Search

Why do I get so anxious after drinking? Here’s the science behind ‘hangxiety’

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/blair-aitken-1510537">Blair Aitken</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rebecca-rothman-2231560">Rebecca Rothman</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> You had a great night out, but the next morning, anxiety hits: your heart races, and you replay every conversation from the night before in your head. This feeling, known as hangover anxiety or “<a href="https://adf.org.au/insights/what-is-hangxiety/">hangxiety</a>”, <a href="https://onlinelibrary.wiley.com/doi/10.1002/hup.2623">affects around 22%</a> of social drinkers. While for some people, it’s mild nerves, for others, it’s a wave of anxiety that feels impossible to ride out. The “Sunday scaries” may make you feel panicked, filled with dread and unable to relax. Hangover anxiety can make even simple tasks feel overwhelming. Here’s why it happens, and what you can do about it. <h2>What does alcohol do to our brains?</h2> A hangover is the body’s way of recovering after drinking alcohol, bringing with it a range of symptoms. <a href="https://www.mdpi.com/2077-0383/10/23/5691">Dehydration and disrupted sleep</a> play a large part in the pounding headaches and nausea many of us know too well after a big night out. But hangovers aren’t just physical – there’s a strong mental side too. Alcohol is a nervous system depressant, meaning it alters how certain chemical messengers (or neurotransmitters) behave in the brain. Alcohol relaxes you by increasing <a href="https://my.clevelandclinic.org/health/articles/22857-gamma-aminobutyric-acid-gaba">gamma-aminobutyric acid</a> (GABA), the neurotransmitter that makes you feel calm and lowers inhibitions. It decreases <a href="https://my.clevelandclinic.org/health/articles/22839-glutamate">glutamate</a> and this also slows down your thoughts and helps ease you into a more relaxed state. Together, this interaction affects your mood, emotions and alertness. This is why when we drink, we often feel more sociable, carefree and willing to let our guard down. As the effects of the alcohol wear off, your brain works to rebalance these chemicals by <a href="https://www.sciencedirect.com/science/article/pii/S0191886918305762">reducing GABA and increasing glutamate</a>. This shift has the opposite effect of the night before, causing your brain to become more excitable and overstimulated, which can lead to feelings of anxiety. So why do some people get hangxiety, while others don’t? There isn’t one clear answer to this question, as several factors can play a role in whether someone experiences hangover-related anxiety. <h2>Genes play a role</h2> For some, a hangover is simply a matter of how much they drank or how hydrated they are. But genetics may also play a significant role. <a href="https://onlinelibrary.wiley.com/doi/10.1111/add.12699">Research</a> shows your genes can explain almost half the reason why you wake up feeling hungover, while your friend might not. Because genes influence how your body processes alcohol, some people may experience more intense hangover symptoms, such as headaches or dehydration. These stronger physical effects can, in turn, <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1002/hup.2623">trigger anxiety during a hangover</a>, making you more susceptible to “hangxiety.” <h2>Do you remember what you said last night?</h2> But one of the most common culprits for feeling anxious the next day is often <a href="https://journals.sagepub.com/doi/pdf/10.1177/0091450915604988">what you do while drinking</a>. Let’s say you’ve had a big night out and you can’t quite recall a conversation you had or something you did. Maybe you acted in ways that you now regret or feel embarrassed about. You might fixate on these thoughts and get trapped in a cycle of worrying and rumination. This cycle can be hard to break and can make you feel more anxious. <a href="https://doi.org/10.1016/j.addbeh.2023.107619">Research</a> suggests people who already struggle with feelings of anxiety in their day-to-day lives are especially vulnerable to hangxiety. Some people drink alcohol to unwind after a stressful day or to make themselves feel more comfortable at social events. This often leads to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9756407">heavier consumption</a>, which can make hangover symptoms more severe. It can also begin a cycle of drinking to feel better, making hangxiety even harder to escape. <h2>Preventing hangover anxiety</h2> The best way to prevent hangxiety is to limit your alcohol consumption. The <a href="https://adf.org.au/reducing-risk/alcohol/alcohol-guidelines">Australian guidelines</a> recommend having no more than ten standard drinks per week and no more than four standard drinks on any one day. Generally, the more you drink, the more intense your hangover symptoms might be, and the worse you are likely to feel. Mixing other drugs with alcohol can also increase the risk of hangxiety. This is especially true for party drugs, such as ecstasy or MDMA, that give you a temporary high but can lead to anxiety as they wear off and you are <a href="https://adf.org.au/insights/drug-comedowns">coming down</a>. If you do wake up feeling anxious: <ul> <li> focus on the physical recovery to help ease the mental strain </li> <li> drink plenty of water, eat a light meal and allow yourself time to rest </li> <li> try <a href="https://www.headspace.com/mindfulness/mindfulness-101">mindfulness meditation</a> or deep breathing exercises, especially if anxiety keeps you awake or your mind races </li> <li> consider journalling. This can help re-frame anxious thoughts, put your feelings into perspective and encourage self-compassion </li> <li> talk to a close friend. This can provide a safe space to express concerns and feel less isolated. </li> </ul> Hangxiety is an unwelcome guest after a night out. Understanding why hangxiety happens – and how you can manage it – can make the morning after a little less daunting, and help keep those anxious thoughts at bay.<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/240991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/blair-aitken-1510537">Blair Aitken</a>, Postdoctoral Research Fellow in Psychopharmacology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> and <a href="https://theconversation.com/profiles/rebecca-rothman-2231560">Rebecca Rothman</a>, PhD Candidate in Clinical Psychology, School of Health Sciences, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-get-so-anxious-after-drinking-heres-the-science-behind-hangxiety-240991">original article</a>. </div>

Mind

New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was <a href="https://theconversation.com/the-rise-of-ozempic-how-surprise-discoveries-and-lizard-venom-led-to-a-new-class-of-weight-loss-drugs-219721">originally developed</a> to help people with type 2 diabetes manage their blood sugar levels. However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032183">weight loss</a>, and hundreds of thousands of people around the world are using it <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">for this purpose</a>. Evidence has also shown the drug can help manage <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2306963">heart failure</a> and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403347">chronic kidney disease</a> in people with obesity and type 2 diabetes. Now, a study published in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">New England Journal of Medicine</a> has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked? <h2>Osteoarthritis and obesity</h2> Osteoarthritis is a common joint disease, affecting <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoarthritis">2.1 million Australians</a>. Most people with osteoarthritis <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">have pain</a> and find it difficult to perform common daily activities such as walking. The knee is <a href="https://pubmed.ncbi.nlm.nih.gov/37675071/">the joint most commonly affected</a> by osteoarthritis. Being overweight or obese is a <a href="https://pubmed.ncbi.nlm.nih.gov/25447976/">major risk factor</a> for osteoarthritis in the knee. The link between the two conditions <a href="https://pubmed.ncbi.nlm.nih.gov/26821091/">is complex</a>. It involves a combination of increased load on the knee, <a href="https://www.nature.com/articles/s41413-023-00301-9">metabolic factors</a> such as high cholesterol and high blood sugar, and inflammation. For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the <a href="https://pubmed.ncbi.nlm.nih.gov/30712918/">development of osteoarthritis</a>. Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. <a href="https://pubmed.ncbi.nlm.nih.gov/31908149/">International</a> and <a href="https://www.safetyandquality.gov.au/sites/default/files/2024-08/osteoarthritis-knee-clinical-care-standard-2024.pdf">Australian guidelines</a> suggest losing as little as 5% of body weight can help. But losing weight with just diet and exercise can be difficult for many people. <a href="https://pubmed.ncbi.nlm.nih.gov/26180980/">One study</a> from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten. Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness. <h2>Semaglutide for osteoarthritis?</h2> The rationale for the <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2403664">recent study</a> was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight. They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight. As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group. The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group. This is much greater than the pain reduction in another <a href="https://pubmed.ncbi.nlm.nih.gov/36511925/">recent study</a> among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale. The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as <a href="https://pubmed.ncbi.nlm.nih.gov/35442752/">anti-inflammatories</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/35137418/">opioids</a> and <a href="https://www.bmj.com/content/372/bmj.m4825">antidepressants</a>. Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test. <h2>How could semaglutide reduce knee pain?</h2> It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain. But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have <a href="https://www.sciencedirect.com/science/article/pii/S1043661822002651">anti-inflammatory</a> properties, and could even protect against <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6731440/">cartilage wear and tear</a>. While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not. The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis <a href="https://pubmed.ncbi.nlm.nih.gov/34527976/">are prescribed opioids</a>. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity. It’s also important to consider semaglutide can have a range of <a href="https://theconversation.com/considering-taking-a-weight-loss-drug-like-ozempic-here-are-some-potential-risks-and-benefits-219312">side effects</a>, including gastrointestinal symptoms and fatigue. There are some concerns that semaglutide could reduce <a href="https://www.sciencealert.com/experts-are-concerned-drugs-like-ozempic-may-cause-muscle-loss">muscle mass</a> and <a href="https://www.healthline.com/health-news/ozempic-muscle-mass-loss">bone density</a>, though we’re still learning more about this. Further, it can be difficult to access. <h2>I have knee osteoarthritis, what should I do?</h2> Osteoarthritis is a disease caused by multiple factors, and it’s important to take <a href="https://www.safetyandquality.gov.au/standards/clinical-care-standards/osteoarthritis-knee-clinical-care-standard/information-consumers-osteoarthritis-knee-clinical-care-standard">a multifaceted approach</a> to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of <a href="https://theconversation.com/do-you-have-knee-pain-from-osteoarthritis-you-might-not-need-surgery-heres-what-to-try-instead-236779">self-management</a>. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.<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/243159/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/giovanni-e-ferreira-1030477">Giovanni E. Ferreira</a>, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/christina-abdel-shaheed-425241">Christina Abdel Shaheed</a>, Associate Professor, School of Public Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstocl 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/new-study-suggests-weight-loss-drugs-like-ozempic-could-help-with-knee-pain-heres-why-there-may-be-a-link-243159">original article</a>. </div>

Body

Your friend has been diagnosed with cancer. Here are 6 things you can do to support them

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/stephanie-cowdery-2217734">Stephanie Cowdery</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/anna-ugalde-2232654">Anna Ugalde</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/trish-livingston-163686">Trish Livingston</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/victoria-white-1888110">Victoria White</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> Across the world, <a href="https://www.who.int/news/item/01-02-2024-global-cancer-burden-growing--amidst-mounting-need-for-services">one in five</a> people are diagnosed with cancer during their lifetime. By age 85, almost <a href="https://www.cancer.org.au/cancer-information/what-is-cancer/facts-and-figures">one in two</a> Australians will be diagnosed with cancer. When it happens to someone you care about, it can be hard to know what to say or how to help them. But providing the right support to a friend can make all the difference as they face the emotional and physical challenges of a new diagnosis and treatment. Here are six ways to offer meaningful support to a friend who has been diagnosed with cancer. <h2>1. Recognise and respond to emotions</h2> When facing a cancer diagnosis and treatment, it’s normal to experience a range of <a href="https://www.canceraustralia.gov.au/impacted-by-cancer/emotions#:%7E:text=It's%20likely%20that%20feelings%20will,these%20feelings%20ease%20with%20time">emotions</a> including fear, anger, grief and sadness. Your friend’s moods may fluctuate. It is also common for feelings to <a href="https://link.springer.com/article/10.1007/s00520-014-2492-9">change over time</a>, for example your friend’s anxiety may decrease, but they may feel more depressed. Some friends may want to share details while others will prefer privacy. Always ask permission to raise sensitive topics (such as changes in physical appearance or their thoughts regarding fears and anxiety) and don’t make assumptions. It’s OK to tell them you feel awkward, as this acknowledges the challenging situation they are facing. When they feel comfortable to talk, follow their lead. Your support and willingness <a href="https://www.cancervic.org.au/get-support/stories/what-to-say-and-not-say.html">to listen without judgement</a> can provide great comfort. You don’t have to have the answers. Simply acknowledging what has been said, providing your full attention and being present for them will be a great help. <h2>2. Understand their diagnosis and treatment</h2> <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/pon.4722">Understanding</a> your friend’s diagnosis and what they’ll go through when being <a href="https://www.cancer.org/cancer/caregivers/what-a-caregiver-does/treatment-timeline.html">treated</a> may be helpful. Being informed can reduce your own worry. It may also help you to listen better and reduce the amount of explaining your friend has to do, especially when they’re tired or overwhelmed. Explore reputable sources such as the <a href="https://www.cancer.org.au/">Cancer Council website</a> for accurate information, so you can have meaningful conversations. But keep in mind your friend has a trusted medical team to offer personalised and accurate advice. <h2>3. Check in regularly</h2> Cancer treatment can be isolating, so regular check-ins, texts, calls or visits can help your friend feel less alone. Having a normal conversation and sharing a joke can be very welcome. But everyone copes with cancer differently. Be patient and flexible in your support – some days will be harder for them than others. Remembering key dates – such as the next round of chemotherapy – can help your friend feel supported. Celebrating milestones, including the end of treatment or anniversary dates, may boost morale and remind your friend of positive moments in their cancer journey. Always ask if it’s a good time to visit, as your friend’s immune system <a href="https://www.cancerresearchuk.org/about-cancer/what-is-cancer/body-systems-and-cancer/the-immune-system-and-cancer#:%7E:text=to%20fight%20cancer-,Cancer%20and%20treatments%20may%20weaken%20immunity,high%20dose%20of%20steroids">may be compromised</a> by their cancer or treatments such as chemotherapy or radiotherapy. If you’re feeling unwell, it’s best to postpone visits – but they may still appreciate a call or text. <h2>4. Offer practical support</h2> Sometimes the best way to show your care is through practical support. There may be different ways to offer help, and what your friend needs might change at the beginning, during and after treatment. For example, you could offer to pick up prescriptions, drive them to appointments so they have transport and company to debrief, or wait with them at appointments. Meals will always be welcome. However it’s important to remember cancer and its treatments may <a href="https://www.cancer.gov/about-cancer/treatment/side-effects/nutrition#effects-of-cancer-treatment-on-nutrition">affect</a> taste, smell and appetite, as well as your friend’s ability to eat enough or absorb nutrients. You may want to check first if there are particular foods they like. <a href="https://www.cancervic.org.au/downloads/resources/booklets/nutrition-cancer.pdf">Good nutrition</a> can help boost their strength while dealing with the side effects of treatment. There may also be family responsibilities you can help with, for example, babysitting kids, grocery shopping or taking care of pets. <h2>5. Explore supports together</h2> Studies <a href="https://pubmed.ncbi.nlm.nih.gov/35834503/">have shown</a> mindfulness practices can be an effective way for people to manage anxiety associated with a cancer diagnosis and its treatment. If this is something your friend is interested in, it may be enjoyable to explore classes (either online or in-person) together. You may also be able to help your friend connect with organisations that provide emotional and practical help, such as the Cancer Council’s <a href="https://www.cancer.org.au/support-and-services/cancer-council-13-11-20">support line</a>, which offers free, confidential information and support for anyone affected by cancer, including family, friends and carers. <a href="https://www.researchgate.net/publication/5659099_Systematic_review_of_peer-support_programs_for_people_with_cancer">Peer support groups</a> can also reduce your friend’s feelings of isolation and foster shared understanding and empathy with people who’ve gone through a similar experience. GPs <a href="https://pubmed.ncbi.nlm.nih.gov/34333571/">can help</a> with referrals to support programs. <h2>6. Stick with them</h2> Be committed. Many people feel <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11120751/">isolated</a> after their treatment. This may be because regular appointments have reduced or stopped – which can feel like losing a safety net – or because their relationships with others have changed. Your friend may also experience emotions such as worry, lack of confidence and uncertainty as they adjust to a <a href="https://www.cancer.gov/about-cancer/coping/survivorship/new-normal">new way of living</a> after their treatment has ended. This will be an important time to support your friend. But don’t forget: looking after <a href="https://www.healthdirect.gov.au/caring-for-someone-with-cancer">yourself</a> is important too. Making sure you eat well, sleep, exercise and have emotional support will help steady you through what may be a challenging time for you, as well as the friend you love. <a href="https://www.deakin.edu.au/faculty-of-health/research/cancer-carer-hub">Our research</a> team is developing new programs and resources to support carers of people who live with cancer. While it can be a challenging experience, it can also be immensely rewarding, and your small acts of kindness can make a big difference.<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/239844/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/stephanie-cowdery-2217734">Stephanie Cowdery</a>, Research Fellow, Carer Hub: A Centre of Excellence in Cancer Carer Research, Translation and Impact, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/anna-ugalde-2232654">Anna Ugalde</a>, Associate Professor & Victorian Cancer Agency Fellow, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>; <a href="https://theconversation.com/profiles/trish-livingston-163686">Trish Livingston</a>, Distinguished Professor & Director of Special Projects, Faculty of Health, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a>, and <a href="https://theconversation.com/profiles/victoria-white-1888110">Victoria White</a>, Professor of Pyscho-Oncology, School of Psychology, <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/your-friend-has-been-diagnosed-with-cancer-here-are-6-things-you-can-do-to-support-them-239844">original article</a>. </div>

Caring

For some people dying alone is not such a bad thing – here’s why

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/glenys-caswell-142188">Glenys Caswell</a>, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a> It seems so obvious that no one should die alone that we never talk about it, but people do often die when they are alone. Sometimes they die in a way that suggests they prefer to be alone as they are coming to the end of their lives. So is it really such a bad thing to be alone when you die? When a person is dying in a hospital or a care home it is common for the nurses caring for them to summon their family. Many people will have the experience of trying to <a href="http://journals.sagepub.com/doi/abs/10.2190/OM.55.3.d">keep vigil beside a family member</a>. It is hard – as everyday life goes on regardless – and it can be emotionally exhausting. Sometimes, the relative will die when their family have gone to make a phone call or get a cup of tea, leaving the family feeling distressed and guilty for not being there when they died. There is plenty of research literature, from many countries, devoted to trying to decide <a href="http://www.sciencedirect.com/science/article/pii/S0885392415001578">what makes a good death</a>. There are differences to be found between countries, but similarities too. One similarity is a belief that <a href="http://www.sciencedirect.com/science/article/pii/S106474811600138X?via%3Dihub">no one should die alone</a>. This idea sits well with the view of dying that can be found in many different places. When interviewed as research participants, health professionals – and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904589/">nurses in particular</a> – commonly say that no one should die alone. There are also many cultural references that suggest that to die alone is a bad thing. Consider, for example, the death of Ebenezer Scrooge in Dickens’s <a href="https://www.gutenberg.org/files/46/46-h/46-h.htm">A Christmas Carol</a>, or the death of Nemo, the law writer in <a href="http://www.gutenberg.org/files/1023/1023-h/1023-h.htm">Bleak House</a>. These are both sad, dark, lonely deaths of a kind to be avoided. Celebrity deaths, such as those of comedian and actress <a href="https://www.theguardian.com/culture/2016/apr/20/victoria-wood-dies-aged-62-comedian">Victoria Wood</a> or <a href="http://www.bbc.co.uk/news/entertainment-arts-35278872">David Bowie</a>, are described in the news as peaceful or good when they are surrounded by family. Ordinary people who die alone make the news when the person’s body is undiscovered for a long time. When this happens the death is likely to be described in <a href="http://www.sciencedirect.com/science/article/pii/S027795360300577X?via%3Dihub">negative terms</a>, such as shocking, lonely, tragic or as a sad indictment of society. <h2>Some people prefer to be alone</h2> Of course, it may be the case that many people would prefer to have their family around them when they are dying. But there is <a href="http://www.tandfonline.com/doi/full/10.1080/21582041.2015.1114663">evidence</a> that suggests that some people would <a href="http://www.sciencedirect.com/science/article/pii/S0277953615003482?via%3Dihub">prefer to be alone </a> as they are coming to the end of their lives. My own <a href="http://www.tandfonline.com/doi/full/10.1080/13576275.2017.1413542">research</a> found that while hospice-at-home nurses believe that no one should die alone, they had seen cases where a person died after their family members had left the bedside. The nurses believed that some people just want to be on their own when they are dying. They also thought that people may have a measure of control over when they die, and choose to do so when their family are not around. In the same study, I also talked to older people who were living alone to find out their views about dying alone. I was intrigued to learn that dying alone was not seen as something that is automatically bad, and for some of the older people it was to be preferred. For some people in this group, dying was not the worst thing that could happen – being trapped in a care home was considered to be far worse than dying alone. Cultural representations of dying suggest that being alone while dying is a dreadful thing. This view is supported by healthcare policy and the practices of health professionals, such as nurses. But we all know people who prefer to be left alone when they are ill. Is it so surprising then that some might wish to be alone when they are dying? It is time we began to talk about this and to accept that we want different things in our dying as we do in our living. Openness created through discussion might also help to remove some of the guilt that family members feel when they miss the moment of their relative’s death.<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/90034/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/glenys-caswell-142188">Glenys Caswell</a>, Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</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/for-some-people-dying-alone-is-not-such-a-bad-thing-heres-why-90034">original article</a>. </div>

Caring

When a baby is stillborn, grandparents are hit with ‘two lots of grief’. Here’s how we can help

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jane-lockton-811825">Jane Lockton</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/clemence-due-100240">Clemence Due</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/melissa-oxlad-811406">Melissa Oxlad</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> <a href="https://www.stillbirthcre.org.au/resources/stillbirth-facts/">Six babies</a> are stillborn every day in Australia. This significant loss <a href="https://www.sciencedirect.com/science/article/pii/S1744165X12001023">affects parents</a> for years to come, often the rest of their lives. However, stillbirth also affects many others, including grandparents. But until now, we have not heard the experiences of grandparents whose grandchildren are stillborn. Their grief was rarely acknowledged and there are few supports tailored to them. Our recently published <a href="https://www.ncbi.nlm.nih.gov/pubmed/31387781">research</a> is the first in the world to specifically look at grandmothers’ experience of stillbirth and the support they need. In Australia, a baby <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0037109">is defined as</a> stillborn when it dies in the womb from 20 weeks’ gestation, or weighs more than 400 grams. Other countries have slightly different definitions. <a href="https://www.stillbirthcre.org.au/resources/stillbirth-facts/">About 2,200</a> babies are stillborn each year here meaning stillbirth may be more common than many people think. And people <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60107-4/fulltext">don’t tend to talk</a> about this openly despite it leading to significant grief. To explore grandparents’ experience of stillbirth, we interviewed 14 grandmothers for our initial study, and a further 23 grandmothers and grandfathers since then. Many grandparents were not aware stillbirth was a risk today. Most felt unprepared. Like parents, grandparents experienced grief like no other after their grandchild was stillborn. Rose said: "The grief is always there, it never leaves you […] I don’t know why but sometimes it is still very raw." Sally said: "I [would do] anything in my power to take it away, even if it meant, you know, something dreadful happening to me, I would have done it." Grandparents also spoke of anticipating the arrival of their grandchild, and disbelief at their loss. Donna said: "It was as bad as it could be and […] I thought it just couldn’t be real, it couldn’t be real." Where grandparents lived a long way from their child, the loss was even more profound. Distance prevented them from holding their grandchild after birth, attending memorials, or helping their own children. Iris said: "I still miss her now […] When she was born and they had her in the hospital they would text me and say you know she’s got hair like her daddy […] and they would describe her and how beautiful she was, and that’s all they have, you know […] that’s all I have really." Grandparents said they wanted to hide their grief to protect their child from pain. This often made them isolated. Their relationships with family members often changed. Mary said: "It’s like two lots of grief […] but I don’t want it to sound like it’s as bad as my daughter’s loss. It’s different, it’s a different grief, because you’re grieving the loss of a grandchild, and you’re also grieving for your daughter and her loss and it’s like yeah you’ve been kicked in the guts twice instead of once." <h2>What grandparents wanted</h2> Grandparents stressed the importance and ongoing value of being involved in “memory making” and spending time with their stillborn grandchild where possible. Creating mementos, such as taking photos and making footprints and hand prints, were all important ways of expressing their grief. These mementos kept the baby “alive” in the family. They were also a way to ensure their own child knew the baby was loved and remembered. Our research also identified better ways to support grandparents. Grandparents said that if they knew more about stillbirth, they would be more confident in knowing how to help support their children. And if people were more aware of grandparents’ grief, and acknowledged their loss, this would make it easier for them to get support themselves, and reduce feelings of isolation. Our research also found families can recognise that grandparents grieve too, for both their child and grandchild. Grandparents can be encouraged to seek support from other family and friends. Families could also encourage grandparents to seek support from professionals if needed. In hospitals, midwives can adopt some simple, time efficient strategies, with a big impact on grandparents. With parent consent, midwives could include grandparents in memory making activities. By acknowledging the connection grandparents have to the baby, midwives can validate the grief that they experience. In recognising the supportive role of grandparents, midwives can also provide early guidance about how best to support their child. Hospitals can help by including grandparents in the education provided after stillbirth. This might include guidance about support for their child, or simply providing grandparents with written resources and guiding them to appropriate supports. In time, development of peer support programs, where grandparents support others in similar situations, could help. And, as a community, we can support grandparents the same way they support their own children. We can be there, listen and learn. <hr /> All grandparents’ names in this article are pseudonyms. If this article raises issues for you or someone you know, contact <a href="http://www.sands.org.au">Sands</a> (stillbirth and newborn death support) on 1300 072 637. Sands also has <a href="https://www.sands.org.au/images/sands-creative/brochures/127517-For-Grandparents-Brochure.pdf">written information specifically for grandparents</a> of stillborn babies.<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/122313/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jane-lockton-811825">Jane Lockton</a>, PhD Candidate (Psychology, Health), <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>; <a href="https://theconversation.com/profiles/clemence-due-100240">Clemence Due</a>, Senior Lecturer in the School of Psychology, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a>, and <a href="https://theconversation.com/profiles/melissa-oxlad-811406">Melissa Oxlad</a>, Lecturer in the School of Psychology, <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/when-a-baby-is-stillborn-grandparents-are-hit-with-two-lots-of-grief-heres-how-we-can-help-122313">original article</a>. </div>

Family & Pets

Could a recent ruling change the game for scam victims? Here’s why the banks will be watching closely

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nicola-howell-1160247">Nicola Howell</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> In Australia, it’s scam victims who foot the bill for the overwhelming majority of the money lost to scams each year. A 2023 <a href="https://download.asic.gov.au/media/mbhoz0pc/rep761-published-20-april-2023.pdf">review</a> by the Australian Securities and Investments Commission (ASIC) found banks detected and stopped only a small proportion of scams. The total amount banks paid in compensation paled in comparison to total losses. So, it was a strong statement this week when it was revealed the Australian Financial Conduct Authority (AFCA) had <a href="https://my.afca.org.au/searchpublisheddecisions/kb-article/?id=f9f8941f-7379-ef11-ac20-000d3a6acbb4">ordered</a> a bank – HSBC – to compensate a customer who lost more than $47,000 through a sophisticated bank impersonation or “spoofing” scam. This decision was significant. An AFCA determination is binding on the relevant bank or other financial institution, which has <a href="https://www.afca.org.au/make-a-complaint#:%7E:text=Any%20determinations%20we%20make%20are,service%20is%20free%20to%20access">no direct right of appeal</a>. It could have implications for the way similar cases are treated in future. The ruling comes amid a broader push for sector-wide reforms to give banks more responsibility for <a href="https://www.fico.com/blogs/detection-prevention-tackling-scams-every-angle">detecting</a>, deterring and responding to scams, as opposed to simply telling customers to be “more careful”. Here’s what you should know about this landmark ruling, and what it might mean for consumers. <h2>A highly sophisticated ‘spoofing’ scam</h2> You might be familiar with “push payment” scams that trick the victim into paying money to a dummy account. These include the “<a href="https://www.acma.gov.au/articles/2024-01/scam-alert-re-emergence-hi-mum-scam">mum I’ve lost my phone</a>” scam and some <a href="https://www.scamwatch.gov.au/types-of-scams/online-dating-and-romance-scams">romance</a> scams. The <a href="https://www.smh.com.au/national/dragged-kicking-and-screaming-banking-giant-loses-battle-against-scam-victim-20241015-p5kide.html">recent case</a> concerned an equally noxious “bank impersonation” or “spoofing” scam. The complainant – referred to as “Mr T” – was tricked into giving the scammer access to his HSBC account, from which an unauthorised payment was made. The scammer sent Mr T a text message, purportedly asking him to investigate an attempted Amazon transaction. In an effort to respond to the (fake) unauthorised Amazon purchase, Mr T revealed security passcodes to the scammer, enabling them to transfer $47,178.54 from his account and disappear with it. The fact Mr T was dealing with scammers was far from obvious – scammers had information about him one might reasonably expect only a bank would know, such as his bank username. On top of this, the scam text message appeared in a thread of other legitimate text messages that had previously been sent by the real HSBC. <h2>AFCA’s ruling</h2> HSBC argued to AFCA that having to pay compensation should be ruled out under the <a href="https://download.asic.gov.au/media/lloeicwb/epayments-code-published-02-june-2022.pdf">ePayments Code</a>, a voluntary code of practice administered by ASIC. Under this code, a bank is not required to compensate a customer for an unauthorised payment if that customer has disclosed their passcode. The bank argued the complainant had voluntarily disclosed these codes to the scammer, meaning the bank didn’t need to pay. AFCA disagreed. It noted the very way the scam had worked was by creating a sense of urgency and crisis. AFCA considered that the complainant had been manipulated into disclosing the passcodes and had not acted voluntarily. AFCA awarded compensation covering the vast majority of the disputed transaction amount, lost interest charged to a home loan account, and $5,000 towards Mr T’s legal costs. It also ordered the bank to pay compensation of $1,000 for poor customer service in dealing with the matter, including communication delays. <h2>Other cases may be more complex</h2> In this case, the determination was relatively straightforward. It found Mr T had not voluntarily disclosed his account information, so was not excluded from being compensated under the ePayments Code. However, many payment scams fall outside the ePayments Code because they involve the customer directly sending money to the scammer (as opposed to the scammer accessing the customer’s account). That means there is no code to direct compensation. Still, AFCA’s jurisdiction is broader than merely applying a code. In considering compensation for scam losses, AFCA must consider what is “fair in all the circumstances”. This means taking into account: <ul> <li>legal principles</li> <li>applicable industry codes</li> <li>good industry practice</li> <li>previous AFCA decisions.</li> </ul> Relevant factors might well include whether the bank was proactive in responding to known scams, as well as the challenges for individual customers in identifying scams. <h2>Broader reforms are on the way</h2> At the heart of this determination by AFCA is a recognition that, increasingly, detecting sophisticated scams can be next to impossible for customers, which can mean they don’t act voluntarily in making payments to scammers. Similar reasoning has informed a range of recent reform initiatives that put more responsibility for detecting and responding to scams on the banks, rather than their customers. In 2023, Australia’s banking sector committed to a new “<a href="https://www.ausbanking.org.au/scam-safe-accord/">Scam-Safe Accord</a>”. This is a commitment to implement new measures to protect customers, including a confirmation of payee service, delays for new payments, and biometric identity checks for new accounts. Changes on the horizon could be more ambitious and significant. The proposed <a href="https://treasury.gov.au/consultation/c2024-573813">Scams Prevention Framework</a> legislation would require Australian banks, telcos and <a href="https://pursuit.unimelb.edu.au/articles/accc-vs-big-tech-round-10-and-counting">digital platforms</a> to take reasonable steps to prevent, detect, report, disrupt and respond to scams. It would also include a compulsory external dispute resolution process, like AFCA’s, for consumers seeking compensation for when any of these institutions fail to comply. Addressing scams is not just an Australian issue. In the United Kingdom, newly introduced <a href="https://www.bbc.com/news/articles/cy94vz4zd7zo">rules</a> make paying and receiving banks responsible for compensating customers, for scam losses up to £85,000 (A$165,136), unless the customer is grossly negligent.<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/241558/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nicola-howell-1160247">Nicola Howell</a>, Senior lecturer, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</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/could-a-recent-ruling-change-the-game-for-scam-victims-heres-why-the-banks-will-be-watching-closely-241558">original article</a>. </div>

Money & Banking

Trying to lose weight? Here’s why your genetics could be just as important as your exercise regime

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a> Weight loss is a complicated process. There are so many factors involved including your diet, how much sleep you get each night and the kind of exercise you do. Our recent study shows that your <a href="https://www.tandfonline.com/doi/full/10.1080/02701367.2024.2404981">specific genetic profile</a> may also have a dominant effect on how well you lose weight through exercise. This might explain why two people who do an identical workout will see very different results. We identified 14 genes that appeared to significantly contribute to how much weight a person lost through running. This suggests that some of us have a natural talent when it comes to burning fat and losing weight through exercise. To conduct our study, we recruited 38 men and women born in the UK aged between 20 and 40. None of the participants regularly exercised at the start of the study. The group was randomly divided, with one half following a strict eight-week endurance programme that consisted of three weekly runs of 20-30 minutes. The other group acted as a <a href="https://www.britannica.com/science/control-group">control</a>. They were instructed to refrain from exercise and continue their daily routines as normal over this study period, including diet and lifestyle habits. All participants conducted a running test to see how far they could run in 12 minutes, and were weighed before and after the study period. This was to gauge their initial fitness level and see how much they changed over the duration of the study. <a href="https://www.nhs.uk/conditions/obesity/">Body mass index</a> (BMI) was also calculated. Additionally, a saliva sample was collected from each person with a <a href="https://muhdo.com/?gclid=Cj0KCQjwiIOmBhDjARIsAP6YhSUB3WI81JP4Q_snYLhh-SBVNeCJNy2m63C8bKJFvO-nJ5UsHuCCdqMaAhTeEALw_wcB">DNA test kit</a> at the end of the study to assess their unique genetic profile. It’s important to note that everyone who participated in the study had a similar body weight, BMI and aerobic fitness level at the start of the study. This is beneficial for <a href="https://casp-uk.net/news/homogeneity-in-research/">multiple reasons</a>. It meant everyone was at the same starting point, and some <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/confounding-variable">confounding variables</a> were already controlled for such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10128125/">fitness level</a>. This ultimately improves accuracy in interpreting the results. <h2>Exercise genes</h2> Everyone in the exercise group managed to lose weight – around 2kg on average. The control group, on the other hand, put on a little bit of weight. While a 2kg weight loss may not sound like a lot, it’s significant considering the exercise regime only lasted eight weeks and participants made no <a href="https://www.intechopen.com/chapters/87186">changes to their diet</a>. More significant, however, was the large variation in results among those that exercised – with an up to 10kg difference in weight loss between some of the participants. In fact, everyone within the exercise group improved at different rates. Since we controlled for factors such as the <a href="https://pubmed.ncbi.nlm.nih.gov/3529283/">intensity, duration and frequency</a> of the exercises and used participants who’d had a similar body weight and fitness level at the start of the study, this suggests that some people naturally benefited more than others from endurance training. When we looked at the genetic profiles of our participants, we found that differences in each person’s response to the exercise was strongly associated with their specific genetics. We showed there was a strong linear correlation between the amount of weight participants lost and 14 genes that have previously been shown to be associated with body weight, metabolism or <a href="https://www.nature.com/articles/s41380-018-0017-5">psychological conditions</a> that affect BMI. The greater number of these genes a participant had, the more weight they lost. Our results also revealed that around 63% of the variance in weight lost among participants were explained by the genes identified. For example, research has shown the <a href="https://www.ncbi.nlm.nih.gov/gene/10891">PPARGC1A gene</a> plays a role in metabolism and the <a href="https://link.springer.com/article/10.1007/S11033-020-05801-Z">use of fats for energy</a> while exercising. Our study found that all participants who lost more than 1.5kg from exercise had this gene. Those who lost less than this did not have this gene. Our findings align with what <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249501&s2=P875440273_1683331208925004155">previous studies</a> have shown. But while previous papers have only looked at the link between individual genes and weight loss, ours is the first to show that 14 different genes appear to work in combination to affect whether a person loses weight from endurance exercise. <h2>Piece of the puzzle</h2> Our study also suggests that while some people possess genes that make it easier for them to get fit and lose weight, people with these favourable genetics can only flourish if they actually exercise. In fact, our control group also had a number of these listed genes, but without exercise these genes could not activate, and so the participants did not lose any weight. While our study provides compelling findings, it’s not without limitations. Since we only looked at endurance-based exercise, it will be important for future studies to investigate whether there are similar links between weight loss, genetics and combinations of different types of training (such as a mixture of endurance and strength sessions into a training plan). It’s also worth mentioning that exercise is only <a href="https://www.who.int/activities/controlling-the-global-obesity-epidemic">one piece of the puzzle</a> when it comes to weight loss. So even if you have all 14 of these genes, you won’t lose any weight or get fit if you don’t exercise and maintain a healthy diet and sleep pattern. On the flip side, someone that only has a few of these favourable genes can still benefit if they exercise and are mindful of other aspects of their lifestyle.<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/240506/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/henry-chung-1279176">Henry Chung</a>, Lecturer in Sport and Exercise Science, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>; <a href="https://theconversation.com/profiles/chris-mcmanus-2226445">Chris McManus</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</a>, and <a href="https://theconversation.com/profiles/sally-waterworth-2226444">Sally Waterworth</a>, Lecturer, School of Sport, Rehabilitation and Exercise Sciences, <a href="https://theconversation.com/institutions/university-of-essex-1291">University of Essex</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-lose-weight-heres-why-your-genetics-could-be-just-as-important-as-your-exercise-regime-240506">original article</a>. </div>

Body

Are you over 75? Here’s what you need to know about vitamin D

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even <a href="https://pubmed.ncbi.nlm.nih.gov/38337682/">more crucial</a> as we age. New guidelines from the international Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommend</a> people aged 75 and over should consider taking vitamin D supplements. But why is vitamin D so important for older adults? And how much should they take? <h2>Young people get most vitamin D from the sun</h2> In Australia, it is possible for most people under 75 to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun for a few minutes on most days. The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer. But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommends</a> people get 800 IU (international units) of vitamin D a day from food or supplements. <h2>Why you need more as you age</h2> This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D. Overall, older adults also tend to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/">less exposure</a> to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors. As we age, our skin also becomes <a href="https://pubmed.ncbi.nlm.nih.gov/18290718/">less efficient</a> at synthesising vitamin D from sunlight. The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889852913000145">harder for the body to maintain</a> adequate levels of the vitamin. All of this combined means older adults need more vitamin D. <h2>Deficiency is common in older adults</h2> Despite their higher needs for vitamin D, people over 75 may not get enough of it. Studies <a href="https://www.abs.gov.au/articles/vitamin-d">have shown</a> one in five older adults in Australia have vitamin D deficiency. In higher-latitude parts of the world, such as the United Kingdom, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627050/">almost half</a> don’t reach sufficient levels. This increased risk of deficiency is partly due to <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">lifestyle factors</a>, such as spending less time outdoors and insufficient dietary intakes of vitamin D. It’s difficult to get enough vitamin D from food alone. <a href="https://dietitiansaustralia.org.au/health-advice/vitamin-d">Oily fish, eggs and some mushrooms</a> are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference. In some countries such as the <a href="https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/">United States</a>, most of the dietary vitamin D comes from fortified products. However, in <a href="https://pubmed.ncbi.nlm.nih.gov/35253289">Australia</a>, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it. <h2>Why vitamin D is so important as we age</h2> Vitamin D <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367643/">helps the body absorb calcium</a>, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis. Keeping bones healthy is crucial. Studies <a href="https://pubmed.ncbi.nlm.nih.gov/28726112/">have shown</a> older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured. Vitamin D may also help <a href="https://pubmed.ncbi.nlm.nih.gov/28202713/">lower the risk</a> of respiratory infections, which can be more serious in this age group. There is also emerging evidence for other potential benefits, including <a href="https://pubmed.ncbi.nlm.nih.gov/29233204/">better brain health</a>. However, this requires more research. According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">moderate evidence</a> to suggest vitamin D supplementation can lower the risk of premature death. The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all. <h2>Should we get our vitamin D levels tested?</h2> The Endocrine Society’s guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">suggest</a> routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75. There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders. Routine <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498906">testing</a> can also be expensive and inconvenient. In most cases, the <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommended approach</a> to over-75s is to consider a daily supplement, without the need for testing. You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation. Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.<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/231820/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, PhD Candidate - Nutrition and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</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/are-you-over-75-heres-what-you-need-to-know-about-vitamin-d-231820">original article</a>. </div>

Body

An unbroken night’s sleep is a myth. Here’s what good sleep looks like

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> What do you imagine a good night’s sleep to be? Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep. Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">the same belief</a>. In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like. <h2>Sleep cycles are a roller-coaster</h2> As an adult, our sleep moves through <a href="https://www.sleepfoundation.org/stages-of-sleep">different cycles</a> and brief awakenings during the night. Sleep cycles last roughly 90 minutes each. We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming. If sleeping well, we get most of our deep sleep in the first half of the night, with <a href="https://www.nhlbi.nih.gov/health/sleep/stages-of-sleep#:%7E:text=During%20REM%20sleep%2C%20your%20eyes,from%20acting%20out%20your%20dreams">REM sleep</a> more common in the second half of the night. Adults usually move through five or six sleep cycles in a night, and it is entirely <a href="https://doi.org/10.1016/j.jpsychores.2014.09.011">normal</a> to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief. <h2>What does getting a ‘good’ sleep actually mean?</h2> You’ll often hear that adults <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need#:%7E:text=Sleep%20requirements%20stabilise%20in%20early,their%20best%20the%20next%20day">need between seven and nine hours</a> of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality. For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day. You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb). But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons. <h2>Common issues</h2> Sleep disorders are common. Up to <a href="https://pubmed.ncbi.nlm.nih.gov/35478719/">25% of adults</a> have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like. Rates of common sleep disorders such as insomnia and <a href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631">sleep apnoea</a> – where your breathing can partially or completely stop many times during the night – also increase with age, affecting <a href="https://pubmed.ncbi.nlm.nih.gov/32280974/">20% of early adults</a> and 40% of people in <a href="https://pubmed.ncbi.nlm.nih.gov/35082023/">middle age</a>. There are effective treatments, so asking for help is important. Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as <a href="https://www.sciencedirect.com/science/article/abs/pii/S0012369218311139">pain</a> – and by <a href="https://onlinelibrary.wiley.com/doi/10.1111/jsr.13075">certain medications</a>. There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “<a href="https://www.tandfonline.com/doi/full/10.1080/07420528.2021.2003375">forced awakenings</a>” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause. A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help. We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own <a href="https://www.sleephealthfoundation.org.au/sleep-categories/circadian-rhythm-disorders#:%7E:text=The%20circadian%20rhythms%20throughout%20the,regulation%20of%20our%20sleeping%20patterns">internal clock</a>, which can influence the time your body prefers to sleep. If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern. <h2>Can my smart watch help?</h2> It is important to remember sleep-tracking devices can <a href="https://www.nature.com/articles/s41746-024-01016-9">vary in accuracy</a> for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure. In-laboratory <a href="https://pubmed.ncbi.nlm.nih.gov/31277862/">polysomnography</a>, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep. Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time. <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.8356">Understanding your sleep patterns</a> may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment. And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.<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/238069/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amy-reynolds-424346">Amy Reynolds</a>, Associate Professor in Clinical Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/claire-dunbar-1651340">Claire Dunbar</a>, Research Associate, Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/gorica-micic-187159">Gorica Micic</a>, Postdoctoral Research Fellow, Clinical Psychologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>; <a href="https://theconversation.com/profiles/hannah-scott-424633">Hannah Scott</a>, Research Fellow in Sleep Health, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a>, and <a href="https://theconversation.com/profiles/nicole-lovato-60684">Nicole Lovato</a>, Associate Professor, Adelaide Institute for Sleep Health, <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/an-unbroken-nights-sleep-is-a-myth-heres-what-good-sleep-looks-like-238069">original article</a>. </div>

Body

Is there anything good about menopause? Yep, here are 4 things to look forward to

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Menopause is having a bit of <a href="https://journals.sagepub.com/doi/full/10.1177/13675494231159562">a moment</a>, with less stigma and more awareness about the changes it can bring. A recent senate inquiry <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Menopause/Report">recommended</a> public education about perimenopause and menopause, more affordable treatments and flexible work arrangements. But like many things in life the experiences of menopause are on a continuum. While some women find it challenging and require support, others experience some physical and emotional benefits. These are rarely reported – but we can learn from the research available and, importantly, from people’s lived experiences. Here are four changes to look forward to once you reach menopause. <h2>1. No more periods or related issues</h2> <a href="https://theconversation.com/what-are-the-most-common-symptoms-of-menopause-and-which-can-hormone-therapy-treat-225174">Menopause</a> is considered “complete” 12 months after the final period of a woman (or person assigned female at birth) who previously menstruated. Perhaps unsurprisingly, the benefit at the top of the list is no more periods (unless you are taking hormone therapy and still have your womb). This can be particularly beneficial for women who have had to manage <a href="https://www.mdpi.com/1660-4601/18/4/1951">erratic, unpredictable and heavy bleeding</a>. At last, you don’t need to keep sanitary protection in every bag “just in case”. No more planning where the bathroom is or having to take extra clothes. And you’ll save money by not purchasing sanitary products. There is also good news for women who have had heavy bleeding due to uterine fibroids – common benign gynaecological tumours that affect up to 80% of women. The evidence <a href="https://journals.lww.com/menopausejournal/abstract/2020/02000/uterine_fibroids_in_menopause_and_perimenopause.17.aspx">suggests</a> hormonal changes (for women not taking hormone therapy) can lead to a reduction in the size of fibroids and relieve symptoms. Women who suffer from menstrual migraine may experience an improvement in migraines post-menopause as their hormonal fluctuations begin to settle – but the timeframe for this <a href="https://www.maturitas.org/article/S0378-5122(20)30329-7/abstract">remains unclear</a>. For some women, no more periods also means more participation in social activities from which they may have been excluded due to periods. For example, <a href="https://www.tandfonline.com/doi/full/10.1080/08952841.2014.954502">religious activities or food preparation</a> in some cultures. <h2>2. Getting your body and your groove back</h2> Throughout their reproductive lives, women in heterosexual relationships are usually the ones expected to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115298/">proactive about preventing pregnancy</a>. Some post-menopausal women <a href="https://www.tandfonline.com/doi/full/10.1080/08952841.2018.1396783">describe</a> a re-emergence of their sexuality and a sense of sexual freedom that they had not previously experienced (despite contraceptive availability) as there is no longer a risk of pregnancy. A participant in my research <a href="https://eprints.soton.ac.uk/451254/">into women’s experiences of menopause</a> described the joy of no longer being child-bearing age: <blockquote> I’ve got a body back for me, you know, coz I can’t get pregnant, not that I haven’t enjoyed having [children] and things like that and it was a decision to get pregnant but I feel like, ooh my body isn’t for anybody now but me, people, you know? </blockquote> For women who have chosen to be child-free there may also be a sense of freedom from social expectations. People will likely stop asking them when they are planning to have children. <h2>3. A new chapter and a time to focus on yourself</h2> Another participant <a href="https://eprints.soton.ac.uk/451254/">described</a> menopause as an unexpected “acceleration point” for change. Women told us they were more accepting of themselves and their needs rather than being focused on the needs of other people. Researchers have previously <a href="https://sk.sagepub.com/books/individualization">tracked this shift</a> from “living for others” to “a life of one’s own”. Some women find the strength of emotions at this time a challenge, whereas others find their potency can <a href="https://doi.org/10.1145/3290605.3300710">facilitate liberation</a> – enabling them to speak their minds or be more assertive than at any other time in their lives. <h2>4. Increased self-confidence</h2> A new sense of liberation can fuel increased self-confidence at menopause. This has been <a href="https://doi.org/10.1145/3290605.3300710">reported</a> in studies based on in-depth <a href="https://doi.org/10.1080/0167482X.2016.1270937">interviews with women</a>. Confidence boosts can coincide with <a href="https://eprints.soton.ac.uk/451254/">changes in career and sometimes in relationships</a> as priorities and self-advocacy transform. <h2>Life on the other side</h2> It can be hard to think about what is good about menopause, particularly if you are having challenges during perimenopause – but these can get better with time. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910086/">cultures where women are valued as they become older</a>, women describe themselves as positively contributing to the community. They find they gain power and respect as they age. We need to work towards more positive societal attitudes on this front. Our bodies change across the lifespan and are remarkable at every stage, including menopause.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239725/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/yvonne-middlewick-1395795">Yvonne Middlewick</a>, Nurse, Lecturer & Director of Post-graduate Studies in the School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan 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/is-there-anything-good-about-menopause-yep-here-are-4-things-to-look-forward-to-239725">original article</a>. </div>

Body

We tend to underestimate our future expenses – here’s one way to prevent that

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ray-charles-chuck-howard-1361224">Ray Charles "Chuck" Howard</a>, <a href="https://theconversation.com/institutions/texas-aandm-university-1672">Texas A&M University</a>; <a href="https://theconversation.com/profiles/abigail-sussman-227057">Abigail Sussman</a>, <a href="https://theconversation.com/institutions/university-of-chicago-952">University of Chicago</a>; <a href="https://theconversation.com/profiles/david-j-hardisty-753777">David J. Hardisty</a>, <a href="https://theconversation.com/institutions/university-of-british-columbia-946">University of British Columbia</a>, and <a href="https://theconversation.com/profiles/marcel-lukas-1236384">Marcel Lukas</a>, <a href="https://theconversation.com/institutions/university-of-st-andrews-1280">University of St Andrews</a> <h2>The big idea</h2> When asked to estimate how much money they would spend in the future, people underpredicted the total amount by more than C$400 per month. However, when prompted to think about unexpected spending in addition to typical expenses, people made much more accurate predictions. These are the main findings of a series of <a href="https://doi.org/10.1177%2F00222437211068025">studies and experiments that we conducted</a> and which have just been published in the <a href="https://journals.sagepub.com/home/mrj">Journal of Marketing Research</a>. In our first study, we began by asking 187 members of a Canadian credit union to predict their weekly spending for the next five weeks. Then, at the end of each week, we asked them how much they actually spent. For the first four weeks, people underpredicted their weekly spending by about $100 per week or $400 for the month. In the study’s fifth and final week, we ran an experiment to see if we could improve people’s prediction accuracy. Specifically, we randomly assigned participants to one of two groups. In group one, participants estimated their spending for the next week just as they had done in previous weeks. These folks once again significantly underpredicted their spending. In group two, participants were asked to think of three reasons why their spending for the next week might be different than usual before making their estimate. This led them to make higher and much more accurate predictions – coming within just $7 of what they actually spent. Importantly, participants in each group spent roughly the same amount of money that week, on average. The only difference between the two groups was whether they accurately predicted that amount. <iframe id="WlDv3" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/WlDv3/3/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Next, we conducted nine experiments to better understand why people underpredict their spending and whether being prompted to think of unusual expenses helps improve accuracy. In all, over 5,800 people participated in these experiments, including a representative sample of U.S. residents. These experiments revealed two important insights. First, people primarily base their spending predictions on typical expenses like groceries, gasoline and rent. They usually fail to account for irregular – though still common – expenses like car repairs, last-minute concert tickets or one-off health care bills. This is what leads to underprediction. Second, prompting people to think of irregular expenses in addition to typical expenses helps them to make more accurate spending predictions. In our studies, people did not factor in atypical expenses unless we asked them to do so. <h2>Why it matters</h2> Helping people improve the accuracy of their spending predictions could help them improve their financial well-being. Underpredicting expenses can be costly. For example, 12 million Americans <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/19/who-borrows-where-they-borrow-and-why">borrow a total of more than $7 billion</a> in payday loans each year because they can’t meet their monthly expenses. These loans typically have extremely high interest rates – <a href="https://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2022/how-well-does-your-state-protect-payday-loan-borrowers">more than 250% in some states</a>. Payday loans also come due in full so quickly that around three in four borrowers <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2012/07/19/who-borrows-where-they-borrow-and-why">end up borrowing again</a> to pay off the original loan. If consumers could better anticipate how much money they will spend in the future, it might help motivate them to spend less and save more in the present. In fact, one of our studies shows that our suggested prediction strategy <a href="https://doi.org/10.1177/0022243721106802">not only boosted spending estimates</a>, it also increased intentions to save. <h2>What’s next</h2> Members of our research team are currently investigating if, when and why underpredicting one’s expenses may be beneficial. For example, if a person sets an optimistically low budget and actively tracks their spending against it, does that help them reduce their spending? We are also investigating whether people who work in the gig economy show a corresponding tendency to mispredict their future income.<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/189100/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/ray-charles-chuck-howard-1361224">Ray Charles "Chuck" Howard</a>, Assistant Professor of Marketing, <a href="https://theconversation.com/institutions/texas-aandm-university-1672">Texas A&M University</a>; <a href="https://theconversation.com/profiles/abigail-sussman-227057">Abigail Sussman</a>, Professor of Marketing, <a href="https://theconversation.com/institutions/university-of-chicago-952">University of Chicago</a>; <a href="https://theconversation.com/profiles/david-j-hardisty-753777">David J. Hardisty</a>, Assistant Professor of Marketing & Behavioral Science, <a href="https://theconversation.com/institutions/university-of-british-columbia-946">University of British Columbia</a>, and <a href="https://theconversation.com/profiles/marcel-lukas-1236384">Marcel Lukas</a>, Lecturer in Banking and Finance, <a href="https://theconversation.com/institutions/university-of-st-andrews-1280">University of St Andrews</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/we-tend-to-underestimate-our-future-expenses-heres-one-way-to-prevent-that-189100">original article</a>. </div>

Money & Banking

Flying to a footy final? Watch your wallet. Here’s why airfares soar

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/doug-drury-1277871">Doug Drury</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> Planning a flight to an AFL final is like trying to decide when and how to hop on an amusement park ride that hasn’t stopped. You don’t know where you need to be until the very last minute, and by then, it seems everyone else wants to be there too. This annual dilemma is now in sharp focus, with preliminary finals coming up this weekend. Sydney will face Port Adelaide at the Sydney Cricket Ground on Friday night, then Geelong will take on Brisbane in Melbourne on Saturday. Getting to these locations on the right dates can be no mean feat, and some fans have already been stung by surging prices. For those who tried to book over the weekend, prices to fly from Adelaide to Sydney in time for Friday’s game <a href="https://www.adelaidenow.com.au/news/south-australia/port-adelaide-fans-will-have-to-pay-a-hefty-price-for-airfare-tickets-to-sydney-for-prelim-final-at-scg/news-story/e549e292c50eb9798f6735d2270aafc3">reportedly ranged</a> from $597 to an eye-watering $1,723. Australia’s airline duopoly is already under intense scrutiny. According to government <a href="https://australianaviation.com.au/2024/09/domestic-airfares-rise-after-rexs-demise/">data</a> released this week, domestic airfares have risen by more than 10% since Rex shut down its capital city services. So how exactly do airlines price their fares today, and then again once the teams are decided? Why are they allowed to charge so much? <h2>How are airfares priced?</h2> Airfares are set through a process called revenue management. Airlines use <a href="https://www.sciencedirect.com/science/article/pii/S0969699714000556">mathematical modelling</a> to help determine what we as consumers are willing to pay. Airlines plan out their entire year based on what services they predict will be needed at certain times – such as travel for school breaks, winter skiing, or summers in Hawaii. In economics, this is known as seasonal supply and demand. Airlines have the supply, planes, and we as consumers provide the demand. The cost of flights to cities hosting footy finals might seem outrageous. But these games are one-off events that happen at the same time each year. Using historical data, airlines have determined that enough people are willing to pay these fares to justify charging them. <h2>Two types of traveller</h2> Airlines base their <a href="https://doi.org/10.1016/j.jksuci.2019.02.001">pricing strategies</a> on the assumption that we as travellers fall into two groups: elastic and inelastic. Here, elasticity simply describes how sensitive demand is to a change in price. Vacationers with a flexible calendar are an example of elastic travellers, who are able to change their flight dates to get the lowest airfare. Inelastic travellers, on the other hand, include business travellers who need to be somewhere specific on a particular date, and aren’t paying fares out of their own pocket. Airlines factor in both of these groups to determine <a href="https://digitalcommons.odu.edu/hms_fac_pubs/27">demand-based pricing</a>. Footy finals create huge amounts of inelastic demand, allowing airlines to push up their prices. <h2>Does the price actually reflect the value?</h2> <a href="https://digitalcommons.odu.edu/hms_fac_pubs/27">Transactional utility</a> is a theory based upon the assumption that the price we pay for a product or service should reflect the value we receive. In this case – how much fans are willing to pay to be there to watch the game live. But individually, this depends on who you barrack for, as well as whether you have the disposable income to pay a premium for the experience. Last year, some airfares to the grand final soared <a href="https://www.couriermail.com.au/sport/travel-tsunami-2300-grand-final-flights-for-diehard-brisbane-footy-fans/news-story/270a34ad89d49cc68f1e7202b0d22e59">above the $2,000 mark</a>. So how are the airlines able to set these prices? Are they not regulated by the government? It all comes back to what we as consumers are collectively willing to pay for a diminished supply during high demand. The government does not regulate airfares on that level. Airlines will not want to sell discounted seats if they know enough of us are willing to pay. They might run more flights, but that doesn’t necessarily mean airfares will come down. Our decision to buy a seat is based on the perception of its fairness. Getting into the final is costly enough – does the price charged to fly there also <a href="https://digitalcommons.odu.edu/hms_fac_pubs/27">seem fair</a>? Airlines know the psychology of fairness is what will fill the seat. So they will continue to test our perception of fairness on last minute purchases. <h2>Less competition makes it worse</h2> These types of pricing strategies are not unique to Australia. Airlines all around the globe understand the passion associated with championship sporting events and position themselves to take advantage of such moments. But we also know that here, airlines are pricing what they can in part due to very low competition, only worsened by the recent demise of Bonza and Rex. We can <a href="https://www.accc.gov.au/by-industry/travel-and-airports/domestic-airline-monitoring">voice our displeasure</a> about this situation with the Australian Competition and Consumer Commission, but in the short term, many of us simply continue to pay the airfares. This is because the other methods of travel either don’t exist, such as high speed rail, or aren’t reasonable, such as driving for multiple days. Remember, airlines see this as an opportunity to increase their bottom line as part of their revenue management system. So what should you do if your team makes the grand final? Sell your car or house? Take out a second mortgage? What if you book now while it’s still relatively cheap and your team doesn’t make the final? Well, there is plenty to do in Melbourne in September! I, for one, will be watching from the comfort of my lounge room.<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/239104/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/doug-drury-1277871">Doug Drury</a>, Professor/Head of Aviation, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</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/flying-to-a-footy-final-watch-your-wallet-heres-why-airfares-soar-239104">original article</a>. </div>

Domestic Travel

Yes, you do need to clean your tongue. Here’s how and why

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Has your doctor asked you to stick out your tongue and say “aaah”? While the GP assesses your throat, they’re also checking out your tongue, which can reveal a lot about your health. The doctor will look for any changes in the tongue’s surface or how it moves. This can indicate issues in the mouth itself, as well as the state of your overall health and immunity. But there’s no need to wait for a trip to the doctor. Cleaning your tongue <a href="https://pubmed.ncbi.nlm.nih.gov/21797979/">twice a day</a> can help you check how your tongue looks and feels – and improve your breath. <h2>What does a healthy tongue look like?</h2> Our tongue plays a crucial role in eating, talking and other vital functions. It is not a single muscle but rather a muscular organ, made up of eight muscle pairs that help it move. The surface of the tongue is covered by tiny bumps that can be seen and felt, called papillae, giving it a rough surface. These are sometimes mistaken for taste buds – they’re not. Of your 200,000-300,000 papillae, only a small fraction contain taste buds. Adults have up to 10,000 taste buds and they are invisible to the naked eye, concentrated mainly on the tip, sides and back of the tongue. <figure><iframe src="https://www.youtube.com/embed/uYvpUl7li9Y?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> A healthy tongue is pink although the shade may vary from person to person, ranging from dark to light <a href="https://my.clevelandclinic.org/health/symptoms/24600-tongue-color">pink</a>. A small amount of white coating can be normal. But significant changes or discolouration may indicate a disease or <a href="https://www.healthline.com/health/tongue-problems-2">other issues</a>. <h2>How should I clean my tongue?</h2> Cleaning your tongue only takes around 10-15 seconds, but it’s is a good way to check in with your health and can easily be incorporated into your teeth brushing routine. You can clean your tongue by gently scrubbing it with a regular toothbrush. This dislodges any food debris and helps prevent microbes building up on its rough textured surface. Or you can use a special <a href="https://pubmed.ncbi.nlm.nih.gov/26865433/">tongue scraper</a>. These curved instruments are made of metal or plastic, and can be used alone or accompanied by scrubbing with your toothbrush. Your co-workers will thank you as well – cleaning your tongue can help combat <a href="https://pubmed.ncbi.nlm.nih.gov/24165218/">stinky breath</a>. Tongue scrapers are particularly <a href="https://pubmed.ncbi.nlm.nih.gov/15341360/">effective</a> at removing the bacteria that commonly causes bad breath, hidden in the tongue’s surface. <h2>What’s that stuff on my tongue?</h2> So, you’re checking your tongue during your twice-daily clean, and you notice something different. Noting these signs is the first step. If you observe any changes and they worry you, you should talk to your GP. Here’s what your tongue might be telling you. White coating Developing a white coating on the tongue’s surface is one of the <a href="https://pubmed.ncbi.nlm.nih.gov/31309703/">most common changes</a> in healthy people. This can happen if you stop brushing or scraping the tongue, even for a few days. In this case, food debris and microbes have accumulated and caused plaque. Gentle scrubbing or scraping will remove this coating. Removing microbes reduces the risk of chronic infections, which can be transferred to other organs and cause <a href="https://www.nature.com/articles/s41368-022-00163-7">serious illnesses</a>. Yellow coating This may indicate oral thrush, a <a href="https://www.nidirect.gov.uk/conditions/oral-thrush-adults">fungal infection</a> that leaves a raw surface when scrubbed. Oral thrush is <a href="https://www.aafp.org/pubs/afp/issues/2008/1001/p845.html">common</a> in elderly people who take multiple medications or have diabetes. It can also affect children and young adults after an illness, due to the temporary <a href="https://pubmed.ncbi.nlm.nih.gov/7636666/">suppression of the immune system</a> or <a href="https://www.stanfordchildrens.org/en/topic/default?id=candidiasis-in-children-90-P01888">antibiotic</a> use. If you have oral thrush, a doctor will usually prescribe a course of anti-fungal medication for at least a month. Black coating Smoking or consuming a lot of strong-coloured food and drink – such as tea and coffee, or dishes with tumeric – can cause a furry appearance. This is known as a <a href="https://my.clevelandclinic.org/health/diseases/17918-black-hairy-tongue">black hairy tongue</a>. It’s not hair, but an overgrowth of bacteria which may indicate poor oral hygiene. Pink patches Pink patches surrounded by a white border can make your tongue look like a map – this is called “<a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/symptoms-causes/syc-20354396">geographic tongue</a>”. It’s <a href="https://www.mayoclinic.org/diseases-conditions/geographic-tongue/diagnosis-treatment/drc-20354401">not known</a> what causes this condition, which usually doesn’t require treatment. Pain and inflammation A red, sore tongue can indicate a <a href="https://medlineplus.gov/ency/article/003047.htm">range of issues</a>, including: <ul> <li>nutritional deficiencies such as folic acid or vitamin B12</li> <li>diseases including <a href="https://my.clevelandclinic.org/health/diseases/22377-pernicious-anemia">pernicious</a> anaemia, <a href="https://www.rch.org.au/kidsinfo/fact_sheets/kawasaki_disease/">Kawasaki disease</a> and <a href="https://www.childrens.health.qld.gov.au/health-a-to-z/scarlet-fever">scarlet fever</a></li> <li>inflammation known as <a href="https://www.ncbi.nlm.nih.gov/books/NBK560627/">glossitis</a></li> <li>injury from hot beverages or food</li> <li>ulcers, including cold sores and canker sores</li> <li><a href="https://www.nidcr.nih.gov/health-info/burning-mouth">burning mouth syndrome</a>.</li> </ul> Dryness Many medications can cause dry mouth, also called xerostomia. These include antidepressants, anti-psychotics, muscle relaxants, pain killers, antihistamines and diuretics. If your mouth is very dry, it may hurt. <h2>What about cancer?</h2> White or red patches on the tongue that can’t be scraped off, are long-standing or growing need to checked out by a dental professional as soon as possible, as do painless ulcers. These are at a <a href="https://oralcancerfoundation.org/cdc/premalignant-lesions/">higher risk</a> of turning into cancer, compared to other parts of the mouth. <a href="https://pubmed.ncbi.nlm.nih.gov/36852511/">Oral cancers</a> have low survival rates due to delayed detection – and they are on the rise. So <a href="https://youtu.be/Y6QkKhEjS5M">checking your tongue</a> for changes in colour, texture, sore spots or ulcers is <a href="https://www.dhsv.org.au/oral-health-programs/oral-cancer-screening-and-prevention">critical</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237130/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dileep-sharma-1562149">Dileep Sharma</a>, Professor and Head of Discipline - Oral Health, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</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/yes-you-do-need-to-clean-your-tongue-heres-how-and-why-237130">original article</a>. </div>

Body

Why isn’t dental included in Medicare? It’s time to change this – here’s how

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> When the forerunner of Medicare was established in the 1970s, dental care was left out. Australians are still suffering the consequences half a century later. Patients pay much more of the cost of dental care than they do for other kinds of care. <a href="https://www.commonwealthfund.org/sites/default/files/2021-08/Schneider_Mirror_Mirror_2021.pdf">More</a> Australians delay or skip dental care because of cost than their peers in most wealthy countries. And as our dental health gets <a href="https://theconversation.com/reform-delay-causes-dental-decay-its-time-for-a-national-deal-to-fund-dental-care-217914">worse</a>, fees keep on rising. For decades, a litany of reports and inquiries have called for universal dental coverage to solve these problems. Now, with the Greens <a href="https://greens.org.au/news/media-release/tax-big-corporate-profits-fix-peoples-teeth-greens">proposing</a> it and Labor backbenchers <a href="https://www.theaustralian.com.au/nation/politics/dental-on-medicare-must-be-next-frontier-for-labor-backbenchers/news-story/1c69314d7609815b937ced5af4542ba0">supporting</a> it, could it finally be time to put the mouth into Medicare? <h2>What’s stopping us?</h2> The Australian Dental Association <a href="https://ada.org.au/ada-responds-to-the-greens-dentistry-in-medicare-proposal">says</a> the idea is too ambitious and too costly, pointing out it would need many more dental workers. They say the government should start small, focusing on the most vulnerable populations, initially seniors. Starting small is sensible, but finishing small would be a mistake. Dental costs aren’t just a problem for the most vulnerable, or the elderly. More than <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/2022-23/patient_experience_202223_tables_13_to_15.xlsx">two million</a> Australians avoid dental care because of the cost. More than <a href="https://www.aihw.gov.au/getmedia/a053aa74-c471-436e-ab7e-a82e83ae73a3/aihw_den_231_dentalcare_oralhealthanddentalcareinaustralia_tranche7_21NOV2023.xlsx">four in ten</a> adults usually wait more than a year before seeing a dental professional. Bringing dental into Medicare will require many thousands of new dental workers. But it will be possible if the scheme is <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">phased in</a> over ten years. The real reason dental hasn’t been added to Medicare is it would cost billions of dollars. The federal government doesn’t have that kind of money lying around. Australia has a <a href="https://theconversation.com/the-budget-is-full-of-good-news-but-good-news-isnt-the-same-as-good-management-230110">structural budget problem</a>. Government spending is growing faster than revenue, because we are a relatively <a href="https://grattan.edu.au/news/can-we-talk-about-a-fairer-more-prosperous-australia/">low-tax country with high service expectations</a>. The growing cost of health care is a major contributor, with hospitals and medical benefits among the top six fastest-growing major payments. The structural gap is only <a href="https://treasury.gov.au/publication/2023-intergenerational-report">likely to grow</a> without major policy changes. So, can we afford health care for all? We can. But we should do it with smart choices on dental care, and tough choices to raise revenue and reduce spending elsewhere. <h2>Smart choices about a new dental scheme</h2> The first step is to avoid repeating the mistakes of Medicare. Medicare payments to private businesses haven’t attracted them to a lot of the communities that need them the most. Many rural and disadvantaged areas are <a href="https://theconversation.com/if-you-live-in-a-bulk-billing-desert-its-hard-to-see-a-doctor-for-free-heres-how-to-fix-this-204029">bulk-billing deserts</a> with too few GPs. The poorest areas have more than <a href="https://grattan.edu.au/wp-content/uploads/2022/12/A-new-Medicare-strengthening-general-practice-Grattan-Report.pdf">twice</a> the psychological distress of the wealthiest areas, but they get about half the Medicare-funded mental health services. As a result, government money isn’t going where it will make the biggest difference. There are about <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/hospitalisations/potentially-preventable-hospitalisations">80,000</a> hospital visits each year for dental problems that could have been avoided with dental care. If there is too little care in disadvantaged and rural communities, where oral health is worst, that number will remain high. That’s why a significant share of new investment should be quarantined for public dental services, with those services targeted to areas where people are missing out on care. Another problem with Medicare is its payments often have little relationship to the cost of care, or the impact that care has on the patient’s health. To tamp down costs, Medicare funding for dental care should exclude cosmetic treatments and orthodontics. It should be based on efficient workforce models where dental assistants and therapists use all their skills – you might not always need to see a dentist. The funding <a href="https://apo.org.au/sites/default/files/resource-files/2019-06/apo-nid241086.pdf">model</a> should take account of a patient’s needs, reward giving them ongoing care, and have a <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">cap</a> on spending per patient. Oral health should be measured and recorded, to make sure patients and taxpayers are getting results. <h2>Tough choices to balance the budget</h2> Those steps would slash the cost of The Greens’ plan, which is hard to estimate but might reach more than <a href="https://www.pbo.gov.au/sites/default/files/2024-09/Putting%20dental%20care%20into%20Medicare.pdf">$20 billion</a> a year once it’s phased in. Instead, the cost would fall to roughly <a href="https://grattan.edu.au/report/filling-the-gap/">$7 billion</a> a year. That would be a good investment. But if you’re worried about where the money will come from, there are good ways to pay for it. Many reforms could reduce government health budgets without harming patients. There is waste in government funding of <a href="https://grattan.edu.au/wp-content/uploads/2016/02/935-blood-money.pdf">pathology</a> tests and <a href="https://grattan.edu.au/wp-content/uploads/2015/06/823-Premium-Policy4.pdf">less cost-effective</a> medicines. In some hospitals, there are <a href="https://grattan.edu.au/wp-content/uploads/2014/03/806-costly-care.pdf">excessive costs</a> and potentially harmful <a href="https://qualitysafety.bmj.com/content/qhc/28/3/205.full.pdf">low-value care</a>. Over the longer-term, investments in <a href="https://grattan.edu.au/wp-content/uploads/2023/02/The-Australian-Centre-for-Disease-Control-ACDC-Highway-to-Health-Grattan-Report.pdf">prevention</a> can reduce demand for health care. A <a href="https://grattan.edu.au/wp-content/uploads/2024/05/Sickly-Sweet-Grattan-Institute-Report-May-2024.pdf">tax on sugary drinks</a>, for example, would improve health while raising hundreds of millions of dollars a year. Measures like this would help the government pay for more dental care. But demand for health care will keep growing as the population ages, and as expensive <a href="https://www.abc.net.au/news/2024-09-11/proposal-to-speed-up-medicine-approvals/104338766">new treatments</a> arrive. This means a broader strategy is needed to meet the three goals of balancing the budget, keeping up with growing health-care demand, and bringing dental into Medicare. There are no easy solutions, but there are many options to reduce spending and boost revenue without hurting economic growth. Choosing Australia’s infrastructure and defence megaprojects <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">more wisely</a> could save several billion dollars each year. Undoing Western Australia’s special GST funding deal – <a href="https://www.austaxpolicy.com/western-australia-gst-deal-the-worst-australian-public-policy-decision-of-the-21st-century-thus-far/">described</a> by economist Saul Eslake as “the worst Australian public policy decision of the 21st Century thus far” – would save another <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$5 billion</a> a year. Reducing income tax breaks and tax minimisation opportunities – including by reining in superannuation tax concessions, reducing the capital gains tax discount, limiting negative gearing, and setting a minimum tax on trust distributions – could raise more than <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$20 billion</a> a year. Major tax reform like this offers economic benefits while creating space for better services such as universal dental coverage. No one likes spending cuts and tax hikes, but they will be needed <a href="https://theconversation.com/chalmers-has-a-70-billion-a-year-budget-hole-here-are-13-ways-to-fill-it-203331">sooner or later</a> regardless. Dental coverage might be just the sweetener taxpayers need to accept it.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239086/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, Deputy Program Director, Budgets and Government, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086">original article</a>. </div>

Money & Banking

Climate change threatens Australian tourism more than is widely believed. Here’s why

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/freya-higgins-desbiolles-181651">Freya Higgins-Desbiolles</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Right now, Australia is one of the <a href="https://www.weforum.org/publications/travel-tourism-development-index-2024/">top five</a> tourist destinations in the world, a distinction the World Economic Forum says it shares with only the United States, France, Spain and Japan. So important is tourism to Australia’s economy that the best estimates are it employs <a href="https://www.tra.gov.au/en/economic-analysis/state-of-the-industry">655,000</a> people, 12 times as many as <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed/jul-2024">Australia’s coal industry</a>. And most of them are employed in <a href="https://www.zurich.com.au/content/dam/au-documents/files/zurich-mandala-climate-risk-index-the-impact-of-climate-change-on-the-australian-tourism-industry.pdf">regional locations</a>, where jobs are scarce. This month a report by the Zurich insurance group and the economic consultancy Mandala found <a href="https://www.zurich.com.au/content/dam/au-documents/files/zurich-mandala-climate-risk-index-the-impact-of-climate-change-on-the-australian-tourism-industry.pdf">half</a> of Australia’s top 178 tourism assets were at risk from foreseeable climate change. There are reasons to believe its findings underplay what we are facing. <h2>All major airports, all national parks at risk</h2> The Zurich-Mandala report examines the impact of a 2⁰C increase in global temperatures on only eight so-called “climate perils”: wind, flood, heat, storm, drought, bushfire, hail and rain. It found that more than half of Australia’s top tourism assets faced a “significant risk from multiple perils” over the next 25 years, including all of Australia’s major airports. Scheduling disruptions and the closure of airports in extreme weather conditions were set to have major impacts on the transport of goods, the transport of tourists and accessibility for emergency services. All of Australia’s vineyards, national parks, scenic roads and railways were at risk. Queensland had the highest number of sites facing significant risk (79%) followed by Western Australia (69%) and the Northern Territory (63%). The report uses the impact of the 2019-20 <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1920/Quick_Guides/AustralianBushfires">black summer bushfires</a> to estimate that 176,000 jobs might be at risk nationwide from predictable climate change, most of them outside of Australia’s capital cities. <h2>Multiple and interacting threats</h2> Here is why I am fearful that the report underplays the threat Australia’s tourism industry is facing. There are many more threats to tourism from climate change than wind, flood, heat, storm, drought, bushfire, hail and rain. One is the threat to biodiversity. Iconic animals and habitats are an important part of Australia’s brand. <a href="https://www.abc.net.au/news/2020-07-28/3-billion-animals-killed-displaced-in-fires-wwf-study/12497976">Three billion</a> animals were killed or displaced in the black summer bushfires. The deaths caused <a href="https://www.theguardian.com/australia-news/2023/apr/01/alexis-wright-black-summer-bushfires-vigil-sydney-speech-3-billion-animals-killed-are-our-relatives-they-deserve-to-be-mourned">loss and grief</a> that risk indexes are incapable of capturing, but that nonetheless might make tourism less attractive. And biodiversity helps in another way by <a href="https://www.australianwildlife.org/wp-content/uploads/2019/12/Hayward-Et-Al.-2016-Could-biodiversity-loss-have-increased-Australias-bushfire-threat.pdf">protecting against bushfires</a>, meaning that as species vanish, other risks to tourism climb in ways that aren’t captured in the assumptions used to evaluate risk. <h2>Threats unexamined</h2> What makes holiday locations unattractive is hard to measure, but is fed by extreme weather events. Although temporary, the smoke and heat from the 2019-20 bushfires made parts of Sydney, Melbourne and Canberra almost unlivable for a while, damaging the reputations of Australian capital cities in a way that is <a href="https://www.smh.com.au/national/nsw/not-a-good-look-bushfire-smoke-threatens-to-pollute-sydney-s-tourist-image-20191206-p53hpl.html">probably ongoing</a>. Another curious omission, especially curious given that the report was prepared by an insurance company, is the damage extreme weather events do to the insurability of tourism assets. The report is also silent on the effort to reduce carbon emissions on Australia’s desirability as an international destination. For many tourists, air travel is the only way to get to Australia and it is likely to become more expensive and also less attractive as tourists try to reduce their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0959652614011810">carbon footprints</a>. Australia might increasingly become an Australian rather than an international destination. Our biggest upcoming international promotion, the 2032 Brisbane Olympic Games, might lose a good deal of its shine, with Queensland tourism assets at the greatest risk from climate change, and those risks set to climb over time. <h2>The higher the temperature the bigger the threats</h2> Zurich and the Mandala consultancy are to be commended for identifying 178 top tourism assets and examining eight types of risk they face. Their finding that just over half of them face serious threats from those risks is likely to be an underestimate because it excludes other risks and fails to examine the way in which some risks can intensify others. And they will be an underestimate if global temperatures climb by more than 2⁰C. The report says if global temperatures climb to 3⁰C above pre-industrial levels, 80% of the Australian sites it examined will face serious threats. Australia could attempt to limit the increase in global temperatures by taking up the opportunity to co-host the <a href="https://theconversation.com/its-a-big-deal-if-australia-and-the-pacific-are-chosen-to-host-un-climate-talks-heres-why-238320">2026 UN climate talks</a> with Pacific nations. It would give us a shot at making a difference and drawing attention to our present status as one of the world’s top tourism destinations.<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/238768/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/freya-higgins-desbiolles-181651">Freya Higgins-Desbiolles</a>, Adjunct professor and adjunct senior lecturer in tourism management, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</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/climate-change-threatens-australian-tourism-more-than-is-widely-believed-heres-why-238768">original article</a>. </div>

Domestic Travel

Ozempic, Wegovy, Rybelsus: Are we losing sight of overall health? Here’s what the science says

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters. The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>. Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized. As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments. <h2>The best of both worlds</h2> GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight. The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction. This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>. <h2>A new era</h2> GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger. These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope. Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions. Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support. <h2>Treating the effects but not the causes</h2> To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again. In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta). Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise. <h2>Prescribe and treat</h2> A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it. This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance. This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic. <h2>What lessons can we learn?</h2> The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment. We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<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/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</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/ozempic-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>. </div>

Body

The internet is worse than it used to be. How did we get here, and can we go back?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> When it comes to our experience of the internet, “the times, <a href="https://en.wikipedia.org/wiki/The_Times_They_Are_a-Changin%27_(song)">they are a-changin’</a>”, as Bob Dylan would say. You can’t quite recall how, but the internet certainly feels different these days. To some, it is “<a href="https://www.npr.org/2024/01/16/1224878097/everyday-users-are-complaining-that-the-internet-is-more-chaotic-than-ever">less fun and less informative</a>” than it used to be. To others, online searches are made up of “<a href="https://www.theverge.com/c/23998379/google-search-seo-algorithm-webpage-optimization?src=longreads">cookie cutter</a>” pages that drown out useful information and are saturated with scams, spam and content generated by artificial intelligence (AI). Your social media feeds are full of eye-catching, provocative, hyper-targeted, or anger-inducing content, from <a href="https://theconversation.com/the-dead-internet-theory-makes-eerie-claims-about-an-ai-run-web-the-truth-is-more-sinister-229609">bizarre AI-generated imagery</a> to robot-like comments. You’re lucky if your video feeds are not solely made up of exhortations to “subscribe”. How did we get here? And can we claw our way back? <h2>Commercial interests rule</h2> One major factor contributing to the current state of the internet is its over-commercialisation: financial motives drive much of the content. This has arguably led to the prevalence of sensationalism, prioritising virality over information quality. Covert and deceptive advertising is widespread, blurring the line between commercial and non-commercial content to attract more attention and engagement. Another driving force is the dominance of tech giants like Google, Meta and Amazon. They reach billions worldwide and wield immense power over the content we consume. Their platforms use advanced tracking technologies and opaque algorithms to generate hyper-targeted media content, powered by extensive user data. This creates <a href="https://www.campaignasia.com/article/the-echo-chamber-effect-how-algorithms-shape-our-worldview/491762">filter bubbles</a>, where users are exposed to limited content that reinforces their existing beliefs and biases, and <a href="https://philarchive.org/archive/NGUECA">echo chambers</a> where other viewpoints are actively discredited. Bad actors like <a href="https://abcnews.go.com/Technology/ai-fuel-financial-scams-online-industry-experts/story?id=103732051">cyber criminals and scammers</a> have been an enduring problem online. However, evolving technology like generative AI has further empowered them, enabling them to create highly realistic fake images, deepfake videos and <a href="https://www.newyorker.com/science/annals-of-artificial-intelligence/the-terrifying-ai-scam-that-uses-your-loved-ones-voice">voice cloning</a>. AI’s ability to automate content creation has also flooded the internet with low-quality, misleading and harmful material at an unprecedented scale. In sum, the accelerated commercialisation of the internet, the dominance of media tech giants and the presence of bad actors have infiltrated content on the internet. The rise of AI further intensifies this, making the internet more chaotic than ever. <h2>Some of the ‘good’ internet remains</h2> So, what was the “good internet” some of us long for with nostalgia? At the outset, the internet was meant to be a free egalitarian space people were meant to “surf” and “browse”. Knowledge was meant to be shared: sites such as Wikipedia and The Internet Archive are continuing bastions of knowledge. Before the advent of filter bubbles, the internet was a creative playground where people explored different ideas, discussed varying perspectives, and collaborated with individuals from “outgroups” – those outside their social circles who may hold opposing views. Early social media platforms were built on the ethos of reconnecting with long-lost classmates and family members. Many of us have community groups, acquaintances and family we reach out to via the internet. The “connection” aspect of the internet remains as important as ever – as we all saw during the COVID pandemic. What else do we want to preserve? Privacy. A New Yorker cartoon joke in 1993 stated that “<a href="https://web.archive.org/web/20051029045942/http://www.unc.edu/depts/jomc/academics/dri/idog.html">on the internet, nobody knows you’re a dog</a>”. Now everyone – especially advertisers – wants to know who you are. To quote the <a href="https://www.oaic.gov.au/privacy/your-privacy-rights/your-personal-information/what-is-privacy">Office of the Australian Information Commissioner</a>, one of the tenets of privacy is “to be able to control who can see or use information about you”. At the very least, we want to control what big tech knows about us, especially if they could stand to profit from it. <h2>Can we ever go back?</h2> We can’t control “a changin’” times, but we can keep as much of the good parts as we can. For starters, we can vote with our feet. Users can enact change and bring awareness to problems on existing platforms. In recent times, we have seen this with the <a href="https://theconversation.com/thinking-of-breaking-up-with-twitter-heres-the-right-way-to-do-it-195002">exodus of users</a> from X (formerly Twitter) to other platforms, and the <a href="https://www.economist.com/the-economist-explains/2023/06/26/why-reddit-users-are-protesting-against-the-sites-leadership">platform-wide protest against Reddit</a> for changing its third-party data access policies. However, voting with our feet is only possible when there’s competition. In the case of X, various other platforms – from Mastodon to Threads to Bluesky – enable users to pick one that aligns with their preferences, values and social circles. Search engines have alternatives, too, such as DuckDuckGo or Ecosia. But competition can only be created by moving to decentralised systems and removing monopolies. This actually happened in the early days of the internet during the 1990s “<a href="https://thehistoryoftheweb.com/browser-wars/">browser wars</a>”, when Microsoft was eventually accused of illegally monopolising the web browser market in <a href="https://en.wikipedia.org/wiki/United_States_v._Microsoft_Corp.">a landmark court case</a>. As users of technology, all of us must remain vigilant about threats to our privacy and knowledge. With cheap and ubiquitous generative AI, misleading content and scams are more realistic as ever. We must exercise healthy scepticism and ensure those most at risk from online threats – such as children and older people – are educated about potential harms. Remember, the internet is not optimised for your best interests. It’s up to you to decide how much power you give to the tech giants who are fuelling theirs.<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/236513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/marc-cheong-998488">Marc Cheong</a>, Senior Lecturer of Information Systems, School of Computing and Information Systems; and (Honorary) Senior Fellow, Melbourne Law School, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/wonsun-shin-1300054">Wonsun Shin</a>, Associate Professor in Media and Communications, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-internet-is-worse-than-it-used-to-be-how-did-we-get-here-and-can-we-go-back-236513">original article</a>. </div>

Technology

Your gas stove might be making your asthma worse. Here’s what you can do about it

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> We may think of air pollution as an outdoor problem, made up of car exhaust and smog. But if the air inside our homes is polluted, this can also affect our health. In Australia, around 12% of childhood asthma can <a href="https://pubmed.ncbi.nlm.nih.gov/29642816/">be attributed</a> to gas stoves and the toxic chemicals they release into the air. And while there’s a growing push to phase out gas indoors, some 38% of Australian households <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">rely on natural gas</a> for cooking. Recommended interventions – such as replacing a gas stove with electric – may not be possible for those who are renting or struggling with the cost of living. This is important because, as our <a href="https://ghrp.biomedcentral.com/articles/10.1186/s41256-024-00361-2">research</a> shows, childhood asthma is more common in socioeconomically disadvantaged areas. If you’re living with gas, here’s how it can affect you or your child’s asthma, and what you can do to improve air quality. <h2>What is asthma?</h2> Asthma is the most common chronic condition in Australian children. The respiratory condition affects <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">almost</a> 400,000 of those aged aged 14 and under – close to 9% of that age group. Asthma narrows the airways and obstructs airflow, making it hard to breath. Many people manage the condition with inhalers and <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma action plans</a>. But it can be serious and even fatal. Australian emergency departments saw <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">56,600 presentations</a> for asthma in 2020-21. While there is no single cause for asthma, both indoor and outdoor air pollution play a <a href="https://pubmed.ncbi.nlm.nih.gov/38247719/">significant role</a>. Being exposed to small <a href="https://aafa.org/asthma/asthma-triggers-causes/air-pollution-smog-asthma/#:%7E:text=Air%20pollution%20can%20increase%20your,if%20you%20already%20have%20asthma.&text=Small%20airborne%20particles%2C%20found%20in,%E2%80%9Cparticulate%20matter%E2%80%9D%20or%20PM.">airborne particles</a> increases your risk of getting asthma, and can aggravate symptoms if you already have it. <h2>Gas stoves release nitrogen dioxide</h2> The gas stoves commonly found in Australian homes release toxic chemicals into the air. They include carbon monoxide (CO), PM₂.₅ (small particles, often from <a href="https://www.epa.vic.gov.au/for-community/environmental-information/air-quality/pm25-particles-in-the-air">smoke</a>), benzene, formaldehyde and nitrogen dioxide (NO₂). All are harmful, but nitrogen dioxide in particular is <a href="https://go.gale.com/ps/i.do?id=GALE%7CA656312383&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00220892&p=AONE&sw=w&userGroupName=anon%7E7027bb9f&aty=open-web-entry">associated</a> with asthma developing and getting <a href="https://www.atsjournals.org/doi/10.1164/rccm.200408-1123OC">worse</a>. Gas heaters can also <a href="https://pubmed.ncbi.nlm.nih.gov/9731022/">produce</a> nitrogen dioxide. As nitrogen dioxide is a tasteless, invisible gas, it’s difficult to know how much is in your air at home unless you have an air monitor. However one US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662932/">study</a> showed houses with gas stoves can have nitrogen dioxide levels three times higher than houses with electric stoves. This is particularly concerning for households with children, given children tend to spend <a href="https://pubmed.ncbi.nlm.nih.gov/11477521/">most</a> of their time indoors. <h2>Banning gas</h2> There is a growing push across Australia to replace gas stoves with electric stoves, which are more energy efficient and can reduce indoor air pollution. <a href="https://www.premier.vic.gov.au/new-victorian-homes-go-all-electric-2024">Victoria</a> and the <a href="https://www.climatechoices.act.gov.au/energy/canberras-electrification-pathway/preventing-new-gas-network-connections">Australian Capital Territory</a> have announced bans on gas connections in new homes from 2024. Sydney’s Waverley council recently made a similar <a href="https://www.waverley.nsw.gov.au/environment/climate_resilience_and_reducing_emissions/go_electric">move</a>. But until a ban on using household gas appliances is implemented across the country, the problem persists for children who are currently living in old homes or rented properties with gas stoves. <h2>Do exhaust fans in the kitchen help?</h2> Using a high-efficiency <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">exhaust hood</a> placed over an existing gas cooktop can be effective. They can <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">capture</a> more than 75% of air pollutants and direct them outside. Cooking on the back burner – rather than the front burner – can also <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">improve their efficiency</a>. However exhaust hoods with lower flow rates, or hoods that don’t vent the air outside, are less effective. And an exhaust hood only improves air quality if you use it. One <a href="https://pubmed.ncbi.nlm.nih.gov/10520075/">study</a> in Melbourne found more than 40% of people didn’t use an exhaust hood regularly while cooking. For many people, installing high-efficiency exhaust hoods will not be practical – especially for those renting or experiencing socio-economic disadvantage. <h2>Natural ventilation</h2> There is a free way to ventilate your home. Keeping windows open during and after cooking will increase air flow and <a href="https://pubmed.ncbi.nlm.nih.gov/32970538/">evidence shows</a> this can improve overall air quality. However this is not always possible, especially during cooler months of the year which can be especially chilly in places such as Victoria and Tasmania. Unfortunately, people are also more likely to use gas heaters during those cooler months. <h2>What about heaters?</h2> There are two kinds of gas heaters, flued and unflued. Like cooking with gas, unflued gas heaters release air pollutants including nitrogen dioxide directly into the home. Flued heaters are better for air quality because they use a chimney, or “flue”, to send emissions outside. If you can, replacing your unflued gas heater with a flued one – or even better, an electric heater – can significantly <a href="https://pubmed.ncbi.nlm.nih.gov/15075170/">alleviate</a> asthma symptoms. If you can’t replace your unflued gas heater, <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/unflued-gas-heaters.aspx">do not use it overnight</a> in the room where you or your children sleep. Asthma can’t be cured, but its symptoms can be controlled by managing triggers – and this may be easier to do indoors than out. Improving air quality, even in a rented or old property, can help people with asthma breathe more easily.<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/238787/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, Senior Lecturer, School of Clinical Medicine, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-gas-stove-might-be-making-your-asthma-worse-heres-what-you-can-do-about-it-238787">original article</a>. </div>

Body

Young homeowners are more likely to use their home as an ‘ATM’ than their Boomer parents. Here’s why

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> For many Australians, the family home is their largest financial asset. With an increasing variety of ways to tap into home equity, the temptation to access this wealth is ever growing. Homeowners increase the debt owed on their home when they borrow against their <a href="https://doi.org/10.1080/02673037.2013.783202">equity</a>. Standard mortgage home loans now provide facilities for relatively cheap or free withdrawals of equity from the home. This turns the <a href="https://theconversation.com/your-home-as-an-atm-home-equity-a-risky-welfare-tool-22000">home into an ATM</a>, which borrowers can access when they choose. Our new <a href="https://doi.org/10.1080/02673037.2024.2400158">study</a> asks what motivates Australians to tap into their home equity, and how does this behaviour change with age? Surprisingly, despite having much lower housing equity levels, younger homeowners borrow often, and borrow more, than their Boomer parents. <h2>How common is equity borrowing?</h2> Using 15 years of data from the government-funded <a href="https://melbourneinstitute.unimelb.edu.au/hilda">Household, Income and Labour Dynamics in Australia </a>(HILDA) survey, we tracked the mortgage debt and repayments of homeowners aged 35 and over. The chart below shows younger owners are far more likely to engage in equity borrowing. In 2006, nearly 39% of the youngest homeowners, aged 35–44, borrowed against their home equity. By 2021, this number had dropped to 29%. Despite the decline, it’s still 24 percentage points more common than those aged 65 and over. The older group has remained steady at about 5% over the years. <hr /> <iframe id="Ll9Cw" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Ll9Cw/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How much do equity borrowers withdraw from their home?</h2> Among those who use their home like an ATM, younger borrowers now withdraw larger amounts than older borrowers. In 2006–07, equity borrowers aged 35–44 and 45–54 withdrew on average $43,000 and $57,000, respectively (expressed in real values set at 2022 price levels). By 2021, the amount withdrawn by these two age groups had climbed to $70,000 and $100,000. On the other hand, the amount withdrawn by borrowers aged 55 or older fell from more than $50,000 to less than $40,000. <hr /> <iframe id="ujq3S" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/ujq3S/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>What motivates equity borrowing?</h2> Young homeowners’ equity borrowing behaviours are sensitive to changes in house prices and debt values, and their financial risk preferences. Among those aged 35–44, a $10,000 increase in the primary home value raises the likelihood of equity borrowing by ten percentage points. Every $10,000 in debt against the primary home reduces the likelihood by 2.8% percentage points. Those willing to take substantial financial risk are eight percentage points more likely to borrow against their home than those who are risk-averse. Those aged 65+ are not inclined to borrow, and exhibit little change in equity borrowing behaviour with variations in asset, debt, income or financial risk preferences. <h2>Why borrowing practices differ between age groups</h2> As well as being more likely than older homeowners to borrow against equity, the younger group also withdraws higher amounts than their Boomer parents. This is despite younger borrowers already carrying much higher debt against their primary home. Among those in our study who engaged in equity borrowing in 2021, the median debt before borrowing was $401,000 for 35-44 year-olds compared to $0 for those aged 65+. As real house prices have risen over decades, the current generation of young homeowners has had to invest more money into purchasing their first home than previous generations. It’s therefore not surprising the primary home is now widely viewed as a financial resource to be <a href="https://theconversation.com/your-home-as-an-atm-home-equity-a-risky-welfare-tool-22000">tapped into to meet spending needs</a>. On the other hand, most Baby Boomers bought their first home at more affordable prices than their children, and at lower levels of debt. Now they don’t appear to be spending their kids’ inheritance by drawing down housing wealth. In fact, older parents may shy away from equity borrowing to <a href="https://www.pc.gov.au/research/completed/wealth-transfers/wealth-transfers.pdf">bequeath wealth to children</a>. Some also <a href="https://doi.org/10.1017/S0047279417000058">dislike passing debt</a> on to their children. Older people may also avoid equity borrowing due to concerns about <a href="https://treasury.gov.au/sites/default/files/2023-08/p2023-435150.pdf">aged care costs</a>. Some may be hampered by <a href="https://doi.org/10.1016/j.jue.2013.08.003">poor financial literacy</a>. <h2>More debt ahead without policy changes</h2> Present trends suggest young homeowners will remain indebted for longer periods, and more and more will <a href="https://theconversation.com/more-of-us-are-retiring-with-mortgage-debts-the-implications-are-huge-115134">retire with mortgage debt</a>. For indebted retirees, there are real prospects of <a href="https://theconversation.com/fall-in-ageing-australians-home-ownership-rates-looms-as-seismic-shock-for-housing-policy-120651">drawing down of superannuation</a> to pay off mortgages in retirement. This may impose extra burdens on the age pension system. Another unwelcome consequence, which may add to health costs, is the prospect of <a href="https://www.ahuri.edu.au/sites/default/files/migration/documents/AHURI-Final-Report-319-Mortgage-stress-and-precarious-home-ownership-implications-for-older-Australians.pdf">debt-related psychological distress</a> among those who can’t pay off their mortgage in old age. If the current trends continue, the <a href="https://www.afr.com/policy/economy/what-happens-when-australia-s-boomers-hand-5-trillion-to-their-heirs-20240515-p5jdvf">great wealth transfer</a> that has already begun looks set to <a href="https://theconversation.com/not-everyone-wins-from-the-bank-of-mum-and-dad-73842">further entrench inequality</a> between those who have access to the bank of mum and dad and those who do not. Encouraging older people to use their housing equity to fund their needs in old age may lighten fiscal burdens on younger generations. But policy reforms will be needed to relieve concerns about the risks of equity borrowing in old 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/238924/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rachel-ong-viforj-113482">Rachel Ong ViforJ</a>, ARC Future Fellow & Professor of Economics, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin University</a> and <a href="https://theconversation.com/profiles/christopher-phelps-378137">Christopher Phelps</a>, Research Fellow, School of Accounting, Economics and Finance, <a href="https://theconversation.com/institutions/curtin-university-873">Curtin 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/young-homeowners-are-more-likely-to-use-their-home-as-an-atm-than-their-boomer-parents-heres-why-238924">original article</a>. </div>

Money & Banking

You’re probably brushing your teeth wrong – here are four tips for better dental health

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> We all know the advice for healthy teeth – brush twice daily and don’t eat too much sugar. So why do those of us following these instructions find we sometimes need a filling when we visit the dentist? The truth is, there’s a little more to preventing tooth decay than these guidelines suggest. Here’s what you need to know. <h2>Brush up on your skills</h2> How you brush makes a big difference. The mechanical act of brushing removes the very sticky dental plaque – a mixture of bacteria, their acids and sticky byproducts and food remnants. It forms naturally on teeth immediately after you’ve eaten but doesn’t get nasty and start to cause damage to the teeth until it reaches a certain stage of maturity. The exact amount of time this takes isn’t known but is at least more than 12 hours. Bacteria consume sugar and, as a byproduct, produce acids which dissolve mineral out of the teeth, leaving microscopic holes we can’t see. If the process isn’t stopped and they aren’t repaired, these can become big, visible cavities. Taking two minutes to brush your teeth is a good target for removing plaque and you should brush at night and one other time daily. Brushing frequently stops the bacteria developing to a stage where the species which produce the most acid can become established. Electric toothbrushes can be <a href="https://www.cochrane.org/CD002281/ORAL_poweredelectric-toothbrushes-compared-to-manual-toothbrushes-for-maintaining-oral-health">more effective than manual brushing</a> and a small toothbrush head helps to reach awkward areas in the mouth, while medium-textured bristles help you clean effectively without causing harm to gums and teeth. The main thing, however, is to get brushing! <h2>Use fluoride toothpaste and disclosing tablets</h2> Most of the benefit from brushing comes from toothpaste. The key ingredient is fluoride, which evidence shows <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002278/full#CD002278-abs-0003">prevents tooth decay</a>. Fluoride replaces lost minerals in teeth and also makes them stronger. For maximum benefit, <a href="https://www.cochrane.org/CD007868/ORAL_comparison-between-different-concentrations-of-fluoride-toothpaste-for-preventing-tooth-decay-in-children-and-adolescents">use toothpaste with 1350-1500 ppmF</a> – that’s concentration of fluoride in parts per million – to prevent tooth decay. Check your toothpaste’s concentration by reading the ingredients on the back of the tube. <a href="https://theconversation.com/childrens-toothpaste-the-facts-80508">Not all children’s toothpastes are strong enough</a> for them to gain maximum benefit. Your dentist may prescribe higher strength fluoride toothpaste based on their assessment of your or your child’s risk of tooth decay. Plaque is difficult to see because it is whitish, like your teeth. Disclosing tablets are available in supermarkets and chemists and they make plaque more visible, showing areas you may have missed when brushing. <h2>Spit, don’t rinse</h2> At night, you produce less saliva than during the day. Because of this, your teeth have less protection from saliva and are more vulnerable to acid attacks. That’s why it’s important to remove food from your teeth before bed so plaque bacteria can’t feast overnight. Don’t eat or drink anything except water <a href="https://www.sign.ac.uk/assets/sign138.pdf">after brushing at night</a>. This also gives fluoride the longest opportunity to work. Once you’ve brushed, don’t rinse your mouth with water or mouthwash – you’re washing away the fluoride! This can be a difficult habit to break, but can <a href="https://www.sign.ac.uk/assets/sign138.pdf">reduce tooth decay by up to 25%</a>. <h2>No more than four ‘sugar hits’</h2> Intrinsic sugars are found naturally in foods like fruit and they are far less likely to cause tooth decay than added or <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/sugar-salt-and-fat/free-sugars">free sugars</a>. Free sugars are generally those added to foods by manufacturers but also include honey, syrup and fruit juices. These are all easy for bacteria to consume, metabolise and produce acids from. However, it can be difficult to tell which are the worst sugars for teeth. For example, although normal amounts of fruit are fine, fruit juices have sugar liberated from the plant cells and heavy consumption can cause decay. <a href="http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/">The World Health Organization</a> and <a href="https://www.nhs.uk/common-health-questions/food-and-diet/how-much-sugar-is-good-for-me/">NHS</a> recommend free sugars should ideally make up less than 5% of your daily calorie intake. So what does this look like? For adults and children over about 11 years old, this is around 30g – about eight teaspoons – of sugar daily. A 330ml can of Coke has <a href="https://www.coca-cola.co.uk/drinks/coca-cola/coca-cola">35g of sugar</a>. The <a href="https://play.google.com/store/apps/details?id=com.phe.c4lfoodsmart&hl=en_GB">change4life app</a> is helpful to track how much sugar you consume in your diet. Although not as important as how much, how often you eat sugar also matters. Simple carbohydrates like sugar are easier for bacteria to digest than proteins or complex carbohydrates. Bacteria produce acids after they metabolise sugar which causes demineralisation. Fortunately, through the actions of fluoride toothpaste and the remineralising effects of saliva, your teeth can recover from the early stages of these attacks. It’s like having a set of scales – trying to keep the balance between sugars on one side, fluoride toothpaste and cleaning on the other. Typically, your teeth can be exposed to four “sugar hits” – episodes of sugar intake – daily without irreversible damage to the teeth. Why not try counting how many sugary hits you have a day? This includes biscuits, cups of sugary tea or coffee and other snacks with refined carbohydrates like crisps. A simple way of cutting down would be to stop putting sugar in hot drinks and limiting snacking. Brush twice daily with fluoride toothpaste, spit don’t rinse, eat and drink nothing after brushing, and don’t have sugar more than four times daily. Easy!<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/103959/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clement-seeballuck-583867">Clement Seeballuck</a>, Clinical Lecturer in Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</a> and <a href="https://theconversation.com/profiles/nicola-innes-388237">Nicola Innes</a>, Professor of Paediatric Dentistry, <a href="https://theconversation.com/institutions/university-of-dundee-955">University of Dundee</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/youre-probably-brushing-your-teeth-wrong-here-are-four-tips-for-better-dental-health-103959">original article</a>. </div>

Body

Our Partners

Over 60

News

Shop

Catalogues

Contests

Entertainment

Travel

Health

Lifestyle

Finance

Property

Games

Information

Keep up to date

Search

Why do I get so anxious after drinking? Here’s the science behind ‘hangxiety’

New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link

Your friend has been diagnosed with cancer. Here are 6 things you can do to support them

For some people dying alone is not such a bad thing – here’s why

When a baby is stillborn, grandparents are hit with ‘two lots of grief’. Here’s how we can help

Could a recent ruling change the game for scam victims? Here’s why the banks will be watching closely

Trying to lose weight? Here’s why your genetics could be just as important as your exercise regime

Are you over 75? Here’s what you need to know about vitamin D

An unbroken night’s sleep is a myth. Here’s what good sleep looks like

Is there anything good about menopause? Yep, here are 4 things to look forward to

We tend to underestimate our future expenses – here’s one way to prevent that

Flying to a footy final? Watch your wallet. Here’s why airfares soar

Yes, you do need to clean your tongue. Here’s how and why

Why isn’t dental included in Medicare? It’s time to change this – here’s how

Climate change threatens Australian tourism more than is widely believed. Here’s why

Ozempic, Wegovy, Rybelsus: Are we losing sight of overall health? Here’s what the science says

The internet is worse than it used to be. How did we get here, and can we go back?

Your gas stove might be making your asthma worse. Here’s what you can do about it

Young homeowners are more likely to use their home as an ‘ATM’ than their Boomer parents. Here’s why

You’re probably brushing your teeth wrong – here are four tips for better dental health

Our Partners