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Music and dementia: researchers are still making discoveries about how songs can help sufferers

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rebecca-atkinson-1288605">Rebecca Atkinson</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/ming-hung-hsu-2215063">Ming-Hung Hsu</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> Music is woven into the fabric of our everyday lives. Whether it’s lifting our spirits, pushing us to run faster or soothing us to sleep, we can all <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.713818/full">recognise its power</a>. So it’s no wonder it is increasingly being used in medical treatment. As well as proving very useful in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863265/">cancer treatment</a>, managing <a href="https://www.sciencedirect.com/science/article/pii/S1526590022000153">chronic pain</a> and even helping the brain <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2014.00245/full">recover after a stroke</a>, researchers have also been making great strides in using music to help patients with dementia. It reduces patients’ <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003477/full">anxiety and depression</a>, and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00401-7/fulltext">improves wellbeing</a> both for them and their carers <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/individual-music-therapy-for-depression-randomised-controlled-trial/A1CD72904929CECCB956F4F3B09605AF">by enhancing</a> everyone’s ability to adapt and cope with adversity or stress. <a href="https://www.bamt.org">Music therapy</a> in the form of playing, singing or listening to music can also have a <a href="https://journals.sagepub.com/doi/abs/10.1177/1362361309105660">positive effect</a> on cognitive function – particularly for <a href="https://link.springer.com/article/10.1186/1472-6882-10-39">older adults</a> either with dementia or memory issues. So why does music appear to have such a powerful effect for people with dementia? <h2>Music and the brain</h2> About a decade ago, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053811911013000">researchers discovered that</a> when people listened to music, multiple areas of the brain were involved in processing it. These included the limbic (which processes emotions and memory), cognitive (involved with perception, learning and reaction) and motor areas (responsible for voluntary movement). This challenged preconceptions that music was processed more narrowly in the brain – and helped explain why it has such a unique neurological impact. Not only that, research has shown that music might help <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306987708002880">regenerate the brain</a> and its connections. Many <a href="https://www.nhs.uk/conditions/dementia/about-dementia/causes/">causes of dementia</a> centre around cell death in the brain, raising the possibility that music could help people with dementia by mending or strengthening damaged neural connections and cells. It’s not just any music that has a regenerative effect on the brain, though. <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2016.00103/full">Familiar and favourite music</a> has been shown to have the biggest impact on the way we feel, and is closely linked with memory and emotions. This is because listening to our favourite songs <a href="https://www.nature.com/articles/nn.2726">releases feel-good hormones</a> that give us a sense of pleasure. Curated music playlists of favourite music could be the key in helping us deal with the <a href="https://journals.sagepub.com/doi/full/10.1177/10298649211030318">stress of everyday life</a>. This is relevant to Alzheimer’s and other forms of dementia because researchers have discovered that parts of the brain linked with <a href="https://academic.oup.com/brain/article/138/8/2438/330016">musical memories</a> are less affected by these conditions than other areas of the brain. This explains why memories and experiences that are linked to <a href="https://link.springer.com/article/10.14283/jpad.2018.19">favourite music</a> are often preserved for people with such conditions. Listening to music can also <a href="https://pubmed.ncbi.nlm.nih.gov/34346261/">help manage</a> their experiences of distress, agitation and “<a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/sundowning">sundowning</a>” – where a person is more confused in the afternoon and evening. In a <a href="https://www.sciencedirect.com/science/article/pii/S0197457224002209?utm_campaign=STMJ_219742_AUTH_SERV_PA&utm_medium=email&utm_acid=224973760&SIS_ID=&dgcid=STMJ_219742_AUTH_SERV_PA&CMX_ID=&utm_in=DM500444&utm_source=AC_">small study</a> conducted by us and our colleagues at the Cambridge Institute for Music Therapy Research, we showed just how great of an effect listening to music can have for people with dementia. We found that when people with dementia repeatedly listened to their favourite music, their heart rate and movements changed in direct response. This showed that people’s physical responses were affected by musical features like rhythm and arrangement. Their heart rate also changed when they sang along to music, or when they began reminiscing about old memories or stories while listening to a song or thinking about the music. These changes are important because they show how music affects movement, emotions and memory recall. Studies have also shown that during and after listening to music, people with dementia <a href="https://www.mdpi.com/2076-3425/13/7/1103">experienced less agitation</a>, aggression and anxiety, and their general mood was improved. They even needed less medication when they had regular music sessions. Other researchers have even begun testing the effects of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.4721?casa_token=VufeKQP7aNsAAAAA%3AMSOgiwUQYKqmmrLsUFv9glmSnc5BMxoqeMmmt3HX4BJX2Fs2UKeXjnN2850o1Umz0j1NvmrpQ3W3Pw">music training programmes</a> to support cognition for people with dementia. Results have been promising so far – with adults in the study showing improved executive functioning (problem solving, emotion regulation and attention) compared to those who took part in just physical exercise. So, music is likely to continue to be a useful medical treatment for people with dementia. But based on what we know so far, it’s important that it comes from the patient’s own music collection – and is used alongside other management techniques such as using drugs that can slow the progression of dementia or help manage symptoms to support self-care and wellbeing.<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/239446/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rebecca-atkinson-1288605">Rebecca Atkinson</a>, Researcher in Music Therapy, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/ming-hung-hsu-2215063">Ming-Hung Hsu</a>, Senior Research Fellow, Music Therapy, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin 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/music-and-dementia-researchers-are-still-making-discoveries-about-how-songs-can-help-sufferers-239446">original article</a>. </div>

Mind

Readers response: What’s your best advice for managing medications while travelling?

When taking a trip, many people often have to factor in how their changing schedule will affect their regular medication routines. We asked our readers for their best advice on managing medications while travelling, and the response was overwhelming. Here's what they said. Kristeen Bon - I put each days tablet into small ziplock bags and staple them at one corner. All that goes into one larger ziplock bag and into my toilet bag. I store all the outer packs flat into another ziplock bag and that stays in the zip pack with my first aid kit in the main suitcase. I travel long haul up to six times a year and this is the most manageable way I have found. Diane Green - Firstly, take sufficient supply of all meds to last the time I'm away. I separate morning medications and evening medications. Then it depends on how long I'm away. I have one that needs to be refrigerated. Depending on where I travel, this can entail arranging overnight in the establishment fridge while taking a freezer pack for daytime travel. Irene Varis - Always get a letter from my doctor, with all my prescriptions for when I get overseas. Saves you a lot of trouble! Helen Lunn - Just get the chemist to pack into Medipacks. I usually take an extra week. I alway put some of the packs in my partners baggage incase my bag goes missing and a pack and a doctor’s letter in my hand luggage. Jancye Winter - Always pack in your carry on with prescriptions. Jenny Gordon - Carry a letter from doc with all medications, leave in original packaging. Double check that it isn’t illegal to carry your medication as some countries have strict regulations for things like Codeine. Always carry in carry on as you don’t want them to get lost. Nina Thomas Rogers - Be organised with all your medicines before you leave. Image credits: Shutterstock

Travel Tips

More Australians are using their superannuation for medical procedures. But that might put their financial health at risk

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> A record number of Australians are accessing their superannuation early on compassionate grounds, mainly to fund their own medical procedures – or those of a family member. Some 150,000 Australians have used the scheme in the last five years. Nearly 40,000 people <a href="https://www.ato.gov.au/about-ato/research-and-statistics/in-detail/super-statistics/early-release/compassionate-release-of-super">had applications approved</a> in 2022-23, compared to just under 30,000 in 2018-19 – an increase of 47%. Some people think this flexible use of funds is a good way to ensure people can fund their own medical needs. But more transparency and better oversight is needed. <h2>What are compassionate grounds?</h2> Since July 2018, the Australian Tax Office has administered the early release of superannuation – meaning before <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/super-withdrawal-options#Preservationage">retirement</a> – under certain circumstances, including compassionate grounds. <a href="https://www.ato.gov.au/individuals-and-families/super-for-individuals-and-families/super/withdrawing-and-using-your-super/early-access-to-super/access-on-compassionate-grounds/expenses-eligible-for-release-on-compassionate-grounds">Compassionate grounds</a> for you or your dependant (such as child or spouse) are: <ul> <li>medical treatment or transport</li> <li>modifying your home or vehicle to accommodate special needs for a severe disability</li> <li>palliative care for a terminal illness</li> <li>death, funeral or burial expenses</li> <li>preventing foreclosure or forced sale of your home.</li> </ul> The medical treatment must be for a life-threatening illness or injury, or to alleviate acute or chronic pain, or acute or chronic mental illness. The treatment cannot be “readily available” through the public system. Cosmetic procedures are excluded. You also have to prove you cannot afford to pay part or all of the expenses without accessing your super, for example, by spending your savings, selling assets or getting a loan. People who can access other funding for the expense, such as via the <a href="https://theconversation.com/lists-of-eligible-supports-could-be-a-backwards-step-for-the-ndis-and-people-with-disability-236578">National Disability Insurance Scheme</a>, are ineligible. <h2>Why are people using this scheme more?</h2> The ATO has not explained what is driving the surge. General cost-of-living pressures may play a role. People may have fewer savings to draw on for medical procedures. But the treatments most commonly being accessed using superannuation – fertility treatments, weight loss surgeries and dental care – point to other systemic issues. There have long been issues with IVF and <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086#:%7E:text=The%20real%20reason%20dental%20hasn,has%20a%20structural%20budget%20problem.">dental care</a> not being readily available or funded in the public health system. Weight loss surgeries (including <a href="https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258">bariatric surgery</a>) can help combat potentially life-threatening conditions such as heart disease. Recent <a href="https://www.monash.edu/news/articles/fewer-australians-having-bariatric-surgery-monash-university-led-report">research</a> suggests there has been an overall drop in the number of Australians having bariatric surgeries since 2016. But of those, 95% are performed through the private system. While early access to super can provide individuals access to critical treatment, there are issues with how compassionate grounds are defined and regulated. <h2>Lack of clarity</h2> As my co-author and I <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2021/06/Issue-442-PDF-3-Bhatia-and-Porceddu.pdf">have shown</a>, the vague wording of the <a href="https://www.legislation.gov.au/F1996B00580/2022-09-28/text">Superannuation Industry regulations</a> leaves them worryingly open to interpretation. For example, the meaning of “mental disturbance” is not defined. You may not meet the criteria of having an acute or life-threatening illness, or acute or chronic pain. But if you can show a certain condition causes you acute mental disturbance, you may qualify to release your superannuation early. People accessing their superannuation for IVF use this criterion, for example, by arguing they need to access funds to continue treatment and alleviate the acute mental distress caused by ongoing infertility issues. Two registered medical practitioners are each required to submit a report demonstrating the treatment is needed, and one must be a specialist in the field in which the treatment is required. However, the regulations do not specify clearly that the specialist should have relevant qualifications. In the IVF example, this means the specialist opinion can be provided by a fertility doctor rather than a mental health expert – and that person may stand to profit if they later also provide treatment. <h2>A closed-loop system</h2> Conflict of interest is another major issue. There is nothing in the regulations to stop a medical practitioner – such as a dentist – being involved in all steps and then financially benefiting. They could encourage a patient to access superannuation for a treatment, write the specialist report and then also receive payment for the treatment. Some clinics <a href="https://www.theguardian.com/australia-news/2024/apr/06/online-ads-promote-simple-access-to-super-to-pay-for-healthcare-despite-strict-rules">promote</a> accessing superannuation as an option to pay for expensive treatments. This raises important questions about the independence of the process, as well as professional ethics. Medical practitioners making recommendations for early release of superannuation should be doing so on genuinely compassionate grounds. But the potential for exploitation remains an ethical concern, when a practitioner can financially benefit from recommending early access to nest egg funds. Transparency around potential <a href="https://theconversation.com/people-are-using-their-super-to-pay-for-ivf-with-their-fertility-clinics-blessing-thats-a-conflict-of-interest-161278">conflicts of interest</a> are impossible to ensure without proper oversight. <h2>What is needed?</h2> 1. Mandatory financial counselling The ATO <a href="https://www.theage.com.au/healthcare/worrying-trend-record-number-of-australians-raid-super-to-fund-medical-treatments-20240920-p5kc44.html">has warned</a> accessing super early is not “free money”, with a spokesperson urging people to get financial advice. But the law should go a step further and make this compulsory. That way people making decisions during an emotionally charged moment can understand any future implications. 2. Tightening of the criteria Greater clarity in the legislation – such as defining “mental disturbance” – would help prevent loopholes being exploited. 3. Better oversight Less health-care industry involvement would promote greater transparency and independence. An independent body of medical practitioners could assess applications rather than practitioners who could financially benefit if applications are approved. This would help alleviate perceived and actual conflicts of interest. Accessing superannuation early may be the only option for some people to start a family or access other life-changing medical care. But they should be able to make this decision in a fully informed way, safeguarded from exploitation and aware of the implications for their future.<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/239588/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, Associate Professor in Law, <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/more-australians-are-using-their-superannuation-for-medical-procedures-but-that-might-put-their-financial-health-at-risk-239588">original article</a>. </div>

Money & Banking

New research proves travelling can slow down the ageing process

It turns out that going on holiday is good for you in more ways than one. According to new research conducted at Edith Cowan University in Western Australia, travelling can actually slow the ageing process both physically and mentally. The study, published in the <a title="Journal of Travel Research" href="https://journals.sagepub.com/doi/10.1177/00472875241269892#:~:text=The%20principle%20of%20entropy%20increase%20provides%20a%20dynamic%20perspective%20to,Silva%20%26%20Annamalai%2C%202008)." target="_blank" rel="noopener">Journal of Travel Research</a>, is believed to be the first-ever that applied the theory of entropy - the general trend of the universe towards death and disorder – to tourism. "Tourism isn't just about leisure and recreation. It could also contribute to people's physical and mental health," ECU PhD candidate Fangli Hu said. "Ageing, as a process, is irreversible. While it can't be stopped, it can be slowed down." According to the research, travelling, exploring new corners of the world and engaging in unique and relaxing activities can stimulate stress responses and elevate metabolic rates, positively influencing metabolic activities and the body's self-organising capabilities. "Leisurely travel activities might help alleviate chronic stress, dampen over-activation of the immune system, and encourage normal functioning of the self-defence system," Fangli added. While some people prefer relaxing holidays, others prefer to stay on their feet and keep active during their travels, enjoying the many well-known benefits of exercise. It can "enhance the body's immune function and self-defence capabilities, bolstering its hardiness to external risks". In response to their study, the experts suggested that "travel therapy could serve as a groundbreaking health intervention." Despite the positive results of the research, experts also warned that travelling can exposed to infectious diseases, accidents, injuries, violence, water and food safety issues, and concerns related to inappropriate tourism engagement, which in turn will have the opposite effect on our health. "Conversely, tourism can involve negative experiences that potentially lead to health problems, paralleling the process of promoting entropy increase," Fangli said. Image credits: Shutterstock

Travel Tips

John Boland’s battle against prostate cancer and the urgent need for reform

John Boland, a 74-year-old retired Navy Reserve Lieutenant Commander, found himself at a crossroads – a place where hope and despair often meet in the lives of those battling life-threatening illnesses like prostate cancer. Diagnosed five years ago, John’s journey has been a relentless fight against a disease that, despite medical advancements, still claims the lives of 10 men in Australia every day. After undergoing surgery and 37 rounds of radiation therapy, John’s battle was far from over. His PSA (Prostate-Specific Antigen) levels, an indicator of prostate cancer activity, were not dropping sufficiently, signalling that the fight was only getting tougher. It was then that John was introduced to a groundbreaking treatment: Lutetium-177 PSMA therapy (LuPSMA), a targeted radionuclide therapy with pinpoint accuracy to attack cancer cells. This innovative treatment offered a glimmer of hope, a chance to strike at the heart of the disease that had disrupted his life. But there was a catch – the cost. Each round of LuPSMA treatment costs $10,000, and while some patients may require up to eight rounds, John’s doctors recommended two based on his response. Even so, the financial burden was immense, forcing John to dip into his superannuation, ultimately spending $60,000 on the treatment that was not covered by insurance. Despite the financial strain, the results were nothing short of miraculous. After just the first round, John’s PSA levels dropped by a staggering 95%. After the second, they fell to nearly zero. The treatment had not only attacked the cancer but had also restored his quality of life, allowing him to once again enjoy the simple pleasures – time with family, daily activities and even golf. It was a victory that brought renewed hope and confidence for the future, a victory that made the $60,000 investment worth every cent. “My case was remarkably successful after the second treatment, which are eight weeks apart, after the scan had no cancer, and my PSA was effective to zero. So it was a reliable result for me and a huge boost, but unfortunately, they're $10,000 a time, and you can require up to eight treatments,” says John. “Fortunately we were able to fund it from our superannuation pension account, the $20,000, but I imagine that a lot of people, they can’t find that $20,000.” But John’s story, while inspiring, also highlights a grim reality: many Australians are not as fortunate. The LuPSMA treatment that worked so well for John remains out of reach for many others due to its prohibitive cost. And this isn’t just an isolated issue; it’s a systemic problem affecting thousands of men across the country. A new report, the <a href="https://www.pcfa.org.au/media/nbennwom/aus-np-1123-80001-amgen-access-gap-report_april-2024-data-final-approved.pdf" target="_blank" rel="noopener">Australian Patient Access Gap Report</a>, has shed light on the alarming delay in the public availability of new medicines in Australia. The report reveals that Australians with life-threatening illnesses are waiting an average of 591 days – more than 18 months – for access to new, potentially life-saving medicines. For some, the wait can be as long as three years. These delays are not just statistics; they represent real people, real lives hanging in the balance. The Prostate Cancer Foundation of Australia (PCFA), the country’s leading organisation in the fight against prostate cancer, is calling for urgent reform. They argue that the current system, which often requires multiple rounds of review before new treatments are approved for public use, is failing Australians. PCFA CEO Anne Savage points out that while 10 men die from prostate cancer every day, the approval process for new treatments drags on, leaving patients like John Boland to fend for themselves – often at great financial and emotional cost. “In almost every instance, Australians are being denied access to new medicines that can extend and save their lives, simply because our approval systems have not kept up with the pace of change,” she says. “In relation to prostate cancer, applications typically undergo two or three rounds of review before achieving a positive recommendation, while 10 men die a day from the disease. It’s simply not good enough.” John’s story serves as a strong call to action. His successful treatment with LuPSMA is a testament to the power of modern medicine, but it also underscores the urgent need for change. No one should have to choose between their life savings and their life; it’s time for Australia to modernise its pharmaceutical benefits scheme, ensuring that all Australians, regardless of their financial situation, have access to the treatments they need. As we move forward, the PCFA is urging Australians to take part in initiatives like <a href="https://www.thelongrun.org.au/" target="_blank" rel="noopener">The Long Run</a> during Prostate Cancer Awareness Month in September, raising awareness and funds to support the fight against this devastating disease. For John Boland, and for the thousands of others who share his struggle, we must work towards a future where no one is left behind in the fight against cancer. Image: Courtesy of John Boland.

Caring

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Migraine is many things, but one thing it’s not is “just a headache”. “Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided. Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function. Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.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/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands. In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect. <iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Aspirin For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication. Triptans For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”. Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack. However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers. <h2>What about preventing migraines?</h2> The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol. Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives. Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached. It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more. <hr /> <iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>‘Nothing works for me!’</h2> In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP. The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections. These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist. Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away. Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives. Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<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/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>. </div>

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Our research shows 4 in 10 Australians in aged care are malnourished. What can we do about it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> In the next 40 years <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150-fs.pdf">in Australia</a>, it’s predicted the number of Australians aged 65 and over will more than double, while the number of people aged 85 and over will more than triple. If you’re not really interested in aged care, you should be. Given these figures, you will almost certainly be engaging with aged care services at some stage – either for yourself, or supporting family members or friends seeking aged care. One service you are likely to encounter is residential aged care homes. In the past few years this sector has been under more scrutiny than ever before. Changes to legislation, workforce and funding are in motion. But the question remains as to whether these changes can happen fast enough to meet our ageing population’s needs. One area of need not being adequately met at present is nutrition. In a <a href="https://www.mdpi.com/2227-9032/12/13/1296">new study</a>, we’ve found four in ten older Australians living in residential aged care are not receiving enough of the right types of nutrients, resulting in loss of weight and muscle. This is known as malnutrition. <h2>Good nutrition is essential for healthy ageing</h2> Malnutrition in older people is <a href="https://www.agedcarequality.gov.au/providers/food-nutrition-dining/why-meals-matter">associated with</a> poorer overall health, such as increased risk of falls and infections. This can accelerate loss of independence for older people, including the need for extra assistance with basic activities such as bathing and dressing. Older people are at increased risk of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)02612-5/abstract">malnutrition</a> for a range of reasons. These can include decreased appetite, difficulties with chewing and swallowing, and the presence of other chronic diseases such as Parkinson’s disease or dementia. Importantly, ensuring adequate nutrition is about more than just offering healthy foods. We eat not only to meet nutritional requirements, but for enjoyment and socialisation. We each have different preferences around what we want to eat, when and with whom. Food provision poses a challenge for residential aged care providers who must navigate the range of residents’ preferences together with dietary restrictions and texture modifications. This must also be balanced against the practicalities of having the right number of appropriately trained kitchen and mealtime assistance staff, and working within funding constraints. Understanding more about who is malnourished in aged care can help providers better address this problem. <h2>Malnutrition is an ongoing problem in aged care</h2> We looked at more than 700 aged care residents in New South Wales, Queensland and South Australia. We assessed participants for malnutrition using a screening tool that collects data on medical history and dietary intake, and includes a physical examination of muscle and fat. We found 40% were malnourished, including 6% who were severely malnourished. This likely underestimates the true rate of malnutrition, as residents with dementia were excluded. International <a href="https://www.mdpi.com/2072-6643/15/13/2927">studies</a> have shown an average of 80% of aged care residents with dementia are malnourished or at risk of developing malnutrition. Our findings are broadly in line with a synthesis of <a href="https://www.sciencedirect.com/science/article/pii/S0378512219301148">38 international studies</a>, which reported an average malnutrition rate in residential aged care of 52%. In Australia, malnutrition was highlighted as <a href="https://www.royalcommission.gov.au/aged-care">a priority</a> for immediate attention in the 2021 Royal Commission into Aged Care Quality and Safety. Its report cited <a href="https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/dairy-food-supplementation-may-reduce-malnutrition-risk-in-institutionalised-elderly/52E93ADD586C634A3913A2AFE9D07847">an Australian study</a> of 215 residents, published in 2017, which found 68% were malnourished or at risk of malnutrition. It’s difficult to directly compare malnutrition rates between studies due to differences in diagnostic measurements. But it’s clear malnutrition is an ongoing challenge in aged care. <h2>What can we do about it?</h2> Since the royal commission, we’ve seen the strengthening of the <a href="https://www.agedcarequality.gov.au/providers/quality-standards/strengthened-quality-standards">quality standards</a> to be included in the new Aged Care Act, anticipated to be introduced to parliament in 2025. The strengthened quality standards provide an important framework to guide action by aged care providers on malnutrition. Key requirements include partnering with residents to design food options, regular assessment and reassessment of resident nutrition requirements, developing systems to monitor and improve satisfaction with food, designing pleasant dining environments, and providing staff with the training they need to achieve all of the above. However, achieving these standards will require investment of money and time. At the moment, <a href="https://kpmg.com/au/en/home/insights/2023/09/australian-aged-care-sector-analysis.html">64% of residential aged care providers</a> in Australia are operating at a financial loss. While we know carers and facility managers want to provide the best care possible, it’s difficult to achieve this when contending with underlying financial problems. As such, our teams at Monash and Griffith universities are focusing on strategies that minimise the burden on staff and providers. We are working on automating malnutrition screening. Current tools take 10–15 minutes and should be used when a new resident moves into an aged care home and regularly during their stay. But anecdotal evidence suggests providers lack the staff and funding needed to routinely carry out this screening. Instead, we aim to use existing data from aged care providers, including quarterly reports from the <a href="https://www.health.gov.au/our-work/qi-program">National Aged Care Mandatory Quality Indicator Program</a>, to detect malnutrition automatically. This will allow staff to focus more on care. Given the complexity of malnutrition, it’s likely that addressing the issue at a national scale will take some time. In the short term, for those with loved ones in aged care homes, we encourage you to be actively involved in their care, including noticing and speaking up if you think more can be done to optimise their nutrition.<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/235507/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jonathan-foo-1551045">Jonathan Foo</a>, Lecturer, Physiotherapy, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> and <a href="https://theconversation.com/profiles/marie-claire-oshea-1373994">Marie-Claire O'Shea</a>, Senior Lecturer, School of Health Sciences and Social Work, <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/our-research-shows-4-in-10-australians-in-aged-care-are-malnourished-what-can-we-do-about-it-235507">original article</a>. </div>

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Major breakthrough holds the key to diagnosing Alzheimer's

A new study has found that a simple blood test could be key to diagnosing Alzheimer's more quickly and more accurately. The research, published on the Journal of the American Medical Association, was conducted by a team of scientists at Sweden’s Lund University, was based off 1213 patients there with the condition. They found that a blood test could correctly identify whether patients with memory problems had Alzheimer’s 90 per cent of the time – making it “significantly” more accurate than cognitive tests and CAT scans in diagnosing the condition. The test itself measures tau protein 217, which if there is an abnormal build up of both in and around brain cells, may be the cause of the disease. “Increases in p tau-217 concentrations in the blood are quite profound in Alzheimer’s disease,” study co-author, Lund University associate professor and senior consultant neurologist, Dr Sebastian Palmqvist, told CNN. “At the dementia stage of the disease, levels are more than eight times higher compared with elderly (people) without Alzheimer’s.” As part of the study, the p tau-217 test was combined with one testing for another blood biomarker for Alzheimer’s called the amyloid 42/40 ratio. Other doctors have shared their thoughts on the research findings, with Chief science officer of America’s Alzheimer’s Association, Dr Maria Carrillo, telling CNN that doctors would “love to have a blood test that can be used in a primary care physician’s office, functioning like a cholesterol test but for Alzheimer’s”. “The p tau-217 blood test is turning out to be the most specific for Alzheimer’s and the one with the most validity. It seems to be the frontrunner,” she added. Blood tests like this could “change the game in the speed in which we can conduct Alzheimer’s trials and get to the next new medication”. Dr Jason Karlawish, the co-director at the University of Pennsylvania’s Penn Memory Centre, said of the research: “Not too long ago measuring pathology in the brain of a living human was considered just impossible.” “This study adds to the revolution that has occurred in our ability to measure what’s going on in the brain of living humans.” Image: Shutterstock

Caring

Taking too many medications can pose health risks. Here’s how to avoid them

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a> When we see an older family member handling a bulky box of medications sorted by day of the week, we might stop and wonder, is it too much? How do all those pills interact? The fact is, as we get older we are more likely to develop different chronic illnesses that require us to take several different medications. This is known as polypharmacy. The concept applies to people taking five or more medications, but there are all sorts of <a href="https://doi.org/10.3390/pharmacy7030126">definitions with different thresholds</a> (for example, four, 10 or 15 medicines). I’m a pharmacist and pharmacoepidemiologist interested in polypharmacy and its impact on the population. The research I carry out with my team at the Faculty of Pharmacy at Université Laval focuses on the appropriate use of medication by older family members. We have published this <a href="https://doi.org/10.1093/ageing/afac244">study</a> on the perceptions of older adults, family carers and clinicians on the use of medication among persons over 65. <h2>Polypharmacy among older adults</h2> Polypharmacy is very common among older adults. In 2021, a quarter of persons over 65 in Canada were prescribed <a href="https://www.cihi.ca/en/drug-use-among-seniors-in-canada">more than ten different classes of medication</a>. In Québec, persons over 65 used an average of <a href="https://www.inspq.qc.ca/sites/default/files/publications/2679_portrait_polypharmacie_aines_quebecois.pdf">8.7 different drugs in 2016</a>, the latest year available for statistics. Is it a good idea to take so many drugs? According to <a href="https://journals.sagepub.com/doi/10.1177/07334648211069553">our study</a>, the vast majority of seniors and family caregivers would be willing to stop taking one or more medications if the doctor said it was possible, even though most are satisfied with their treatments, <a href="https://doi.org/10.1093/ageing/afac244">have confidence in their doctors</a> and feel that their doctors are taking care of them to the best of their ability. In the majority of cases, medicine prescribers are helping the person they are treating. Medications have a positive impact on health and are essential in many cases. But while the treatment of individual illnesses is often adequate, the whole package can sometimes become problematic. <h2>The risks of polypharmacy: 5 points to consider</h2> When we evaluate cases of polypharmacy, we find that the quality of treatment is often compromised when many medications are being taken. <ol> <li> Drug interactions: polypharmacy increases the risk of drugs interacting, which can lead to undesirable effects or reduce the effectiveness of treatments. </li> <li> A drug that has a positive effect on one illness may have a negative effect on another: what should you do if someone has both illnesses? </li> <li> The greater the number of drugs taken, the greater the risk of undesirable effects: for adults over 65, for example, there is an increased risk of confusion or falls, which have significant consequences. </li> <li> The more medications a person takes, the more likely they are to take a <a href="https://www.doi.org/10.1093/fampra/cmz060">potentially inappropriate medication</a>. For seniors, these drugs generally carry more risks than benefits. For example, benzodiazepines, medicine for anxiety or sleep, are the <a href="https://www.inspq.qc.ca/sites/default/files/publications/2575_utilisation_medicaments_potentiellement_inappropries_aines.pdf">most frequently used class</a> of medications. We want to reduce their use as much as possible <a href="https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/benzodiazepines.html">to avoid negative impacts</a> such as confusion and increased risk of falls and car accidents, not to mention the risk of dependence and death. </li> <li> Finally, polypharmacy is associated with various adverse health effects, such as an <a href="https://www.doi.org/10.1007/s41999-021-00479-3">increase in frailty, hospital admissions and emergency room visits</a>. However, studies conducted to date have not always succeeded in isolating the effects specific to polypharmacy. As polypharmacy is more common among people with multiple illnesses, these illnesses may also contribute to the observed risks. </li> </ol> Polypharmacy is also a combination of medicines. There are almost as many as there are people. The risks of these different combinations can vary. For example, the risks associated with a combination of five potentially inappropriate drugs would certainly be different from those associated with blood pressure medication and vitamin supplements. Polypharmacy is therefore complex. <a href="https://doi.org/10.1186/s12911-021-01583-x">Our studies attempt to use artificial intelligence</a> to manage this complexity and identify combinations associated with negative impacts. There is still a lot to learn about polypharmacy and its impact on health. <h2>3 tips to avoid the risks associated with polypharmacy</h2> What can we do as a patient, or as a caregiver? <ol> <li> Ask questions: when you or someone close to you is prescribed a new treatment, be curious. What are the benefits of the medication? What are the possible side effects? Does this fit in with my treatment goals and values? How long should this treatment last? Are there any circumstances in which discontinuing it should be considered ? </li> <li> Keep your medicines up to date: make sure they are all still useful. Are there still any benefits to taking them? Are there any side effects? Are there any drug interactions? Would another treatment be better? Should the dose be reduced? </li> <li> Think about de-prescribing: this is an increasingly common clinical practice that involves stopping or reducing the dose of an inappropriate drug after consulting a health-care professional. It is a shared decision-making process that involves the patient, their family and health-care professionals. The <a href="https://www.deprescribingnetwork.ca">Canadian Medication Appropriateness and Deprescribing Network</a> is a world leader in this practice. It has compiled a number of tools for patients and clinicians. You can find them on their website and subscribe to the newsletter. </li> </ol> <h2>Benefits should outweigh the risks</h2> Medications are very useful for staying healthy. It’s not uncommon for us to have to take more medications as we age, but this shouldn’t be seen as a foregone conclusion. Every medication we take must have direct or future benefits that outweigh the risks associated with them. As with many other issues, when it comes to polypharmacy, the saying, “everything in moderation,” frequently applies.<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/230612/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caroline-sirois-1524891">Caroline Sirois</a>, Professor in Pharmacy, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</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/taking-too-many-medications-can-pose-health-risks-heres-how-to-avoid-them-230612">original article</a>. </div>

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Trying to save money? Our research suggests paying in cash – while you still can

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lachlan-schomburgk-1535737">Lachlan Schomburgk</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/alex-belli-1538870">Alex Belli</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/arvid-o-i-hoffmann-1150527">Arvid O. I. Hoffmann</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Cash is in crisis. In Australia, it’s now only used for 16% of in-person transactions, down from <a href="https://www.rba.gov.au/publications/bulletin/2023/jun/cash-use-and-attitudes-in-australia.html">about 70%</a> in 2007. The situation is so dire that on Monday, independent federal MP Andrew Gee introduced a <a href="https://www.smh.com.au/politics/federal/saving-the-lobster-prawn-and-pineapple-mps-fight-to-force-shops-to-take-cash-20240603-p5jit4.html">private member’s bill</a> that would force businesses to accept cash or else face big fines. The reality is that over the past decade, technological advancements have utterly transformed the way we pay for goods and services. Phones and smartwatches can now easily be used to pay by card, and buy-now-pay-later schemes and cryptocurrency payments offer further alternatives. The shift away from cash only <a href="https://www.worldbank.org/en/news/press-release/2022/06/29/covid-19-drives-global-surge-in-use-of-digital-payments">accelerated</a> throughout the COVID pandemic, as health experts recommended avoiding using it for hygiene reasons. Despite these big changes in how we spend money, Australians have perhaps been more focused on how much amid a stubborn cost-of-living crisis. In light of this, our research team wanted to investigate how our choice of payment method can interact with our actual spending habits. Our <a href="https://www.sciencedirect.com/science/article/pii/S0022435924000216#bib0104">latest research</a> offers a simple solution for anyone looking to save money — carry more cash! <h2>We pay less when we pay cash</h2> Drawing on both academic and industry sources, our research team combined the results from more than four decades of prior research on spending behaviour and payment methods into a large dataset. This data spanned 71 research papers, 17 countries, and more than 11,000 participants. State-of-the-art meta-analysis techniques then allowed us to collectively analyse the results from all these prior studies, and re-examine their insights. We found that cashless payments were indeed associated with higher levels of consumer spending compared to cash transactions, something that is referred to in the literature as the “cashless effect”. This cashless effect was consistent across all other payment methods in the data set. Put simply, it doesn’t matter whether you use a credit card, debit card or a buy-now-pay-later service – you are likely to spend more money using cashless methods than when you pay with cash. <h2>The pain of paying</h2> Under the traditional economic view that consumers behave rationally, there should be no differences in spending behaviour between different payment methods – money is money after all. But the existence of the cashless effect shows that the payment methods we use do indeed influence our spending behaviour. The leading theory to explain this effect attributes it to differences in the “pain of paying”, a concept <a href="https://www.researchgate.net/publication/280711796_The_Pain_of_Paying">first coined in 1996</a> that describes the emotions we feel when spending money. Importantly, our choice of payment method can influence the level of pain felt. When paying with cash, we have to physically count out notes and coins and hand them over. Humans seek to avoid losses, and paying by cash sees us physically lose a tangible object. Conversely, nothing has to be handed over to pay cashlessly. We don’t lose anything tangible with a swipe or a tap, so it feels less painful. Preliminary neurological evidence suggests that the “pain of paying” isn’t just an abstract metaphor, and we may feel actual psychological pain with each transaction we make. <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2901808">Research</a> employing functional magnetic resonance imaging (fMRI) scans to observe brain activity in consumers has shown that paying activates brain regions related to experiencing psychological discomfort. Picture this: You’re at a theme park, excited for a fun day. You use your smartwatch to pay for snacks, souvenirs and rides. It’s all so convenient that you don’t realise how much you’re spending until you check your account later and see that you have completely blown your budget! This is the cashless effect in action − if nothing is physically handed over, it’s easy to lose track of how much is spent. <h2>A great tool for budgeting – while it lasts</h2> The cost of living crisis has made spending control front-of-mind for many people. Our meta-analysis suggests that returning to “cold hard cash” whenever possible could be one valuable tool to help. The increased friction felt when using cash could help people better control their money, even just by providing a moment to pause and consider whether a transaction is necessary. This could help individuals make more mindful decisions, saving money while they can in an increasingly cashless world.<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/231499/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lachlan-schomburgk-1535737">Lachlan Schomburgk</a>, PhD Researcher in Marketing, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/alex-belli-1538870">Alex Belli</a>, Senior Lecturer in Marketing, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/arvid-o-i-hoffmann-1150527">Arvid O. I. Hoffmann</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</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/trying-to-save-money-our-research-suggests-paying-in-cash-while-you-still-can-231499">original article</a>. </div>

Money & Banking

‘Sleeping on it’ really does help and four other recent sleep research breakthroughs

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</a> Twenty-six years. That is roughly <a href="https://www.nature.com/articles/s41467-022-34624-8">how much of our lives</a> are spent asleep. Scientists have been trying to explain why we spend so much time sleeping since at least the <a href="https://plato.stanford.edu/entries/alcmaeon/">ancient Greeks</a>, but pinning down the exact functions of sleep has proven to be difficult. During the past decade, there has been a surge of interest from researchers in the nature and function of sleep. New experimental models coupled with advances in technology and analytical techniques are giving us a deeper look inside the sleeping brain. Here are some of the biggest recent breakthroughs in the science of sleep. <h2>1. We know more about lucid dreaming</h2> No longer on the fringes, the neuroscientific study of dreaming has now become mainstream. US researchers in a 2017 study woke their participants up at regular intervals during the night and asked them what was going through their minds prior to the alarm call. Sometimes participants couldn’t recall any dreaming. The study team then looked at what was <a href="https://www.nature.com/articles/nn.4545">happening in the participant’s brain</a> moments before waking. Participants’ recall of dream content was associated with increased activity in the posterior hot zone, an area of the brain closely <a href="https://www.nature.com/articles/d41586-018-05097-x">linked to conscious awareness</a>. Researchers could predict the presence or absence of dream experiences by monitoring this zone in real time. Another exciting development in the study of dreams is research into lucid dreams, in which <a href="https://theconversation.com/the-ability-to-control-dreams-may-help-us-unravel-the-mystery-of-consciousness-52394">you are aware that</a> you are dreaming. A 2021 study established <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00059-2?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982221000592%3Fshowall%3Dtrue">two-way communication</a> between a dreamer and a researcher. In this experiment, participants signalled to the researcher that they were dreaming by moving their eyes in a pre-agreed pattern. The researcher read out maths problems (what is eight minus six?). The dreamer could respond to this question with eye movements. The dreamers were accurate, indicating they had access to high level cognitive functions. The researchers used <a href="https://www.mayoclinic.org/tests-procedures/polysomnography/about/pac-20394877">polysomnography</a>, which monitors bodily functions such as breathing and brain activity during sleep, to confirm that participants were asleep. These discoveries have dream researchers excited about the future of “interactive dreaming”, such as practising a skill or solving a problem in our dreams. <h2>2. Our brain replays memories while we sleep</h2> This year marks the centenary of the first demonstration that <a href="https://www.jstor.org/stable/1414040?origin=crossref">sleep improves our memory</a>. However, a 2023 review of recent research has shown that memories formed during the day <a href="https://portlandpress.com/emergtoplifesci/article/7/5/487/233796/Neural-reactivation-during-human-sleep">get reactivated</a> while we are sleeping. Researchers discovered this using machine learning techniques to “decode” the contents of the sleeping brain. <a href="https://www.nature.com/articles/s41467-021-24357-5">A 2021 study</a> found that training algorithms to distinguish between different memories while awake makes it possible to see the same neural patterns re-emerge in the sleeping brain. A different study, also in 2021, found that the more times these patterns re-emerge during sleep, <a href="https://www.nature.com/articles/s41467-021-23520-2">the bigger the benefit</a> to memory. In other approaches, scientists have been able to reactivate certain memories by <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)31035-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219310358%3Fshowall%3Dtrue">replaying sounds</a> associated with the memory in question while the participant was asleep. A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144680/">2020 meta-analysis of 91 experiments</a> found that when participants’ memory was tested after sleep they remembered more of the stimuli whose sounds were played back during sleep, compared with control stimuli whose sounds were not replayed. Research has also shown that sleep strengthens memory for the <a href="https://www.pnas.org/doi/10.1073/pnas.2202657119">most important aspects</a> of an experience, restructures our memories to form <a href="https://www.jneurosci.org/content/40/9/1909">more cohesive narratives</a> and helps us come up with <a href="https://journals.sagepub.com/doi/10.1177/0956797619873344">solutions to problems</a> we are stuck on. Science is showing that sleeping on it really does help. <h2>3. Sleep keeps our minds healthy</h2> We all know that a lack of sleep makes us feel bad. Laboratory sleep deprivation studies, where researchers keep willing participants awake throughout the night, have been combined with <a href="https://www.open.edu/openlearn/body-mind/health/health-sciences/how-fmri-works">functional MRI brain scans</a> to paint a detailed picture of the sleep-deprived brain. These studies have shown that a lack of sleep severely disrupts the <a href="https://www.nature.com/articles/nrn.2017.55">connectivity between</a> different brain networks. These changes include a breakdown of connectivity between brain regions <a href="https://link.springer.com/article/10.1007/s11682-018-9868-2">responsible for cognitive control</a>, and an amplification of those involved in <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(19)30761-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982219307614%3Fshowall%3Dtrue">threat and emotional processing</a>. The consequence of this is that the sleep-deprived brain is worse at <a href="https://academic.oup.com/cercor/article/33/5/1610/6573958">learning new information</a>, <a href="https://academic.oup.com/sleep/article/44/6/zsaa289/6053003">poorer at regulating emotions</a>, and unable to <a href="https://journals.sagepub.com/doi/10.1177/2167702620951511">suppress intrusive thoughts</a>. Sleep loss may even make you less likely to <a href="https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3001733">help other people</a>. These findings may explain why poor sleep quality is so <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13930">ubiquitous in poor mental health</a>. <h2>4. Sleep protects us against neurodegenerative diseases</h2> Although we naturally <a href="https://www.nature.com/articles/s41467-022-34624-8">sleep less as we age</a>, mounting evidence suggests that sleep problems earlier in life <a href="https://jnnp.bmj.com/content/91/3/236">increase the risk</a> of dementia. The build-up of β-amyloid, a <a href="https://www.nhs.uk/conditions/alzheimers-disease/causes/">metabolic waste product</a>, is one of the mechanisms underlying Alzheimer’s disease. Recently, it has become apparent that deep, undisturbed sleep is good for <a href="https://www.science.org/doi/10.1126/sciadv.aav5447">flushing these toxins</a> out of the brain. Sleep deprivation increases the the rate of build-up of β-amyloid in parts of the brain involved in memory, <a href="https://www.pnas.org/doi/full/10.1073/pnas.1721694115">such as the hippocampus</a>. A longitudinal study published in 2020 found that sleep problems were associated with a higher rate of β-amyloid accumulation at a follow-up <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(20)31171-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982220311714%3Fshowall%3Dtrue">four years later</a>. In a different study, published in 2022, sleep parameters <a href="https://elifesciences.org/articles/78191">forecasted the rate</a> of cognitive decline in participants over the following two years. <h2>5. We can engineer sleep</h2> The good news is that research is developing treatments to get a better night’s sleep and boost its benefits. For example, the <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.14035">European Sleep Research Society</a> and the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8986">American Academy of Sleep Medicine</a> recommend cognitive behavioural therapy for insomnia (CBT-I). <a href="https://www.cntw.nhs.uk/services/nctalkingtherapies/what-do-nc-talking-therapies-offer/cbt-i-cbt-for-insomnia/">CBT-I works by</a> identifying thoughts, feelings and behaviour that contribute to insomnia, which can then be modified to help promote sleep. In 2022, a CBT-I app became the <a href="https://www.nice.org.uk/news/article/nice-recommends-offering-app-based-treatment-for-people-with-insomnia-instead-of-sleeping-pills">first digital therapy</a> recommended by England’s National Institute for Health and Care Excellence for treatment on the NHS. These interventions can improve other aspects of our lives as well. A <a href="https://www.sciencedirect.com/science/article/pii/S1087079221001416?via%3Dihub">2021 meta-analysis</a> of 65 clinical trials found that improving sleep via CBT-I reduced symptoms of depression, anxiety, rumination and stress.<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/230484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dan-denis-158199">Dan Denis</a>, Marie Skłodowska-Curie Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-york-1344">University of York</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/sleeping-on-it-really-does-help-and-four-other-recent-sleep-research-breakthroughs-230484">original article</a>. </div>

Body

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

Shannon Noll postpones show due to medical emergency

Shannon Noll has been forced to postpone two of his upcoming shows in Victoria due to a medical emergency. The former Australian Idol winner, 48, took to Instagram to announce that he had to undergo an "emergency procedure" although the exact details of the procedure was kept under wraps. "Hi guys, due to unforeseen circumstances I'm afraid I have to postpone this weekend's shows at Thornbury Theatre and West Gippsland Arts Centre," he began on the post shared on Friday. "I'm so sorry to do this but I had to undergo an emergency procedure yesterday that now prevents me from travelling for the next few days. "Huge apologies again everyone but I look forward to seeing you all at the rescheduled shows soon!" he concluded. Fans took to the comments to wish the star a speedy recovery. "Health comes first, wishing you a speedy recovery," one wrote. "Hope you are back to good health quickly Shannon. All the very best," another added. "Health is the absolute priority - we hope that you’re back fit and fighting very soon!" a third commented. "Get well soon Shannon! Take the time you need to recover," added a fourth. It has been 20 years since the singer rose to fame after becoming a runner-up on the first season of Australian Idol. "To still be a professional musician travelling the country and playing music 20 years later after a singing competition, I'm so thankful and blessed," he told 9Honey. "And it's all because of the support the Australian public has given me over the years, during the ups and downs as well." "It's all because of the public. I'm thankful to them and will be forever," he added. Image: Getty

Caring

How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a> People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">good sleep is imperative</a>. However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health? <a href="https://link.springer.com/article/10.1007/s00125-024-06145-0">Our research</a> attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each. <iframe id="dw4bx" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/dw4bx/" width="100%" height="400px" frameborder="0"></iframe> <h2>Finding the right balance</h2> Current health guidelines recommend you stick to a <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">sensible regime</a> of moderate-to vigorous-intensity physical activity 2.5–5 hours per week. However <a href="https://doi.org/10.1016/j.jacc.2019.02.031">mounting evidence</a> now <a href="https://doi.org/10.2337/dc14-2073">suggests</a> how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping. Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours. At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model. Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity. When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk. <h2>You’re doing more physical activity than you think</h2> We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise. Our experimental evidence shows that <a href="https://diabetesjournals.org/care/article/39/6/964/29532/Benefits-for-Type-2-Diabetes-of-Interrupting">interrupting our sitting</a> regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch. While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk. It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies. The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time. <h2>Australia’s adult physical activity guidelines need updating</h2> Australia’s <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">physical activity guidelines</a> currently only recommend exercise intensity and time. A <a href="https://www.uow.edu.au/media/2023/why-adults-need-to-move-more-stop-sitting-and-sleep-better-.php">new set of guidelines</a> are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements. While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night. Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening. It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.<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/228894/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/christian-brakenridge-1295221">Christian Brakenridge</a>, Postdoctoral research fellow at Swinburne University, Centre for Urban Transitions, <a href="https://theconversation.com/institutions/baker-heart-and-diabetes-institute-974">Baker Heart and Diabetes Institute</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-much-time-should-you-spend-sitting-versus-standing-new-research-reveals-the-perfect-mix-for-optimal-health-228894">original article</a>. </div>

Body

What is childhood dementia? And how could new research help?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> “Childhood” and “dementia” are two words we wish we didn’t have to use together. But sadly, around <a href="https://doi.org/10.1093/brain/awad242">1,400 Australian children and young people</a> live with currently untreatable childhood dementia. Broadly speaking, childhood dementia is caused by any one of <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">more than 100</a> rare genetic disorders. Although the causes differ from dementia acquired later in life, the progressive nature of the illness is the same. <a href="https://doi.org/10.1093/brain/awad242">Half</a> of infants and children diagnosed with childhood dementia will not reach their tenth birthday, and most will die <a href="https://www.childhooddementia.org/what-is-childhood-dementia#what">before turning 18</a>. Yet this devastating condition has lacked awareness, and importantly, the research attention needed to work towards treatments and a cure. <h2>More about the causes</h2> Most types of childhood dementia are <a href="https://academic.oup.com/brain/article/146/11/4446/7226999">caused</a> by <a href="https://www.genome.gov/genetics-glossary/Mutation">mutations</a> (or mistakes) in our <a href="https://www.genome.gov/genetics-glossary/Deoxyribonucleic-Acid">DNA</a>. These mistakes lead to a range of rare genetic disorders, which in turn cause childhood dementia. <a href="https://doi.org/10.1093/brain/awad242">Two-thirds</a> of childhood dementia disorders are caused by “<a href="https://www.ncbi.nlm.nih.gov/books/NBK459183/">inborn errors of metabolism</a>”. This means the metabolic pathways involved in the breakdown of carbohydrates, lipids, fatty acids and proteins in the body fail. As a result, nerve pathways fail to function, neurons (nerve cells that send messages around the body) die, and progressive cognitive decline occurs. <h2>What happens to children with childhood dementia?</h2> Most children initially appear unaffected. But after a period of apparently normal development, children with childhood dementia <a href="https://doi.org/10.1016/j.pediatrneurol.2023.09.006">progressively lose</a> all previously acquired skills and abilities, such as talking, walking, learning, remembering and reasoning. Childhood dementia also leads to significant changes in behaviour, such as aggression and hyperactivity. Severe sleep disturbance is common and vision and hearing can also be affected. Many children have seizures. The age when symptoms start can vary, depending partly on the particular genetic disorder causing the dementia, but the average is around <a href="https://doi.org/10.1093%2Fbrain%2Fawad242">two years old</a>. The symptoms are caused by significant, progressive brain damage. <h2>Are there any treatments available?</h2> Childhood dementia treatments currently <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">under evaluation</a> or approved are for a very limited number of disorders, and are only available in some parts of the world. These include gene replacement, <a href="https://doi.org/10.1002/jmd2.12378">gene-modified cell therapy</a> and protein or <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1712649">enzyme replacement therapy</a>. Enzyme replacement therapy is available in Australia for <a href="https://australianprescriber.tg.org.au/articles/cerliponase-alfa-for-neuronal-ceroid-lipofuscinosis-type-2-disease.html">one form of childhood dementia</a>. These therapies attempt to “fix” the problems causing the disease, and have shown promising results. Other experimental therapies include ones that <a href="https://doi.org/10.3390/life12050608">target</a> faulty protein production or <a href="https://doi.org/10.1056/nejmoa2310151">reduce inflammation</a> in the brain. <h2>Research attention is lacking</h2> Death rates for Australian children with cancer <a href="http://www.childhooddementia.org/getasset/2WX39O">nearly halved</a> between <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">1997 and 2017</a> thanks to research that has enabled the development of multiple treatments. But over recent decades, <a href="http://www.childhooddementia.org/getasset/2WX39O">nothing has changed</a> for children with dementia. In 2017–2023, research for childhood cancer received over four times more funding per patient compared to funding for <a href="https://www.childhooddementia.org/getasset/2WX39O">childhood dementia</a>. This is despite childhood dementia causing a <a href="https://doi.org/10.1093/brain/awad242">similar number of deaths</a> each year as childhood cancer. The success <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/cancer-incidence-survival">for childhood cancer sufferers</a> in recent decades demonstrates how adequately funding medical research can lead to improvements in patient outcomes. Another bottleneck for childhood dementia patients in Australia is the lack of access to clinical trials. An <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">analysis</a> published in March this year showed that in December 2023, only two clinical trials were recruiting patients with childhood dementia in Australia. Worldwide however, 54 trials were recruiting, meaning Australian patients and their families are left watching patients in other parts of the world receive potentially lifesaving treatments, with no recourse themselves. That said, we’ve seen a slowing in the establishment of <a href="https://www.childhooddementia.org/news/report-reveals-global-research-inequity">clinical trials</a> for childhood dementia across the world in recent years. In addition, we know from <a href="https://www.childhooddementia.org/join-us/professionals/impacts">consultation with families</a> that current care and support systems <a href="https://www.childhooddementia.org/getasset/44MLP8">are not meeting the needs</a> of children with dementia and their families. <h2>New research</h2> Recently, we were awarded <a href="https://www.premier.sa.gov.au/media-releases/news-items/major-funding-boost-for-research-into-childhood-dementia">new funding</a> for <a href="https://www.flinders.edu.au/giving/our-donors/impact-of-giving/improving-the-lives-of-children-with-dementia">our research</a> on childhood dementia. This will help us continue and expand studies that seek to develop lifesaving treatments. More broadly, we need to see increased funding in Australia and around the world for research to develop and translate treatments for the broad spectrum of childhood dementia conditions. Dr Kristina Elvidge, head of research at the <a href="https://www.childhooddementia.org/our-people">Childhood Dementia Initiative</a>, and Megan Maack, director and CEO, contributed to this article.<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/228508/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kim-hemsley-1529322">Kim Hemsley</a>, Head, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/nicholas-smith-1529324">Nicholas Smith</a>, Head, Paediatric Neurodegenerative Diseases Research Group, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/siti-mubarokah-1529323">Siti Mubarokah</a>, Research Associate, Childhood Dementia Research Group, Flinders Health and Medical Research Institute, College of Medicine and Public Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders 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/what-is-childhood-dementia-and-how-could-new-research-help-228508">original article</a>. </div>

Mind

Do optimists really live longer? Here’s what the research says

<a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, <a href="https://theconversation.com/institutions/durham-university-867">Durham University</a> Do you tend to see the glass as half full, rather than half empty? Are you always looking on the bright side of life? If so, you may be surprised to learn that this tendency could actually be good for your health. A <a href="https://content.apa.org/record/2020-71981-001">number of studies</a> have shown that optimists enjoy higher levels of wellbeing, better sleep, lower stress and even better cardiovascular health and immune function. And now, <a href="https://pubmed.ncbi.nlm.nih.gov/35674052/">a recent study</a> has shown that being an optimist is linked to longer life. To conduct their study, researchers tracked the lifespan of nearly 160,000 women aged between 50 to 79 for a period of 26 years. At the beginning of the study, the women completed a <a href="https://local.psy.miami.edu/people/faculty/ccarver/availbale-self-report-instruments/lot-r/">self-report measure of optimism</a>. Women with the highest scores on the measure were categorised as optimists. Those with the lowest scores were considered pessimists. Then, in 2019, the researchers followed up with the participants who were still living. They also looked at the lifespan of participants who had died. What they found was that those who had the highest levels of optimism were more likely to live longer. More importantly, the optimists were also more likely than those who were pessimists to live into their nineties. Researchers refer to this as “exceptional longevity”, considering the average lifespan for women is about 83 years in developed countries. What makes these findings especially impressive is that the results remained even after accounting for other factors known to predict a long life – including education level and economic status, ethnicity, and whether a person suffered from depression or other chronic health conditions. But given this study only looked at women, it’s uncertain whether the same would be true for men. However, <a href="https://www.pnas.org/doi/abs/10.1073/pnas.1900712116">another study</a> which looked at both men and women also found that people with the highest levels of optimism enjoyed a lifespan that was between 11% and 15% longer than those who were the least optimistic. <h2>The fountain of youth?</h2> So why is it that optimists live longer? At first glance it would seem that it may have to do with their healthier lifestyle. For example, <a href="https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.117.310828">research from several studies</a> has found that optimism is linked to eating a healthy diet, staying physically active, and being less likely to smoke cigarettes. These healthy behaviours are well known to improve heart health and <a href="https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases">reduce the risk</a> for cardiovascular disease, which is a <a href="https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)">leading cause of death</a> globally. Adopting a healthy lifestyle is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3857242/">important for reducing the risk</a> of other potentially deadly diseases, such as diabetes and cancer. But having a healthy lifestyle may only be part of the reason optimists live a longer than average life. This latest study found that lifestyle only accounted for 24% of the link between optimism and longevity. This suggests a number of other factors affect longevity for optimists. Another possible reason could be due to the way optimists manage stress. When faced with a stressful situation, optimists tend to deal with it head-on. They <a href="https://pubmed.ncbi.nlm.nih.gov/16859439/">use adaptive coping strategies</a> that help them resolve the source of the stress, or view the situation in a less stressful way. For example, optimists will problem-solve and plan ways to deal with the stressor, call on others for support, or try to find a “silver lining” in the stressful situation. All of these approaches are well-known to reduce feelings of stress, as well as the biological reactions that occur when we feel stressed. It’s these <a href="https://www.apa.org/topics/stress/body">biological reactions to stress</a> –- such as elevated cortisol (sometimes called the “stress hormone”), increased heart rate and blood pressure, and impaired immune system functioning –- that can take a toll on health over time and increase the risk for developing <a href="https://www.sciencedirect.com/science/article/pii/S0889159115004316?via%3Dihub">life-threatening diseases</a>, such as cardiovascular disease. In short, the way optimists cope with stress may help protect them somewhat against its harmful effects. <h2>Looking on the bright side</h2> Optimism is typically viewed by researchers as a relatively stable personality trait that is determined by both <a href="https://www.cambridge.org/core/journals/twin-research-and-human-genetics/article/sex-differences-in-the-genetic-architecture-of-optimism-and-health-and-their-interrelation-a-study-of-australian-and-swedish-twins/58F21AA11943D44B4BA4C63A966E6AC7">genetic</a> and early childhood influences (such as having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6541423/">secure and warm relationship</a> with your parents or caregivers). But if you’re not naturally prone to seeing the glass as half full, there are some ways you can increase your <a href="https://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1221122?journalCode=rpos20">capacity to be optimistic</a>. Research shows optimism can change over time, and can be cultivated by engaging in simple exercises. For example, visualising and then writing about your “<a href="https://www.psychologytoday.com/us/blog/what-matters-most/201303/what-is-your-best-possible-self">best possible self</a>” (a future version of yourself who has accomplished your goals) is a technique that studies have found can <a href="https://www.tandfonline.com/doi/full/10.1080/17439760.2016.1221122">significantly increase optimism</a>, at least temporarily. But for best results, the goals need to be both positive and reasonable, rather than just wishful thinking. Similarly, simply <a href="https://www.tandfonline.com/doi/abs/10.3200/SOCP.149.3.349-364">thinking about positive future events</a> can also be effective for boosting optimism. It’s also crucial to temper any expectations for success with an accurate view of what you can and can’t control. Optimism is reinforced when we experience the positive outcomes that we expect, and <a href="https://psycnet.apa.org/record/1970-20680-001">can decrease</a> when these outcomes aren’t as we want them to be. Although more research is needed, it’s possible that regularly envisioning yourself as having the best possible outcomes, and taking realistic steps towards achieving them, can help develop an optimistic mindset. Of course, this might be easier said than done for some. If you’re someone who isn’t naturally optimistic, the best chances to improve your longevity is by <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003332">living a healthy lifestyle</a> by staying physically active, eating a healthy diet, managing stress, and getting a good night’s sleep. Add to this cultivating a more optimistic mindset and you might further increase your chances for a long life.<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/184785/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/fuschia-sirois-331254">Fuschia Sirois</a>, Professor in Social & Health Psychology, <a href="https://theconversation.com/institutions/durham-university-867">Durham 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/do-optimists-really-live-longer-heres-what-the-research-says-184785">original article</a>.

Caring

Asking ChatGPT a health-related question? Better keep it simple

It’s tempting to <a href="https://cosmosmagazine.com/news/chatgpt-and-dr-google/">turn to search engines</a> to seek out health information, but with the rise of large language models, like ChatGPT, people are becoming more and more likely to depend on AI for answers too. <div class="copy"> Concerningly, an Australian study has now found that the more evidence given to <a href="https://cosmosmagazine.com/technology/chatgpt-an-intimate-companion/">ChatGPT</a> when asked a health-related question, the less reliable it becomes. Large language models (LLM) and artificial intelligence use in health care is still developing, creating a a critical gap when providing incorrect answers can have serious consequences for people’s health. To address this, scientists from Australia’s national science agency, CSIRO, and the University of Queensland (UQ) explored a hypothetical scenario: an average person asking ChatGPT if ‘X’ treatment has a positive effect on condition ‘Y’. They presented ChatGPT with 100 questions sourced from the <a href="https://trec-health-misinfo.github.io/" target="_blank" rel="noopener">TREC Health Misinformation track</a> – ranging from ‘Can zinc help treat the common cold?’ to ‘Will drinking vinegar dissolve a stuck fish bone?’ Because queries to search engines are typically shorter, while prompts to a LLM can be far longer, they posed the questions in 2 different formats: the first as a simple question and the second as a question biased with supporting or contrary evidence. By comparing ChatGPT’s response to the known correct response based on existing medical knowledge, they found that ChatGPT was 80% accurate at giving accurate answers in a question-only format. However, when given an evidence-biased prompt, this accuracy reduced to 63%, which was reduced again to 28% when an “unsure” answer was allowed. “We’re not sure why this happens,” says CSIRO Principal Research Scientist and Associate Professor at UQ, Dr Bevan Koopman, who is co-author of the paper. “But given this occurs whether the evidence given is correct or not, perhaps the evidence adds too much noise, thus lowering accuracy.” Study co-author Guido Zuccon, Director of AI for the Queensland Digital Health Centre at UQ says that major search engines are now integrating LLMs and search technologies in a process called Retrieval Augmented Generation. “We demonstrate that the interaction between the LLM and the search component is still poorly understood, resulting in the generation of inaccurate health information,” says Zuccon. Given the widespread popularity of using LLMs online for answers on people’s health, Koopman adds, we need continued research to inform the public about risks and to help them optimise the accuracy of their answers. “While LLMs have the potential to greatly improve the way people access information, we need more research to understand where they are effective and where they are not.” Image credits: Getty Images <div> <noscript data-spai="1"><img decoding="async" class="aligncenter size-full wp-image-198773" src="https://cdn.shortpixel.ai/spai/q_lossy+ret_img+to_auto/cosmosmagazine.com/wp-content/uploads/2023/12/MICROSCOPIC-TO-TELESCOPIC__Embed-graphic-720x360-1.jpg" data-spai-egr="1" width="600" alt="Buy cosmos print magazine" title="asking chatgpt a health-related question? better keep it simple 2"></noscript> </div>  <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=301406&title=Asking+ChatGPT+a+health-related+question%3F+Better+keep+it+simple" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /><a href="https://cosmosmagazine.com/technology/ai/asking-chatgpt-a-health-related-question-better-keep-it-simple/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto/">Imma Perfetto</a>. </div>

Caring

Embracing healing: The rise of medical cannabis in Australia

In recent years, Australia has made significant strides in healthcare, particularly in the realm of alternative medicine. One such breakthrough gaining widespread recognition is the availability and utilisation of medical cannabis. <a href="https://www.oversixty.com.au/health/body/how-nurses-are-changing-the-conversation-around-medicinal-cannabis" target="_blank" rel="noopener">As attitudes shift and research unfolds</a>, the once-stigmatised plant is emerging as a source of genuine hope and relief for patients across the country. Medical cannabis, derived from the cannabis plant, contains compounds known as cannabinoids, notably THC (tetrahydrocannabinol) and CBD (cannabidiol), which possess therapeutic properties. While recreational use remains a contentious issue, the medicinal potential of cannabis cannot be overlooked. In Australia, its legal status has evolved; in October 2016 the Australian Government changed the law to allow organisations to grow cannabis for research and to make pharmaceutical products, allowing patients to access cannabis-based products under specific conditions. One of the most significant benefits of medical cannabis is its ability to alleviate symptoms and improve the quality of life for patients suffering from various medical conditions. From chronic pain and epilepsy to nausea induced by chemotherapy, medical cannabis offers relief where traditional treatments can fall short or have significant long-term side effects. For people with debilitating illnesses, this alternative therapy can open doors to a life with reduced discomfort and enhanced well-being. Moreover, the availability of medical cannabis fosters a more patient-centric approach to healthcare. By recognising the diverse needs of individuals and offering alternative treatment options, healthcare professionals empower patients to take control of their health journey. This shift towards personalised medicine acknowledges that what works for one person may not work for another, and cannabis-based treatments provide another tool in the arsenal of healthcare interventions. Australia's embrace of medical cannabis also extends to research and innovation. With an increasing number of clinical trials and studies exploring its efficacy and safety, the medical community is uncovering new insights into the potential applications of cannabis-based therapies. This commitment to scientific inquiry ensures that medical cannabis is integrated into healthcare practices responsibly and ethically. Furthermore, the legalisation of medical cannabis opens doors for economic growth and innovation. Australia's burgeoning cannabis industry has the potential to create jobs, stimulate investment and drive technological advancements in cultivation, processing and distribution. By capitalising on this emerging market, Australia can position itself as a global leader in medical cannabis research and production. Take the example of <a href="https://www.montu.com.au/" target="_blank" rel="noopener">Montu</a>, a Melbourne-based medical cannabis company that in November was <a href="https://www.montu.com.au/_files/ugd/0ee6ca_f78badef1cf64ccba22263ed6b5ea5d0.pdf" target="_blank" rel="noopener">named the fastest-growing tech company</a> in the entire country for the second consecutive year. The groundswell of public and investor support for such a company – whose stated mission is to deploy technology to create a better medical cannabis ecosystem for suppliers, practitioners, pharmacies and the patients they serve – is testament to the rapidly growing popularity of medical cannabis as a viable everyday resource for health and wellbeing. Companies like Montu that are streamlining and regulating access to medical cannabis via a growing network of medical practitioners are playing a vital role in getting help for those who need it most. Even though Montu was only formed in 2019, with its first products entering the market in 2020, the evolution of its company ecosystem has been dramatic to say the least. Now with a diverse range of companies under its umbrella, Montu is using innovative solutions to enhance the patient experience – from their "Leafio" dispensing system bridging the gap between suppliers and pharmacies, to their growing variety of products and brands, to their "Alternaleaf" telehealth service that connects patients with expert clinicians, and their high-end "Saged" professional online learning portal for healthcare professionals, this integrated approach is shaping a future where medical cannabis is accessible, efficient and tailored to meet the diverse needs of patients and healthcare providers alike. Perhaps most importantly of all, the availability of medical cannabis promotes harm reduction by offering a safer alternative to potentially addictive pharmaceutical drugs. For patients struggling with opioid dependence or other addictive substances, cannabis-based treatments provide a non-addictive option for managing symptoms, reducing the risk of substance abuse and overdose. The legalisation of medical cannabis in Australia marked a pivotal moment in the nation's healthcare landscape. With growing recognition of the therapeutic potential of cannabis-derived treatments, Australia has taken decisive steps to ensure that patients in need have access to this alternative therapy. Through rigorous regulation and oversight, the legal framework surrounding medical cannabis balances patient safety with the need for compassionate care, allowing individuals suffering from debilitating conditions to explore new avenues of treatment. This landmark decision not only reflected a shift in societal attitudes towards cannabis but also underscored Australia's commitment to evidence-based medicine and the well-being of its citizens. As attitudes towards cannabis evolve and its medicinal benefits become more widely recognised, Australia stands at the forefront of a healthcare revolution – one of hope, healing and a future where patients can experience relief and improved quality of life. Image: Getty

Caring

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

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

Body

Attempts to access Kate Middleton’s medical records are no surprise. Such breaches are all too common

<a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> The <a href="https://www.abc.net.au/news/2024-03-20/claim-hospital-staff-tried-to-access-kate-middleton-health-info/103608066">alleged</a> data breach involving Catherine, Princess of Wales tells us something about health privacy. If hospital staff can apparently access a future queen’s medical records without authorisation, it can happen to you. Indeed it may have already happened to you, given many breaches of health data go under the radar. Here’s why breaches of health data keep on happening. <h2>What did we learn this week?</h2> Details of the alleged data breaches, by <a href="https://www.mirror.co.uk/news/royals/breaking-kate-middleton-three-london-32401247">up to three staff</a> at The London Clinic, emerged in the UK media this week. These breaches are alleged to have occurred after the princess had abdominal surgery at the private hospital earlier this year. The UK Information Commissioner’s Office <a href="https://ico.org.uk/about-the-ico/media-centre/news-and-blogs/2024/03/ico-statement-in-response-to-reports-of-data-breach-at-the-london-clinic/">is investigating</a>. Its report should provide some clarity about what medical data was improperly accessed, in what form and by whom. But it is unlikely to identify whether this data was given to a third party, such as a media organisation. <h2>Health data isn’t always as secure as we’d hope</h2> Medical records are inherently sensitive, providing insights about individuals and often about biological relatives. In an ideal world, only the “right people” would have access to these records. These are people who “need to know” that information and are aware of the responsibility of accessing it. Best practice digital health systems typically try to restrict overall access to databases through hack-resistant firewalls. They also try to limit access to specific types of data through grades of access. This means a hospital accountant, nurse or cleaner does not get to see everything. Such systems also incorporate blocks or alarms where there is potential abuse, such as unauthorised copying. But in practice each health records ecosystem – in GP and specialist suites, pathology labs, research labs, hospitals – is less robust, often with fewer safeguards and weaker supervision. <h2>This has happened before</h2> Large health-care providers and insurers, including major hospitals or chains of hospitals, have a <a href="https://www.theguardian.com/australia-news/2023/dec/22/st-vincents-health-australia-hack-cyberattack-data-stolen-hospital-aged-care-what-to-do">worrying</a> <a href="https://www.afr.com/technology/medical-information-leaked-in-nsw-health-hack-20210608-p57z7k">history</a> of <a href="https://www.innovationaus.com/oaic-takes-pathology-company-to-court-over-data-breach/">digital breaches</a>. Those breaches include hackers accessing the records of millions of people. The <a href="https://www.theguardian.com/world/2022/nov/11/medical-data-hacked-from-10m-australians-begins-to-appear-on-dark-web">Medibank</a> data breach involved more than ten million people. The <a href="https://www.hipaajournal.com/healthcare-data-breach-statistics/">Anthem</a> data breach in the United States involved more than 78 million people. Hospitals and clinics have also had breaches specific to a particular individual. Many of those breaches involved unauthorised sighting (and often copying) of hardcopy or digital files, for example by nurses, clinicians and administrative staff. For instance, this has happened to public figures such as <a href="https://www.latimes.com/archives/la-xpm-2008-mar-15-me-britney15-story.html">singer</a> <a href="https://journals.lww.com/healthcaremanagerjournal/abstract/2009/01000/health_information_privacy__why_trust_matters.11.aspx">Britney Spears</a>, actor <a href="https://www.nytimes.com/2007/10/10/nyregion/10clooney.html">George Clooney</a> and former United Kingdom prime minister <a href="https://www.theguardian.com/uk-news/2024/mar/20/when-fame-and-medical-privacy-clash-kate-and-other-crises-of-confidentiality">Gordon Brown</a>. Indeed, the Princess of Wales has had her medical privacy breached before, in 2012, while in hospital pregnant with her first child. This was no high-tech hacking of health data. Hoax callers from an Australian radio station <a href="https://theconversation.com/did-2day-fm-break-the-law-and-does-it-matter-11250">tricked</a> hospital staff into divulging details over the phone of the then Duchess of Cambridge’s health care. <h2>Tip of the iceberg</h2> Some unauthorised access to medical information goes undetected or is indeed undetectable unless there is an employment dispute or media involvement. Some is identified by colleagues. Records about your health might have been improperly sighted by someone in the health system. But you are rarely in a position to evaluate the data management of a clinic, hospital, health department or pathology lab. So we have to trust people do the right thing. <h2>How could we improve things?</h2> Health professions have long emphasised the need to protect these records. For instance, medical ethics bodies <a href="https://www.bmj.com/content/350/bmj.h2255">condemn</a> medical students who <a href="https://www.abc.net.au/news/2014-04-14/picture-sharing-app-for-doctors-raises-privacy-concerns/5389226">share</a> intimate or otherwise inappropriate images of patients. Different countries have various approaches to protecting who has access to medical records and under what circumstances. In Australia, for instance, we have a mix of complex and inconsistent laws that vary across jurisdictions, some covering privacy in general, others specific to health data. There isn’t one comprehensive law and set of standards <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">vigorously administered</a> by one well-resourced watchdog. In Australia, it’s mandatory to report <a href="https://www.oaic.gov.au/privacy/notifiable-data-breaches">data breaches</a>, including breaches of health data. This reporting system is currently <a href="https://theconversation.com/governments-privacy-review-has-some-strong-recommendations-now-we-really-need-action-200079">being updated</a>. But this won’t necessarily prevent data breaches. Instead, we need to incentivise Australian organisations to improve how they handle sensitive health data. The best policy <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1475-4932.12693">nudges</a> involve increasing penalties for breaches. This is so organisations act as responsible custodians rather than negligent owners of health data. We also need to step-up enforcement of data breaches and make it easier for victims to sue for breaches of privacy – princesses and tradies alike.<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/226303/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bruce-baer-arnold-1408">Bruce Baer Arnold</a>, Associate Professor, School of Law, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/attempts-to-access-kate-middletons-medical-records-are-no-surprise-such-breaches-are-all-too-common-226303">original article</a>. Images: Getty

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