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Popular names Generation Alpha believe are “for old people”

Today's youth have a very different idea of what constitutes an "old person" name, and one mum was left flabbergasted after a conversation she had with her six-year-old daughter about her classmates’ names. “You know what I find wild? I have an eight-year-old and a six-year-old, and the names of their friends, I can’t even pronounce some of them,” Australian entrepreneur and mum-of-two Steph Pase said in a now viral TikTok. “I asked her, so do you have anyone in your year called Sarah, Alex, Jack or Daniel? “She laughed and said ‘they’re old people names!’.” She then probed her daughter with a few other common names saying: “I asked, what about Steph … Michelle … she’s like no,” she laughed. “It just makes me realise, that we are that generation … our parents’ generation. Names like Helen, Karen or Joanna … now we’re that generation. “We have the old people names.” She captioned her video with the text "Millennial names are officially old" and many of her followers agreed with the upsetting revelation. “In my classes we have Vision, Stoney, Diesel, Hennesy, Blaze, Cruze, Kingdom, Ace, Boss, Oasis, Mercedes, Destiny,” one shared. “Luna, Harper & Arlo are the new Ashley, Jessica & Stephanie,” another said. “The names in my kids classes are Lamb, Honey, Hazard, Blu, Bambi,” another added. “My six year old has a girl in his class named ‘Summah’ and another called ‘Phox’ because Fox was too mainstream,” a fourth wrote. “My daughter has a Moses, Twayla, Lorde it’s wild …” a fifth commented. Baby name expert and CEO of Fifth Dimension Consulting Lyndall Spooner told news.com.au that there are a few reasons why there's been a shift in children's names over the years, including popularity, less pressure to follow traditional family names, and a trend towards more gender-neutral names. “Parents want their children to be unique and so they use nouns or verbs as names, or character names from books, TV shows, movies, shopping chains or cars," she said. And while the "millennial names" are not as common, "they are not extinct". “We will continue to see changes in baby names and the ‘recycling’ of older names that become popular again,” she told the publication. Images: TikTok

Family & Pets

New support system helps older Aussies who have fallen victim to scams

A new support system has been set up to help vulnerable older Australians who have fallen victim to dangerous scams. With millions of Aussies targeted every year, many of these targets are elderly with 30 percent of victims hesitant to come forward because they are too embarrassed to admit what's happened to them. One such victim, 86-year-old Mary, said she was humiliated after falling for a scam saying she is old enough to know better. "It serves me right, I shouldn't have been so trusting," she said. "You blame yourself and you don't really want to tell people how stupid you are, so you think, 'Well, I'll just have to bear it'." Mary was scammed when she received a call from a man pretending to be a technician, saying he needed access to her computer to resolve a problem in her area. Step by step, the "technician" got Mary to log-in and give him complete access to her entire online identification, completely cleaning her out of $20,000 in savings. This is why <a title="ID Support NSW" href="https://www.nsw.gov.au/id-support-nsw" target="_blank" rel="noopener">ID Support NSW</a> is now offering a free service to help older Australians be able to protect themselves online and spot suspicious activity. "The most common scams are romance and impersonation scams, where people pretend to be someone they're not," ID Support NSW's Jacqueline Wilson told <a href="https://9now.nine.com.au/today/scam-awareness-week-id-support-nsw-offering-free-help-for-older-australians/20d3f8d6-fe32-4b1d-af32-294e47f4412d" target="_blank" rel="noopener">Today</a>. "Most start with a text or call and once someone responds or engages, they usually end up losing money." Jacqueline said the best thing you could do if you even suspect a scammer was to just hang up the phone, saying, "You don't need to indulge them, you don't need to be polite, you don't need to engage in a long conversation." Image credits: Today

Legal

Readers response: Who’s the most interesting person you’ve met while travelling?

One of the best parts of travelling is the people you met along the way. Whether it's as part of a tour group or an interesting character you meet by chance, interacting with interesting people in interesting places can bring a lot to your travel experience. We asked our readers to tell us about the most interesting person they've encountered on their travels and the response was overwhelming. Here's what they said. Diana Jason - Cargo Holly Harrison. He walked 15000 miles from the bottom of South America to the top of Alaska. A truly fascinating man. Margie Buckingham - While caravanning around Oz, every night we would meet interesting ppl enjoying pre-dinner drinks & nibbles around the campfire. We all had personal stories to tell or the best places to camp. Ann Smith - Myself. Travelled to the UK and found my independence and confidence, two and a bit years after I lost love of my life to cancer. Pamela Cari - We met the lady who played the mother of Apollonia Vitelli in The Godfather when we were in Savoca. Rosalie Busch - A couple who grew up behind the wall in East Berlin. Sue Velvin - Shaquille O'Neal when my daughter and I had a holiday in the states a few years ago! Awesome man. Wendy Farnham - A Buddhist Nun in Cambodia who lost her husband and 6 of her 7 children to starvation under Pol Pot’s regime. Lyn Schuemaker - Everybody. They all have stories to tell. Image credits: Shutterstock

International Travel

Five people arrested over Matthew Perry's death

Five people have been arrested in connection with the death of Friends actor Matthew Perry, who died of a drug overdose in October 2023. Matthew Perry’s assistant Kenneth Iwamasa, two doctors, and two alleged drug dealers, including Jasveen Sangha, the so-called “Ketamine Queen of Los Angeles”, have been arrested over the star's death. All five suspectes are facing charges including “conspiracy to distribute ketamine” over allegations they supplied the 54-year-old with the illegal drugs in the final weeks of his life. In the last four days of his life, Mr Perry paid $100,000 AUD for 70 vials of ketamine. Three of the five people charged have pleaded guilty to several drug-related offences, while a licensed doctor and an alleged drug dealer arrested in California on Thursday are the lead defendants in a “broad, underground criminal network” to distribute ketamine to Mr Perry and others. “These defendants took advantage of Mr Perry’s addiction issues to enrich themselves. They knew what they were doing was wrong. They knew what they were doing was risking great danger to Mr Perry, but they did it anyway,” said US Attorney Martin Estrada. Following the arrests, Matthew Perry's stepfather has shared a message of gratitude to law enforcement and hoped justice would be served. Keith Morrison, a Canadian journalist, and other loved ones of the Friends star in a statement issued to NBC News say they are finding some solace in the legal system nine months on from his death. "We were and still are heartbroken by Matthew's death, but it has helped to know law enforcement has taken his case very seriously," they said. "We look forward to justice taking its course." Image credits: Matt Baron/BEI/Shutterstock Editorial

Legal

People who are bad with numbers often find it harder to make ends meet – even if they are not poor

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/wandi-bruine-de-bruin-275600">Wändi Bruine de Bruin</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> and <a href="https://theconversation.com/profiles/paul-slovic-359838">Paul Slovic</a>, <a href="https://theconversation.com/institutions/university-of-oregon-811">University of Oregon</a> <h2>The big idea</h2> People who are bad with numbers are more likely to experience financial difficulties than people who are good with numbers. That’s according to <a href="https://doi.org/10.1371/journal.pone.0260378">our analyses</a> of the <a href="https://wrp.lrfoundation.org.uk/explore-the-poll">Lloyd’s Register Foundation World Risk Poll</a>. In this World Risk Poll, people from 141 countries were asked if 10% was bigger than, smaller than or the same as 1 out of 10. Participants were said to be bad with numbers if they did not provide the correct answer – which is that 10% is the same as 1 out of 10. <a href="https://doi.org/10.1371/journal.pone.0260378">Our analyses</a> found that people who answered incorrectly are often among the poorest in their country. Prior studies in the <a href="https://doi.org/10.1111/j.1468-0297.2010.02394.x">United States</a>, <a href="https://doi.org/10.1111/j.1475-5890.2007.00052.x">United Kingdom</a>, <a href="https://doi.org/10.1016/j.joep.2016.02.011">the Netherlands</a> and <a href="https://doi.org/10.1111/joca.12294">Peru</a> had also found that people who are bad with numbers are financially worse off. But <a href="https://doi.org/10.1371/journal.pone.0260378">our analyses of the World Risk Poll</a> further showed that people who are bad with numbers find it harder to make ends meet, even if they are not poor. When we say that they found it harder to make ends meet, we mean that they reported on the poll that they found it difficult or very difficult to live on their current income, as opposed to living comfortably or getting by on their current income. <a href="https://doi.org/10.1371/journal.pone.0260378">Our analyses</a> also indicate that staying in school longer is related to better number ability. People with a high school degree tend to be better with numbers than people without a high school degree. And college graduates do even better. But even among college graduates there are people who are bad with numbers – and they struggle more financially. <iframe id="yOIiX" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/yOIiX/3/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Of course, being good with numbers is not going to help you stretch your budget if you are very poor. <a href="https://doi.org/10.1371/journal.pone.0260378">We found</a> that the relationship between number ability and struggling to make ends meet holds across the world, except in low-income countries like Ethiopia, Somalia and Rwanda. <iframe id="RejA1" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/RejA1/8/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <h2>Why it matters</h2> The ability to understand and use numbers is also called <a href="http://doi.org/10.1093/oso/9780190861094.001.0001">numeracy</a>. Numeracy is <a href="https://doi.org/10.1787/1f029d8f-en">central to modern adult life</a> because numbers are everywhere. A lot of well-paying jobs involve working with numbers. People who are bad with numbers often perform worse in these jobs, including <a href="https://doi.org/10.1111/ecin.12873">banking</a>. It can therefore be hard for people who are bad with numbers to <a href="http://www.doi.org/10.1108/00400919710164125">find employment and progress in their jobs</a>. People who are bad with numbers are less likely <a href="https://www.pnas.org/content/116/39/19386.short">to make good financial decisions</a>. Individuals who can’t compute how interest compounds over time <a href="https://doi.org/10.1111/j.1540-6261.2009.01518.x">save the least and borrow the most</a>. People with poor numerical skills are also more likely <a href="https://doi.org/10.1037/0022-3514.41.3.586">to take on high-cost debt</a>. If you’re bad with numbers, it is hard to <a href="https://doi.org/10.1017/S1474747215000232">recognize</a> that paying the US$30 minimum payment on a credit card with a $3,000 balance and an annual percentage rate of 12% means it will never be paid off. <h2>What still isn’t known</h2> It is clear that people who are bad with numbers also tend to struggle financially. But we still need to explore whether teaching people math will help them to avoid financial problems. <h2>What’s next</h2> In her book “<a href="http://doi.org/10.1093/oso/9780190861094.001.0001">Innumeracy in the Wild</a>,” Ellen Peters, director of the Center for Science Communication Research at the University of Oregon, suggests that it is important for students to take math classes. American high school students who had to <a href="https://doi.org/10.3368/jhr.51.3.0113-5410R1">take more math courses</a> than were previously required had better financial outcomes later in life, such as avoiding bankruptcy and foreclosures. Successfully teaching numeracy also means helping students gain confidence in using numbers. People with <a href="https://doi.org/10.1073/pnas.1903126116">low numerical confidence</a> experience bad financial outcomes, such as a foreclosure notice, independent of their numeric ability. This is because they may not even try to take on complex financial decisions. Numerical confidence can be boosted in different ways. Among American <a href="https://doi.org/10.1037/0022-3514.41.3.586">elementary school children</a> who were bad with numbers, setting achievable goals led to better numerical confidence and performance. Among American <a href="https://doi.org/10.1371/journal.pone.0180674">undergraduate students</a>, a writing exercise that affirmed their positive values improved their numerical confidence and performance. Other important next steps are to find out whether training in numeracy can also be provided to adults, and whether training in numeracy improves the financial outcomes of people who do not live in high-income countries.<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/172272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/wandi-bruine-de-bruin-275600">Wändi Bruine de Bruin</a>, Professor of Public Policy, Psychology and Behavioral Science, USC Sol Price School of Public Policy, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> and <a href="https://theconversation.com/profiles/paul-slovic-359838">Paul Slovic</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-oregon-811">University of Oregon</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/people-who-are-bad-with-numbers-often-find-it-harder-to-make-ends-meet-even-if-they-are-not-poor-172272">original article</a>. </div>

Money & Banking

Why are some people happy when they are dying?

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

Caring

Readers response: What are you starting to like more as you get older?

As we age, we start to have a whole new appreciation for things we previously overlooked in our younger years. We asked our reader what of life's simple pleasures they are starting to enjoy more as they get older, and the response was overwhelming. Here's what you said. Wendy Turner - The beauty and companionship of dogs, the wildness of a garden, the treasured times between physical pain, and the love of family and treasured friends. SE Rosenberg - Being on my own away from people but hanging out with my cats. Lynette Miller - Taking time to enjoy sunrise and sunsets, smelling the roses and just little things that sometimes pass you by because you're too busy to enjoy them. Antoinette Devlin - Peace and quiet. Robert Edward Fleming - Not having to work for the man anymore. Janine Sarai George - Putting my feet up, a good book and my wildlife. Maureen Brown Montgomery - Finally starting not to mind living a solo life and enjoying my own company without drama. Liz Lewis - Not having to set the alarm but being able to wake up naturally and usually not having to be anywhere in a hurry. Roselyn Reincastle - Appreciating life more now that I have had the experience. Frances Bradshaw - Peace and hearing the birds sing. Margie Buckingham - Serenity, that my opinions matter, travelling, spare time & being a grandparent. Rob Anderson - Time with the grandchildren, and reflection. Wendy Hope - Travel and wonder at the diversity of people. Maya Richardson - Staying as far away from people as possible. Christine Tully - Not having to commit to anything if I don’t want to. Margaret Inglis - Doing what I want to do, although my 4 legged mate still wants to get me out of the house each morning. Image credits: Shutterstock

Retirement Life

Is your smartwatch making you anxious? Wearables can lead people to stress more about their health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Wearable trackers and monitors (such as smartwatches) are <a href="https://www.idtechex.com/en/research-report/wearable-technology-forecasts-2023-2033/928">increasingly popular and sophisticated</a>. For people living with heart conditions, they can provide important information, including updates about abnormalities in heart rate and rhythm. But a recent study published in the <a href="https://www.ahajournals.org/doi/10.1161/JAHA.123.033750">Journal of the American Heart Association</a> found using wearables to monitor heart conditions like atrial fibrillation – an irregular heartbeat – can actually make people more anxious about their health. It’s a catch-22 situation: the wearable device may help you better manage your chronic heart condition, but wearing it could make you anxious – which is bad for those conditions. So what are the tradeoffs? And how can we get the most out of wearables, without unnecessary worry? <h2>Wearables to monitor heart conditions</h2> Wearables are playing an increasing role in managing and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1901183">detecting</a> conditions like atrial fibrillation, the <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013408.pub2/full">most common heart rhythm problem</a>. Atrial fibrillation <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/atrial-fibrillation-in-australia/contents/how-many-australians-have-atrial-fibrillation">affects</a> around 2% of the general population, and about 5% of those aged over 55. Symptoms may include palpitations, fatigue and shortness of breath, although some patients may live relatively symptom-free. Self management is important to improve quality of life and prevent complications, such as stroke and heart failure. People with atrial fibrillation also often experience high rates of <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013508.pub3/full">anxiety linked to their condition</a>. <a href="https://link.springer.com/article/10.1007/s11886-020-01396-w">Psychological distress</a> – including anxiety, depression and worry about symptoms – affects between 25% and 50% of those living with the condition. Wearable devices can help people understand and monitor their condition by providing heart rate and rhythm data and alerts to detect atrial fibrillation episodes. This can be helpful to understand the impact of their disease, particularly for those living with paroxysmal (or episodic) atrial fibrillation. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10800119/">One study</a> found smartwatches were very effective at detecting irregular heart rhythms – and could help manage and even prevent them. But any benefits of using wearables to monitor atrial fibrillation need to be balanced with the high rates of anxiety people with this condition experience, to make sure their use doesn’t exacerbate psychological distress. <h2>Wearables can empower patients</h2> For many people, the sense they are receiving reliable, objective and personalised health data can encourage <a href="https://www.cvdigitalhealthjournal.com/article/S2666-6936(21)00020-7/fulltext">feelings of confidence, safety and assurance</a>, especially when combined with symptom trackers or patient diaries. This may allow patients to self-manage their condition at home with their families, rather than spending time in hospital – reducing anxiety and stress. In a clinical setting, data may also encourage patients to take part in <a href="https://academic.oup.com/eurjcn/article/16/3/178/5924768">shared decision-making</a>. Interpreting health data together with doctors or other health-care professionals, they can develop goals and action plans, including when to seek help from a GP – and when to go to hospital. Patients who understand their condition <a href="https://www.tandfonline.com/doi/full/10.2147/JMDH.S19315">tend to report</a> fewer atrial fibrillation symptoms. <h2>But wearables can induce anxiety</h2> The study published by the Journal of the American Heart Association examined the behaviour and wellbeing of 172 people with atrial fibrillation over a nine-month period. It found the 83 people who used wearables to monitor their condition were more worried about their symptoms and treatment, with one in five experiencing “intense anxiety”. Chronic anxiety can contribute to stress, burnout and poor physical health, which in turn can <a href="https://www.jacc.org/doi/full/10.1016/j.jacep.2021.12.008">exacerbate heart conditions</a>. Previous <a href="https://link.springer.com/article/10.1186/s12911-017-0486-5">research</a> has also explored the impacts of wearables on patients with long-term conditions, including heart disease. Patients in this study similarly reported increased anxiety while using these devices, as one explained: <blockquote> I am one of these people who do worry about things. I do get concerned about myself […] and I just thought this is silly. This is reminding me every day, […] I wonder what my reading is, how good it is or how bad it is […]. Every time as soon I started thinking about it, I started thinking about my illness. </blockquote> Some people also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777278/">describe</a> being a “prisoner of the numbers”. They feel they “need to keep checking the device to know how they were doing, leading to the device dominating their lives”. The volume and frequency of notifications, alarms and vibrations from wearable devices can be overwhelming and make people worry about their health. Information overload can also discourage self-management, with notifications instead prompting people to seek health advice more often than they otherwise would. But this isn’t necessarily a bad thing. For other people, low levels of health or digital literacy – not knowing how to use the devices or interpret the data – may make them feel so stressed or anxious they <a href="https://link.springer.com/article/10.1186/s12911-017-0486-5">abandon wearables</a> altogether. <h2>The future of wearables</h2> In the future, digital devices may help paint a holistic picture of health and wellbeing through a “<a href="https://theconversation.com/digital-diagnosis-how-your-smartphone-or-wearable-device-could-forecast-illness-102385">digital phenotype</a>” that combines data like sleep patterns, weight changes and physical activity. But more research is needed to understand the effects of wearables – including their notifications and alarms – on patients’ anxiety levels. If you already use a wearable device for health monitoring, it can be helpful to regularly review the data and notification settings. You may wish to discuss how you are using your device to help you self-manage your condition with your doctor or nurse. With any chronic disease, having a management action plan is important. This includes discussing with your health-care professional when to seek care (such as attending the emergency department or GP). Meanwhile, there’s still work to be done to help make nurses and doctors feel more confident <a href="https://www.tandfonline.com/doi/full/10.1080/10376178.2018.1486943">integrating wearables</a> – and the data they provide – into patient care.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/235596/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, Professor of Nursing; Director of Health Innnovations, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</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/is-your-smartwatch-making-you-anxious-wearables-can-lead-people-to-stress-more-about-their-health-235596">original article</a>. </div>

Body

Mysterious leg pain that’s quietly killing older Australians

Peripheral Artery Disease (PAD) has long been overshadowed by its more widely recognised counterparts, such as heart attacks and strokes. Often referred to as the “poor cousin” or “Cinderella” of cardiovascular diseases, PAD affects one in five older Australians, yet it remains largely under-diagnosed and misunderstood. However, a wave of optimism is sweeping through the medical community with the launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a>, an Australian-first facility dedicated to pioneering research and improving patient outcomes. Spearheaded by the Heart Research Institute, the Centre for Peripheral Artery Disease, marks a significant step forward in addressing the challenges posed by PAD. The centre aims to fill critical gaps in our understanding of the disease, which is responsible for a limb amputation in Australia every two hours. This initiative promises to enhance diagnosis, transform patient care, and raise awareness about PAD. Associate Professor Mary Kavurma, the Centre Lead, is at the forefront of this ground-breaking effort. “We’re supercharging research into PAD because there are still many unknowns about the disease’s biology that could unlock new methods for early detection and better management,” she explains. This research is particularly urgent given the prevalence of PAD among women and First Nations Australians, groups that remain disproportionately affected by this condition. The centre’s mission is to develop a simple blood test for early diagnosis and explore novel therapies that could reduce the need for limb amputations and significantly improve patients’ quality of life. Unlike current treatments that primarily focus on symptom management, this new approach seeks to prevent the disease from progressing. One of the most inspiring aspects of the centre is its commitment to involving patients and their families in the research process. At the inaugural consumer meeting, nearly 20 patients and their carers shared their personal experiences with PAD. Take the story of Simon Josephson, a renowned advertising guru – who famously designed the Solo logo. PAD almost cost him his life after taking more than five years to diagnose. He woke up one morning with a sore leg, thinking he’d overdone it exercising but the 73-year-old – who was otherwise healthy and active – unknowingly had Peripheral Artery Disease, caused by a build-up of plaque in his arteries causing them to narrow and stiffen. It wasn’t until a trip to the hospital emergency department years later that doctors would discover his aorta had expanded to more than twice the usual size and was at risk of rupturing. He immediately underwent open heart surgery and has faced a lengthy recovery. The launch of <a href="https://www.hri.org.au/our-research/centreforpad" target="_blank" rel="noopener">The Centre for Peripheral Artery Disease</a> heralds a new era of hope and progress in the fight against PAD. Through world-leading research, community engagement, and a commitment to patient-centred care, the CPAD is poised to make a profound impact on the lives of many Australians. As Assoc Prof Kavurma aptly put it, “By understanding more about this debilitating condition, we are paving the way for better health outcomes and a brighter future for all those affected by PAD.” Images: CPAD

Caring

We have too few aged care workers to care for older Australians. Why? And what can we do about it?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a> In a country like Australia, we all expect that when we get old, we’ll be able to rely on a robust aged care system. But aged care providers can’t find staff and a crisis is brewing. If the problem isn’t fixed, there are serious risks to quality and access to services for older people who need support. There are also broader social, economic and political consequences for undervaluing the rapidly expanding health and social assistance workforce. Aged care <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">employs</a> around 420,000 people. Around 80% of those are front line staff providing care and demand for them is increasing rapidly. <h2>Australians are ageing</h2> The number of people aged 80 and over is <a href="https://treasury.gov.au/sites/default/files/2019-03/IGR_2010_Overview.pdf">projected to double</a> by 2050. At the same time, informal family care is becoming less available. In the next 25 years, <a href="https://www.australianageingagenda.com.au/executive/shortfall-of-400000-aged-care-workers-predicted-by-2050/">twice as many</a> aged care staff will be needed. Currently, about 1.4 million older people <a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/aged-care">receive</a> aged care services, including basic and more intensive home care and residential care. Health care and social support job vacancies and ads are the highest of any industry. Between 30,000 and 35,000 additional direct aged care workers a year are already needed. By 2030 the <a href="https://cedakenticomedia.blob.core.windows.net/cedamediacontainer/kentico/media/attachments/ceda-duty-of-care-3.pdf">shortfall</a> is likely to be 110,000 full time equivalent workers. <h2>Why don’t enough people want to work in aged care?</h2> Despite recent <a href="https://www.health.gov.au/topics/aged-care-workforce/what-were-doing/better-and-fairer-wages">pay increases</a>, it is difficult to attract and retain aged care workers because the work is under-valued. The Australian workforce is undergoing profound change. A generation ago, manufacturing made up 17% of the workforce. Today it has fallen to 6%. By contrast, the health care and social assistance workforce has doubled from 8% to 16%. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=423&fit=crop&dpr=1 754w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=423&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/607090/original/file-20240716-17-hup1e8.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=423&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>The manufacturing workforce has declined, while health, aged care and social assistance has risen. ABS 6291.0.55.001 Labour Force, Australia.</figcaption></figure> Manufacturing jobs were <a href="https://australiainstitute.org.au/wp-content/uploads/2020/12/Manufacturing-Briefing-Paper-FINAL.pdf">mainly</a> secure, full-time, reasonably paid jobs dominated by male workers. By contrast, jobs in aged care are often insecure, part-time and poorly paid, dominated by women, with many workers coming from non-English speaking backgrounds. Since moving to take over aged care in the 1980s, the federal government has over-emphasised <a href="https://arena.org.au/a-genealogy-of-aged-care/">cost constraint</a> through service privatisation, activity-based funding and competition, often under the cover of consumer choice. The result is a highly fragmented and poorly coordinated aged care sector with almost 3,200, often small and under-resourced providers centrally funded and regulated from Canberra. This has <a href="https://www.health.gov.au/sites/default/files/a-matter-of-care-australia-s-aged-care-workforce-strategy.pdf">led to</a> high levels of casualisation, low investment in training and professional development, and inadequate supervision, particularly in the home care sector. Aged care is facing a perfect storm. Demand for care and support staff is increasing dramatically. The sector is poorly coordinated and difficult to navigate. Pay and conditions remain poor and the workforce is relatively untrained. There are no minimum standards or registration requirements for many front-line aged care staff. <h2>What are the consequences?</h2> An understaffed and under-trained aged care workforce reduces access to services and the quality of care and support. Aged care providers <a href="https://www.agedhealth.com.au/content/compliance-and-governance/news/troubled-outlook-for-aged-care-reforms-1224428737#:%7E:text=Its%20report%20found%20that%2053.8,was%20%22impossible%20to%20achieve%22.">routinely report</a> it is difficult to attract staff and they can’t meet the growing demand for services from older people. Staff shortages are already having an impact on residential care occupancy rates falling, with some regional areas now down to only 50% occupancy. That means older people either don’t get care or they are at increased risk of neglect, malnutrition, avoidable hospital admissions and a poorer quality of life. Inevitably, lack of aged care workers puts pressure on hospital services when older people have nowhere else to go. <h2>What needs to be done?</h2> Addressing these challenges requires a multifaceted approach. Australia will need a massive increase in the number of aged care workers and the quality of the care they provide. Wages have to be competitive to attract and retain staff. But better pay and conditions is only part of the story. Unless aged care becomes a career the community recognises, values and supports, it will continue to be difficult to train, attract and retain staff. The recent <a href="https://www.royalcommission.gov.au/aged-care">Royal Commission on Aged Care Quality and Safety</a> highlighted the need for a more skilled workforce, emphasising the importance of ongoing professional development for all staff. To date the federal government’s aged care workforce initiatives have been underwhelming. They are a limited and piecemeal rather than a coherent workforce strategy. In the short term, skilled migration may be part of the solution. But progress to bring in skilled aged care workers has been glacial. Currently only about 1% of providers <a href="https://theconversation.com/overseas-recruitment-wont-solve-australias-aged-care-worker-crisis-189126">have agreements</a> to bring in staff from overseas. At best, overseas migration will meet only 10% of the workforce shortfall. Registration, qualifications and training for direct care work have to become mandatory to make sure care standards are met. Much more significant and systematic incentives and support for training will be needed. Supervision, career progression and staff development will also have to be dramatically improved if we are to attract and retain the workforce that is needed. “Learn and earn” incentives, including scholarships and traineeships for aged care, are needed to attract the future workforce. At the same time, a much broader investment in upskilling the entire workforce through continuing professional development and good quality supervision is necessary. Like manufacturing a generation ago, aged care needs to become valued, skilled, secure and well-paid employment if it is going to attract the staff that are needed to avoid a looming crisis.<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/232707/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, Emeritus Professor of Public Health, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe 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/we-have-too-few-aged-care-workers-to-care-for-older-australians-why-and-what-can-we-do-about-it-232707">original article</a>. </div>

Caring

Six people found dead in luxury hotel

A disturbing theory has emerged after six people were found dead in a luxury hotel room in central Bangkok. According to Bangkok’s Metropolitan Police commissioner Thiti Saengsawang, hotel staff at the Grand Hyatt Erawan discovered the bodies of six people in a fifth-floor room after they missed check out time by more than 24 hours. After concluding that the incident did not appear to be a robbery and none of the bodies showed any signs of physical violence, Thai Police are exploring the possibility that the people were poisoned. Police shared that they "needed to find out the motives", and that the deaths were the result of a "killing", not a suicide. Authorities conformed they are investigating the potential poisoning after Thiti said cups with traces of a white powder were located in the room, along with untouched food that had been ordered earlier. As police continue their investigation into the shocking deaths, they are currently searching for a seventh person who was part of the hotel booking and is now a possible suspect. Two of the dead were US citizens of Vietnamese background, while the other four were Vietnamese nationals. Thiti said police believe one member of the group had tried to reach the door to escape but fell and died before they could get there. The Thai government issued a statement after the killings, with Thai Prime Minister Srettha Thavisin saying, "There were no signs of a struggle," adding, "We need to conduct an autopsy." He also "ordered all agencies to urgently take action to avoid impact on tourism,” given that the luxury hotel is situated in a popular tourist area. Image credits: BBC / Royal Thai Police

Travel Trouble

‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians

<a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Our <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">ageing population</a> brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss). Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are <a href="https://www.senseswa.com.au/wp-content/uploads/2016/01/a-clear-view---senses-australia.pdf">living with dual sensory impairment</a>. Combined vision and hearing loss <a href="https://doi.org/10.1177/0264619613490519">describes</a> any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is <a href="https://doi.org/10.1016/j.annepidem.2012.02.004">increasingly common</a> as people get older. The experience can make older people feel isolated and unable to participate in important conversations, including about their health. <h2>Causes and conditions</h2> Conditions related to hearing and vision impairment often <a href="https://theconversation.com/why-we-lose-our-hearing-and-vision-as-we-age-67930">increase as we age</a> – but many of these changes are subtle. Hearing loss can start <a href="https://www.who.int/teams/noncommunicable-diseases/sensory-functions-disability-and-rehabilitation/highlighting-priorities-for-ear-and-hearing-care">as early as our 50s</a> and often accompany other age-related visual changes, such as <a href="https://www.mdfoundation.com.au/">age-related macular degeneration</a>. Other age-related conditions are frequently prioritised by patients, doctors or carers, such as <a href="https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview">diabetes or heart disease</a>. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our <a href="https://hdl.handle.net/2123/29262">research</a> told us <blockquote> I don’t see too good or hear too well. It’s just part of old age. </blockquote> <h2>An invisible disability</h2> Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts <a href="https://doi.org/10.1080/09638280210129162">social activities and communication</a>, making it difficult for older adults to manage. It is underdiagnosed, underrecognised and sometimes misattributed (for example, to <a href="https://doi.org/10.1093/geronb/gbz043">cognitive impairment or decline</a>). However, there is also growing evidence of links between <a href="https://doi.org/10.1002/dad2.12054">dementia and dual sensory loss</a>. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, <a href="https://doi.org/10.1002/dad2.12054">feel happy and be safe</a>. A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us: <blockquote> There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else. </blockquote> <h2>Isolated yet more dependent on others</h2> Global trends show a worrying conundrum. Older people with dual sensory impairment become <a href="https://doi.org/10.1002/dad2.12054">more socially isolated</a>, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing. One aspect of this is how effectively they can <a href="https://doi.org/10.1001/jamanetworkopen.2020.25522">comprehend and communicate in a health-care setting</a>. Recent research shows <a href="http://dx.doi.org/10.3390/healthcare12080852">doctors and nurses in hospitals</a> aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, <a href="https://www.mdpi.com/2227-9032/12/8/852">researchers note</a>. It facilitates: <ul> <li>shorter hospital stays</li> <li>fewer re-admissions</li> <li>reduced emergency room visits</li> <li>better treatment adherence and medical follow up</li> <li>less unnecessary diagnostic testing</li> <li>improved health-care outcomes.</li> </ul> <h2>‘Too hard’</h2> Globally, there is a better understanding of how important it is to <a href="https://www.who.int/publications/i/item/9789240030749">maintain active social lives</a> as people age. But this is difficult for older adults with dual sensory loss. One person told us <blockquote> I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people. </blockquote> Again, these experiences increase reliance on family. But caring in this context is tough and largely <a href="https://doi.org/10.3389/feduc.2020.572201">hidden</a>. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring <a href="https://doi.org/10.1159/000507856">frustration, social isolation and depression</a> for carers too. One spouse told us: <blockquote> He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair. </blockquote> So, what can we do? Dual sensory impairment is a growing problem with potentially devastating impacts. It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers. We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to <a href="https://www.tandfonline.com/doi/full/10.1080/09649069.2019.1627088">navigate health care</a>. Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.<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/232142/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/moira-dunsmore-295190">Moira Dunsmore</a>, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/annmaree-watharow-1540942">Annmaree Watharow</a>, Lived Experience Research Fellow, Centre for Disability Research and Policy, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/emily-kecman-429210">Emily Kecman</a>, Postdoctoral research fellow, Department of Linguistics, <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/i-keep-away-from-people-combined-vision-and-hearing-loss-is-isolating-more-and-more-older-australians-232142">original article</a>.

Body

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

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

Body

Four people found dead in Melbourne home

Four people have been found dead in a house in Melbourne's north after emergency services were called to a house in Broadmeadows around 2am on Tuesday. Two men, a woman, aged up to 40 years old, and a 17-year-old teenage boy were found dead inside the property. Speaking candidly on the Today show, Corey, who is the uncle of the teenager, said he went to visit the home in the early hours of Tuesday, and saw his nephew on the ground. Corey then explained how he smashed the windows to their unit to gain access, where he discovered the bodies. “I’ve come home to find family members in the house deceased and it just tortured me, shocked me,” said Corey. “It’s really, really got to me.” Speaking to Sunrise, he shared his love for his young nephew. “He’s my nephew. He looks up to his uncle. Me being there is ultimately the best thing, you know, I’ve come home to find him gone. He was a kid. 17 years old. I wouldn’t know what’s caused this,” he said. While Corey believes the family died of a drug overdose, police have not confirmed this and say they are still investigating. A police spokesperson said in a statement: “The cause of the deaths is yet to be determined but at this stage not believed to be suspicious”. Image credits: Today

Caring

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

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

Mind

Millions of older people don’t get enough nutrients – how to spot it and what to do about it

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</a> By 2050, approximately a quarter of the UK population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/january2021">expected to be over the age of 65</a>. With this in mind, the World Health Organization (WHO) has put “<a href="https://cdn.who.int/media/docs/default-source/decade-of-healthy-ageing/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_28">healthy ageing</a>” on its agenda. This means finding ways to maintain health, wellbeing and functional ability in order to have a good quality of life and enjoy the later years. Everyone ages at a different rate – but there are some things that can influence how well we age, such as by making changes to the types of activity we do and the foods we eat. Older adults are <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/research-report-2019--one-step-at-a-time.pdf">generally less physically active</a> than they were when they were younger and because of this, their energy intake requirement may decrease. However, there is a difference between energy requirements and nutrient requirements, and nutrient requirements actually remain the same, if not increase, as we get older. This means we need to get more nutrients into less energy which can be tricky as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4589891/#:%7E:text=The%20physiological%20changes%20that%20occur,can%20contribute%20to%20declining%20appetite.">older adults often have lower appetites</a>. This is why <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6971894/">scientists suggest</a> that it may be necessary to enrich the food of older people to maintain the nutrient intake. <h2>How to spot when someone isn’t eating enough?</h2> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399049/">Several studies have shown</a> that undernutrition affects one in ten older people living independently at home. However, it affects five in ten older people living in nursing homes, and seven in ten older people in hospital. Being overweight, even obese, <a href="https://link.springer.com/article/10.1007/s40520-023-02650-1">does not protect</a> against undernutrition. And when older adults lose weight, they lose muscle, meaning that they are more likely to lose their <a href="https://www.frontiersin.org/articles/10.3389/fnut.2022.892675/full?&utm_source=Email_to_authors_&utm_medium=Email&utm_content=T1_11.5e1_author&utm_campaign=Email_publication&field=&journalName=Frontiers_in_Nutrition&id=892675">abilities to do daily tasks</a>. Weight loss in older adults is a key sign of malnutrition that needs to be addressed – but it can be easily missed, especially when many older adults associate the idea of thinness <a href="https://www.sciencedirect.com/science/article/pii/S0195666319307603?casa_token=iU5UIdNwGDgAAAAA:I81EKDJ2T0oBsOsZunpPBk6uI-TcgiCr-5gPJE1tz4-Tq3w8pK4Yi_mv22AhVHHpRpiv1Bvz0RI">with good health</a>. But clothing that’s too loose or a watchstrap that floats on the wrist are all warning signs of undernourishment. Similarly, if someone you care for has started to say things like, “Oh, I don’t want much food today, I’m not hungry”, “I’m not hungry, it’s natural, I’m getting older”, or “I’d rather just have a biscuit to be honest,” then these could be warning signs. An effective way to keep on top of this is regular weighing at least once per month which enables a quick response to potential indicators of malnutrition. <h2>Getting more nutrients into less food</h2> If people are eating small amounts of food, it is important to think about how to add more nutrients into it. A very effective technique, “fortification” is commonly done with pre-made products such as breakfast cereals, plant-based milk and bread in the UK. Fortification (adding foods, ingredients or nutrients into to existing foods or meals) is easy to do at home as well and can provide a flexible approach for older adults as it allows them to continue eating the foods that they most enjoy. <figure><iframe src="https://www.youtube.com/embed/kNu8auu3fuU?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> For older adults in particular, protein is a very important nutrient, because of muscle loss (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/#:%7E:text=Sarcopenia%20has%20been%20defined%20as,decade%20of%20life%20%5B1%5D.">sarcopenia)</a> which is a natural part of ageing. This could be slowed down or even reversed by <a href="https://www.medicalnewstoday.com/articles/could-a-higher-protein-intake-lead-to-healthier-eating">eating enough protein</a> at regular intervals throughout the day. A few ways to increase protein include: • Adding dairy ingredients such as milk, high-protein yoghurt, Quark (soft cheese), milk powders, eggs and cheese into meals – even into simple foods like mashed potato. • Nuts are a great source of protein, try adding ground almonds to savoury or sweet meals (beware of nut allergies). • Soy protein can be a convenient and cost-effective option, either for vegetarians or to further fortify minced-meat meals. • Look in the sports section of supermarkets to find <a href="https://www.sciencedirect.com/topics/agricultural-and-biological-sciences/whey-powder#:%7E:text=Whey%20powders%20are%20characterized%20as,of%20products%20obtained%20from%20milk.">whey protein</a> powders. These are marketed to gym enthusiasts, but actually whey is one of the <a href="https://www.mdpi.com/2072-6643/15/15/3424">best proteins to stimulate muscle growth</a>. This versatile ingredient can be mixed into porridge before cooking or used it as a substitute for other powdered ingredients in baking. <h2>Importance of physical activity and strength exercises</h2> Physical activity and nutrition go hand-in-hand – both are equally important. As we age, being physically active becomes <a href="https://link.springer.com/article/10.1007/s12603-021-1665-8?fbclid=IwAR3dJkeHjgcSrR9Xq5kBfN-HLrbpli8WcAnz7AeY5Nu9XcGCHEB07Sd2z1w">even more essential</a> as it helps to prevent disease, maintains independence, decreases risk of falls, improves cognitive function, mental health and sleep. Exercise can also <a href="https://academic.oup.com/ageing/article/48/4/476/5423796?login=false">combat isolation and loneliness</a> which has also been <a href="https://www.bda.uk.com/resource/loneliness-and-malnutrition.html">linked to decreased appetite</a> in older adults. Often strength training gets ignored when we think of being active but to keep independence and prevent falls, older adults should do varied physical activity that emphasises balance and strength training at moderate or greater intensity on three or more days a week. Ultimately, it’s essential to contact a doctor or dietician with any worries or concerns about malnutrition or unintentional weight loss. There are, however, <a href="https://www.futurelearn.com/courses/ageing-well-nutrition-and-exercise-for-older-adults">some excellent resources</a> to learn more about ageing healthily and maintaining a good quality of life in later years.<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/221380/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/miriam-clegg-997096">Miriam Clegg</a>, Senior Lecturer in Human Nutrition, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> and <a href="https://theconversation.com/profiles/rachel-smith-1505111">Rachel Smith</a>, Sensory and Consumer Scientist, <a href="https://theconversation.com/institutions/university-of-reading-902">University of Reading</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/millions-of-older-people-dont-get-enough-nutrients-how-to-spot-it-and-what-to-do-about-it-221380">original article</a>. </div>

Body

New study reveals people who do this daily make more money over their lifetimes

You’ve heard that regular exercise can help you live richly. Frequent movement, even in short bursts throughout the day, has been linked to lower all-cause mortality rates and reduced risk of heart disease, type-2 diabetes and other age-related conditions, helping you age healthfully and stay independent. Now, new research suggests frequent exercise might help you live well in another meaningful way; in terms of income. In a recent study published in the journal Clinical Orthopaedics and Related Research, doctors from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), which is part of the National Institute of Health (NIH), investigated whether individuals who stayed active would earn more money as a result of their active lifestyle. The researchers’ findings revealed that staying active not only resulted in higher present earnings, but also predicted increased future income throughout one’s life. In essence, the science was clear: Getting more exercise could make you wealthier. <h2>How exercise predicted future earnings</h2> The researchers set out to explore three key correlations: How mobility affected income, how mobility influenced income over time, and whether exercise could help people maintain their mobility as they aged. The team analysed data from the US-federally-supported Health and Retirement Study (HRS), the largest study tracking changes over time in Americans aged 50 and above. This comprehensive study takes into account various life aspects, including work, socio-economic status, health, psychology and family matters, as individuals age. To assess the impact of current mobility on income, the researchers examined data from over 19,000 respondents to determine how well they could perform simple tasks, such as walking several blocks, climbing multiple flights of stairs, or moving around a room. Each person received a numerical score, with 5 indicating full mobility and 0 indicating difficulties with these tasks. <h2>What earnings over time revealed</h2> The researchers found that for each decrease in the mobility category, individuals lost out on an average of US$3000 in annual income compared to their peers. Those who were active were also significantly more likely to remain working for longer than the other group. It appeared that engaging in exercise enabled individuals to maintain mobility and engage in professional life for a longer period of time than those who were less active. Looking at earnings over time revealed even more substantial benefits for those who remained active throughout their lives. Active individuals showed an overall income level that was US$6500 higher, along with higher rates of employment. For the third part of the study, it’s not surprising that those who engaged in exercise continued to maintain their mobility after the age of 55 and had higher employment rates. Even exercising just one day a week showed improvements in mobility outcomes. <h2>Moving more benefits more than just health</h2> While this study doesn’t definitively prove that leading a healthy lifestyle directly leads to higher earnings, it strongly suggests that staying healthy and mobile brings benefits beyond just lower levels of disease (which is a type of wealth in and of itself). NIAMS Director Lindsey A. Criswell, M.D., M.P.H., underscores this point: “We have long understood that greater mobility is an important indicator of good health … The notion that mobility can have economic rewards further extends the evidence for the benefits of exercise and maintaining an active lifestyle.” If this science inspires you to make a healthy lifestyle change, speak with a licensed healthcare provider to determine the right exercise programme for you. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.com.au/food-home-garden/money/new-study-reveals-people-who-do-this-daily-make-more-money-over-their-lifetimes" target="_blank" rel="noopener">Reader's Digest</a>.

Body

People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ben-white-15387">Ben White</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/casey-haining-1486290">Casey Haining</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> Dementia is the <a href="https://www.dementia.org.au/about-dementia">second leading cause of death</a> for Australians aged over 65. More than 421,000 Australians <a href="https://www.dementia.org.au/about-dementia">currently live with dementia</a> and this figure is expected to almost double in the next 30 years. There is ongoing public <a href="https://www.mja.com.au/journal/2024/220/9/should-voluntary-assisted-dying-victoria-be-extended-encompass-people-dementia">discussion</a> about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">now lawful in all six states</a>, but is not available for a person living with dementia. The Australian Capital Territory has <a href="https://www.canberratimes.com.au/story/8631104/marisa-paterson-to-consult-on-voluntary-assisted-dying-amendments/?cs=14329">begun debating</a> its voluntary assisted dying bill in parliament but the government has <a href="https://www.legislation.act.gov.au/DownloadFile/es/db_68610/current/PDF/db_68610.PDF">ruled out</a> access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to <a href="https://www.legislation.act.gov.au/b/db_68609/">revisit the issue</a> in three years. The Northern Territory is also considering reform and <a href="https://www.theaustralian.com.au/subscribe/news/1/?sourceCode=TAWEB_WRE170_a_GGL&dest=https%3A%2F%2Fwww.theaustralian.com.au%2Fnation%2Fpolitics%2Fconcerning-territory-nt-surveys-public-support-on-euthanasia-for-mentally-ill%2Fnews-story%2F4e45111bb293af4cf32ac3c6df058869&memtype=anonymous&mode=premium&v21=GROUPA-Segment-2-NOSCORE&V21spcbehaviour=append">has invited views</a> on access to voluntary assisted dying for dementia. Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, <a href="https://www.abc.net.au/listen/programs/melbourne-drive/voluntary-assisted-dying-dementia-victoria/103467864">called for the law to be widened</a> to allow access. Others <a href="https://www.smh.com.au/national/voluntary-assisted-dying-should-not-be-available-to-dementia-patients-20230607-p5deqo.html">argue</a> permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group. <h2>Australian laws exclude access for dementia</h2> Current Australian voluntary assisted dying laws <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">exclude access</a> for people who seek to qualify because they have dementia. In New South Wales, the <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2022-017">law specifically states</a> this. In the other states, this occurs through a <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2022/04/Issue-451-White-et-al.pdf">combination of the eligibility criteria</a>: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying. This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying. <h2>What happens internationally?</h2> Voluntary assisted dying laws in some other countries allow access for people living with dementia. One mechanism, used in the Netherlands, is through <a href="https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16692">advance directives or advance requests</a>. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor. Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “<a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2022/04/Issue-451-White-et-al.pdf">ten minutes to midnight</a>” approach. <h2>But these approaches have challenges</h2> International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are <a href="https://link.springer.com/article/10.1186/1472-6939-16-7">reluctant</a> to act on advance directives. Particularly challenging are <a href="https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0401-y">scenarios</a> where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying. Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex. Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life. Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group. <h2>More thought is needed before changing our laws</h2> There is <a href="https://www.parliament.qld.gov.au/Documents/TableOffice/TabledPapers/2020/5620T490.pdf">public demand</a> to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation <a href="https://www.publish.csiro.au/ah/pdf/AH23005">present an opportunity</a> to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly. The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “<a href="https://www.legislation.qld.gov.au/view/pdf/asmade/act-2021-017">must include a review of the eligibility criteria</a>”. And the ACT bill requires the review to <a href="https://www.legislation.act.gov.au/b/db_68609/">consider</a> “advanced care planning”. Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity. This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it. This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia. Any future law reform should be <a href="https://www.publish.csiro.au/AH/AH19201">evidence-based</a> and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.<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/224075/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ben-white-15387">Ben White</a>, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/casey-haining-1486290">Casey Haining</a>, Research Fellow, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, Postdoctoral research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</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/people-with-dementia-arent-currently-eligible-for-voluntary-assisted-dying-should-they-be-224075">original article</a>. </div>

Caring

“These are people’s lives”: Calls for gambling reform after fatal cruise ship plunge

The shocking death of a 50-year-old father who went overboard on a P&O Cruise has caused widespread outrage, with many questioning who is to blame for his untimely passing. Shane Dixon had racked up $5,000 of gambling debt while onboard the Elvis-themed voyage, which his mother, who was also travelling with him, helped him to repay. The next day, Dixon went back to the cruise ship's casino where he racked up another $4,000 in debt, before he plunged to his death while the vessel was on its way into Sydney Harbour. While questions have arisen about the circumstances surrounding his death, the CEO of the Alliance for Gambling Reform Carol Bennett said the cruise ship operator had failed to provide Shane with an adequate duty of care, and encouraged him to keep gambling. "It's really concerning that when a ship sails 12 nautical miles off the coast it can then allow anything and everything to happen," she told <a href="https://www.dailymail.co.uk/news/article-13414919/Anti-gambling-Shane-Dixon-cruise-ship-casino.html" target="_blank" rel="noopener">Daily Mail Australia</a>. "The rules that might apply on land no longer seem to apply and yet you would expect this cruise line would have some kind of duty of care to ensure that people are not plied with inducements, promotions and advertisements that are pushing them to gamble to extremely harmful levels." "It is just beyond belief that there is not an expectation that when a cruise ship leaves a dock that the rules of that jurisdiction apply." "But clearly that's not the case and we leave it all in the hands of the cruise line operator who may or may not apply the responsible service of gambling." Ms Bennett said it was "fundamental" that gamblers were able to set spend limits, self-exclude themselves and be in an environment free of inducements: all of which are required by law when it comes to casinos on Australian soil. "This is just basic harm reduction that any provider or organisation that is providing gambling services should be complying with," she said. "And if they're not, we need to really seriously think about what governments need to do to address this problem because you do wonder how widespread this is. This could be just the tip of the iceberg." Ms Bennett said Australia loses an estimated $25billion on legal forms of gambling each year, with the consequences spreading far beyond the impact on the economy. "It leads to everything from domestic and family violence to health and mental health issues, anxiety, depression, financial distress, right through to suicide," she said. "It is a huge and to some degree hidden problem in Australia, which is why we need stronger enforcement of safeguards and guardrails around gambling that don't see people led into a situation where they see no other way out but suicide." "These are peoples lives. For every person who gambles, there are six people around them who are going to be directly impacted." Labor backbencher Graham Perrett said the British cruise line most likely operated under the UK's gambling laws. "My understanding is that the UK gambling laws are not dissimilar to ours in terms of marketing and advertising," he said. "It's not just a gambling free-for-all, even if they are outside our territorial seas they still have to follow the laws of the UK." Image credits: Facebook / Shutterstock

Cruising

Technology is alienating people – and it’s not just those who are older

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/carolyn-wilson-nash-1255329">Carolyn Wilson-Nash</a>, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> and <a href="https://theconversation.com/profiles/julie-tinson-277507">Julie Tinson</a>, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> We take it for granted that technology brings people closer together and improves our access to essential products and services. If you can’t imagine life without your smartphone, it’s easy to forget that people who can’t or don’t want to engage with the latest technology are being left behind. For example, there have recently been reports that <a href="https://www.express.co.uk/life-style/cars/1618497/parking-poll-results-cashless-car-parks-card-smartphone-app-only-elderly-drivers-spt">cashless payment systems</a> for car parking in the UK are seeing older drivers unfairly hit with fines. This has led to calls for the <a href="https://www.dailymail.co.uk/news/article-10851103/Esther-Rantzen-tells-ministers-pensioners-not-use-apps-pay-parking.html">government to intervene</a>. Age is one of the biggest predictors of <a href="https://ageing-better.org.uk/sites/default/files/2020-08/landscape-covid-19-digital.pdf">digital exclusion</a>. Only 47% of those aged <a href="https://www.ons.gov.uk/businessindustryandtrade/itandinternetindustry/bulletins/internetusers/2019">75 and over</a> use the internet regularly. And out of the 4 million who have never used the internet in the UK, only 300,000 people are <a href="https://ageing-better.org.uk/sites/default/files/2020-08/landscape-covid-19-digital.pdf">under 55</a>. But older people are not the only ones who feel shut out by new technology. For example, research shows vulnerable people, such as those with disabilities, are also disengaging with e-services and being <a href="https://www.tandfonline.com/doi/full/10.1080/0267257X.2012.691526">“locked out” of society</a>. <h2>The digital transition</h2> From train tickets to vaccine passports, there is a growing expectation that consumers should embrace technology to participate in everyday life. This is a global phenomenon. Out in front, Sweden predicts its economy will be <a href="https://sweden.se/life/society/a-cashless-society">fully cashless</a> by March 2023. Shops increasingly use QR codes, virtual reality window displays and self-service checkouts. Many of these systems require a smart device, and momentum is building for QR codes to be integrated into <a href="https://www.thegrocer.co.uk/technology-and-supply-chain/the-time-has-finally-arrived-for-electronic-shelf-labels-heres-why/661068.article">digital price tags</a> as they can give customers extra information such as nutritional content of food. Changing paper labels is a labour intensive process. Technology pervades all aspects of consumer life. Going on holiday, enjoying the cinema or theatre, and joining sport and social clubs all make people feel part of society. But many popular artists now use online queues to sell tickets to their shows. Social groups use WhatsApp and Facebook to keep their members updated. When it comes to booking a holiday, there is a <a href="https://www.statista.com/statistics/919811/number-of-travel-agents-united-kingdom-uk/#:%7E:text=Overall%2C%20there%20were%203%2C710%20retail,as%20TUI%20and%20Hays%20Travel.">decreasing number</a> of in-person travel agents. This limits the social support to make the best choice, which is particularly important for those with specific needs such as people with health issues. And once travelling, aircrew expect flight boarding passes and COVID passports to be available on smartphones. Essential services such as healthcare, which can already <a href="https://www.tandfonline.com/doi/full/10.1080/0267257X.2022.2078861">be difficult</a> for older and other people to navigate, are also moving online. Patients are increasingly expected to use the GP website or email to request to see a doctor. Ordering prescriptions online is encouraged. <h2>Not just older people</h2> <a href="https://www.gov.uk/government/publications/digital-lifeline-a-qualitative-evaluation/digital-lifeline-a-qualitative-evaluation">Not everyone can afford</a> an internet connection or smart technology. Some regions, particularly rural ones, struggle for phone signal. The UK phone network’s plans for a <a href="https://www.bbc.co.uk/news/uk-england-shropshire-61377944">digital switchover</a> by 2025, which would render traditional landlines redundant, could cut off people who rely on their landlines. Concerns about privacy can also stop people using technology. Data collection and security breaches impact people’s confidence in organisations. A 2020 survey into <a href="https://www.mckinsey.com/business-functions/risk-and-resilience/our-insights/the-consumer-data-opportunity-and-the-privacy-imperative">consumers’ trust</a> in businesses showed no industry reached a trust rating of 50% for data protection. The majority of respondents (87%) said they would not do business with a company if they had concerns about its security practices. Some people view “forced” digitisation as a symbol of consumer culture and will limit their technology use. Followers of the <a href="https://www.researchgate.net/publication/228310981_The_Voluntary_Simplicity_Movement_Reimagining_the_Good_Life_Beyond_Consumer_Culture">simple living movement</a>, which gained momentum in the 1980s, try to minimise their use of technology. Many people take a “less is more” <a href="https://www.emerald.com/insight/content/doi/10.1108/JCM-04-2020-3749/full/html">approach to technology</a> simply because they feel it offers a more meaningful existence. One of the most common reasons for digital exclusion, however, <a href="https://www.iriss.org.uk/resources/esss-outlines/digital-inclusion-exclusion-and-participation">is poverty</a>. When the <a href="https://www.local.gov.uk/parliament/briefings-and-responses/tackling-digital-divide-house-commons-4-november-2021">pandemic hit in March 2020</a>, 51% of households earning between £6,000 to £10,000 had home internet access, compared with 99% of households with an income over £40,000. Limited access to tablets, smartphones and laptops can result in feelings of isolation. Many older consumers have developed strategies to manage and overcome the <a href="https://www.tandfonline.com/doi/full/10.1080/0267257X.2021.1945662">digital challenges</a> presented by these devices. But those unable to <a href="https://theconversation.com/how-older-people-are-mastering-technology-to-stay-connected-after-lockdown-165562">engage with technology</a> remain excluded if their family and friends don’t live close by. <h2>Smart change</h2> The solution is not simply to give devices to those without smart technology. While there is a need to provide affordable internet access and technology, and offer support in learning new skills, we need to recognise diversity in society. Services should provide non-digital options that embrace equality. For example, cash systems should not be abolished. There might be a demand for services to become digital, but service providers need to be aware of the people who will be isolated by this transition. Retailers, local councils, health providers and businesses in tourism, entertainment and leisure should try to understand more about the diversity of their consumers. They need to develop services that cater for the needs of all people, especially those without access to technology. We live in a diverse world and diverse consumers need choice. After all, access to and inclusion in society is a human right.<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/184095/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/carolyn-wilson-nash-1255329">Carolyn Wilson-Nash</a>, Lecturer, Marketing and Retail, Stirling Management School, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</a> and <a href="https://theconversation.com/profiles/julie-tinson-277507">Julie Tinson</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-stirling-1697">University of Stirling</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/technology-is-alienating-people-and-its-not-just-those-who-are-older-184095">original article</a>. </div>

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