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3 key differences between an ocean and river cruise

People often have a personal preference when it comes to ocean cruises or river cruises, so if you’re not sure what to go for, it’s best to know how they really differ before booking your next trip. Here are the three key differences between an ocean and river cruise. 1. Cost River cruises are initially more expensive, and travellers can expect the price to be from $200-500 per person per night. Ocean ships can cost less than $100 per night if you get a good deal. However, once onboard your ocean cruise there will be a likelihood that you splurge on extra costs such as drinks, tours and souvenirs. 2. Inclusions Only the most upmarket ocean cruises are all-inclusive but on an ocean cruise if you want mealtime alcohol, Wi-Fi and other extras, you will be expected to pay up. All these extras are included in river-cruise fares and sometimes airport transfers are included too. River cruises require you to pay a heftier sum upon booking but if you are going on an ocean cruise, be sure to keep track of your spending. 3. Ship amenities On river cruises, expect your onboard entertainment to be a massage room, fitness room or hot tub as most of the focus is on the destination. However, ocean cruises are lined with Broadway-styled shows, casinos, kids’ clubs, water parks, spas and various pools. If you prefer a quiet, intimate setting then river cruises would suit your desires but if you want a wide-range of entertainment, ocean cruises are for you. Image credits: Shutterstock

Cruising

What’s the difference between a psychopath and a sociopath? Less than you might think

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/bruce-watt-1486350">Bruce Watt</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/katarina-fritzon-402205">Katarina Fritzon</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as <a href="https://psychologyeverywhere.com/articles/7-signs-your-boss-is-a-psychopath/">7 signs your boss is a psychopath</a> or <a href="https://www.elephantjournal.com/2022/08/how-to-avoid-the-sociopath-next-door-erica-leibrandt/">How to avoid the sociopath next door</a>. You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from <a href="https://www.imdb.com/title/tt0102926/">The Silence of the Lambs</a>. In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with <a href="https://psychiatryonline.org/doi/pdf/10.1176/appi.psychotherapy.2002.56.1.100">something else</a> entirely. So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts. <h2>What’s a psychopath?</h2> Psychopathy has been mentioned in the psychiatric literature <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/#:%7E:text=The%20term%20psychopathy%20comes%20from,which%20literally%20means%20suffering%20soul.">since the 1800s</a>. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">doesn’t list</a> it as a recognised clinical disorder. <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm#section_5">Since the 1950s</a>, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with <a href="https://www.ncbi.nlm.nih.gov/books/NBK546673/">antisocial personality disorder</a>, which is what we have today. Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions. To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves. US psychiatrist <a href="https://psycnet.apa.org/record/2018-37736-001">Hervey Cleckley</a> provided the first formal description of psychopathy traits in his 1941 book <a href="https://gwern.net/doc/psychology/personality/psychopathy/1941-cleckley-maskofsanity.pdf">The Mask of Sanity</a>. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame. <a href="https://psych.ubc.ca/profile/robert-hare/">Canadian psychologist</a> Professor <a href="http://www.hare.org/">Robert Hare</a> refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM. When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others. Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions. <h2>So how about a sociopath?</h2> The term sociopath first appeared <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/#:%7E:text=The%20term%20psychopathy%20comes%20from,which%20literally%20means%20suffering%20soul.">in the 1930s</a>, and was attributed to US psychologist George Partridge. He <a href="https://psychiatryonline.org/doi/abs/10.1176/ajp.85.6.1053?journalCode=ajp">emphasised</a> the societal consequences of behaviour that habitually violates the rights of others. Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/#:%7E:text=The%20term%20psychopathy%20comes%20from,which%20literally%20means%20suffering%20soul.">preferred the term sociopath</a> because they said the public sometimes confused the word psychopath with psychosis. “Sociopathic personality disturbance” <a href="https://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf">was the term</a> used in the first edition of the DSM in 1952. This aligned with the <a href="https://journals.sagepub.com/doi/epdf/10.1177/0306624X01453005">prevailing views</a> at the time that antisocial behaviours were largely the product of the social environment, and that behaviours were only judged as deviant if they broke social, legal, and/or cultural rules. Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 <a href="https://pubmed.ncbi.nlm.nih.gov/26618655/">definition</a> of a psychopath. In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy. Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead. <h2>Born or made?</h2> Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes. For example, people with psychopathic traits have <a href="https://www.theguardian.com/science/2013/may/12/how-to-spot-a-murderers-brain">certain brain differences</a> especially <a href="https://psycnet.apa.org/record/2006-01001-014">in regions</a> associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their <a href="https://www.psypost.org/psychopathic-women-exhibit-low-cardiac-defense-responses-study-finds/">nervous system</a>, including a <a href="https://www.sciencedirect.com/science/article/pii/S0301051123001345?via%3Dihub">reduced heart rate</a>. However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to <a href="https://www.aic.gov.au/sites/default/files/2020-05/19-1415-FinalReport.pdf">run in families</a>. These behaviours has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801766/#:%7E:text=Childhood%20abuse%20is%20a%20risk,and%20psychopathic%20traits%20remain%20unclear">associated with</a> physical abuse and parental conflict. <h2>What are the consequences?</h2> Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series <a href="https://www.imdb.com/title/tt7016936/">Killing Eve</a> – <a href="https://www.psychologytoday.com/au/blog/making-evil/201902/what-we-get-wrong-about-psychopaths#:%7E:text=Most%20psychopaths%20are%20not%20offenders,extreme%20violence%20or%20serial%20killing.">not all people</a> with psychopathy or sociopathy traits are serial killers or are physically violent. But psychopathy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/">predicts</a> a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature. In the general population, psychopathy is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0160252709000028?casa_token=5lSd35qRO7oAAAAA:CTu-KkDXxsoYEPvpceItex9go1Fn_YlfBQSW9O9_MwNEX6NxlZ23GRcWnS5YYV_kAig24E4Ahdj7">associated with</a> drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250605/">failure to follow</a> COVID restrictions. But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour. <h2>In a nutshell</h2> Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics. Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment. Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.<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/226714/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bruce-watt-1486350">Bruce Watt</a>, Associate Professor in Psychology, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/katarina-fritzon-402205">Katarina Fritzon</a>, Associate Professor of Psychology, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-a-psychopath-and-a-sociopath-less-than-you-might-think-226714">original article</a>. </div>

Mind

What’s the difference between a heart attack and cardiac arrest? One’s about plumbing, the other wiring

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a <a href="https://apnews.com/article/bronny-james-cardiac-arrest-3953eee8789e83f3cccfb6dd798bc54e">cardiac arrest</a>. Many media outlets incorrectly referred to the event as a “<a href="https://en.as.com/nba/lebron-james-son-bronny-plays-for-the-usc-trojans-for-the-first-time-since-suffering-a-heart-attack-n/">heart attack</a>” or used the terms interchangeably. A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart. With some background in <a href="https://www.youtube.com/watch?v=uKrgEv7-rVM&t=16s">how the heart works</a>, we can see how they differ and how they’re related. <h2>Understanding the heart</h2> The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body. For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs. This can cause the heart muscle to become injured or die, and results in the heart not pumping properly. <h2>Heart attack or cardiac arrest?</h2> Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle. A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump. In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other. <h2>Why do they happen? Who’s at risk?</h2> Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease. The underlying cause in about <a href="https://www.ncbi.nlm.nih.gov/books/NBK507799/#:%7E:text=It%20has%20been%20reported%20that,increases%20beyond%20age%2050%20years.">75% of people</a> is a process called <a href="https://youtu.be/jwL4lkSlvSA?si=H2as7dQkhbIqWWkU">atherosclerosis</a>. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot. Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process. Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle. Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.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/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" alt="Heart attack vs cardiac arrest" /></a><figcaption>Here’s a simple way to remember the difference. Author provided</figcaption></figure> But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to <a href="https://www.youtube.com/watch?v=M_soKG-Tzh0&t=903s">electrical malfunctions</a> in the heart. There are four distinct types: <ul> <li> ventricular tachycardia: a rapid and abnormal heart rhythm in which the heartbeat is more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541285/">100 beats per minute</a> (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately </li> <li> ventricular fibrillation: instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute </li> <li> pulseless electrical activity: arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse </li> <li> asystole: the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart. </li> </ul> Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a <a href="https://www.espn.com.au/mens-college-basketball/story/_/id/38260006/bronny-james-cardiac-arrest-caused-congenital-heart-defect">congenital heart defect</a>, a heart condition he was born with. But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting <a href="https://pubmed.ncbi.nlm.nih.gov/11898927/">for 70%</a> of all cases. So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest. So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack. <h2>What do they look like?</h2> Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin. But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating. <h2>What’s the take-home message?</h2> While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes. A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring. Despite their different nature both conditions can have severe consequences and require immediate medical attention.<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/229633/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, Associate Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, Senior lecturer, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-a-heart-attack-and-cardiac-arrest-ones-about-plumbing-the-other-wiring-229633">original article</a>. </div>

Body

Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> The weight-loss drug <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101&d=20240827172310101">Wegovy</a> is now <a href="https://www.tga.gov.au/safety/shortages/medicine-shortage-alerts/new-semaglutide-product-becomes-available">available</a> in Australia. Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">in combination</a> with a reduced-energy diet and increased physical activity. So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it? Let’s look at what the science says. <h2>What is Wegovy?</h2> Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better. Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten. Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231279/">several years</a> to treat type 2 diabetes. <h2>How does Wegovy differ from Ozempic?</h2> Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk. But there are two differences: 1) They are approved for two different (but related) reasons. In Australia (and the United States), Ozempic is <a href="https://www.tga.gov.au/resources/prescription-medicines-registrations/ozempic-novo-nordisk-pharmaceuticals-pty-ltd">approved for use</a> to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease. Wegovy is <a href="https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent=&id=CP-2022-PI-01930-1&d=20240731172310101">approved for use</a> alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure. Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease. 2) They are both injected but come in different strengths. Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed. Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly. While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-2024">anticipated to be in low supply</a> for the remainder of 2024. <h2>Is Wegovy effective for weight loss?</h2> Given Wegovy is a semaglutide, there is <a href="https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02495006/full">very strong evidence</a> it can help people lose weight and maintain this weight loss. A recent <a href="https://www.nature.com/articles/s41591-024-02996-7">study</a> found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm. For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">regained</a>. <h2>What are the side effects of Wegovy?</h2> The most common <a href="https://www.wegovy.com/dashboard/my-library/week-02-tips-for-managing-common-side-effects.html">side effects</a> are nausea and vomiting. However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11050669/">scientific literature</a>. In the four-year Wegovy <a href="https://www.nejm.org/doi/10.1056/NEJMoa2307563">trial</a>, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient). Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo. Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo. Recently, concerns about suicidal thoughts and behaviours have been raised, after a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822453">global analysis</a> reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000. There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play. Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. <a href="https://www.theguardian.com/food/2022/nov/09/i-miss-eating-weight-loss-drug-ozempic-food-repulsive">Anecdotal</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7839771/">scientific</a> evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones. <h2>How can people access Wegovy?</h2> Wegovy is available for purchase at pharmacists with a prescription from a doctor. But there is a hefty price tag. Wegovy is <a href="https://www.diabetesaustralia.com.au/news/wegovy-to-be-available-in-australia/">not currently subsidised</a> through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=Novo%20Nordisk%20told%20newsGP%20the,each%20dose%20lasting%20one%20month.">estimated at around A$460</a> per month dose. If you’re considering Wegovy, <a href="https://www1.racgp.org.au/newsgp/clinical/wegovy-launches-in-australia#:%7E:text=The%20manufacturer%20assured%20GPs%20supply,cost%20to%20customers%20than%20Ozempic.">make an appointment</a> with your doctor for individual advice.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237308/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">original article</a>. </div>

Body

Your legacy. Their future. Will you be the difference in an uncertain world?

Connection. Safety. Friendship. Family. When you <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener">leave a gift in your Will for Australian Red Cross</a>, there’s no end to the difference you can make. Just ask Elsie. At 95 years old, Elsie has been transformed by weekly visits from Fiona, her Red Cross volunteer. For Fiona, her visits to see 95-year-old nursing home resident Elsie quickly turned into a family affair. "My children, Tom and Meg, have become very attached to her and vice versa. They're like, 'Are you going to see Elsie, can we come too?' They see how lovely it is to be kind to someone like Elsie," says Fiona. "Elsie tells me, 'You're my special family.'" Fiona's dog, Mia, is even a regular visitor at the Tasmanian nursing home. "Mia's like a celebrity. All the residents love her." The family marks all the big milestones with Elsie, like Christmas Day when they brought her home for a special morning tea. "When she turned 95 in December, we took her to a café. She said that was the best birthday she'd had for a long time." <img src="https://oversixtydev.blob.core.windows.net/media/2024/08/RedCross_01.jpg" alt="" width="1280" height="720" /> Elsie celebrating her birthday with Fiona's children, Tom and Meg. It is very much a two-way friendship, says Fiona. "I wasn't expecting it to be like that. I thought it was going to be more me doing lots of things for Elsie. But she gives back a lot." Like when Fiona's daughter, Meg, didn't pass her driver's license test. "Meg was quite upset. Elsie goes to her, 'That's why they invented pencils with rubbers at the end. They are there for you to rub out your mistakes, and then you can have another go.' "She's wise. She gives them little bits of advice and words of wisdom, and they listen to what she says … I can't believe she's 95 years old. Her mind is so unbelievably sharp." Fiona says that, lately, Elsie has not been as mobile as she was, and so they often spend their time together at the nursing home. "We find a nice spot and have a cuppa … She likes telling stories about her life. She talks a lot about her husband, her upbringing, people she's met. "Often, I'll bring her some magazines, or she will have asked me to get some stamps. And my kids have been great with her with technology, how to do this and how to do that. "We chat with other residents as well. Even though Elsie's our person, there are other people we've got to know. She introduces us as 'This is my family.'" Fiona says the first time they met, she and Elsie discovered they had much in common. They both grew up in the same country town and had travelled around Australia managing hotels. They care a lot about each other, she says. "I think it's given her more of a will to live. That sounds pretty deep, but I know how much she looks forward to seeing us; it's giving her more purpose in life. "Elsie always says, 'You make me feel so happy. I love seeing you, it's such a highlight.' I say it back to her because it's the same for me, 'I get so much joy out of seeing you.'" Fiona says she hopes her story inspires other people to volunteer, too. Your generosity, captured in your Will, can help fund programs like our Aged Care Volunteer Visitors Scheme and foster social connections like Elsie and Fiona’s. The program supports more than 1000 participants across the country with the majority between the ages of 78 and 89. Everybody deserves the warmth of kindness and friendship, and your Will can help Australian Red Cross share that with people for generations to come. <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener"><img src="https://oversixtydev.blob.core.windows.net/media/2024/08/RedCross_02_wQRCode.jpg" alt="" width="1280" height="638" /></a> If you would like a free <a href="https://www.redcross.org.au/donate-funds/bequest/pass-it-on/will-planning-checklist-social/?utm_medium=digital&utm_source=edm&utm_campaign=bequests&utm_content=over60s" target="_blank" rel="noopener">Will Planning Checklist</a>, or more information, our <a href="mailto:litran@redcross.org.au" target="_blank" rel="noopener">Gifts in Wills Specialist</a> would love to help. You <a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="mailto:litran@redcross.org.au" target="_blank" rel="noopener">get in touch here</a> or call 1800 733 276. All images: Supplied. This is a sponsored article produced in partnership with Australian Red Cross.

Caring

What’s the difference between miscarriage and stillbirth?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/gita-mishra-286486">Gita Mishra</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/chen-liang-1356342">Chen Liang</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Former US First Lady Michelle Obama <a href="https://www.pbs.org/newshour/nation/michelle-obama-reveals-she-had-a-miscarriage-used-ivf-to-conceive-daughters">revealed</a> in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has <a href="https://www.usmagazine.com/celebrity-news/news/lily-allen-shares-details-about-delivering-a-stillborn-baby/#:%7E:text=Lily%20Allen%20was%20six%20months,named%20George%20%E2%80%94%20did%20not%20survive.">gone on the record</a> about her stillbirth. Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused. Here are some similarities and differences between miscarriage and stillbirth, and why they matter. <h2>Let’s start with some definitions</h2> In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb). This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb. However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery. The Australian Institute of Health and Welfare <a href="https://www.aihw.gov.au/reports/mothers-babies/stillbirths-and-neonatal-deaths-in-australia/contents/technical-notes/definitions-used-in-reporting">defines stillbirth</a> as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams. Internationally, definitions of stillbirth <a href="https://www.nhs.uk/conditions/stillbirth/">vary</a> <a href="https://www.cdc.gov/nchs/data/misc/itop97.pdf">depending on</a> <a href="https://www.who.int/data/gho/indicator-metadata-registry/imr-details/2444">the jurisdiction</a>. <h2>How common are they?</h2> It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">Studies</a> from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life. Around <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">1–2%</a> of women have recurrent miscarriages. <a href="https://miscarriageaustralia.com.au/understanding-miscarriage/recurrent-miscarriage/">In Australia</a> this is when someone has three or more miscarriages with no pregnancy in between. Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% <a href="https://www.aihw.gov.au/reports/mothers-babies/stillbirths-and-neonatal-deaths">or around</a> seven per 1,000 pregnancies. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?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/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=456&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=456&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=456&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=573&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=573&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=573&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Who’s at risk?</h2> Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy. Compared with women who have had a live birth, those who have had a stillbirth have <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04355-7">double the risk</a> of another. For those who have had recurrent miscarriages, the risk of another miscarriage is <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">four-fold</a> higher. Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle. For instance, maternal age is a risk factor for both <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">miscarriage</a> and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00528-X/fulltext">stillbirth</a>, especially if under 20 years old or older than 35. Increasing age of the male is only a <a href="https://link.springer.com/article/10.1007/s10654-017-0237-z">risk factor</a> for stillbirth, especially for fathers over 40. Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">miscarriage</a> and <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00837-5/abstract?code=lancet-site&rss=yes=">stillbirth</a> compared with those in the obese or underweight categories. Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth. So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus. <h2>Why do they happen?</h2> Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00837-5/abstract?code=lancet-site&rss=yes=">account for</a> only <a href="https://jamanetwork.com/journals/jama/fullarticle/1104720">7-14%</a> of stillbirths. Instead, stillbirths <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00837-5/abstract?code=lancet-site&rss=yes=">often relate</a> directly to <a href="https://jamanetwork.com/journals/jama/fullarticle/1104720">pregnancy complications</a>, such as a prolonged pregnancy or problems with the umbilical cord. <a href="https://www.nichd.nih.gov/health/topics/factsheets/pregnancyloss">Maternal health</a> at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths. Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can <a href="https://www.nichd.nih.gov/health/topics/factsheets/pregnancyloss">increase the risk</a> of miscarriage. Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an <a href="https://www.nichd.nih.gov/health/topics/factsheets/stillbirth">increased risk</a> of stillbirth. In many cases, however, the specific cause of pregnancy loss is not known. <h2>How about the long-term health risks?</h2> Miscarriage and stillbirth can be <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">early indicators</a> of health issues later in life. For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of <a href="https://pubmed.ncbi.nlm.nih.gov/33028606/">cardiovascular disease</a> (such as heart disease or stroke). Our <a href="https://www.bmj.com/content/377/bmj-2022-070603.abstract">research</a> has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke. Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke. We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing. Our data showed women with a history of recurrent miscarriages or stillbirths were at a <a href="https://thorax.bmj.com/content/79/6/508.abstract">36% or 67% higher risk</a> of COPD, respectively, even after accounting for a history of asthma. <h2>Why is all this important?</h2> Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one. Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant. <hr /> More information and support about miscarriage and stillbirth is available from <a href="https://www.sands.org.au">SANDS</a> and <a href="https://www.pinkelephants.org.au">Pink Elephants</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225660/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/gita-mishra-286486">Gita Mishra</a>, Professor of Life Course Epidemiology, Faculty of Medicine, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/chen-liang-1356342">Chen Liang</a>, PhD student, reproductive history and non-communicable diseases in women, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-miscarriage-and-stillbirth-225660">original article</a>. </div>

Body

What’s the difference between ‘strep throat’ and a sore throat? We’re developing a vaccine for one of them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/kim-davis-1535254">Kim Davis</a>, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a>; <a href="https://theconversation.com/profiles/alma-fulurija-1535255">Alma Fulurija</a>, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a>, and <a href="https://theconversation.com/profiles/myra-hardy-1535253">Myra Hardy</a>, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a> the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”. But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried? Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter. <h2>How are they similar?</h2> It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar. People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days. Thankfully, both types of sore throat usually get better <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655103/">by themselves</a>. <h2>How are they different?</h2> Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus). These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted <a href="https://www.ncbi.nlm.nih.gov/books/NBK401243/#:%7E:text=People%20may%20then%20wonder%20whether,infection%2C%20such%20as%20bacterial%20tonsillitis.">antibiotic side-effects</a>. But strep throat is caused by Streptococcus pyogenes bacteria, also known as strep A. Strep throat is most common in <a href="https://www.tandfonline.com/doi/full/10.2217/fmb-2021-0077">school-aged children</a>, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications. In fact, the potential for complications is one key difference between a viral sore throat and strep throat. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.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/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=508&fit=crop&dpr=1 754w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=508&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=508&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> Generally, a viral sore throat is <a href="https://www.bmj.com/content/347/bmj.f6867">very unlikely</a> to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893202/">chronic fatigue syndrome</a>, <a href="https://www.science.org/doi/10.1126/science.abj8222">multiple sclerosis</a> and certain <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00404-7/fulltext">cancers</a>). But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick. Invasive strep A infections and deaths have been <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429">rising in recent years</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786649/">around the world</a>, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear. Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells. The most common example is <a href="https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease">rheumatic heart disease</a>. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection. <a href="https://www.nejm.org/doi/10.1056/NEJMoa2102074?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">Around the world</a> more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries. However, parts of Australia have some of the <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50682">highest rates</a> of rheumatic heart disease in the world. <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/all-heart-stroke-and-vascular-disease/arf-and-rhd">More than 5,300</a> Indigenous Australians live with it. <h2>Why do some people get sicker than others?</h2> We know strep A infections and rheumatic heart disease <a href="https://link.springer.com/chapter/10.1007/82_2012_280">are more common</a> in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease. However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease. We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out. <h2>How about a vaccine for strep A?</h2> There is no strep A vaccine but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028081/">many</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545125/">groups</a> in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6495378/">Australia</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902606/">New Zealand</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620221/">and</a> <a href="https://www.clinicalkey.com.au/#!/content/playContent/1-s2.0-S0264410X19316457?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0264410X19316457%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F">worldwide</a> are working towards one. For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the <a href="https://www.asavi.org.au">Australian Strep A Vaccine Initiative</a> to develop strep A vaccines. There’s also a <a href="https://savac.ivi.int/">global consortium</a> working towards the same goal. Companies such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10747066/">Vaxcyte</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696035/">GlaxoSmithKline</a> have also been developing strep A vaccines. <h2>What if I have a sore throat?</h2> Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP. Your GP can examine you, consider running some tests and help you decide if you need antibiotics.<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/230292/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-davis-1535254">Kim Davis</a>, General paediatrician and paediatric infectious diseases specialist, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a>; <a href="https://theconversation.com/profiles/alma-fulurija-1535255">Alma Fulurija</a>, Immunologist and the Australian Strep A Vaccine Initiative project lead, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a>, and <a href="https://theconversation.com/profiles/myra-hardy-1535253">Myra Hardy</a>, Postdoctoral Researcher, Infection, Immunity and Global Health, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-strep-throat-and-a-sore-throat-were-developing-a-vaccine-for-one-of-them-230292">original article</a>. </div>

Body

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> The term “man flu” takes a <a href="https://www.oxfordlearnersdictionaries.com/definition/english/man-flu">humorous poke</a> at men with minor respiratory infections, such as colds, who supposedly exaggerate their symptoms. According to the stereotype, a man lies on the sofa with a box of tissues. Meanwhile his female partner, also with a snotty nose, carries on working from home, doing the chores and looking after him. But is man flu real? Is there a valid biological reason behind men’s symptoms or are men just malingering? And how does man flu differ from flu? <h2>What are the similarities?</h2> Man flu could refer to a number of respiratory infections – a cold, flu, even a mild case of COVID. So it’s difficult to compare man flu with flu. But for simplicity, let’s say man flu is actually a cold. If that’s the case, man flu and flu have some similar features. Both are caused by viruses (but different ones). Both are improved with rest, fluids, and if needed painkillers, throat lozenges or decongestants to <a href="https://activities.nps.org.au/nps-order-form/Resources/NPS-Cold-and-Flu-Brochure-May-2014.pdf">manage symptoms</a>. Both <a href="https://www.cdc.gov/flu/symptoms/coldflu.htm">can share</a> similar symptoms. Typically, more severe symptoms such as fever, body aches, violent shivering and headaches are more common in flu (but sometimes occur in colds). Meanwhile sore throats, runny noses, congestion and sneezing are more common in colds. A cough is common in both. <h2>What are the differences?</h2> <a href="https://www.cdc.gov/flu/about/keyfacts.htm">Flu</a> is a more serious and sometimes fatal respiratory infection caused by the influenza virus. Colds are caused by various viruses such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553670/">rhinoviruses</a>, <a href="https://www.cdc.gov/adenovirus/about/?CDC_AAref_Val=https://www.cdc.gov/adenovirus/symptoms.html">adenoviruses</a>, and common cold <a href="https://journals.lww.com/pidj/citation/2022/03000/proving_etiologic_relationships_to_disease_.18.aspx">coronaviruses</a>, and are rarely serious. Colds tend to <a href="https://www.cdc.gov/flu/symptoms/coldflu.htm">start gradually</a> while flu tends to start abruptly. Flu can be <a href="https://www.cdc.gov/flu/professionals/diagnosis/overview-testing-methods.htm">detected</a> with laboratory or at-home tests. Man flu is not an official diagnosis. Severe flu symptoms may be prevented with <a href="https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm">a vaccine</a>, while cold symptoms cannot. Serious flu infections may also be <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/racf-antiviral-treatments-and-prophylaxis.aspx">prevented or treated</a> with antiviral drugs such as Tamiflu. There are no antivirals for colds. <h2>OK, but is man flu real?</h2> Again, let’s assume man flu is a cold. Do men really have worse colds than women? The picture is complicated. <a href="https://www.sciencedirect.com/science/article/pii/S0022399922003324?via%3Dihub">One study</a>, with the title “Man flu is not a thing”, did in fact show there were differences in men’s and women’s symptoms. This study looked at symptoms of acute rhinosinusitis. That’s inflammation of the nasal passages and sinuses, which would explain a runny or stuffy nose, a sinus headache or face pain. When researchers assessed participants at the start of the study, men and women had similar symptoms. But by days five and eight of the study, women had fewer or less-severe symptoms. In other words, women had recovered faster. But when participants rated their own symptoms, we saw a somewhat different picture. Women rated their symptoms worse than how the researchers rated them at the start, but said they recovered more quickly. All this suggests men were not exaggerating their symptoms and did indeed recover more slowly. It also suggests women feel their symptoms more strongly at the start. <h2>Why is this happening?</h2> It’s not straightforward to tease out what’s going on biologically. There are <a href="https://www.nature.com/articles/nri.2016.90">differences</a> in immune responses between men and women that provide a plausible reason for worse symptoms in men. For instance, women generally produce antibodies more efficiently, so they <a href="https://www.nature.com/articles/nri.2016.90">respond more effectively</a> to vaccination. Other aspects of women’s immune system also appear to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2735332/">work more strongly</a>. So why do women tend to have <a href="https://www.nature.com/articles/nri.2016.90">stronger immune responses</a> overall? That’s probably partly because women have two X chromosomes while men have one. X chromosomes carry important <a href="https://www.nature.com/articles/nri.2016.90#Tab3">immune function genes</a>. This gives women the benefit of immune-related genes from two different chromosomes. Oestrogen (the female sex hormone) also seems to <a href="https://www.nature.com/articles/nri.2016.90">strengthen</a> the immune response, and as levels vary throughout the lifespan, so does <a href="https://www.science.org/doi/10.1126/sciimmunol.aan2946">the strength</a> of women’s immune systems. Men are certainly more likely to die from some infectious diseases, such as <a href="https://www.aihw.gov.au/reports/life-expectancy-deaths/deaths-in-australia/contents/covid-10-deaths">COVID</a>. But the picture is less clear with other infections such as the flu, where the incidence and mortality between men and women <a href="https://iris.who.int/bitstream/handle/10665/44401/9789241500111_eng.pdf?sequence=1&isAllowed=y">varies widely</a> between countries and particular flu subtypes and outbreaks. Infection rates and outcomes in men and women can also depend on the way a virus is <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.712688/full">transmitted</a>, the person’s age, and social and behavioural factors. For instance, women seem to be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077589/#R20">practice protective behaviours</a> such as washing their hands, wearing masks or avoiding crowded indoor spaces. Women are also <a href="https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-016-0440-0">more likely</a> to seek medical care when ill. <h2>So men aren’t faking it?</h2> Some evidence suggests men are not over-reporting symptoms, and may take longer to clear an infection. So they may experience man flu more harshly than women with a cold. So cut the men in your life some slack. If they are sick, gender stereotyping is unhelpful, and may discourage men from seeking medical advice.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231161/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/thea-van-de-mortel-1134101">Thea van de Mortel</a>, Professor, Nursing, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-man-flu-and-flu-hint-men-may-not-be-exaggerating-231161">original article</a>. </div>

Body

Why do dogs have different coats? Experts explain – and give grooming tips for different types

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Dog hair comes in many varieties, from shaggy to short, curly to straight. If you live with a dog, you live with their hair – on your couch, in your clothes, it’s everywhere! Beyond colour, have you ever wondered what’s behind the differences in coat type? We actually know quite a lot about why dogs have different coats, and it comes down to their genes. <h2>What are the main coat types in dogs?</h2> The three main features of dog coats are how long the hairs are, whether they are curly or straight, and whether they have extra flourishes. The flourishes are called “furnishings”, and can include a hairy moustache and shaggy eyebrows. Combinations of these three features result in seven different coat types in dogs: short, wire, wire and curly, long, long with furnishings, curly, and curly with furnishings. We know from a <a href="https://www.science.org/doi/abs/10.1126/science.1177808">study of more than 1,000 dogs with varying coats</a> that differences in only three genes are responsible for this variety. The gene responsible for long hair (called FGF5) is <a href="https://learn.genetics.utah.edu/content/basics/patterns">recessive</a>, meaning dogs must have two copies of the mutated gene to have long hair. <a href="https://doi.org/10.1073/pnas.1402862111">In humans</a>, the same gene has been identified in families with excessively long eyelashes. Curly coats in dogs are related to a gene called <a href="https://www.pawprintgenetics.com/products/tests/details/173/">KRT71</a>, which affects keratin, a protein involved in hair formation. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974189/">Mutations in this gene</a> in cats result in hairless (Sphynx) or curly-haired (Devon Rex) breeds. The gene responsible for furnishings (<a href="https://medlineplus.gov/genetics/gene/rspo2/">RSPO2</a>) is involved in establishing hair follicles. <a href="https://www.healthline.com/health/hair-follicle">Hair follicles</a> are small pockets in the skin that grow hair. Variations in these three genes could explain the coat type in most (but not all!) of the dogs tested. For example, the long coat of the Afghan hound is not explained by these three genes. Further study is needed to identify less common mutations and genes controlling the coat in these dogs. The earliest dog breeds would have been short-haired, as a result of the “wild-type” genes. Later changes would have arisen through mutation and deliberate selection <a href="https://theconversation.com/managing-mutations-of-a-species-the-evolution-of-dog-breeding-96635">through modern breeding practices</a>. If all three mutations are present, the dog has a long, curly coat with furnishings. An example is the Bichon Frisé. <h2>What else varies in dog coats?</h2> Dog coat types can also be single or double. In a double-coated breed such as a Labrador, there is a longer coarse layer of hairs and a softer and shorter undercoat. Wolves and ancestral dogs are single-coated, and the double coat is a result of a <a href="https://www.mdpi.com/2073-4425/10/5/323">mutation in chromosome 28</a>. In the Labrador, the mutation was probably selected for as they were bred to <a href="https://www.gov.nl.ca/releases/2023/exec/0525n07/">retrieve fishing nets in Canada</a>. The double coat is a great insulator and helps them to stay warm, even in icy water. <h2>Why does it matter what kind of coat a dog has?</h2> We know with climate change our world is going to get hotter. Dogs with a double coat are less able to tolerate heat stress, as their hair prevents heat loss. In a study of dogs <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/avj.13296">suffering heat-related illness</a>, most of the 15 breeds at higher risk had double coats. The death rate in these dogs was 23%. We can only imagine how it must feel going out on a 40 degree day wearing a thick fur coat. Dogs with a double coat shed more hair than dogs with a single coat. This means even short-haired breeds, like the Labrador retriever, can shed an astonishing amount of hair. If you can’t tolerate dog hair, then a dog with a double-coat may not suit you. When we think of wool we think of sheep, but in the past <a href="https://www.si.edu/stories/woolly-dog-mystery-unlocked">woolly dogs were kept for their wool</a> that was <a href="https://www.science.org/doi/10.1126/science.adi6549">woven by Indigenous groups</a> and used to make blankets. A dog’s coat also affects how much time and effort is needed for grooming. Dogs with long or curly hair with furnishings are likely to need more time invested in their care, or visits to a professional groomer. Designer dogs (cross-bred dogs often crossed with a poodle, such as groodles), are likely to be curly with furnishings. In a US study, people with designer dogs reported meeting their dogs’ maintenance and grooming requirements was <a href="https://www.mdpi.com/2076-2615/12/23/3247">much harder than they expected</a>. It’s not just bank balances and the time needed that can suffer. If people are unable to cope with the demands of grooming long-haired dogs, lack of grooming can cause welfare problems. A study of animal cruelty cases in New York found <a href="https://www.frontiersin.org/articles/10.3389/fvets.2022.827348/full">13% involved hair matting</a>, with some hair mats causing strangulation wounds and 93% of affected dogs having long hair. <h2>How can you prevent problems?</h2> If you have a curly- or long-haired breed of dog, it will help to train them to like being brushed from an early age. You can do this by counter-conditioning so they have a positive emotional response to being groomed, rather than feeling anxious. First show the brush or lightly brush them, then give them a treat. They learn to associate being brushed with something positive. If you take your dog to the groomer, it’s very important their first experience is positive. A scary or painful incident will make it much more difficult for future grooming. Is your dog difficult to groom or hard to get out of the car at the groomers? It’s likely grooming is scary for them. Consulting a dog trainer or animal behaviourist who focuses on positive training methods can help a lot. Keeping your dog well groomed, no matter their hair type, will keep them comfortable. More important than looking great, feeling good is an essential part of dogs living their best lives with us.<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/232480/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, Associate Professor, School of Animal and Veterinary Science, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, Research Fellow, Animal Welfare Science Centre, <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/why-do-dogs-have-different-coats-experts-explain-and-give-grooming-tips-for-different-types-232480">original article</a>. </div>

Family & Pets

What are financial years – and why are they different from calendar years?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/michaela-rankin-1544784">Michaela Rankin</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Yesterday was July 1, the first day of the new financial year in Australia. Also called fiscal years, financial years are often abbreviated in print. The one that’s just begun in Australia – July 1 2024 to June 30 2025 – will typically be denoted by FY24/25 or FY25. As the name suggests, financial years are used for financial reporting, tax and budgeting purposes. Whether you are preparing an individual tax return or financial statements for a business, it is important to understand the difference between financial and calendar years. Both have 365 days. But the calendar year, based on the <a href="https://www.timeanddate.com/calendar/gregorian-calendar.html">Gregorian calendar</a>, runs from New Years’ Day on January 1 through to December 31. Australian financial years on the other hand run from July 1 of one year to June 30 the next. But this July to June financial year <a href="https://web.archive.org/web/20200430054150/https:/www.cia.gov/library/publications/the-world-factbook/fields/228.html">does not apply</a> in all countries. Many align their financial year with the calendar year, but others have further variations still. So why are they different, and what does that mean for businesses operating across borders? <h2>Different around the world</h2> In contrast to our own, the United Kingdom’s financial year starts on April 6 each year and runs to April 5 the next. The English and Irish New Year traditionally fell on March 25, when taxes and other accounts were due. But in the 18th century, the British empire switched from the Roman Julian calendar to the Gregorian calendar, and had to <a href="https://www.bowesbrooks.co.uk/why-does-the-tax-year-start-on-6th-april/">adjust the start date</a> to avoid losing tax revenue. India’s fiscal year runs from April 1 until March 31, for a <a href="https://www.idfcfirstbank.com/finfirst-blogs/finance/reasons-why-the-financial-year-starts-from-april">number of reasons</a>. Historically a country that was heavily focused on agriculture, this timeframe aligned with the crop cycle and allowed the government to develop financial plans for the sector. The British empire also influenced the April reporting schedule in India, as prior to independence many financial policies were based on the British system. <h2>Government budgets play a role</h2> In the United States, fiscal years once ran from July 1 to June 30, like Australia’s do now. But in 1974 this was <a href="https://www.federaltimes.com/management/budget/2022/09/20/why-the-us-federal-fiscal-year-2023-starts-in-october/">changed</a> to instead span October 1 to September 30, giving Congress more time to agree on a budget each year. In the US, however, companies can also <a href="https://www.business.com/articles/how-to-decide-on-fiscal-year/">choose their own</a> fiscal years. Some choose a calendar year, but others elect dates that better align with their business cycle. Walmart’s, for example, ends on January 31 each year to reflect its typically strong financial performance over the holiday period at the end of the year. In Australia, the financial year matches government reporting cycles. Unlike the northern hemisphere, our parliamentarians typically take holidays over summer in December and January, which makes meeting over November and December to approve government budgets difficult. The federal budget is issued in May for the following financial year, giving parliament time to consider it before the new fiscal year begins. <h2>Comparing (and taxing) performance</h2> Regardless of the time period over which a financial year operates, its primary purpose is to provide a standardised time frame for financial reporting. Financial years allow income and expenses to be tracked and compared over the same timeframe each year. This allows investors to compare business performance across consistent periods. They are also used to determine the collection of personal income tax. Our government uses this information to calculate the amount of tax it will collect through the Australian Taxation Office each year. Businesses with operations spanning multiple countries may have to contend with fiscal years that do not align. Where this is the case, they may need to choose one financial year for the whole company, typically that used by the parent company. Keeping track of the financial year is helpful for individuals, in knowing when tax returns need to be prepared (and when to expect end-of-financial-year sales). It is also important for businesses to consider the financial year in making budgeting, business and tax planning 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/233655/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michaela-rankin-1544784">Michaela Rankin</a>, Professor and Head, Department of Accounting, <a href="https://theconversation.com/institutions/monash-university-1065">Monash 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/what-are-financial-years-and-why-are-they-different-from-calendar-years-233655">original article</a>. </div>

Money & Banking

What’s the difference between Alzheimer’s and dementia?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Changes in thinking and memory as we age can occur for a variety of reasons. These changes are <a href="https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging#changes">not always cause for concern</a>. But when they begin to disrupt daily life, it could indicate the first signs of dementia. Another term that can crop up when we’re talking about dementia is Alzheimer’s disease, or Alzheimer’s for short. So what’s the difference? <h2>What is dementia?</h2> Dementia is an umbrella term used to describe a range of syndromes that result in changes in memory, thinking and/or behaviour due to degeneration in the brain. To meet the <a href="https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1016/j.jalz.2011.03.005">criteria</a> for dementia these changes must be sufficiently pronounced to interfere with usual activities and are present in at least two different aspects of thinking or memory. For example, someone might have trouble remembering to pay bills and become lost in previously familiar areas. It’s less-well known that dementia can also occur in <a href="https://www.childhooddementia.org/what-is-childhood-dementia">children</a>. This is due to progressive brain damage associated with more than 100 rare genetic disorders. This can result in similar cognitive changes as we see in adults. <h2>So what’s Alzheimer’s then?</h2> <a href="https://www.alz.org/alzheimers-dementia/what-is-alzheimers">Alzheimer’s</a> is the most common type of dementia, accounting for <a href="https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12068">about 60-80%</a> of cases. So it’s not surprising many people use the terms dementia and Alzheimer’s interchangeably. Changes in memory are the most common sign of Alzheimer’s and it’s what the public <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01219-4">most often</a> associates with it. For instance, someone with Alzheimer’s may have trouble recalling recent events or keeping track of what day or month it is. We still don’t know exactly what <a href="https://link.springer.com/article/10.1134/s002689332104004x">causes Alzheimer’s</a>. However, we do know it is associated with a build-up in the brain of two types of protein called <a href="https://www.dementiasplatform.uk/news-and-media/blog/amyloid-and-tau-the-proteins-involved-in-dementia">amyloid-β and tau</a>. While we all have some amyloid-β, when too much builds up in the brain it clumps together, forming plaques in the spaces between cells. These plaques cause damage (inflammation) to surrounding brain cells and leads to disruption in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468450/">tau</a>. Tau forms part of the structure of brain cells but in Alzheimer’s tau proteins become “tangled”. This is toxic to the cells, causing them to die. A <a href="https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180583">feedback loop</a> is then thought to occur, triggering production of more amyloid-β and more abnormal tau, perpetuating damage to brain cells. Alzheimer’s can also occur with other forms of dementia, such as <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">vascular dementia</a>. This combination is the most common example of a <a href="https://www.dementiauk.org/information-and-support/types-of-dementia/mixed-dementia/">mixed dementia</a>. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.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/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=456&fit=crop&dpr=1 600w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=456&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=456&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=573&fit=crop&dpr=1 754w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=573&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=573&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Vascular dementia</h2> The second most common type of dementia is <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">vascular dementia</a>. This results from disrupted blood flow to the brain. Because the changes in blood flow can occur throughout the brain, signs of vascular dementia can be more varied than the memory changes typically seen in Alzheimer’s. For example, vascular dementia may present as general confusion, slowed thinking, or difficulty organising thoughts and actions. Your <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">risk of vascular dementia</a> is greater if you have heart disease or high blood pressure. <h2>Frontotemporal dementia</h2> Some people may not realise that dementia can also affect behaviour and/or language. We see this in different forms of frontotemporal dementia. The behavioural variant of <a href="https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.20090238#:%7E:text=The%20behavioral%20variant%20of%20frontotemporal,often%20delayed%20for%20several%20years.">frontotemporal dementia</a> is the second most common form (after Alzheimer’s disease) of <a href="https://www.healthdirect.gov.au/younger-onset-dementia">younger onset dementia</a> (dementia in people under 65). People living with this may have difficulties in interpreting and appropriately responding to social situations. For example, they may make uncharacteristically rude or offensive comments or invade people’s personal space. <a href="https://www.sciencedirect.com/topics/neuroscience/semantic-dementia">Semantic dementia</a> is also a type of frontotemporal dementia and results in difficulty with understanding the meaning of words and naming everyday objects. <h2>Dementia with Lewy bodies</h2> <a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/dementia-with-lewy-bodies">Dementia with Lewy bodies</a> results from dysregulation of a different type of protein known as α-synuclein. We often see this in people with Parkinson’s disease. So people with this type of dementia may have altered movement, such as a stooped posture, shuffling walk, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428504/">changes in handwriting</a>. Other symptoms include changes in alertness, visual hallucinations and significant <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029467/">disruption to sleep</a>. <h2>Do I have dementia and if so, which type?</h2> If you or someone close to you is concerned, the first thing to do is to <a href="https://cdpc.sydney.edu.au/research/clinical-guidelines-for-dementia/">speak to your GP</a>. They will likely ask you some questions about your medical history and what changes you have noticed. Sometimes it might not be clear if you have dementia when you first speak to your doctor. They may suggest you watch for changes or they may refer you to a specialist for <a href="https://www.nia.nih.gov/health/alzheimers-and-dementia/what-dementia-symptoms-types-and-diagnosis#diagnosis">further tests</a>. There is no single test to clearly show if you have dementia, or the type of dementia. A diagnosis comes after multiple tests, including brain scans, tests of memory and thinking, and consideration of how these changes impact your daily life. Not knowing what is happening can be a challenging time so it is important to speak to someone about how you are feeling or to reach out to <a href="https://www.dementia.org.au/get-support/national-dementia-helpline">support services</a>. <h2>Dementia is diverse</h2> As well as the different forms of dementia, everyone experiences dementia in different ways. For example, the speed dementia progresses varies a lot from person to person. Some people will continue to <a href="https://livingwellwithdementia.org.au">live well with dementia</a> for some time while others may decline more quickly. There is still significant <a href="https://academic.oup.com/gerontologist/article-abstract/64/5/gnad130/7281753">stigma</a> surrounding dementia. So by learning more about the various types of dementia and understanding differences in how dementia progresses we can all do our part to create a more <a href="https://www.dementiafriendly.org.au/">dementia-friendly community</a>. <hr /> The <a href="https://www.dementia.org.au/get-support/national-dementia-helpline">National Dementia Helpline</a> (1800 100 500) provides information and support for people living with dementia and their carers. To learn more about dementia, you can take this <a href="https://www.utas.edu.au/wicking/understanding-dementia">free online course</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225271/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/whats-the-difference-between-alzheimers-and-dementia-225271">original article</a>. </div>

Mind

What’s the difference between vegan and vegetarian?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Vegan and vegetarian diets are <a href="https://link.springer.com/article/10.1007/s00394-023-03086-z">plant-based diets</a>. Both include plant foods, such as fruits, vegetables, legumes and whole grains. But there are important differences, and knowing what you can and can’t eat when it comes to a vegan and vegetarian diet can be confusing. So, what’s the main difference? <h2>What’s a vegan diet?</h2> A <a href="https://link.springer.com/article/10.1007/s00394-023-03086-z">vegan diet</a> is an entirely plant-based diet. It doesn’t include any meat and animal products. So, no meat, poultry, fish, seafood, eggs, dairy or honey. <h2>What’s a vegetarian diet?</h2> A <a href="https://link.springer.com/article/10.1007/s00394-023-03086-z">vegetarian diet</a> is a plant-based diet that generally excludes meat, poultry, ﬁsh and seafood, but can include animal products. So, unlike a vegan diet, a vegetarian diet can include eggs, dairy and honey. But you may be wondering why you’ve heard of vegetarians who eat fish, vegetarians who don’t eat eggs, vegetarians who don’t eat dairy, and even vegetarians who eat some meat. Well, it’s because there are variations on a vegetarian diet: <ul> <li> a lacto-ovo vegetarian diet excludes meat, poultry, fish and seafood, but includes eggs, dairy and honey </li> <li> an ovo-vegetarian diet excludes meat, poultry, fish, seafood and dairy, but includes eggs and honey </li> <li> a lacto-vegetarian diet excludes meat, poultry, fish, seafood and eggs, but includes dairy and honey </li> <li> a pescatarian diet excludes meat and poultry, but includes eggs, dairy, honey, fish and seafood </li> <li> a flexitarian, or semi-vegetarian diet, includes eggs, dairy and honey and may include small amounts of meat, poultry, fish and seafood. </li> </ul> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.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/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=456&fit=crop&dpr=1 600w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=456&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=456&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=573&fit=crop&dpr=1 754w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=573&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=573&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Are these diets healthy?</h2> A <a href="https://academic.oup.com/eurheartj/article/44/36/3423/7224412">2023 review</a> looked at the health effects of vegetarian and vegan diets from two types of study. Observational studies followed people over the years to see how their diets were linked to their health. In these studies, eating a vegetarian diet was associated with a lower risk of developing cardiovascular disease (such as heart disease or a stroke), diabetes, hypertension (high blood pressure), dementia and cancer. For example, in a <a href="https://www.sciencedirect.com/science/article/pii/S0002916523054497?via%3Dihub">study</a> of 44,561 participants, the risk of heart disease was 32% lower in vegetarians than non-vegetarians after an average follow-up of nearly 12 years. Further evidence came from randomised controlled trials. These instruct study participants to eat a specific diet for a specific period of time and monitor their health throughout. These studies showed eating a vegetarian or vegan diet led to reductions in weight, blood pressure, and levels of unhealthy cholesterol. For example, one <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1832195">analysis</a> combined data from seven randomised controlled trials. This so-called meta-analysis included data from 311 participants. It showed eating a vegetarian diet was associated with a systolic blood pressure (the first number in your blood pressure reading) an average 5 mmHg lower compared with non-vegetarian diets. It seems vegetarian diets are more likely to be healthier, across a number of measures. For example, a 2022 <a href="https://link.springer.com/article/10.1007/s00394-022-02942-8">meta-analysis</a> combined the results of several observational studies. It concluded a vegetarian diet, rather than vegan diet, was recommended to prevent heart disease. There is also <a href="https://link.springer.com/article/10.1007/s13668-024-00533-z">evidence</a> vegans are more likely to have bone fractures than vegetarians. This could be partly due to a lower body-mass index and a lower intake of nutrients such as calcium, vitamin D and protein. <h2>But it can be about more than just food</h2> Many vegans, where possible, do not use products that directly or indirectly involve using animals. So vegans would not wear leather, wool or silk clothing, for example. And they would not use soaps or candles made from beeswax, or use products tested on animals. The motivation for following a vegan or vegetarian diet can vary from person to person. Common motivations <a href="https://www.sciencedirect.com/science/article/pii/S2475299123157957">include</a> health, environmental, ethical, religious or economic reasons. And for many people who follow a vegan or vegetarian diet, this forms a central part of their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231820/">identity</a>. <h2>So, should I adopt a vegan or vegetarian diet?</h2> If you are thinking about a vegan or vegetarian diet, here are some things to consider: <ul> <li> eating more plant foods does not automatically mean you are eating a healthier diet. Hot chips, biscuits and soft drinks can all be vegan or vegetarian foods. And many <a href="https://theconversation.com/we-looked-at-700-plant-based-foods-to-see-how-healthy-they-really-are-heres-what-we-found-222991">plant-based alternatives</a>, such as plant-based sausages, can be high in added salt </li> <li> meeting the <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients">nutrient intake targets</a> for vitamin B12, iron, calcium, and iodine requires more careful planning while on a vegan or vegetarian diet. This is because meat, seafood and animal products are good sources of these vitamins and minerals </li> <li> eating a plant-based diet doesn’t necessarily mean <a href="https://theconversation.com/why-you-should-eat-a-plant-based-diet-but-that-doesnt-mean-being-a-vegetarian-78470">excluding</a> all meat and animal products. A healthy flexitarian diet prioritises eating more whole plant-foods, such as vegetables and beans, and less processed meat, such as bacon and sausages </li> <li> the <a href="https://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5">Australian Dietary Guidelines</a> recommend eating a wide variety of foods from the five food groups (fruit, vegetables, cereals, lean meat and/or their alternatives and reduced-fat dairy products and/or their alternatives). So if you are eating animal products, choose lean, reduced-fat meats and dairy products and limit processed meats.<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/225275/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-vegan-and-vegetarian-225275">original article</a>. </div>

Food & Wine

What’s the difference between shyness and social anxiety?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/kayla-steele-1042011">Kayla Steele</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jill-newby-193454">Jill Newby</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations. However, <a href="https://theconversation.com/shyness-isnt-nice-but-shyness-shouldnt-stop-you-28010">feeling shy</a>, or having a shy personality, is not the same as experiencing <a href="https://theconversation.com/explainer-what-is-social-anxiety-disorder-36601">social anxiety</a> (short for “social anxiety disorder”). Here are some of the similarities and differences, and what the distinction means. <h2>How are they similar?</h2> It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others. For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations. People who are shy or socially anxious may <a href="https://theconversation.com/paralysed-with-fear-why-do-we-freeze-when-frightened-60543">respond with</a> “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “<a href="https://theconversation.com/what-is-fawning-how-is-it-related-to-trauma-and-the-fight-or-flight-response-205024">fawn</a>” (by trying to appease or placate others). A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety. For example, both <a href="https://link.springer.com/article/10.3758/s13415-021-00916-7">shy children</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428215/">adults with social anxiety</a> have neural circuits that respond strongly to stressful social situations, such as being excluded or left out. People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.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/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=456&fit=crop&dpr=1 600w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=456&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=456&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=573&fit=crop&dpr=1 754w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=573&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=573&fit=crop&dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>How are they different?</h2> Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder. For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected. To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self. Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder. People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults. Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations. However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations. The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics. The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study. The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness. Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or <a href="https://theconversation.com/what-is-selective-mutism-and-is-it-a-lifelong-condition-219930">refuse to speak</a> in certain situations. If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and <a href="https://theconversation.com/back-to-school-blues-how-to-help-your-child-with-shyness-90228">parental support</a>, patience and guidance, children can be taught <a href="https://theconversation.com/7-tips-to-help-kids-feeling-anxious-about-going-back-to-school-139207">strategies</a> to overcome social anxiety. <h2>Why does the distinction matter?</h2> Social anxiety disorder is a mental health condition that <a href="https://link.springer.com/article/10.1186/s12916-017-0889-2?utm_source=getftr&utm_medium=getftr&utm_campaign=getftr_pilot">persists</a> for people who do not receive adequate support or treatment. Without treatment, it can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/22306132/">difficulties</a> in education and at work, and in developing meaningful relationships. Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness. A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment. Different people have different support needs. However, <a href="https://www.nice.org.uk/guidance/cg159/chapter/Recommendations">clinical practice guidelines</a> recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with <a href="https://theconversation.com/explainer-what-is-exposure-therapy-and-how-can-it-treat-social-anxiety-64483#:%7E:text=Exposure%20therapy%20is%20where%20people,addresses%20the%20underlying%20unhelpful%20thoughts.">exposure therapy</a> (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective <a href="https://theconversation.com/explainer-what-is-exposure-therapy-and-how-can-it-treat-social-anxiety-64483#:%7E:text=Exposure%20therapy%20is%20where%20people,addresses%20the%20underlying%20unhelpful%20thoughts.">in-person</a>, <a href="https://www.semanticscholar.org/paper/Computer-therapy-for-the-anxiety-and-depression-is-Andrews-Basu/25e9ee98a1af8d2780ac3e1f687ebc40ebd1b47c">online</a> and in <a href="https://pubmed.ncbi.nlm.nih.gov/34534800/">brief treatments</a>. <h2>For more support or further reading</h2> Online resources about social anxiety include: <ul> <li> This Way Up’s <a href="https://thiswayup.org.au/programs/social-anxiety-program/">online program</a> for managing excessive shyness and fear of social situations </li> <li> Beyond Blue’s <a href="https://www.beyondblue.org.au/mental-health/anxiety/types-of-anxiety/social-anxiety-disorder">resources</a> on social anxiety </li> <li> a guide to <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Social-Anxiety">looking after yourself</a> if you have social anxiety, from the Western Australian health department </li> <li> social anxiety <a href="https://brave4you.psy.uq.edu.au/">online program for children and teens</a> from the University of Queensland </li> <li> inroads, a <a href="https://inroads.org.au/">self-guided online program</a> for young adults who drink alcohol to manage their anxiety. </li> </ul> <hr /> We thank the Black Dog Institute <a href="https://www.blackdoginstitute.org.au/about/who-we-are/lived-experience/">Lived Experience Advisory Network</a> members for providing feedback and input for this article and our research.<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/225669/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kayla-steele-1042011">Kayla Steele</a>, Postdoctoral research fellow and clinical psychologist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jill-newby-193454">Jill Newby</a>, Professor, NHMRC Emerging Leader & Clinical Psychologist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW 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/whats-the-difference-between-shyness-and-social-anxiety-225669">original article</a>. </div>

Mind

Are young people smarter than older adults? My research shows cognitive differences between generations are diminishing

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> We often assume young people are smarter, or at least quicker, than older people. For example, we’ve all heard that scientists, and even more so mathematicians, <a href="https://www.forbes.com/sites/nextavenue/2014/08/07/who-says-scientists-peak-by-age-50/">carry out their most important work</a> when they’re comparatively young. But my new research, <a href="https://www.sciencedirect.com/science/article/pii/S027322972400008X#:%7E:text=Highlights&text=Three%20review%20studies%20measure%20secular,%2C%20education%2C%20and%20overall%20health.">published in Developmental Review</a>, suggests that cognitive differences between the old and young are tapering off over time. This is hugely important as stereotypes about the intelligence of people in their sixties or older may be holding them back – in the workplace and beyond. Cognitive ageing is often measured by comparing young adults, aged 18-30, to older adults, aged 65 and over. There are a variety of tasks that older adults do not perform well on compared to young adults, such as memory, spatial ability and speed of processing, which often form the basis of <a href="https://theconversation.com/the-iq-test-wars-why-screening-for-intelligence-is-still-so-controversial-81428">IQ tests</a>. That said, there are a few tasks that older people do better at than younger people, such as reading comprehension and vocabulary. Declines in cognition are driven by a process called <a href="https://www.nature.com/collections/cbjacdabdf">cognitive ageing</a>, which happens to everyone. Surprisingly, age-related cognitive deficits start very early in adulthood, and declines in cognition have been measured as dropping in adults as young as just 25. Often, it is only when people reach older age that these effects add up to a noticeable amount. Common complaints consist of walking into a room and forgetting why you entered, as well as difficulty remembering names and struggling to drive in the dark. <h2>The trouble with comparison</h2> Sometimes, comparing young adults to older adults can be misleading though. The two generations were brought up in different times, with different levels of education, healthcare and nutrition. They also lead different daily lives, with some older people having lived though a world war while the youngest generation is growing up with the internet. Most of these factors favour the younger generation, and this can explain a proportion of their advantage in cognitive tasks. Indeed, much existing research shows that <a href="https://theconversation.com/iq-tests-are-humans-getting-smarter-158837">IQ has been improving</a> globally throughout the 20th century. This means that later-born generations are more cognitively able than those born earlier. This is even found when both generations are tested in the same way at the same age. Currently, there is growing evidence that <a href="https://www.pnas.org/doi/10.1073/pnas.1718793115">increases in IQ are levelling off,</a> such that, in the most recent couple of decades, young adults are no more cognitively able than young adults born shortly beforehand. Together, these factors may underlie the current result, namely that cognitive differences between young and older adults are diminishing over time. <h2>New results</h2> My research began when my team started getting strange results in our lab. We found that often the age differences we were getting between young and older adults was smaller or absent, compared to prior research from early 2000s. This prompted me to start looking at trends in age differences across the psychological literature in this area. I uncovered a variety of data that compared young and older adults from the 1960s up to the current day. I plotted this data against year of publication, and found that age deficits have been getting smaller over the last six decades. Next, I assessed if the average increases in cognitive ability over time seen across all individuals was a result that also applied to older adults specifically. Many large databases exist where groups of individuals are recruited every few years to take part in the same tests. I analysed studies using these data sets to look at older adults. I found that, just like younger people, older adults were indeed becoming more cognitively able with each cohort. But if differences are disappearing, does that mean younger people’s improvements in cognitive ability have slowed down or that older people’s have increased? I analysed data from my own laboratory that I had gathered over a seven-year period to find out. Here, I was able to dissociate the performance of the young from the performance of the older. I found that each cohort of young adults was performing to a similar extent across this seven-year period, but that older adults were showing improvements in both processing speed and vocabulary scores. <figure class="align-center "><img src="https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.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/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=333&fit=crop&dpr=1 600w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=333&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=333&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=418&fit=crop&dpr=1 754w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=418&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/591482/original/file-20240501-24-esxcic.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=418&fit=crop&dpr=3 2262w" alt="The figure shows data for a speed-based task where higher scores represent better performance." /><figcaption>The figure shows data for a speed-based task where higher scores represent better performance. <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></figcaption></figure> I believe the older adults of today are benefiting from many of the factors previously most applicable to young adults. For example, the number of children who went to school <a href="https://education-uk.org/history/chapter12.html">increased significantly</a> in the 1960s – with the system being more similar to what it is today than what it was at the start of the 20th century. This is being reflected in that cohort’s increased scores today, now they are older adults. At the same time, young adults have hit a ceiling and are no longer improving as much with each cohort. It is not entirely clear why the young generations have stopped improving so much. Some research has <a href="https://doi.org/10.1016/j.intell.2016.10.002">explored maternal age, mental health and even evolutionary trends</a>. I favour the opinion that there is just a natural ceiling – a limit to how much factors such as education, nutrition and health can improve cognitive performance. These data have important implications for research into dementia. For example, it is possible that a modern older adult in the early stages of dementia might pass a dementia test that was designed 20 or 30 years ago for the general population at that time. Therefore, as older adults are performing better in general than previous generations, it may be necessary to revise definitions of dementia that depend on an individuals’ expected level of ability. Ultimately, we need to rethink what it means to become older. And there’s finally some good news. Ultimately, we can expect to be more cognitively able than our grandparents were when we reach their age.<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/229132/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephen-badham-1531316">Stephen Badham</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/nottingham-trent-university-1338">Nottingham Trent University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-young-people-smarter-than-older-adults-my-research-shows-cognitive-differences-between-generations-are-diminishing-229132">original article</a>. </div>

Mind

What’s the difference between ADD and ADHD?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Around <a href="https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd#:%7E:text=Around%201%20in%20every%2020,have%20symptoms%20as%20an%20adult.">one in 20 people</a> has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood. ADHD is <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">diagnosed</a> when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home. Some people call the condition attention-deficit disorder, or ADD. So what’s the difference? In short, what was previously called ADD is now known as ADHD. So how did we get here? <h2>Let’s start with some history</h2> The <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">first clinical description</a> of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still <a href="https://pubmed.ncbi.nlm.nih.gov/26740929/">presented</a> a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate. Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions. The first DSM, published in 1952, did not include a specific related child or adolescent category. But the <a href="https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420355.dsm-ii">second edition</a>, published in 1968, <a href="https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1009310">included a section</a> on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder. In the early 1980s, the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">third DSM</a> added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity. However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today: <ul> <li>predominantly inattentive</li> <li>predominantly hyperactive-impulsive</li> <li>combined.</li> </ul> <h2>Why change ADD to ADHD?</h2> ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons. First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">initially named</a>, little research had been done to determine the similarities and differences between the two sub-types. The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions? Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours <a href="https://academic.oup.com/shm/article/30/4/767/2919401">may not necessarily be</a> disruptive and challenging but are more likely to be forgetful and daydreamers. <h2>Why do some people use the term ADD?</h2> There was a <a href="https://academic.oup.com/shm/article/30/4/767/2919401">surge of diagnoses</a> in the 1980s. So it’s understandable that some people still hold onto the term ADD. Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits. Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed. <h2>How is ADHD currently diagnosed?</h2> The three sub-types of ADHD, outlined in the DSM-5 are: <ul> <li> predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions </li> <li> predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control </li> <li> combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive. </li> </ul> ADHD diagnoses <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/children-mental-illness">continue to rise</a> among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses. However, some international experts <a href="https://academic.oup.com/shm/article/30/4/767/2919401">contest</a> the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors. Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, Program Director for the Bachelor of Education, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> 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/whats-the-difference-between-add-and-adhd-225162">original article</a>. </div>

Mind

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

<a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Swedish climate activist Greta Thunberg describes herself as having <a href="https://www.theguardian.com/environment/2019/sep/02/greta-thunberg-responds-to-aspergers-critics-its-a-superpower">Asperger’s</a> while others on the autism spectrum, such as Australian comedian Hannah Gatsby, <a href="https://www.theguardian.com/stage/2022/mar/19/hannah-gadsby-autism-diagnosis-little-out-of-whack">describe</a> themselves as “autistic”. But what’s the difference? Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD. Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges. When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of <a href="https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder">autism spectrum disorder</a> is made. <h2>Where do the definitions come from?</h2> The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders. Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4. In 2013, the DSM-5 collapsed both diagnoses into one <a href="https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">autism spectrum disorder</a>. <h2>How did we used to think about autism?</h2> The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder. Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress. Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism. The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech. Today, as a legacy of the recognition of the autism itself, the <a href="https://www.aihw.gov.au/reports/disability/autism-in-australia/contents/autism">majority of people</a> diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability. <h2>What changed with ‘autism spectrum disorder’?</h2> The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term. It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things. The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”. The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in. <h2>Why do some people prefer the old terminology?</h2> Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism. The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, <a href="https://xminds.org/resources/Documents/Web%20files/Aspie%20Criteria%20by%20Attwood.pdf">Tony Attwood and Carol Gray</a>, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges. <h2>What about identity-based language?</h2> A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”. The neurodiversity rights movement describes its aim to <a href="https://researchonline.jcu.edu.au/71531/1/JCU_71531_AAM.pdf">push back</a> against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism. The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments. However the social model contrasts itself against a very outdated medical or clinical model. Current clinical thinking and practice focuses on <a href="https://www.collegianjournal.com/article/S1322-7696(22)00122-6/fulltext">targeted</a> supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism. A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223643/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, Professor of Nursing, School of Health and Human Sciences, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> 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/whats-the-difference-between-autism-and-aspergers-disorder-223643">original article</a>.

Mind

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

<a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Have you ever felt a sudden pang of sadness? A bird seems to stop and look you in the eye. A photo drops out of a messy drawer from long ago, in the mundanity of a weekend spring clean. Your day is immediately derailed, unsettled. You are pulled into something you thought was past. And yet, in being pulled back, you are grateful, reconnected, and grief-stricken all over again. “You’ll get over it”. “Give it time”. “You need time to move on”. These are common cultural refrains in the face of loss. But what if grief doesn’t play by the rules? What if grief is a different thing altogether? We talked to 95 people about their experiences of grief surrounding the loss of a loved one, and <a href="https://journals.sagepub.com/doi/10.1177/00380261241228412">their stories</a> provided a fundamentally different account of grief to the one often presented to us culturally. <h2>Disordered grief?</h2> Grief is often imagined as a time-bound period in which one processes the pain of loss – that is, adjusts to absence and works toward “moving on”. The bereaved are expected to process their pain within the confines of what society deems “normal”. The <a href="https://theconversation.com/explainer-what-is-the-dsm-and-how-are-mental-disorders-diagnosed-9568">DSM-5 psychiatric manual</a> says if grief drags on too long, in fact, it becomes a pathology (a condition with a medical diagnosis). “Prolonged grief disorder” is the name given to “persistent difficulties associated with bereavement that exceeded expected social, cultural, or religious expectations”. While there can be <a href="https://theconversation.com/why-prolonged-grief-should-be-listed-as-a-mental-disorder-4262">value</a> in clinical diagnostic categories such as this, the danger is they put artificial boundaries around emotions. The pathologisation of grief can be deeply alienating to those experiencing it, for whom the pressure to “move on” can be hurtful and counterproductive. The stories we gathered in our research were raw, complex and often fraught. They did not sit comfortably with commonsense understandings of how grief “should” progress. As bereaved daughter Barbara told us: "Grief is not in the little box, it doesn’t even come close to a little box." <h2>Grief starts early</h2> The tendency is to think of grief as something that happens post death. The person we love dies, we have a funeral, and the grief sets in. Then it slowly subsides with the steady march of time. In fact, grief often begins earlier, often in a clinical consultation where the words “terminal” or “nothing more we can do” are used. Or when a loved one is told “go home and get your life in order”. Grief can begin months or even years before bereavement. As the people we interviewed experienced it, loss was also cumulative. The gradual deterioration of a loved one’s health in the years or months before their death imposed other painful losses: the loss of chosen lifestyles, the loss of longstanding relational rhythms, the loss of shared hopes and anticipated futures. Many participants felt their loved ones – and, indeed, the lives they shared with them – slipping away long before their physical deaths. <h2>Living with the dead</h2> Yet the dead do not simply leave us. They remain with us, in memories, rituals and cultural events. From <a href="https://theconversation.com/what-ancient-cultures-teach-us-about-grief-mourning-and-continuity-of-life-86199">Mexico’s Dia de los Muertos</a> to <a href="https://theconversation.com/japans-obon-festival-how-family-commemoration-and-ancestral-worship-shapes-daily-life-179890">Japan’s Opon</a>, festivals of the dead play a key role in cultures around the world. In that way, remembering the dead remains a critical aspect of living. So too does <a href="https://theconversation.com/theres-not-always-closure-in-the-never-ending-story-of-grief-3096">the ongoing experience of grief</a>. Events of this kind are not merely celebratory. They are critical forms through which life and death, joy and grief, are brought together and integrated. The absence of remembering can hold its own trouble, as our participants’ accounts revealed. As bereaved wife Anna explained: "I just find it really frustrating and I do get quite angry and upset sometimes. I know that life goes on. I’d be talking to girlfriends and stuff like that and it’s like they’ve forgotten that I’ve lost my husband. They haven’t, but nothing really changed in their life. But for me, and my family, it has." Part of the problem, here, is the ambivalent role grief plays in advanced industrialised societies like ours. Many of our participants felt pressure to perform resilience or (in clinical terms) to <a href="https://journals.sagepub.com/doi/full/10.1177/1363459317724854">“recover” quickly after loss</a>. But whose interests does a swift recovery serve? An employer’s? Friends who just want to get on with a death-free life? And, even more importantly, mightn’t ongoing connections with the dead enable better living? Might bringing the dead along with us actually make for better deaths and better lives? Many of our participants felt their loved ones remained with them, and experienced their “absent presence” as a source of comfort. Grieving, in this context, involved spending time “with” the dead. Anna described her practice as follows: "I had a diary, so I just write stuff in it about how I’m feeling or something happened and I’ll say to [my deceased husband], it’s all to [my deceased husband], “Do you remember, blah, blah, blah.” I’ll just talk about that memory that I have of that particular time and I find that that helps." <h2>Caring for those who grieve</h2> Grief does not begin at death, but neither do relationships end there. To rush the bereaved through grief – to usher them towards “recovery” and the more comfortable territories of happiness and productivity – is to do them a disservice. And, perhaps more critically, ridding our lives of the dead and grief may, in the end, make for more limited and muted emotional lives.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/223848/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-peterie-564209">Michelle Peterie</a>, Research Fellow, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-talked-to-dozens-of-people-about-their-experience-of-grief-heres-what-we-learned-and-how-its-different-from-what-you-might-think-223848">original article</a>.

Caring

What’s the difference between memory loss and dementia?

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

Mind

Body language expert breaks down royal family's Christmas card

A body language expert has broken down the subtle meanings and messages hidden in the royal family's Christmas card. On Monday, Prince William and Kate Middleton shared their 2023 Christmas card portrait, which features the Prince and Princess of Wales and their three children in a charming black and white photo. While their family portrait was met with <a href="https://oversixty.com.au/lifestyle/family-pets/blah-brutal-reactions-to-royal-family-s-2023-christmas-card" target="_blank" rel="noopener">mixed reactions</a>, royal fans wasted no time in praising the family for their charming photo. Now, body language experts have dived deep into the real meaning behind almost unnoticeable actions taken by the royals in the pic. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C0pf0IXNv15/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C0pf0IXNv15/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a> </div> </blockquote> Body language analyst Judi James told <a href="https://www.thesun.co.uk/royals/24997829/kate-william-christmas-card-body-language-signal/" target="_blank" rel="nofollow noopener" data-ylk="slk:The Sun;elm:context_link;itc:0" data-rapid_p="26" data-v9y="1">The Sun</a> that, "The strong sense of tight, loving ‘uniformed’ grouping and the stark monochrome, plus the relaxed and confident body language looks like the emotional equivalent of them having a moat and drawbridge around them." Judi went on to say that their choice of relaxed outfits - jeans and white button-up shirts - would be an intentional choice as they show "the strength and total confidence of the pared-down family brand here, without all the trimmings and trappings of their royal status." As she notes, "We know they look superb in formalwear and royal regalia but this is the casual and much more relatable version." Judi also claims that Prince William's slight head tilt "suggests a desire to be liked", while "Kate leans into William’s torso to make this a subtly romantic pose too." Meanwhile, according to Judi, the position of Princess Charlotte right in the middle of the family could be intentional, who says "Charlotte looks so much like the late Queen and this central status-rich pose and beautiful smile are like echoes of Elizabeth when she was young." "This effect doesn’t look deliberate but it is still a rather moving message from this family Christmas card." Image credits: Getty Images

Body

Body language expert analyses Hugh Jackman's last public outings with his wife

A body language expert has analysed the last public outings of Hugh Jackman and Deborra-Lee Furness before they <a href="https://www.oversixty.com.au/lifestyle/relationships/hugh-jackman-devastated-after-marriage-split" target="_blank" rel="noopener">announced their split</a> after 27 years of marriage. The couple were spotted at both the Met Gala in New York and Wimbledon in the UK earlier this year, seemingly looking like a perfect loved-up couple. However, Aussie body language expert Louise Mahler said there could be more than meets the eye at their public outings. “These are two people so well rehearsed at being with each other. They lean in together, they move in unison,” Mahler told <a href="https://7news.com.au/entertainment" target="_blank" rel="noopener" data-link-type="article-inline">7Life.</a> Assessing footage from their joint appearance at the Met Gala in May 2023, Mahler noticed that “at one point in the video Hugh goes to walk away and she briefly pulls him back and he stops with no hesitation”. “There is no giveaway whatsoever... and remember, they are both actors." “They are working as a team and showing total harmony.” However, Mahler went on to assess a specific moment from the Met Gala where the couple were gazing at one another head-on. “I’m going to speculate that he has left her because he’s looking at her quickly,” she said. “He still loves her but he’s moving on." “And what I see from her is, ‘I get that you’re moving on, you b******, but I will allow this’,” Mahler speculated about Furness’ body language. Two months after their Met Gala appearance, the couple attended Wimbledon to sit side by side and watch the game. Mahler acknowledged that they looked “a little cranky” but said that they were concentrated on the game and likely had cameras on them “for a long time”. “I don’t see that they’re pulling away from each other in any way,” she said. “In fact, their arms are touching the full length. This is a couple who have been together for 30 years, they know each other. I would say they still love each other, but they’re deciding to go their separate ways.” The Hollywood couple shocked the world on Saturday when they released a statement confirming their separation after being married for 27 years. “We have been blessed to share almost three decades together as husband and wife in a wonderful, loving marriage,” Jackman and Furness told <a href="https://people.com/hugh-jackman-and-deborra-lee-jackman-separate-exclusive-7970286" target="_blank" rel="noopener" data-link-type="article-inline">People</a>. “Our journey now is shifting and we have decided to separate to pursue our individual growth." Image credits: Getty Images

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