australia may <a href="https://www.cancer.org.au/about-us/policy-and-advocacy/early-detection/breast-cancer/rosa/key-findings">change</a>. There’s international debate on the <a href="https://www.bmj.com/content/385/bmj.q1353">age</a> women should be invited for screening. But an even larger change being considered worldwide is whether to screen women at <a href="https://www.nature.com/articles/s41416-021-01550-3">high and low risk</a> of breast cancer differently. But what such a “risk-based” approach to screening might look like in Australia is not yet clear. Here’s why researchers and public health officials are floating a change to breast cancer screening in Australia, and what any changes might mean. <h2>Why breast cancer screening may need to change</h2> Mass screening (known as population-based screening) for breast cancer was introduced in Australia and many other developed countries in the 1980s and 90s. This was based on <a href="https://pubmed.ncbi.nlm.nih.gov/26756588/">robust research</a> that found early detection and treatment of cancers before there were symptoms prevented some women from dying from breast cancer. These programs offer regular breast cancer screening to women within a specific age group. For example, <a href="https://www.aihw.gov.au/reports/cancer-screening/national-cancer-screening-programs-participation/contents/breastscreen-australia">in Australia</a>, women aged 40-74 years can have free mammograms (x-rays of the breasts) every two years. The BreastScreen program sends invitations for screening to those aged 50-74. However, evidence has been mounting that mammography screening could be inadvertently causing <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61611-0/abstract">harm</a> for some women. For some, screening causes a false alarm that may cause anxiety, and unnecessary tests and procedures. Even though these tests rule out cancer, these women may remain anxious and perceive something is wrong <a href="https://bmjopen.bmj.com/content/13/4/e072188">for many years</a>. A more insidious harm is <a href="https://theconversation.com/five-warning-signs-of-overdiagnosis-110895">overdiagnosis</a>, where screening detects a non-growing or slow-growing lesion that looks like “cancer” under the microscope, but would not have progressed or caused harm if it had been left alone. This means some women are having unnecessary surgery, radiotherapy and hormone therapy that will not benefit them, but may harm. Although trials have shown screening reduces the risk of dying from breast cancer, questions are being raised about how much it <a href="https://www.bmj.com/content/352/bmj.h6080.abstract">saves lives overall</a>. That is, it’s uncertain how much the reduced risk of dying from breast cancer translates into improvements in a woman’s overall survival. <h2>How about better targeting women?</h2> One idea is to target screening to those most likely to benefit. Under such a “<a href="https://www.nature.com/articles/s41416-021-01550-3">risk-based</a>” approach, a women’s personal risk of breast cancer is estimated. This may be based on her age and many other factors that may include breast density, family history of breast cancer, body-mass index, genetics, age she started and stopped her periods, and the number of children she’s had. Women who are at higher risk would be recommended to start screening at a younger age and to screen more frequently or to use different, more sensitive, imaging tests. Women at lower risk would be recommended to start later and to screen less often. The idea of this more “precise” approach to screening is to direct efforts and resources towards the smaller number of women most likely to benefit from screening via the early detection of cancer. At the same time, this approach would reduce the risk of harm from false positives (detection of an anomaly but no cancer is present) and overdiagnosis (detection of a non-growing or slow-growing cancer) for the larger number of women who are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230256/">unlikely to benefit</a>. On face value this sounds like a good idea, and could be a favourable change for breast cancer screening. <h2>But there’s much we don’t know</h2> However, it’s uncertain how this would play out in practice. For one thing, someone’s future risk of a cancer diagnosis includes the risk of detecting both <a href="https://www.acpjournals.org/doi/10.7326/m17-2792">overdiagnosed cancers</a> as well as potentially lethal ones. This is proving to be a problem in risk-based screening for <a href="https://www.nature.com/articles/s41698-022-00266-8">prostate cancer</a>, another cancer prone to overdiagnosis. Ideally, we’d want to predict someone’s risk of <a href="https://www.thelancet.com/journals/landig/article/PIIS2589-7500(23)00113-9/fulltext">potentially lethal cancers</a> as these are the ones we want to catch early. It is also still uncertain how many women found to be at <a href="https://pubmed.ncbi.nlm.nih.gov/31701797/">low risk</a> will accept a recommendation for <a href="https://pubmed.ncbi.nlm.nih.gov/23092125/">less screening</a>. These uncertainties mean we need robust evidence the benefits outweigh the harms for Australian women before we make changes to the breast cancer screening program. There are several international <a href="https://www.nature.com/articles/s41416-021-01550-3">randomised controlled trials</a> (the gold standard for research) under way to evaluate the effectiveness of risk-based screening compared to current practice. So it may be prudent to wait for their findings before making changes to policy or practice. Even if such trials did give us robust evidence, there are still a number of issues to address before implementing a risk-based approach. One key issue is having enough staff to run the program, including people with the skills and time to discuss with women any concerns they have about their calculated risk. <h2>How about breast density?</h2> Women with dense breasts are at <a href="https://www.sciencedirect.com/science/article/pii/S0960977622001618#:%7E:text=Mammographic%20density%20is%20a%20well,increased%20risk%20of%20breast%20cancer.">higher risk of breast cancer</a>. So notifying women about their breast density has been proposed as a “first step” on the pathway to risk-based screening. However, this ignores the many other factors that determine a woman’s risk of breast cancer. Legislation in the <a href="https://www.fda.gov/radiation-emitting-products/mammography-quality-standards-act-and-program">United States</a> and changes in some <a href="https://australianbreastcancer.org.au/news-stories/latest-news/breast-density-reporting-at-all-sa-clinics/">Australian states</a> mean some women are already being notified about their breast density. The idea is to enhance their knowledge about their breast cancer risk so they can make informed decisions about future screening. But this has happened before we know what the best options are for such women. An <a href="https://www.mja.com.au/journal/2023/219/9/psychosocial-outcomes-and-health-service-use-after-notifying-women-participating">ongoing Australian trial</a> is investigating the effects that breast density notification has on individual women and the health system. <h2>What next?</h2> Robust evidence and careful planning are needed before risk-based screening or other changes are made to Australia’s breast cancer screening program. Where changes are made, there needs to be early evaluation of both the <a href="https://www.bmj.com/content/350/bmj.h1566.abstract">benefits and harms</a>. Programs also need <a href="https://www.bmj.com/content/374/bmj.n2049.long">independent, regular re-evaluation</a> in the longer term.<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/231917/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/brooke-nickel-200747">Brooke Nickel</a>, NHMRC Emerging Leader Research Fellow, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/katy-bell-134554">Katy Bell</a>, Professor in Clinical Epidemiology, Sydney School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/breast-cancer-screening-in-australia-may-change-heres-what-we-know-so-far-231917">original article</a>. </div>

Body

How you experience the menopause may have a lot to do with your family

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> The <a href="https://www.ncbi.nlm.nih.gov/pubmed/30346539">menopause</a> happens around the age of 50, and for many women, the end of their fertile life is accompanied by uncomfortable symptoms, such as hot flashes, night sweats and anxiety. In the West, it is generally taken as read that these symptoms are a normal part of the menopause. But <a href="https://www.ncbi.nlm.nih.gov/pubmed/11330770">cross-cultural research</a> suggests that menopause symptoms are not necessarily inevitable. For example, <a href="https://www.ncbi.nlm.nih.gov/pubmed/18521049">Japanese women</a> rarely report hot flashes, whereas for European women they are a common complaint. As a result, scientists have begun to focus on what causes this difference in experience and the potential impact that behavioural and lifestyle factors, such as <a href="https://www.ncbi.nlm.nih.gov/pubmed/16735636">smoking</a>, might have. Our latest <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ece3.5705">study</a> adds to this knowledge. We found that living away from your genetic family may worsen the menopause. <h2>Family matters?</h2> Where people live once they’re married varies across cultures. To investigate whether these different living arrangements affect menopause symptoms, we travelled to south-west China to collect data. In this region, there are groups with distinct living arrangements. First, the Han and the Yi, in which women typically leave their family after they’ve got married and live with their husband’s family. Second, the Mosuo and Zhaba, who engage in the practice of zou hun (“<a href="https://www.ncbi.nlm.nih.gov/pubmed/23486437">walking marriage</a>”), where the husband and wife live separately with their own related families, and only visit each other at night. We found that women who remained living with their own family following marriage had significantly less severe menopause symptoms than those who went to live with their husband’s family. <h2>In-law conflict</h2> Many anthropologists are interested in how different levels of relatedness within households can have behavioural and physiological implications. For the menopause, we think the difference in symptom severity between the groups may be the result of the different levels of conflict that result from being more or less related to other members of your household. If a woman lives with her husband’s family, then until she has children, she is unrelated to anyone in the household. This lack of relatedness can cause <a href="https://link.springer.com/article/10.1007/s40806-017-0114-8">tension</a> between the new wife and her husband’s relatives as they have little direct genetic interest in her. As well as conflict with non-related household members, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/evan.20226">earlier research</a> has shown that women who live with their husband’s family tend to argue with their partners more and are also more likely to get divorced. Additionally, rates of domestic violence are <a href="https://www.ncbi.nlm.nih.gov/pubmed/27279077">higher</a> when women live away from their genetic family. But how does this relate to the severity of menopause symptoms? We think that increased levels of household conflict would result in the woman being more stressed. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795524/">Stress</a> is known to worsen pain perception and so could aggravate menopause symptoms. In contrast to women who leave their kin group, women who live with their own family once they’re married also tend to have higher levels of <a href="https://scholar.harvard.edu/slowes/publications/matrilineal-spousal-cooperation">social support</a>. There are more people to help with childcare and more shoulders to cry on. This can help to lower stress and thus soften the mental and physical burden of the menopause. <h2>Global perspectives</h2> While our research was conducted in China, globally, we see a wide range of living arrangements, which themselves can bring different levels of conflict and social support. In the West, many women live away from their families, which may mean that they lack social support, perhaps contributing to more turbulent menopause symptoms. Distance from one’s own family can also be seen to increase <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1741-3737.2005.00155.x">conflict</a> within the household – be it between a husband and wife, or wife and in-laws. These results aren’t an excuse to visit your in-laws less, but they show that menopause symptoms are not only about hormonal irregularities. They may also be a product of your social environment, which should be worth bearing in mind when approaching and going through the menopause.<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/123621/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/megan-arnot-416253">Megan Arnot</a>, PhD Candidate, Evolutionary Anthropology and Behavioural Ecology, <a href="https://theconversation.com/institutions/ucl-1885">UCL</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-you-experience-the-menopause-may-have-a-lot-to-do-with-your-family-123621">original article</a>. </div>

Body

Drinking lots of water may seem like a healthy habit – here’s when and why it can prove toxic

<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> In late 2023, actor <a href="https://www.glamour.com/story/brooke-shields-recently-experienced-a-full-blown-seizure-and-bradley-cooper-came-running?utm_source=instagram&utm_medium=social&utm_content=instagram-bio-link&client_service_id=31196&client_service_name=glamour&service_user_id=1.78e+16&supported_service_name=instagram_publishing&utm_brand=glm&utm_social_type=owned">Brooke Shields</a> suffered a seizure after “flooding” her body with water. Shields became dangerously low on sodium while preparing for her show by drinking loads of water. “I flooded my system and I drowned myself,” she would later explain. “And if you don’t have enough sodium in your blood or urine or your body, you can have a seizure.” Shields said she found herself walking around outside for “no reason at all”, wondering: “Why am I out here?” <blockquote> Then I walk into the restaurant and go to the sommelier who had just taken an hour to watch my run through. That’s when everything went black. Then my hands drop to my side and I go headfirst into the wall. </blockquote> Shields added that she was “frothing at the mouth, totally blue, trying to swallow my tongue”. Like Shields, many people may be unaware of the dangers of drinking excessive amounts of water – especially because hydration is so often associated with health benefits. Models and celebrities <a href="https://www.teenvogue.com/story/drinking-water-flawless-skin#:%7E:text=If%20you're%20reading%20a,long%20hours%20at%20a%20time.">often advocate</a> drinking lots of water to help maintain clear, smooth skin. Some <a href="https://www.independent.co.uk/life-style/75-hard-challenge-before-and-after-tiktok-b2382706.html">social media influencers</a> have promoted drinking a gallon of water daily for weight loss. But excessive water consumption can cause <a href="https://patient.info/treatment-medication/hyponatraemia-leaflet">hyponatraemia</a> – a potentially fatal condition of low sodium in the blood. <h2>Worried about hydration levels? Check your urine</h2> The body strictly regulates its water content to maintain the optimum level of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323003/">total body water</a> and “osmolality” – the concentration of dissolved particles in your blood. Osmolality increases when you are dehydrated and decreases when you have too much fluid in your blood. Osmolality is monitored by <a href="https://pubmed.ncbi.nlm.nih.gov/9074779/">osmoreceptors</a> that regulate sodium and water balance in the hypothalamus – the part of the brain that controls numerous hormones. These osmoreceptors signal the release of antidiuretic hormone (ADH), which acts on blood vessels and the kidneys to control the amount of water and salt in the body. <figure><iframe src="https://www.youtube.com/embed/Qghf7Y9ILAs?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> In healthy people, the body releases ADH when osmolality becomes high. ADH tells the kidneys to reabsorb water, which makes urine more concentrated. The reabsorbed water dilutes the blood, bringing osmolality back to normal levels. Low blood osmolality suppresses the release of ADH, reducing how much water the kidneys reabsorb. This dilutes your urine, which the body then passes to rid itself of the excess water. Healthy urine should be clear and odourless. Darker, yellower urine with a noticeable odour can indicate dehydration – although medications and certain foods, including <a href="https://pubmed.ncbi.nlm.nih.gov/3433805/">asparagus</a>, can affect urine colour and odour, too. <h2>How much is too much?</h2> Adults should consume <a href="https://www.nhs.uk/live-well/eat-well/food-guidelines-and-food-labels/water-drinks-nutrition/">two-to-three litres per day</a>, of which around 20% comes from food. However, we can lose <a href="https://www.ncbi.nlm.nih.gov/books/NBK236237/">up to ten litres</a> of water through perspiration – so sweating during exercise or in hot weather increases the amount of water we need to replace through drinking. Some medical conditions can cause overhydration. Approximately <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616165/">one in five</a> schizophrenia patients drink water compulsively, a dangerous condition known as <a href="https://www.theguardian.com/uk-news/2024/apr/15/woman-died-mental-hospital-excessive-water-drinking-inquest#:%7E:text=Woman%20died%20at%20mental%20hospital%20after%20excessive%20water%20drinking%2C%20inquest%20told,-Parents%20of%20Lillian&text=A%20woman%20collapsed%20and%20died,water%2C%20an%20inquest%20has%20heard.">psychogenic polydipsia</a>. One long-term study found that patients with psychogenic polydipsia have a <a href="https://pubmed.ncbi.nlm.nih.gov/18984069/">“74% greater chance</a> of dying before a non-polydipsic patient”. In <a href="https://pubmed.ncbi.nlm.nih.gov/22306188/">some cases</a>, people with <a href="https://psychiatry-psychopharmacology.com/en/childhood-and-adolescence-disorders-psychogenic-polydipsia-in-an-adolescent-with-eating-disorder-a-case-report-132438">anorexia nervosa</a> can also suffer from compulsive water drinking. <figure><iframe src="https://www.youtube.com/embed/ReQew2zcN7c?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For those suffering from polydipsia, treatment is focused on medication to reduce the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10675986/">urge to drink</a>, as well as <a href="https://www.uptodate.com/contents/overview-of-the-treatment-of-hyponatremia-in-adults/print">increasing sodium levels</a>. This should be done gradually to avoid causing <a href="https://www.ncbi.nlm.nih.gov/books/NBK562251/">myelinolysis</a> – <a href="https://www.ncbi.nlm.nih.gov/books/NBK551697/">neurological damage</a> caused by rapid changes in sodium levels in nerve cells. In rare but often highly publicised cases such as that of <a href="http://news.bbc.co.uk/onthisday/hi/dates/stories/november/13/newsid_2516000/2516593.stm">Leah Betts</a> in 1995, some users of the illegal drug MDMA (also known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6119400/">ecstasy)</a> have <a href="https://pubmed.ncbi.nlm.nih.gov/11265566/">died</a> after drinking copious amounts of water to rehydrate after dancing and sweating. The drug <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">increases body temperature</a>, so users drink water to avoid overheating. Unfortunately, MDMA also triggers the <a href="https://pubmed.ncbi.nlm.nih.gov/12105115/">unnecessary release of ADH</a>, causing water retention. The body becomes unable to rid itself of excess water, which affects its electrolyte levels – causing cells to swell with water. Symptoms of water intoxication start with nausea, vomiting, blurred vision and dizziness. As the condition progresses, sufferers can often display symptoms of <a href="https://www.nhs.uk/mental-health/conditions/psychosis/symptoms/">psychosis</a>, such as inappropriate behaviour, confusion, delusions, disorientation and hallucinations. These symptoms are caused by <a href="https://www.ncbi.nlm.nih.gov/books/NBK470386/">hyponatraemia</a>, where sodium levels are diluted or depleted in blood and the subsequent imbalance of electrolytes affects the nervous system. Water begins to move into the brain causing <a href="https://www.sciencedirect.com/science/article/pii/S1572349604000149">a cerebral oedema</a> – brain swelling because of excessive fluid buildup, which is usually fatal if not treated. A healthy body will tell you when it needs water. If you’re thirsty and your urine is dark with a noticeable odour, then you need to drink more. If you aren’t thirsty and your urine is clear or the colour of light straw, then you’re already doing a good job of hydrating yourself.<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/228715/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: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drinking-lots-of-water-may-seem-like-a-healthy-habit-heres-when-and-why-it-can-prove-toxic-228715">original article</a>. </div>

Body

The voice in your head may help you recall and process words. But what if you don’t have one?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/derek-arnold-106381">Derek Arnold</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Can you imagine hearing yourself speak? A voice inside your head – perhaps reciting a shopping list or a phone number? What would life be like if you couldn’t? Some people, including me, cannot have imagined visual experiences. We cannot close our eyes and conjure an experience of seeing a loved one’s face, or imagine our lounge room layout – to consider if a new piece of furniture might fit in it. This is called “<a href="https://theconversation.com/a-blind-and-deaf-mind-what-its-like-to-have-no-visual-imagination-or-inner-voice-226134">aphantasia</a>”, from a Greek phrase where the “a” means without, and “phantasia” refers to an image. Colloquially, people like myself are often referred to as having a “blind mind”. While most attention has been given to the inability to have imagined visual sensations, aphantasics can lack other imagined experiences. We might be unable to experience imagined tastes or smells. Some people cannot imagine hearing themselves speak. A <a href="https://www.sciencealert.com/we-used-to-think-everybody-heard-a-voice-inside-their-heads-but-we-were-wrong">recent study</a> has advanced our understanding of people who cannot imagine hearing their own internal monologue. Importantly, the authors have identified some tasks that such people are more likely to find challenging. <h2>What the study found</h2> Researchers at the University of Copenhagen in Denmark and at the University of Wisconsin-Madison in the United States <a href="https://journals.sagepub.com/doi/10.1177/09567976241243004">recruited 93 volunteers</a>. They included 46 adults who reported low levels of inner speech and 47 who reported high levels. Both groups were given challenging tasks: judging if the names of objects they had seen would rhyme and recalling words. The group without an inner monologue performed worse. But differences disappeared when everyone could say words aloud. Importantly, people who reported less inner speech were not worse at all tasks. They could recall similar numbers of words when the words had a different appearance to one another. This negates any suggestion that aphants (people with aphantasia) simply weren’t trying or were less capable. <h2>A welcome validation</h2> The study provides some welcome evidence for the lived experiences of some aphants, who are still often told their experiences are not different, but rather that they cannot describe their imagined experiences. Some people feel anxiety when they realise other people can have imagined experiences that they cannot. These feelings may be deepened when others assert they are merely confused or inarticulate. In my own <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2024.1374349/full">aphantasia research</a> I have often quizzed crowds of people on their capacity to have imagined experiences. Questions about the capacity to have imagined visual or audio sensations tend to be excitedly endorsed by a vast majority, but questions about imagined experiences of taste or smell seem to cause more confusion. Some people are adamant they can do this, including a colleague who says he can imagine what combinations of ingredients will taste like when cooked together. But other responses suggest subtypes of aphantasia may prove to be more common than we realise. The authors of the recent study suggest the inability to imagine hearing yourself speak should be referred to as “anendophasia”, meaning without inner speech. Other authors had suggested <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8551557/">anauralia</a> (meaning without auditory imagery). Still other researchers have referred to all types of imagined sensation as being different types of “imagery”. Having <a href="https://www.sciencedirect.com/science/article/abs/pii/S0010945222000417">consistent names</a> is important. It can help scientists “talk” to one another to compare findings. If different authors use different names, important evidence can be missed. <h2>We have more than 5 senses</h2> Debate continues about how many senses humans have, but some scientists reasonably argue for a <a href="https://www.sensorytrust.org.uk/blog/how-many-senses-do-we-have#:%7E:text=Because%20there%20is%20some%20overlap,sensation%20of%20hunger%20or%20thirst.">number greater than 20</a>. In addition to the five senses of sight, smell, taste, touch and hearing, lesser known senses include thermoception (our sense of heat) and proprioception (awareness of the positions of our body parts). Thanks to proprioception, most of us can close our eyes and touch the tip of our index finger to our nose. Thanks to our vestibular sense, we typically have a good idea of which way is up and can maintain balance. It may be tempting to give a new name to each inability to have a given type of imagined sensation. But this could lead to confusion. Another approach would be to adapt phrases that are already widely used. People who are unable to have imagined sensations commonly refer to ourselves as “aphants”. This could be adapted with a prefix, such as “audio aphant”. Time will tell which approach is adopted by most researchers. <h2>Why we should keep investigating</h2> Regardless of the names we use, the study of multiple types of inability to have an imagined sensation is important. These investigations could reveal the essential processes in human brains that bring about a conscious experience of an imagined sensation. In time, this will not only lead to a better understanding of the diversity of humans, but may help uncover how human brains can create any conscious sensation. This question – how and where our conscious feelings are generated – remains one of the great mysteries of science.<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/230973/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/derek-arnold-106381">Derek Arnold</a>, Professor, School of Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-voice-in-your-head-may-help-you-recall-and-process-words-but-what-if-you-dont-have-one-230973">original article</a>. </div>

Mind

Would you be happy as a long-term single? The answer may depend on your attachment style

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christopher-pepping-1524533">Christopher Pepping</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/geoff-macdonald-1527971">Geoff Macdonald</a>, <a href="https://theconversation.com/institutions/university-of-toronto-1281">University of Toronto</a>; <a href="https://theconversation.com/profiles/tim-cronin-415060">Tim Cronin</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/yuthika-girme-1494822">Yuthika Girme</a>, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser University</a> Are all single people insecure? When we think about people who have been single for a long time, we may assume it’s because single people have insecurities that make it difficult for them to find a partner or maintain a relationship. But is this true? Or can long-term single people also be secure and thriving? Our <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jopy.12929">latest research</a> published in the Journal of Personality suggests they can. However, perhaps unsurprisingly, not everybody tends to thrive in singlehood. Our study shows a crucial factor may be a person’s attachment style. <h2>Singlehood is on the rise</h2> Singlehood is on the rise around the world. In Canada, single status among young adults aged 25 to 29 has increased from <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713b-eng.htm">32% in 1981 to 61% in 2021</a>. The number of people <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/220713/dq220713a-eng.htm">living solo</a> has increased from 1.7 million people in 1981 to 4.4 million in 2021. People are single for many reasons: <a href="https://www.ucpress.edu/ebook/9780520971004/happy-singlehood">some choose</a> to remain single, some are focusing on <a href="https://link.springer.com/article/10.1007/s12147-020-09249-0">personal goals and aspirations</a>, some report <a href="https://www.pewresearch.org/social-trends/2020/08/20/nearly-half-of-u-s-adults-say-dating-has-gotten-harder-for-most-people-in-the-last-10-years/">dating has become harder</a>, and some become single again due to a relationship breakdown. People may also remain single due to their attachment style. Attachment theory is a popular and well-researched model of how we form relationships with other people. An <a href="https://www.amazon.com.au/s?k=attachment+theory">Amazon search for attachment theory</a> returns thousands of titles. The hashtag #attachmenttheory has been viewed <a href="https://www.cnbc.com/2022/08/20/why-attachment-theory-is-trending-according-to-dr-amir-levine.html">over 140 million times</a> on TikTok alone. <h2>What does attachment theory say about relationships?</h2> Attachment theory suggests our relationships with others are shaped by our degree of “anxiety” and “avoidance”. Attachment anxiety is a type of insecurity that leads people to feel anxious about relationships and worry about abandonment. Attachment avoidance leads people to feel uncomfortable with intimacy and closeness. People who are lower in attachment anxiety and avoidance are considered “securely attached”, and are comfortable depending on others, and giving and receiving intimacy. Single people are often stereotyped as being <a href="https://journals.sagepub.com/doi/full/10.1177/01461672231203123">too clingy or non-committal</a>. Research comparing single and coupled people also suggests single people have <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-6494.2012.00793.x?casa_token=6iiCm5PjHgkAAAAA:0kBeofx3M-72YrkVppmNxdWBIAImFwm3lAakCnuiNXL20SVP1zaW7UeDIahW_43imAjSRXgtyN0hLVI">higher levels of attachment insecurities</a> compared to people in relationships. At the same time, evidence suggests many single people are choosing to remain single and <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221136119">living happy lives</a>. <h2>Single people represent a diverse group of secure and insecure people</h2> In our latest research, our team of social and clinical psychologists examined single people’s attachment styles and how they related to their happiness and wellbeing. We carried out two studies, one of 482 younger single people and the other of 400 older long-term singles. We found overall 78% were categorised as insecure, with the other 22% being secure. Looking at our results more closely, we found four distinct subgroups of singles: <ul> <li> secure singles are relatively comfortable with intimacy and closeness in relationships (22%) </li> <li> anxious singles question whether they are loved by others and worry about being rejected (37%) </li> <li> avoidant singles are uncomfortable getting close to others and prioritise their independence (23% of younger singles and 11% of older long-term singles) </li> <li> fearful singles have heightened anxiety about abandonment, but are simultaneously uncomfortable with intimacy and closeness (16% of younger singles and 28% of older long-term singles). </li> </ul> <h2>Insecure singles find singlehood challenging, but secure singles are thriving</h2> Our findings also revealed these distinct subgroups of singles have distinct experiences and outcomes. Secure singles are happy being single, have a greater number of non-romantic relationships, and better relationships with family and friends. They meet their sexual needs outside romantic relationships and feel happier with their life overall. Interestingly, this group maintains moderate interest in being in a romantic relationship in the future. Anxious singles tend to be the most worried about being single, have lower self-esteem, feel less supported by close others and have some of the lowest levels of life satisfaction across all sub-groups. Avoidant singles show the least interest in being in a romantic relationship and in many ways appear satisfied with singlehood. However, they also have fewer friends and close relationships, and are generally less satisfied with these relationships than secure singles. Avoidant singles also report less meaning in life and tend to be less happy compared to secure singles. Fearful singles reported more difficulties navigating close relationships than secure singles. For instance, they were less able to regulate their emotions, and were less satisfied with the quality of their close relationships relative to secure singles. They also reported some of the lowest levels of life satisfaction across all sub-groups. <h2>It’s not all doom and gloom</h2> These findings should be considered alongside several relevant points. First, although most singles in our samples were insecure (78%), a sizeable number were secure and thriving (22%). Further, simply being in a romantic relationship is not a panacea. Being in an unhappy relationship is linked to <a href="https://doi.org/10.1371/journal.pmed.1000316">poorer life outcomes</a> than being single. It is also important to remember that attachment orientations are not necessarily fixed. They are open to <a href="https://www.sciencedirect.com/science/article/pii/S2352250X18300113">change</a> in response to life events. Similarly, <a href="https://journals.sagepub.com/doi/full/10.1177/0963721413510933">sensitive and responsive behaviours</a> from close others and <a href="https://doi.org/10.1177/02654075231162390">feeling loved and cared about</a> by close others can soothe underlying attachment concerns and foster attachment security over time. Our studies are some of the first to examine the diversity in attachment styles among single adults. Our findings highlight that many single people are secure and thriving, but also that more work can be done to help insecure single people feel more secure in order to foster happiness.<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/227595/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christopher-pepping-1524533">Christopher Pepping</a>, Associate Professor in Clinical Psychology, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/geoff-macdonald-1527971">Geoff Macdonald</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-toronto-1281">University of Toronto</a>; <a href="https://theconversation.com/profiles/tim-cronin-415060">Tim Cronin</a>, Lecturer in Clinical Psychology, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/yuthika-girme-1494822">Yuthika Girme</a>, Associate Professor, Department of Psychology, <a href="https://theconversation.com/institutions/simon-fraser-university-1282">Simon Fraser 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/would-you-be-happy-as-a-long-term-single-the-answer-may-depend-on-your-attachment-style-227595">original article</a>. </div>

Relationships

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

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

Money & Banking

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

<a href="https://theconversation.com/profiles/alexandru-nichifor-1342216">Alexandru Nichifor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/scott-duke-kominers-1494057">Scott Duke Kominers</a>, <a href="https://theconversation.com/institutions/harvard-university-1306">Harvard University</a> Loyalty programs enable firms to offer significantly lower prices to some of their customers. You’d think this would encourage strong competition. But that isn’t always what actually happens. <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4377561">New research</a> shows that paradoxically, by changing the way companies target customers, loyalty programs can sometimes reduce price competition. The research also points to solutions. <h2>A win-win proposition?</h2> Joining a loyalty program is supposed to be a win-win. You – the customer – get to enjoy perks and discounts, while the company gains useful commercial insights and builds brand allegiance. For example, a hotel chain loyalty program might reward travellers for frequent stays, with points redeemable for future bookings, upgrades or other benefits. The hotel chain, in turn, records and analyses how you spend money and encourages you to stay with them again. Such programs are commonplace across many industries – appearing everywhere from travel and accommodation to supermarket or petrol retailing. But they are increasingly coming under scrutiny. In 2019, the Australian Competition and Consumer Commission (ACCC) <a href="https://www.accc.gov.au/about-us/publications/customer-loyalty-schemes-final-report">cautioned</a> consumers about the sheer volume of personal data collected when participating in a loyalty program, and what companies can do with it. Hidden costs – such as having to pay a redemption fee on rewards or losing benefits when points expire – are another way these schemes can harm consumers. But a larger question – how loyalty programs impact consumers overall – remains difficult to settle, because their effect on competitiveness is unclear. As the ACCC’s <a href="https://www.accc.gov.au/about-us/publications/customer-loyalty-schemes-final-report">final report</a> notes, on the one hand: "Loyalty schemes can have pro-competitive effects and intensify competition between rivals leading to competing loyalty discounts and lower prices for consumers." But on the other hand: "Loyalty schemes can also reduce the flexibility of consumers’ buying patterns and responsiveness to competing offers, which may reduce competition." <h2>How a two-speed price system can hurt everyone</h2> A new economic theory research <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4377561">working paper</a>, coauthored by one of us (Kominers), suggests that on competitive grounds alone, loyalty programs can sometimes harm all consumers – both ordinary shoppers and the program’s own members. It’s easy to see how the ordinary shopper can be worse off. Since a firm’s loyalty program enables it to offer discounted prices to its members, the firm can raise the base prices it offers to everyone else. Those not participating in the program pay more than they otherwise would have, and the firm can respond by saying “join our program!” instead of having to lower its price. But sometimes, even the program’s own members can end up worse off. When a given customer’s loyalty status is not visible to a firm’s competitors – as is the case in many loyalty programs today – it’s hard for those competitors to identify them and entice them to switch. The main way to compete for those customers becomes to lower the base price for everyone, but this means missing out on the high base margins achieved through the existence of your own loyalty program – remember, having a loyalty program means you can charge non-members more. It’s often more profitable for firms to just maintain high base prices. This, in turn, reduces overall price competition for loyal customers, so firms can raise prices for them, too. <h2>What’s the solution?</h2> Despite these effects on competition, loyalty programs still offer benefits for consumers and an opportunity for brands to form closer relationships with them. So, how do we preserve these benefits while enabling price competition? The research suggests an answer: making a customer’s loyalty status verifiable, transparent and portable across firms. This would make it possible for firms to tailor offers for their competitors’ loyal customers. This is already happening in the market for retail electricity. While there aren’t loyalty programs there per se, a consumer’s energy consumption profile, which could be used by a competitor to calibrate a personalised offer, is known only to their current electricity supplier. To address this, in 2015, the Victorian government launched a <a href="https://compare.energy.vic.gov.au">program</a> encouraging households to compare energy offers. This process involved first revealing a customer’s energy consumption profile to the market, and then asking retailers to compete via personalised offers. By opening information that might have otherwise been hidden to the broader market, this approach enabled firms to compete for each other’s top customers, in a way that could be emulated for loyalty programs. Such systems in the private sector could build upon “<a href="https://thepointsguy.com/guide/airline-status-matches-challenges/">status match</a>” policies at airlines. These allow direct transfer of loyalty status, but currently rely on a lengthy, individual-level verification process. For example, a design paradigm known as “<a href="https://hbr.org/2022/05/what-is-web3">Web3</a>” – where customer transactions and loyalty statuses are recorded on public, shared blockchain ledgers – offers a way to make loyalty transparent across the market. This would enable an enhanced, decentralised version of status match: a firm could use blockchain records to verifiably identify who its competitors’ loyal customers are, and directly incentivise them to switch. Both startups and established firms have experimented with building such systems. <h2>What next?</h2> New academic research helps us model and better understand when loyalty programs could be weakening supply side competition and undermining consumer welfare. A neat universal solution may prove elusive. But targeted government or industry interventions – centred on increasing the transparency of a customer’s loyalty status and letting them move it between firms – could help level the playing field between firms and consumers.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/220669/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alexandru-nichifor-1342216">Alexandru Nichifor</a>, Associate Professor, Faculty of Business and Economics, University of Melbourne, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/scott-duke-kominers-1494057">Scott Duke Kominers</a>, Sarofim-Rock Professor of Business Administration, <a href="https://theconversation.com/institutions/harvard-university-1306">Harvard University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/loyalty-programs-may-limit-competition-and-they-could-be-pushing-prices-up-for-everyone-220669">original article</a>.

Money & Banking

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

<a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> Most of us don’t worry about getting vitamin D when the weather’s warm and the sun is shining. But as winter approaches, accompanied by overcast days and long nights, you may be wondering if it could be useful to take a vitamin D supplement – and what benefit it might have. During the summer, the best way to get vitamin D is by getting a bit of sunshine. Ultraviolet rays (specifically UVB, which have a shorter wavelength) interact with a form of cholesterol called <a href="https://www.ncbi.nlm.nih.gov/books/NBK278935/">7-dehydrocholesterol</a> in the skin, which is then converted into vitamin D. Because vitamin D production is dependent on UVB, this means our ability to make it <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/#:%7E:text=From%20about%20late%20March%2Fearly,enough%20vitamin%20D%20from%20sunlight.">declines in the winter months</a>. Vitamin D production also <a href="https://pubmed.ncbi.nlm.nih.gov/24494042/">depends on where you live</a>, with people living nearer to the equator making more vitamin D than those living nearer the poles. Vitamin D deficiency is a <a href="https://assets.publishing.service.gov.uk/media/5a804e36ed915d74e622dafa/SACN_Vitamin_D_and_Health_report.pdf">problem in the UK</a> during the winter months. This is due to its northerly position and cloudy weather, and lack of time spent outdoors. One study of over 440,000 people in the UK found that <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">18% were vitamin D deficient</a> during the winter months. Vitamin D deficiency was even higher in certain ethnic groups – with the data showing 57% of Asian participants and 38% of black participants were vitamin D deficient. This is because the melanin content of skin determines a person’s ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946242/#:%7E:text=Skin%20pigmentation%2C%20i.e.%2C%20melanin%2C,%5B7%5D%20and%20more%20generally.">make UVB into vitamin D</a>. Given the prevalence of vitamin D deficiency in the UK, and the importance it has for our health, in 2016 the UK’s Science Advisory Council on Nutrition outlined recommendations for the <a href="https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report#:%7E:text=In%20a%20change%20to%20previous,aged%204%20years%20and%20older">amount of vitamin D</a> people should aim to get in the winter. They recommend people aim to get ten micrograms (or 400 IU – international units) of vitamin D per day. This would help people avoid severe deficiency. This can be achieved either by taking a supplement, or eating <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/ask-the-expert/foods-high-in-vitamin-d">certain foods</a> that are rich in vitamin D – including fatty fish such as herring, mackerel and wild salmon. A 100 gram serving of fresh herring, for example, would have approximately five micrograms of vitamin D. The clearest benefit of taking a vitamin D supplement is for <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/">bone health</a>. In fact, vitamin D was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899558/">first discovered</a> 100 years ago because of its ability to prevent the disease rickets, which causes weak bones that bend. Although rickets <a href="https://www.nhs.uk/conditions/rickets-and-osteomalacia/#:%7E:text=The%20number%20of%20rickets%20cases,from%20sunlight%2C%20can%20develop%20rickets.">isn’t very common</a> in the UK today, it can still occur in children if they lack vitamin D. In adults, vitamin D deficiency can cause bone pain, tenderness and muscles weakness, as well as increased risk of osteomalacia – often called “soft bone disease” – which leads to weakening or softening bones. The reason a lack of vitamin D can have such an effect on bone health is due to the vitamin’s relationship with <a href="https://pubmed.ncbi.nlm.nih.gov/18844850/">calcium and phosphate</a>. Both of these minerals help keep our bones strong – but they require vitamin D in order to be able to reinforce and strengthen bones. <h2>Other health benefits</h2> In addition to its effects on the skeleton, a growing body of research is beginning to indicate that vitamin D supplements may have additional benefits to our health. For example, <a href="https://ar.iiarjournals.org/content/42/10/5009.long">research shows</a> there’s a link between vitamin D deficiency and increased risk of catching certain viral illnesses, including the <a href="https://pubmed.ncbi.nlm.nih.gov/19237723/">common cold</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231123/">flu</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385774/">COVID</a>. Similarly, several studies – <a href="https://pubmed.ncbi.nlm.nih.gov/32904944/">including my own</a> – have demonstrated in cell models that vitamin D promotes immunity against microbes, such as the bacteria which causes tuberculosis. This means vitamin D may potentially prevent some types of infections. Vitamin D may also dampen inflammatory immune responses, which could potentially protect against autoimmune diseases, such as <a href="https://pubmed.ncbi.nlm.nih.gov/29243029/">multiple sclerosis</a> and <a href="https://www.frontiersin.org/articles/10.3389/fmed.2020.596007/full">rheumatoid arthritis</a>. One 2022 trial, which looked at over 25,000 people over the age of 50, found taking a 2,000 IU (50 micrograms) vitamin D supplement each day was associated with an <a href="https://www.bmj.com/content/376/bmj-2021-066452">18% lower risk</a> of autoimmune disease – notably rheumatoid arthritis. Vitamin D supplements may also be linked with lower risk of cardiovascular disease. A <a href="https://www.bmj.com/content/381/bmj-2023-075230">major Australian study</a>, which looked at over 21,000 people aged 60-84, found that participants who took a 2,000 IU vitamin D supplement a day for five years had a lower risk of suffering a major cardiovascular event (such as stroke or heart attack) compared to those who didn’t take a supplement. It’s currently not known why vitamin D may have these benefits on these other areas of our health. It’s also worth noting that in many of these trials, very few of the participants were actually vitamin D deficient. While we might speculate the observed health benefits may be even greater in people with vitamin D deficiency, it will be important for future research to study these factors. While it’s too early to say whether vitamin D supplements have broad health benefits, it’s clear it’s beneficial for bone health. It may be worthwhile to take a supplement in the winter months, especially if you’re over 65, have darker skin or spent a lot of time indoors as these factors can put you at <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-deficiency/faq-20058397#:%7E:text=However%2C%20some%20groups%20%E2%80%94%20particularly%20people,sun%20exposure%20or%20other%20factors.">increased risk of vitamin D deficiency</a>. The research also shows us that we should be rethinking vitamin D supplementation advice. While in the UK it’s recommended people get 400 IU of vitamin D a day, many trials have shown 2,000 IU a day is associated with health benefits.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219521/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, Professor of Molecular Endocrinology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/vitamin-d-supplements-can-keep-bones-strong-but-they-may-also-have-other-benefits-to-your-health-219521">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/mario-peucker-192086">Mario Peucker</a>, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> Footballer Sam Kerr has been charged with “racially aggravated harassment” over a January 2023 incident in which she allegedly insulted a London police officer. According to <a href="https://www.theguardian.com/football/2024/mar/06/sam-kerr-allegedly-called-police-officer-a-stupid-white-bastard-source-says">widespread media reports</a>, she is said to have called the officer a “stupid white bastard”. Kerr has pleaded not guilty to the charge and has <a href="https://www.9news.com.au/world/sam-kerr-legal-team-reportedly-challenge-allegations-of-police-harassment/744598ef-75f9-4e03-acb5-7b37aecde8d1">reportedly denied</a> using the word “bastard”. According to section 33 of the British Crime and Disorder Act, to be found guilty of such an offence, the conduct would have had to cause – or have intended to cause – alarm or distress. Regardless of the court’s ultimate verdict, one big question seems to occupy the minds of many: does the phrase attributed to Kerr constitute racism? Kerr was born in Western Australia, and has Indian ancestry on her father’s side. Can she be racist towards a white person, and more specifically to a white police officer? Assuming it is true Kerr used the term “white”, there is a racial element. But “racial” is not the same as “racist”. <h2>Definitions of racism</h2> It is important to note here that “race” is not a biological category (there is only one human race). Race is a <a href="https://www.scientificamerican.com/article/race-is-a-social-construct-scientists-argue/">social construct</a>, invented and cemented centuries ago to legitimise colonial atrocities, oppression and forms of subjugation including slavery. There are many definitions of racism, but there has been a broad consensus for decades that racism is more than “just” prejudice and discriminatory behaviour. It is not simply a matter of less favourable treatment of an individual or group of people based on their actual or ascribed ethnic background, skin colour, origin or related characteristics. Racism also reflects and manifests as systemic exclusion and marginalisation based on historically rooted power imbalances and racial hierarchies that put white people at the top. To put it very simply, the scholarly (if not the legal) definition is that “<a href="https://psycnet.apa.org/record/1998-07453-002">racism equals power plus prejudice</a>”. In a vicious cycle, everyday racism and discrimination are shaped and justified by racial hierarchies, while they operate continuously in a way that cements power imbalances and racial marginalisation. This may sound a bit abstract, but if we do not recognise this power dynamic, we trivialise racism as little more than name-calling. We will fail to understand how racism operates and how it continues to affect people from racially marginalised groups in their daily lives. One way to illustrate the systemic nature of racism is to look at the persistent lack of representation of people of colour in leadership positions in the corporate sector, the media and governments in Australia and elsewhere. In the United Kingdom, where the alleged incident occurred, institutional racism – including within the police force – has been recognised since the release of the <a href="https://www.gov.uk/government/publications/the-stephen-lawrence-inquiry">Macpherson report</a> in 1999. It was reaffirmed in 2023 by the <a href="https://www.met.police.uk/SysSiteAssets/media/downloads/met/about-us/baroness-casey-review/update-march-2023/baroness-casey-review-march-2023a.pdf">Baroness Casey Review</a>, despite some political pushback. The review found “Met officers are 82% White and 71% male, and the majority do not live in the city they police. As such, the Met does not look like the majority of Londoners.” <h2>Reverse racism?</h2> Anti-discrimination legislation in the UK and Australia usually does not speak explicitly of “racism”. It outlaws certain acts that are motivated, partially or wholly, by a person’s race (or other personal identity markers). Legislators introduced these laws with the intention of enhancing the legal protections for those who were considered vulnerable to racism. In Australia, for example, the <a href="https://www.legislation.gov.au/C2004A00274/latest/text">Racial Discrimination Act</a> (1975) is often celebrated as a legal cornerstone in the country’s journey away from its racist “White Australia” history towards a modern multicultural society. The United Nations’ <a href="https://www.ohchr.org/en/instruments-mechanisms/instruments/international-convention-elimination-all-forms-racial">International Convention on the Elimination of All Forms of Racial Discrimination</a> (1965), ratified by Australia in 1975 and the UK in 1969, makes its intention explicit when it calls on all state parties to make it an offence to disseminate “ideas based on racial superiority”. The issue of power structures should also be seen through an institutional lens. It is difficult to imagine a person on the streets of London with more institutional power than a white police officer. Being called a “stupid bastard” might hurt someone’s feelings. But while I’m in no position to judge whether Sam Kerr’s alleged actions have caused “distress” to the officer – as the law would require – labelling the incident as racist is clearly not in line with what racism means. Such a definition would not align with the concept’s institutional and systemic dimensions. It is not what anti-discrimination laws were intended to outlaw. Claims of anti-white or “reverse” racism are based on a shallow, misguided and inaccurate understanding of what racism really constitutes. If Kerr’s court case fails to acknowledge the deeper purpose of anti-racism legislation by equating “racial” with “racist”, it risks setting a highly problematic precedent that would undermine efforts to acknowledge and tackle racism in all its forms. What would be the message to those millions of people in the UK, Australia and elsewhere who have to face racism every day without recognition of the harm it causes and without the support and capacity to sue the perpetrators? What would they think about their right to equality and their place in society?<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225267/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mario-peucker-192086">Mario Peucker</a>, Associate Professor and Principal Research Fellow, Institute for Sustainable Industries and Liveable Cities, <a href="https://theconversation.com/institutions/victoria-university-1175">Victoria University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sam-kerrs-alleged-comments-may-have-had-a-racial-element-but-they-were-not-racist-225267">original article</a>.

Legal

"Harper is my favourite Tilly": Matildas toddler steals the show

In a heartwarming turn of events at Melbourne’s Marvel Stadium, the Matildas' post-game press conference took an unexpected twist when two-year-old Harper decided to steal the show. As her mother, Katrina Gorry, attempted to navigate the world of media interviews, young Harper had other plans, firmly establishing herself as the newest sensation in Australian football – or at least in press conference antics. With the Aussies securing their spot at the Paris 2024 Olympics with a resounding 10-0 victory over Uzbekistan, it seemed fitting that the youngest member of the team would make her mark in the spotlight. Sporting a yellow team jersey and adorned with Taylor Swift-esque friendship bracelets, little Harper made it clear that she was not to be ignored. As Alanna Kennedy patiently awaited her turn to address the media, Harper decided that the press conference desk was the perfect spot for her impromptu playdate. Refusing to budge, she left her mark by placing her bracelets on the table, much to the delight of amused onlookers. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/reel/C35D414PZxD/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C35D414PZxD/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by CommBank Matildas (@matildas)</a> </div> </blockquote> Despite gentle prodding from her mother, Harper was determined to make her presence known. With a polite "bye bye" into the mic, she momentarily bid farewell before settling back down, much to the amusement of the room. Gorry, unable to contain her laughter, gracefully ushered her daughter away from the limelight, but not before receiving a wave and a cheerful "Byyyyeee" from the pint-sized press conference crasher. The Matildas, quick to embrace the adorable interruption, shared the sweet moment on social media, solidifying Harper's status as the unofficial mascot of the team. In a caption that perfectly captured the essence of the moment, they affectionately dubbed it "Crashing Lani's press conference," tagging Gorry for good measure. Fans took to the comments section to praise the Tilly Toddler, with one claiming "Harper is my favourite Tilly", and another declaring that "No offence, but I'd actually like to hear harpers press conference." As the Matildas look ahead to the Paris Olympics, one thing is for certain – they have a secret weapon in their midst, and her name is Harper. Images: Instagram

Family & Pets

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

<a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> The cost-of-living crisis may be driving some Australians to look for cheaper medicines, especially if those medicines are not subsidised or people don’t have a Medicare card. Options can include buying their medicines from overseas, in a process called “<a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation</a>”. Others also use this option to import medicine that is not available in Australia. Here’s what’s involved and what you need to know about the health and legal risks. <h2>Cost-of-living crisis bites</h2> Many Australians, particularly those with long-term illnesses, are finding it increasingly hard to afford health care. The <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">Australian Bureau of Statistics</a> reports the proportion of people who delayed or did not see a GP due to cost doubled in 2022-23 (7%) compared with 2021-22 (3.5%). A <a href="https://australianhealthcareindex.com.au/wp-content/uploads/2022/11/Australian-Healthcare-Index-Report-Nov-22.pdf">survey</a> published in 2022 of over 11,000 people found more than one in five went without a prescription medicine due to the cost. For those with a Medicare card it’s usually best (and cheapest) to get medicines locally, especially if you also have a concession card. However, for some high-cost medicines, personal importation may be cheaper. That’s when an individual arranges for medicine to be sent to them directly from an overseas supplier. A 2023 study found <a href="https://www.publish.csiro.au/AH/AH23143?jid=AHv47n6&xhtml=5AA1F839-38C8-45E8-A458-79DCDB7597FB">1.8%</a> of Australians aged 45 or older had imported prescription medicines in the past 12 months. That indicates potentially hundreds of thousands of Australians are importing prescription medicines each year. Almost half of the survey respondents indicated they would consider importing medicines to save money. <h2>What’s involved?</h2> Australia’s drug regulator, the Therapeutic Goods Administration (TGA), allows individuals to import up to three months’ supply of medicines for their own personal use (or use by a close family member) under the <a href="https://www.tga.gov.au/products/unapproved-therapeutic-goods/personal-importation-scheme">personal importation scheme</a>. This often involves ordering a medicine through an overseas website. If the medicine would require a prescription in Australia, you must also have a legally valid prescription to import it. Selling or supplying these medicines to others outside your immediate family is strictly prohibited. <h2>How could this help?</h2> For some high-cost medicines, personal importation may be cheaper than having the medicine dispensed in Australia. This is most likely for medicines not subsidised by the <a href="https://www.pbs.gov.au/info/about-the-pbs">Pharmaceutical Benefits Scheme</a> (the PBS). People who do not hold a Medicare card may also find it cheaper to import certain medicines as they do not have access to PBS-subsidised medicines. For example, for people with a specific type of leukaemia, treatment with sorafenib is not covered by the PBS. For these patients it could be up to about ten times more expensive to have their treatment dispensed in Australia as it is to import. That’s because there is a cheaper generic version available overseas. Personal importation may also allow you to access medicines that are available overseas but are not marketed in Australia. <h2>What are the risks?</h2> All medicines carry risks, and medicine sold online can pose additional dangers. The TGA does not regulate medicines sold overseas, so the safety and quality of such medicines can be uncertain; they may not be produced to <a href="https://www.tga.gov.au/what-tga-regulates">Australian standards</a>. While similar regulatory agencies exist in other countries, when ordering medicines from overseas websites it can be difficult to determine if the product you are buying has been assessed to ensure it is safe and will do what it says it will do. The medicines purchased could be counterfeit or “fake”. Products bought through unverified or overseas websites may have undisclosed ingredients, contain a dose that differs from that on the label, or lack the active ingredient entirely. <a href="https://www.tga.gov.au/importing-therapeutic-goods">Not all medicines</a> can be legally imported through the personal importation scheme. Certain medicines are never allowed to be imported into Australia, and others can only be imported by a medical professional on behalf of a patient. So if you attempt to import a restricted medicine, the Australian Border Force <a href="https://www.abf.gov.au/entering-and-leaving-australia/can-you-bring-it-in/categories/medicines-and-substances">may seize it</a>. Not only would you lose your medicine, but you could also receive a fine or face <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use#:%7E:text=If%20you%20try%20to%20import,a%20fine%20or%20jail%20time.">jail time</a>. As with any purchase from an overseas business, there is also a risk you may lose your money and you might not be protected by Australian consumer laws. If you do choose to import medicines by buying them from an overseas website, you should also consider what could happen if delivery is delayed and you don’t get your medicine in time. <h2>Where can I get more advice?</h2> If you are thinking about importing medicines you should first discuss this with a health professional, such as your GP or pharmacist. They can help you determine if personal importation is permitted for the medicine you need. You can also discuss if this is the best option for you. If you are having difficulty covering the cost of your medicines your doctor or pharmacist can also explore other potential alternatives to ensure you are receiving the most cost-effective treatment available in Australia. <h2>Where do I go online?</h2> If you then decide to import, here are some reputable sites to help navigate the global online medicines market: <ul> <li> <a href="https://everyone.org/">everyone.org</a> helps people everywhere in the world access the latest medicines not available in their own countries </li> <li> <a href="https://buysaferx.pharmacy/">Alliance for Safe Online Pharmacies</a> is a not-for-profit organisation that collates information on how to find safe online pharmacies based in different regions of the world </li> <li> <a href="https://www.pharmacychecker.com/accredited-online-pharmacies/">PharmacyChecker</a> has also collated a list of trusted online pharmacies that ship medicines internationally. </li> </ul> Australian government websites about importing medicines include those from <a href="https://www.tga.gov.au/news/blog/can-i-import-medicine-personal-use">the TGA</a> and on what to consider when buying medicines online from <a href="https://www.healthdirect.gov.au/buying-medicines-online#overseas">overseas</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219394/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacinta-l-johnson-1441348">Jacinta L. Johnson</a>, Senior Lecturer in Pharmacy Practice, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/kirsten-staff-1494356">Kirsten Staff</a>, Senior Lecturer in Pharmacy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/taking-expensive-medicines-or-ones-unavailable-in-australia-importing-may-be-the-answer-219394">original article</a>.

Caring

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

<a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> An article published this week in the prestigious journal <a href="https://www.nature.com/articles/s41591-023-02729-2">Nature Medicine</a> documents what is believed to be the first evidence that Alzheimer’s disease can be transmitted from person to person. The finding arose from long-term follow up of patients who received human growth hormone (hGH) that was taken from brain tissue of deceased donors. Preparations of donated hGH were used in medicine to treat a variety of conditions from 1959 onwards – including in Australia from the mid 60s. The practice stopped in 1985 when it was discovered around 200 patients worldwide who had received these donations went on to develop <a href="https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/creutzfeldt-jakob-disease-cjd/">Creuztfeldt-Jakob disease</a> (CJD), which causes a rapidly progressive dementia. This is an otherwise extremely rare condition, affecting roughly one person in a million. <h2>What’s CJD got to do with Alzehimer’s?</h2> CJD is caused by prions: infective particles that are neither bacterial or viral, but consist of abnormally folded proteins that can be transmitted from cell to cell. Other prion diseases include kuru, a dementia seen in New Guinea tribespeople caused by eating human tissue, scrapie (a disease of sheep) and variant CJD or bovine spongiform encephalopathy, otherwise known as mad cow disease. This raised <a href="https://en.wikipedia.org/wiki/United_Kingdom_BSE_outbreak">public health concerns</a> over the eating of beef products in the United Kingdom in the 1980s. <h2>Human growth hormone used to come from donated organs</h2> Human growth hormone (hGH) is produced in the brain by the pituitary gland. Treatments were originally prepared from purified human pituitary tissue. But because the amount of hGH contained in a single gland is extremely small, any single dose given to any one patient could contain material from around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00000563.htm">16,000 donated glands</a>. An average course of hGH treatment lasts around four years, so the chances of receiving contaminated material – even for a very rare condition such as CJD – became quite high for such people. hGH is now manufactured synthetically in a laboratory, rather than from human tissue. So this particular mode of CJD transmission is no longer a risk. <h2>What are the latest findings about Alzheimer’s disease?</h2> The Nature Medicine paper provides the first evidence that transmission of Alzheimer’s disease can occur via human-to-human transmission. The authors examined the outcomes of people who received donated hGH until 1985. They found five such recipients had developed early-onset Alzheimer’s disease. They considered other explanations for the findings but concluded donated hGH was the likely cause. Given Alzheimer’s disease is a much more common illness than CJD, the authors presume those who received donated hGH before 1985 may be at higher risk of developing Alzheimer’s disease. Alzheimer’s disease is caused by presence of two abnormally folded proteins: amyloid and tau. There is <a href="https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-017-0488-7">increasing evidence</a> these proteins spread in the brain in a <a href="https://pubmed.ncbi.nlm.nih.gov/8086126/">similar way to prion diseases</a>. So the mode of transmission the authors propose is certainly plausible. However, given the amyloid protein deposits in the brain <a href="https://www.nia.nih.gov/news/estimates-amyloid-onset-may-predict-alzheimers-progression">at least 20 years</a> before clinical Alzheimer’s disease develops, there is likely to be a considerable time lag before cases that might arise from the receipt of donated hGH become evident. <h2>When was this process used in Australia?</h2> In Australia, donated pituitary material <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">was used</a> from 1967 to 1985 to treat people with short stature and infertility. <a href="https://www.health.gov.au/sites/default/files/documents/2022/07/the-cjd-review-final-report.pdf">More than 2,000 people</a> received such treatment. Four developed CJD, the last case identified in 1991. All four cases were likely linked to a single contaminated batch. The risks of any other cases of CJD developing now in pituitary material recipients, so long after the occurrence of the last identified case in Australia, are <a href="https://www.mja.com.au/journal/2010/193/6/iatrogenic-creutzfeldt-jakob-disease-australia-time-amend-infection-control">considered to be</a> incredibly small. Early-onset Alzheimer’s disease (defined as occurring before the age of 65) is uncommon, accounting for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356853/">around 5%</a> of all cases. Below the age of 50 it’s rare and likely to have a genetic contribution. <h2>The risk is very low – and you can’t ‘catch’ it like a virus</h2> The Nature Medicine paper identified five cases which were diagnosed in people aged 38 to 55. This is more than could be expected by chance, but still very low in comparison to the total number of patients treated worldwide. Although the long “incubation period” of Alzheimer’s disease may mean more similar cases may be identified in the future, the absolute risk remains very low. The main scientific interest of the article lies in the fact it’s first to demonstrate that Alzheimer’s disease can be transmitted from person to person in a similar way to prion diseases, rather than in any public health risk. The authors were keen to emphasise, as I will, that Alzheimer’s cannot be contracted via contact with or providing care to people with Alzheimer’s disease.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/222374/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steve-macfarlane-4722">Steve Macfarlane</a>, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/alzheimers-may-have-once-spread-from-person-to-person-but-the-risk-of-that-happening-today-is-incredibly-low-222374">original article</a>.

Mind

Nick Kyrgios admits tennis career "may be over"

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

Retirement Life

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

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

International Travel

Drug resistance may make common infections like thrush untreatable

<a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> We’ve all heard about antibiotic resistance. This happens when bacteria develop strategies to avoid being destroyed by an antibiotic. The consequences of antibiotic resistance mean an antibiotic previously used to cure bacterial infections no longer works effectively because the bacteria have become resistant to the drug. This means it’s getting harder to cure the infections some bacteria cause. But unfortunately, it’s only one part of the problem. The same phenomenon is also happening with other causes of infections in humans: fungi, viruses and parasites. “Antimicrobial resistance” means the drugs used to treat diseases caused by microbes (bugs that cause infection) no longer work. This occurs with antibacterial agents used against bacteria, antifungal agents used against fungi, anti-parasitic agents used against parasites and antiviral agents used against viruses. This means a wide range of previously controllable infections are becoming difficult to treat – and may become untreatable. <h2>Fighting fungi</h2> Fungi are responsible for a range of infections in humans. Tinea, ringworm and vulvovaginal candidiasis (thrush) are some of the more familiar and common superficial fungal infections. There are also life-threatening fungal infections such as aspergillosis, cryptococcosis and invasive fungal bloodstream infections including those caused by Candida albicans and Candida auris. Fungal resistance to antifungal agents is a problem for several reasons. First, the range of antifungal agents available to treat fungal infections is limited, especially compared to the range of antibiotics available to treat bacterial infections. There are only four broad families of antifungal agents, with a small number of drugs in each category. Antifungal resistance further restricts already limited options. Life-threatening fungal infections happen less frequently than life-threatening bacterial infections. But they’re rising in frequency, especially among people whose immune systems are compromised, including by <a href="https://7news.com.au/news/qld/first-heart-transplant-patient-to-die-from-fungal-infection-at-brisbanes-prince-charles-hospital-identified-as-mango-hill-gp-muhammad-hussain-c-12551559">organ transplants</a> and chemotherapy or immunotherapy for cancer. The threat of getting a drug-resistant fungal infection makes all of these health interventions riskier. The greatest <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2017.00735/full">burden of serious fungal disease</a> occurs in places with limited health-care resources available for diagnosing and treating the infections. Even if infections are diagnosed and antifungal treatment is available, antifungal resistance reduces the treatment options that will work. But even in Australia, common fungal infections are impacted by resistance to antifungal agents. Vulvovaginal candidiasis, known as thrush and caused by Candida species and some closely related fungi, is usually reliably treated by a topical antifungal cream, sometimes supplemented with an oral tablet. However, instances of <a href="https://www.theage.com.au/national/victoria/they-can-t-sit-properly-doctors-treat-growing-number-of-women-with-chronic-thrush-20230913-p5e499.html">drug-resistant thrush</a> are increasing, and new treatments are needed. <h2>Targeting viruses</h2> Even <a href="https://theconversation.com/why-are-there-so-many-drugs-to-kill-bacteria-but-so-few-to-tackle-viruses-137480">fewer antivirals</a> are available than antibacterial and antifungal agents. Most antimicrobial treatments work by exploiting differences between the microbe causing the infection and the host (us) experiencing the infection. Since viruses use our cells to replicate and cause their infection, it’s difficult to find antiviral treatments that selectively target the virus without damaging us. With so few antiviral drugs available, any resistance that develops to one of them significantly reduces the treatment options available. Take COVID, for example. Two antiviral medicines are in widespread use to treat this viral infection: Paxlovid (containing nirmatrelvir and ritonavir) and Lagevrio (molnupiravir). So far, SARS-CoV-2, the virus that causes COVID, has not developed significant resistance to either of these <a href="https://www.cidrap.umn.edu/covid-19/low-levels-resistance-paxlovid-seen-sars-cov-2-isolates">treatments</a>. But if SARS-CoV-2 develops resistance to either one of them, it halves the treatment options. Subsequently relying on one would likely lead to its increased use, which may heighten the risk that resistance to the second agent will develop, leaving us with no antiviral agents to treat COVID. The threat of antimicrobial resistance makes our ability to treat serious COVID infections rather precarious. <h2>Stopping parasites</h2> Another group of microbes that cause infections in humans are single-celled microbes such as Plasmodium, Giardia, Leishmania, and Trypanosoma. These microbes are sometimes referred to as parasites, and they are becoming increasingly resistant to the very limited range of anti-parasitic agents used to treat the infections they cause. Several Plasmodium species cause malaria and anti-parasitic drugs have been the cornerstone of malaria treatment for decades. But their usefulness has been significantly reduced by the <a href="https://www.mmv.org/our-work/mmvs-pipeline-antimalarial-drugs/antimalarial-drug-resistance">development of resistance</a>. Giardia parasites cause an infection called giardiasis. This can resolve on its own, but it can also cause severe gastrointestinal symptoms such as diarrhea, nausea, and bloating. These microbes have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207226/">developed resistance</a> to the main treatments and patients infected with drug-resistant parasites can have protracted, unpleasant infections. <h2>Resistance is a natural consequence</h2> Treating infections influences microbes’ evolutionary processes. Exposure to drugs that stop or kill them pushes microbes to either evolve or die. The exposure to antimicrobial agents provokes the evolutionary process, selecting for microbes that are resistant and can survive the exposure. The pressure to evolve, provoked by the antimicrobial treatment, is called “selection pressure”. While most microbes will die, a few will evolve in time to overcome the antimicrobial drugs used against them. The evolutionary process that leads to the emergence of resistance is inevitable. But some things can be done to minimise this and the problems it brings. Limiting the use of antimicrobial agents is one approach. This means reserving antimicrobial agents for when their use is known to be necessary, rather than using them “just in case”. Antimicrobial agents are precious resources, holding at bay many infectious diseases that would otherwise sicken and kill millions. It is imperative we do all we can to preserve the effectiveness of those that remain, and give ourselves more options by working to discover and develop new ones.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/213460/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christine-carson-109004">Christine Carson</a>, Senior Research Fellow, School of Medicine, <a href="https://theconversation.com/institutions/the-university-of-western-australia-1067">The University of Western Australia</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/drug-resistance-may-make-common-infections-like-thrush-untreatable-213460">original article</a>.

Body

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

<a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a> Climate change will affect every aspect of our <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01859-7/fulltext">health and wellbeing</a>. But its potential harms go beyond the body’s ability to handle extreme heat, important as this is. Extreme weather events, such as floods, droughts, storms and wildfires, are becoming more frequent and severe. These affect our <a href="https://pubmed.ncbi.nlm.nih.gov/36165756/">mental health</a> in a multitude of <a href="https://www.nature.com/articles/s41558-018-0102-4">ways</a>. Coping with climate change can be overwhelming. Sometimes, the best someone can do is to seek refuge in alcohol, tobacco, over-the-counter and prescription drugs, or other psychoactive substances. This is understandable, but dangerous, and can have serious consequences. We outline <a href="https://journals.sagepub.com/doi/full/10.1177/17456916221132739">five ways</a> climate change could increase the risk of harmful substance use. <h2>1. Mental health is harmed</h2> Perhaps the most obvious way climate change can be linked to harmful substance use is by damaging mental health. This <a href="https://onlinelibrary.wiley.com/doi/10.1111/dar.12448">increases the risk</a> of new or worsened substance use. People with a mental disorder are <a href="https://www.hindawi.com/journals/psychiatry/2018/5697103/">at high risk</a> of also having a <a href="https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-25#:%7E:text=Prevalence%20of%20comorbidity%20in%20epidemiological%20studies&text=Among%20subjects%20with%20an%20alcohol,a%20comorbid%20SUD%20%5B39%5D.">substance-use disorder</a>. This often precedes their mental health problems. Climate change-related increases in the number and nature of extreme events, in turn, are escalating risks to mental health. For example, extreme heat is linked to increased <a href="https://pubmed.ncbi.nlm.nih.gov/27727320/">distress</a> across the whole population. In extreme heat, more people go to the <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2789481">emergency department</a> for psychiatric problems, including for <a href="https://www.sciencedirect.com/science/article/abs/pii/S0048969720338249">alcohol</a> and <a href="https://www.nature.com/articles/s43856-023-00346-1">substance use</a> generally. This is even true for <a href="https://www.sciencedirect.com/science/article/pii/S0048969720325572">a single very hot day</a>. Post-traumatic stress disorder, depression, anxiety and <a href="https://onlinelibrary.wiley.com/doi/abs/10.5694/mja13.10307">other mental health</a> problems are <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2019.00367/full">common</a> at the time of extreme weather events and can persist for months, even years afterwards, especially if people are exposed to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9116266/">multiple events</a>. This can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101235/">increase</a> the likelihood of using substances as a way to cope. <h2>2. Worry increases</h2> With <a href="https://climatecommunication.yale.edu/publications/climate-change-in-the-american-mind-beliefs-attitudes-december-2022/">increasing public awareness</a> of how climate change is endangering wellbeing, people are <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/worriesaboutclimatechangegreatbritain/septembertooctober2022#:%7E:text=The%20level%20of%20worry%20about,lives%20right%20now%20(29%25).">increasingly worried</a> about what will happen if it remains unchecked. Worrying isn’t the same as meeting the criteria for a mental disorder. But <a href="https://www.undp.org/publications/peoples-climate-vote">surveys</a> show climate change generates complex emotional responses, <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(21)00278-3/fulltext">especially in children</a>. As well as feelings of worry, there is anxiety, fear, guilt, anger, grief and helplessness. Some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904966/">emotional states</a>, such as <a href="https://www.pnas.org/doi/full/10.1073/pnas.1909888116">sadness</a>, are linked with long-term tobacco use and also make substance use <a href="https://pubmed.ncbi.nlm.nih.gov/16011392/">relapse</a> more likely. <h2>3. Physical injuries hurt us in many ways</h2> Physical injuries caused by extreme weather events – such as smoke inhalation, burns and flood-related cuts and infections – increase the risk of harmful substance use. That’s partly because they <a href="https://pubmed.ncbi.nlm.nih.gov/20033251/">increase</a> the risk of psychological distress. If injuries cause long-term illness or disability, consequent feelings of hopelessness and depression can dispose some people to self-medicate with alcohol or other drugs. Substance use itself can also generate long-term physiological harm, disabilities or other chronic health problems. These are <a href="https://www.tandfonline.com/doi/abs/10.3109/00952999609001655">linked with</a> higher rates of harmful substance use. <h2>4. Our day-to-day lives change</h2> A single catastrophic event, such as a storm or flood, can devastate lives overnight and change the way we live. So, too, can the more subtle changes in climate and day-to-day weather. Both can disrupt behaviour and routines in ways that risk new or worsened substance use, for example, using stimulants to cope with fatigue. Take, for example, hotter temperatures, which disrupt <a href="https://www.cell.com/one-earth/fulltext/S2590-3322(22)00209-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2590332222002093%3Fshowall%3Dtrue">sleep</a>, undermine <a href="https://jhr.uwpress.org/content/57/2/400">academic performance</a>, <a href="https://www.nature.com/articles/s41562-017-0097">reduce physical activity</a>, and promote <a href="https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(22)00173-5/fulltext">hostile language</a> and <a href="https://www.cambridge.org/core/elements/abs/climate-change-and-human-behavior/F64471FA47B8A6F5524E7DDDDE571D57">violent behaviour</a>. <h2>5. It destabilises communities</h2> Finally, climate change is destabilising the socioeconomic, natural, built and geopolitical <a href="https://www.nature.com/articles/s41558-018-0102-4">systems</a> on which human wellbeing – <a href="https://theconversation.com/climate-change-and-health-ipcc-reports-emerging-risks-emerging-consensus-24213">indeed survival</a> – depends. Damaged infrastructure, agricultural losses, school closures, homelessness and displacement are significant <a href="https://www.nature.com/articles/s41558-018-0102-4">sources of psychosocial distress</a> that prompt acute (short-term) and chronic (long-term) stress responses. <a href="https://doi.org/10.1196/annals.1441.030">Stress</a>, in turn, can <a href="https://doi.org/10.1007/s002130100917">increase</a> the risk of <a href="https://link.springer.com/article/10.1007/s002130100917">harmful substance use</a> and make people more likely to relapse. <h2>Why are we so concerned?</h2> Substance-use disorders are economically and socially <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30337-7/fulltext">very costly</a>. Risky substance use that doesn’t meet the criteria for a formal diagnosis <a href="https://digitalcommons.fiu.edu/srhreports/health/health/32/">can also harm</a>. Aside from its direct physical harm, harmful substance use disrupts <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843305/">education</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234116/">employment</a>. It increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676144/">accidents</a> and <a href="https://www.tandfonline.com/doi/abs/10.1080/09595230600944479">crime</a>, and it undermines social relationships, intimate <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795906/#:%7E:text=Results%20indicated%20that%20alcohol%20use,drinkers%20with%20low%20relationship%20satisfaction.">partnerships</a> and <a href="https://www.cambridge.org/core/journals/development-and-psychopathology/article/abs/longitudinal-relations-between-parental-drinking-problems-family-functioning-and-child-adjustment/CE508589A9E799FD6DC9E23DF364FB8F">family functioning</a>. <h2>Politicians take note</h2> As we head towards the <a href="https://www.cop28.com">COP28 global climate talks</a> in Dubai, climate change is set to hit the headlines once more. Politicians know climate change is undermining human health and wellbeing. It’s well past time to insist they act. As we have seen for populations as a whole, there are multiple possible ways for climate change to cause a rise in harmful substance use. This means multidimensional <a href="https://www.nature.com/articles/s41558-018-0102-4">prevention strategies</a> are needed. As well as addressing climate change more broadly, we need strategies including: <ul> <li> supporting vulnerable individuals, especially <a href="https://journals.sagepub.com/doi/full/10.1177/21677026211040787">young people</a>, and marginalised commmunities, who are <a href="https://www.nature.com/articles/s41558-018-0102-4">hit hardest</a> by extreme weather-related events </li> <li> focusing health-related policies more on broadscale health promotion, for example, healthier eating, active transport and community-led mental health support </li> <li> investing in climate-resilient infrastructure, such as heat-proofing buildings and greening cities, to prevent more of the destabilising effects and stress we know contributes to mental health problems and harmful substance use. </li> </ul> There is now <a href="https://news.un.org/en/story/2022/10/1129912">no credible pathway</a> to avoiding dangerous climate change. However, if <a href="https://carnegieendowment.org/2023/01/12/climate-protests-tracking-growing-unrest-pub-88778#:%7E:text=These%20are%20just%20a%20few,even%20more%20numerous%20and%20influential.">increasing rates</a> of climate protests are anything to go by, the world may finally be ready for radical change – and perhaps for reduced harmful substance use.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/217894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helen-louise-berry-8608">Helen Louise Berry</a>, Honorary Professor, Centre for Health Systems and Safety Research, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> and <a href="https://theconversation.com/profiles/francis-vergunst-230743">Francis Vergunst</a>, Associate Professor, Psychosocial Difficulties, <a href="https://theconversation.com/institutions/university-of-oslo-934">University of Oslo</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/5-reasons-why-climate-change-may-see-more-of-us-turn-to-alcohol-and-other-drugs-217894">original article</a>.

Mind

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

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

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It may be macabre, but dark tourism helps us learn from the worst of human history

Cheeky diet soft drink getting you through the work day? Here’s what that may mean for your health

What’s the difference between ‘man flu’ and flu? Hint: men may not be exaggerating

Breast cancer screening in Australia may change. Here’s what we know so far

How you experience the menopause may have a lot to do with your family

Drinking lots of water may seem like a healthy habit – here’s when and why it can prove toxic

The voice in your head may help you recall and process words. But what if you don’t have one?

Would you be happy as a long-term single? The answer may depend on your attachment style

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

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

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

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

"Harper is my favourite Tilly": Matildas toddler steals the show

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

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

Nick Kyrgios admits tennis career "may be over"

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

Drug resistance may make common infections like thrush untreatable

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

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

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