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What’s the difference between ageing and frailty? One is inevitable – the other is not

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/julee-mcdonagh-1525476">Julee McDonagh</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>Ageing is a normal part of the life course. It doesn’t matter how many green smoothies you drink, or how many “anti-ageing” skin care products you use, you can’t stop the <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2685272/">ageing process</a>.</p> <p>But while we’re all getting older, not everyone who ages will necessarily become frail. Ageing and frailty are closely related, but they’re not the same thing.</p> <p>Let’s break down the difference between the two.</p> <h2>What is ageing?</h2> <p>On a biological level, ageing is the result of the build-up of <a href="https://www.who.int/news-room/fact-sheets/detail/ageing-and-health">cellular and molecular damage</a> in the body over time.</p> <p>The ageing process causes a gradual decline in physical and mental function, a higher risk of disease, and eventual (and unavoidable) death.</p> <p>Still, some people think they can cheat the system, <a href="https://fortune.com/well/article/bryan-johnson-live-longer-unrecognizable-anti-aging-procedure/">spending millions</a> trying to stay young forever. While we may be able to reduce the <a href="https://theconversation.com/do-these-three-popular-anti-ageing-skincare-ingredients-work-heres-what-the-evidence-says-182200">appearance of ageing</a>, ultimately there’s <a href="https://www.nature.com/articles/s44324-024-00040-3">no magic pill</a> to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2685272/">increase our longevity</a>.</p> <p>Around one in six Australians are over the age of 65 (<a href="https://www.aihw.gov.au/reports/older-people/older-australians/contents/demographic-profile">16% of the total population</a>). Yet <a href="https://www.tandfonline.com/doi/full/10.1080/03601277.2024.2402056">as individuals</a> and <a href="https://theconversation.com/fear-of-ageing-is-really-a-fear-of-the-unknown-and-modern-society-is-making-things-worse-220925">a society</a> many of us still have a <a href="https://www.smh.com.au/lifestyle/health-and-wellness/we-ve-been-constructed-to-think-a-certain-way-the-psychology-of-ageing-20231213-p5er6a.html">fear of ageing</a>.</p> <p>But what is it about ageing we are so afraid of? When it comes down to it, many people are probably less afraid of ageing, and more afraid of becoming frail.</p> <h2>What is frailty?</h2> <p><a href="https://www.afn.org.au/what-is-frailty/">Frailty</a> is defined as a state of vulnerability characterised by a loss of reserve across multiple parts of the body.</p> <p>Frailty is generally characterised by <a href="https://www1.racgp.org.au/newsgp/clinical/frailty-declared-a-medical-condition">several physical symptoms</a>, such as weakness, slow walking speed, exhaustion, unintentional weight loss, and low activity level.</p> <p>Lower bone density and osteoporosis (a condition where the bones become weak and brittle) are also <a href="https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04875-w">associated with frailty</a>, increasing the risk of <a href="https://www.sciencedirect.com/science/article/pii/S1279770723020250">falls and fractures</a>.</p> <p>Notably, someone who is frail is less able to “bounce back” (or recover) after a stressor event compared to someone who is not frail. A stressor event could be, for example, having a fall, getting a urinary infection, or even being admitted to hospital.</p> <p>Frailty is more common in older people. But in some cases, frailty can affect younger people too. For example, people with advanced chronic diseases, such as <a href="https://academic.oup.com/eurjcn/article/22/4/345/6775229">heart failure</a>, can <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja15.00801">develop frailty</a> much younger.</p> <p>Frailty is dynamic. While it can get worse over time, in some cases <a href="https://www.sciencedirect.com/science/article/pii/S037851221830478X">frailty can also be reversed</a> or even prevented through health and lifestyle changes.</p> <p>For example, we know physical inactivity and a sedentary lifestyle can <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31786-6/abstract">significantly increase a person’s risk</a> of becoming frail. On the flip side, evidence shows doing more exercise can <a href="https://pubmed.ncbi.nlm.nih.gov/36746389/">reduce frailty in older adults</a>.</p> <p>There are other lifestyle modifications we can make too. And the earlier we make these changes, the better.</p> <h2>Preventing frailty</h2> <p>Here are some <a href="https://youtu.be/41cMkvsaOOM">key things</a> you can do to <a href="https://www.self.com/story/how-to-avoid-frailty-old-age">help prevent frailty</a>:</p> <p><strong>1. Get moving</strong></p> <p>Exercise more, including resistance training (such as squats and lunges, or grab some stretchy resistance bands). Many of these sorts of exercises can be done at home. YouTube has some <a href="https://youtu.be/XDQo4wslr7I?si=FAoyHLDZgSG5AN1r">great resources</a>.</p> <p>You might also consider joining a gym, or asking your GP about seeing an accredited exercise physiologist or physiotherapist. Medicare <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&amp;q=10953&amp;qt=item">subsidies may be available</a> for these specialists.</p> <p>The <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-older-australians-65-years-and-over">physical activity guidelines</a> for older Australians recommend at least 30 minutes of moderate intensity physical activity on most days or preferably every day.</p> <p>The guidelines also highlight the importance of incorporating different types of activities (such as resistance, balance or flexibility exercises) and reducing the time you spend sitting down.</p> <p><strong>2. Stay socially active</strong></p> <p>Social isolation and loneliness can <a href="https://academic.oup.com/gerontologist/article-abstract/64/10/gnae114/7734069">contribute to the progression of frailty</a>. Reach out to friends and family for support or contact local community groups that you may be able to join. This might include your local Zumba class or bridge club.</p> <p><strong>3. Ask your doctor or pharmacist to regularly check your medications</strong></p> <p>“Polypharmacy” (when someone is prescribed <a href="https://www.safetyandquality.gov.au/our-work/healthcare-variation/fourth-atlas-2021/medicines-use-older-people/61-polypharmacy-75-years-and-over">five or more medications</a>) is associated with an increased <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6005607/">risk of frailty</a>. The presence of frailty can also interfere with how the <a href="https://www.sciencedirect.com/science/article/pii/S0047637419300387">body absorbs medicines</a>.</p> <p><a href="https://www.healthdirect.gov.au/home-medicines-review">Home medicine reviews</a> are available for older adults with a <a href="https://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&amp;q=900">chronic medical condition or a complex medication regimen</a>. These reviews aims to help people get the most benefit from their medicines and reduce their risk of <a href="https://www.safetyandquality.gov.au/sites/default/files/2021-04/fourth_atlas_2021_-_6.2_medications_management_reviews_75_years_and_over_0.pdf">experiencing adverse effects</a>.</p> <p>Always consult your doctor before making any changes to your current medications.</p> <p><strong>4. Eat a protein-rich diet with plenty of fruit and vegetables</strong></p> <p><a href="https://academic.oup.com/biomedgerontology/article/61/6/589/589472?login=true#9578331">Low nutrient intake</a> can negatively impact physical function and may increase your risk of becoming frail. There’s some evidence to suggest eating more protein may <a href="https://academic.oup.com/ageing/article/49/1/32/5618813">delay the onset of frailty</a>.</p> <p>A food-first approach is best when looking to increase the <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7598653/#:%7E:text=Many%20studies%20have%20described%20an,are%20necessary%20to%20prevent%20frailty.">protein in your diet</a>. Protein is found in <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/protein#protein-foods">foods such as</a> lean meats, poultry, seafood, eggs, dairy products, legumes and nuts.</p> <p>Adults over 50 should aim to eat <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/protein">64 grams of protein</a> per day for men and 46g per day for women. Adults over 70 should aim for 81g per day for men and 57g per day for women.</p> <p>Ask your GP for a referral to a dietitian who can provide advice on a dietary regime that is best for you.</p> <p>Supplements may be recommended if you are struggling to meet your protein needs from diet alone.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/247450/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/julee-mcdonagh-1525476"><em>Julee McDonagh</em></a><em>, Senior Research Fellow of Frailty Research, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, Professor of Nursing and Director of Health Innovations, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-ageing-and-frailty-one-is-inevitable-the-other-is-not-247450">original article</a>.</em></p> </div>

Body

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What’s the difference between Hass and Shepard avocados? It’s not just the colour

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/yasmine-probst-235268">Yasmine Probst</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/karen-zoszak-1474727">Karen Zoszak</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>Whether with crumbled feta or poached eggs, you’d be challenged to find a cafe in Australia or farther afield that doesn’t have avocado somewhere on the menu.</p> <p>This fruit (yep, it’s a fruit from a tree, not a vegetable) is widely associated with brunch culture and other trendy eating habits.</p> <p>The Australian avocado industry developed in the 1960s, 30 years after the start of the first large-scale <a href="https://australianfoodtimeline.com.au/wp-content/uploads/2019/04/Avocado-history.pdf">production in California</a>. Orchards producing avocados now span most parts of Australia.</p> <p>Avocados are considered a <a href="https://theconversation.com/what-actually-makes-avocados-bad-for-the-environment-230571">monoculture crop</a>: they’re grown on the same land each year, making them more susceptible to pests and creating a need for increased fertiliser use. The carbon footprint of avos is almost twice as high as that of apples, but much lower than many animal food sources.</p> <p>There are now over 50 different avocado types globally, but only a few are grown commercially.</p> <h2>Not all avos are the same</h2> <p>You may not notice a difference when you get your avocado toast at a cafe. But at the shops or the market, a striking difference occurs each year in Australia.</p> <p>In autumn, the familiar dark purple Hass avocado disappears and is replaced with the lighter green Shepard variety. In Australia, this typically happens between February and May.</p> <p>If you don’t know the difference between the two, you may expect Shepard avos to perform the same way as Hass – and be left disappointed. There are some important differences.</p> <h2>Hass avocados</h2> <p>Hass avocados are known for their dark, pebbly-looking skin that appears almost black when ripe. They have an ovoid shape with a slight pear-like appearance. The thick skin can be a challenge to peel, often requiring a sharp knife or avocado slicer.</p> <p>Hass avocado flavour is rich, creamy and buttery, with nutty undertones. Their texture is ideal for mashing, blending and spreading, creating a creamy texture in dips, guacamole and smoothies.</p> <p>Hass avocados ripen – and darken in colour – slowly over several days. They remain firm to the touch when ripe, and will feel squishy when overripe. A slight give when pressed confirms Hass avos are ready to eat.</p> <p>Available in Australia from May to January, Hass are the dominant variety of commercially grown avocado worldwide. They were <a href="https://modernfarmer.com/2019/08/scientists-crack-the-genetic-code-of-the-hass-avacado/">cultivated by horticulturalist Rudolph Hass</a> in California in the 1920s.</p> <h2>Shepard avocados</h2> <p>Shepard avocados have smooth, green skin that remains green even when they are fully ripe. They are round to slightly oblong in shape and have a slightly milder and sweeter taste, with less pronounced nutty undertones.</p> <p>Shepard avocados ripen more quickly than Hass, but you won’t be able to tell that by the colour. Instead, check for softness – Shepard avocados are very soft when ripe. What might feel overripe when handling a Hass will likely be ideal ripeness if it’s a Shepard. The thin, smooth skin makes them easy to peel by hand or with a gentle squeeze.</p> <p>Their buttery soft texture is firm and creamy, and they hold their shape well when cut, making them ideal for slicing, dicing and spreading despite being structurally firm.</p> <p>Interestingly, Shepard avocados brown much more slowly than Hass, making them perfect for garnishes. Their milder flavour also makes Shepard avos well suited to sweet dishes, such as chocolate mousse.</p> <p>Shepard avos account for approximately 10–15% of Australian avocados and are in season from February to April each year while there is a gap in the Hass season.</p> <p><a href="https://www.abc.net.au/news/rural/2023-04-13/hass-avocados-more-popular-variety-shepard/102154678">Australia is the only country in the world</a> that grows Shepard avocados commercially. (They are grown in Queensland.)</p> <h2>Avocados and our health</h2> <p>As avocados contain <a href="https://afcd.foodstandards.gov.au/fooddetails.aspx?PFKID=F000162">roughly 13 grams of fat per 100g</a>, people <a href="https://theconversation.com/four-simple-food-choices-that-help-you-lose-weight-and-stay-healthy-112054">wishing to lose weight</a> were previously advised to avoid or limit eating them.</p> <p>We now know that a majority of this fat is oleic acid, a monounsaturated (healthy) fat that helps to reduce cholesterol and improve <a href="https://nutritionj.biomedcentral.com/articles/10.1186/s12937-024-00915-7/tables/1">heart health</a>.</p> <p>Additionally, only 1% of an avocado is made up of carbohydrates, making the fruit popular with people following a ketogenic (keto) diet of low carbs and high fat.</p> <p>People who consume avos also tend to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9361124/">follow a better pattern of eating</a> in general. They eat more whole grains, fruit and vegetables and fewer discretionary or takeaway foods.</p> <p>As an energy-dense food, consuming a whole avocado is about the same as eating 2.5 whole apples. Per 100 grams, avocado actually gives you less energy than an equivalent amount of cooked white rice.</p> <p>As avocado dishes are visually appealing and often featured in food photography, they have become a symbol of modern eating habits.</p> <p><em>Correction: this article has been amended to clarify that most parts of Australia now have avocado orchards, and that avocados have roughly 13g of fat per 100g, not 53%.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/233243/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/yasmine-probst-235268"><em>Yasmine Probst</em></a><em>, Professor, School of Medical, Indigenous and Health Sciences, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> and <a href="https://theconversation.com/profiles/karen-zoszak-1474727">Karen Zoszak</a>, Accredited Practising Dietitian, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-hass-and-shepard-avocados-its-not-just-the-colour-233243">original article</a>.</em></p> </div>

Food & Wine

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What’s the difference between a food allergy and an intolerance?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/jennifer-koplin-13384">Jennifer Koplin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/desalegn-markos-shifti-1530163">Desalegn Markos Shifti</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>At one time or another, you’ve probably come across someone who is lactose intolerant and might experience some unpleasant gut symptoms if they have dairy. Maybe it’s you – food intolerances are estimated to affect <a href="https://nutritionaustralia.org/fact-sheets/food-intolerances/#How-common-are-food-intolerance-reactions?">up to 25%</a> of Australians.</p> <p>Meanwhile, cow’s milk allergy is one of the most common food allergies in infants and young children, affecting around <a href="https://pubmed.ncbi.nlm.nih.gov/38992429/">one in 100</a> infants.</p> <p>But what’s the difference between food allergies and food intolerances? While they might seem alike, there are some fundamental differences between the two.</p> <h2>What is an allergy?</h2> <p>Australia has one of the <a href="https://theconversation.com/were-the-allergy-capital-of-the-world-but-we-dont-know-why-food-allergies-are-so-common-in-australian-children-228786">highest rates of food allergies</a> in the world. Food allergies can develop at any age but are more common in children, affecting more than <a href="https://pubmed.ncbi.nlm.nih.gov/38992429/">10% of one-year-olds</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/38597846/">6% of children</a> at age ten.</p> <p>A food allergy happens when the body’s <a href="https://www.allergy.org.au/patients/immune-system">immune system</a> mistakenly reacts to certain foods as if they were dangerous. The <a href="https://pubmed.ncbi.nlm.nih.gov/24388012/">most common foods</a> that trigger allergies include eggs, peanuts and other nuts, milk, <a href="https://pubmed.ncbi.nlm.nih.gov/37375617/">shellfish</a>, fish, soy and wheat.</p> <p>Mild to moderate signs of food allergy include a swollen face, lips or eyes; hives or welts on your skin; or vomiting. A <a href="https://www.allergy.org.au/patients/fast-facts/food-allergy">severe allergic reaction</a> (called anaphylaxis) can cause trouble breathing, persistent dizziness or collapse.</p> <h2>What is an intolerance?</h2> <p>Food <a href="https://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance">intolerances</a> (sometimes called non-allergic reactions) are also reactions to food, but they don’t involve your immune system.</p> <p>For example, lactose intolerance is a metabolic condition that happens when the body doesn’t produce enough lactase. This enzyme is needed to break down the lactose (a type of sugar) in dairy products.</p> <p>Food intolerances can also include reactions to natural chemicals in foods (<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4604636/">such as salicylates</a>, found in some fruits, vegetables, herbs and spices) and problems with artificial preservatives or flavour enhancers.</p> <p>Symptoms of <a href="https://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance">food intolerances</a> can include an upset stomach, headaches and fatigue, among others.</p> <p>Food intolerances don’t cause life-threatening reactions (anaphylaxis) so are less dangerous than allergies in the short term, although they can cause problems in the longer term <a href="https://www.foodauthority.nsw.gov.au/consumer/life-events-and-food/allergy-and-intolerance">such as malnutrition</a>.</p> <p>We don’t know a lot about how common food intolerances are, but they appear to be <a href="https://www.foodauthority.nsw.gov.au/consumer/life-events-and-food/allergy-and-intolerance">more commonly reported</a> than allergies. They can develop at any age.</p> <h2>It can be confusing</h2> <p>Some foods, such as <a href="https://pubmed.ncbi.nlm.nih.gov/33510829/">peanuts and tree nuts</a>, are more often associated with allergy. Other foods or ingredients, such as caffeine, are more often associated with intolerance.</p> <p>Meanwhile, certain foods, such as cow’s milk and wheat or gluten (a protein found in wheat, rye and barley), can cause both allergic and non-allergic reactions in different people. But these reactions, even when they’re caused by the same foods, are quite different.</p> <p>For example, children with a cow’s milk allergy can react to very small amounts of milk, and serious reactions (such as throat swelling or difficulty breathing) can happen within minutes. Conversely, many people with lactose intolerance can tolerate small amounts of lactose <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10708184/">without symptoms</a>.</p> <p>There are other differences too. Cow’s milk allergy is more common in children, though many infants will <a href="https://pubmed.ncbi.nlm.nih.gov/36185550/">grow out</a> of this allergy during childhood.</p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/30388735/">Lactose intolerance</a> is more common <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11155274/">in adults</a>, but can also sometimes be temporary. One type of lactose intolerance, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10708184/">secondary lactase deficiency</a>, can be caused by damage to the gut after infection or with medication use (such as antibiotics or cancer treatment). This can go away by itself when the underlying condition resolves or the person stops using the relevant medication.</p> <p>Whether an allergy or intolerance is likely to be lifelong depends on the food and the reason that the child or adult is reacting to it.</p> <p>Allergies to some foods, such as milk, egg, wheat and soy, often resolve during childhood, whereas allergies to nuts, fish or shellfish, often (but not always) <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7899184/">persist into adulthood</a>. We don’t know much about how likely children are to grow out of different types of food intolerances.</p> <h2>How do you find out what’s wrong?</h2> <p>If you think you may have a <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8152468/">food allergy or intolerance</a>, see a doctor.</p> <p><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7794657/">Allergy tests</a> help doctors find out which foods might be causing your allergic reactions (but can’t diagnose food intolerances). There are two common types: skin prick tests and blood tests.</p> <p>In a skin prick test, doctors put tiny amounts of allergens (the things that can cause allergies) on your skin and make small pricks to see if your body reacts.</p> <p>A blood test checks for allergen-specific immunoglobulin E (IgE) antibodies in your blood that show if you might be allergic to a particular food.</p> <p>Food intolerances can be tricky to figure out because the symptoms depend on what foods you eat and how much. To diagnose them, doctors look at your health history, and may do <a href="https://www.allergy.org.au/patients/food-other-adverse-reactions/food-intolerance">some tests</a> (such as a breath test). They may ask you to keep a record of foods you eat and timing of symptoms.</p> <p>A temporary elimination diet, where you stop eating certain foods, can also help to work out which foods you might be intolerant to. But this should only be done with the help of a doctor or dietitian, because eliminating particular foods can lead to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4604636/">nutritional deficiencies</a>, especially in children.</p> <h2>Is there a cure?</h2> <p>There’s currently no cure for food allergies or intolerances. For allergies in particular, it’s important to strictly avoid allergens. This means reading food labels carefully and being vigilant when eating out.</p> <p>However, researchers are studying a treatment called <a href="https://www.allergy.org.au/patients/allergy-treatments/oral-immunotherapy-for-food-allergy">oral immunotherapy</a>, which may help some people with food allergies become less sensitive to certain foods.</p> <p>Whether you have a food allergy or intolerance, your doctor or dietitian can help you to make sure you’re eating the right foods.</p> <p><em>Victoria Gibson, a Higher Degree by Research student and Research Officer at the School of Nursing, Midwifery and Social Work at the University of Queensland, and Rani Scott-Farmer, a Senior Research Assistant at the University of Queensland, contributed to this article.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/243685/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/jennifer-koplin-13384">Jennifer Koplin</a>, Group Leader, Childhood Allergy &amp; Epidemiology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/desalegn-markos-shifti-1530163">Desalegn Markos Shifti</a>, Postdoctoral Research Fellow, Child Health Research Centre, Faculty of Medicine, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-a-food-allergy-and-an-intolerance-243685">original article</a>.</em></p> </div>

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What’s the difference between heat exhaustion and heat stroke? One’s a medical emergency

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>When British TV doctor Michael Mosley died last year in Greece after walking in extreme heat, local police said “<a href="https://www.telegraph.co.uk/news/2024/06/10/michael-mosley-autopsy-symi-greece-death/">heat exhaustion</a>” was a contributing factor.</p> <p>Since than a coroner could not find a definitive cause of death <a href="https://www.theguardian.com/media/2024/dec/20/michael-mosleys-cause-of-death-unascertainable-coroner-says">but said</a> this was most likely due to an un-identified medical reason or heat stroke.</p> <p>Heat exhaustion and heat stroke are two illnesses that relate to heat.</p> <p>So what’s the difference?</p> <h2>A spectrum of conditions</h2> <p>Heat-related illnesses range from mild to severe. They’re caused by exposure to excessive heat, whether from hot conditions, physical exertion, or both. The most common ones include:</p> <ul> <li> <p><strong>heat oedema</strong>: swelling of the hands, feet and ankles</p> </li> <li> <p><strong>heat cramps</strong>: painful, involuntary muscle spasms usually after exercise</p> </li> <li> <p><strong>heat syncope</strong>: fainting due to overheating</p> </li> <li> <p><strong>heat exhaustion</strong>: when the body loses water due to excessive sweating, leading to a rise in core body temperature (but still under 40°C). Symptoms include lethargy, weakness and dizziness, but there’s no change to consciousness or mental clarity</p> </li> <li> <p><strong>heat stroke</strong>: a medical emergency when the core body temperature is over 40°C. This can lead to serious problems related to the nervous system, such as confusion, seizures and unconsciousness including coma, leading to death.</p> </li> </ul> <p>As you can see from the diagram below, some symptoms of heat stroke and heat exhaustion overlap. This makes it hard to recognise the difference, even for medical professionals.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=455&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=455&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=455&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=572&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=572&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/636118/original/file-20241204-15-qhk6rk.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=572&amp;fit=crop&amp;dpr=3 2262w" alt="Heat exhaustion vs heat stroke venn diagram" /></a><figcaption><span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure> <h2>How does this happen?</h2> <p>The human body is an incredibly efficient and adaptable machine, equipped with several in-built mechanisms to keep our core temperature at an optimal 37°C.</p> <p>But in healthy people, regulation of body temperature begins to break down when it’s hotter than about 31°C with 100% humidity (think Darwin or Cairns) or about 38°C with 60% humidity (typical of other parts of Australia in summer).</p> <p>This is because humid air makes it harder for sweat to evaporate and take heat with it. Without that cooling effect, the body starts to overheat.</p> <p>Once the core temperature rises above 37°C, heat exhaustion can set in, which can cause intense thirst, weakness, nausea and dizziness.</p> <p>If the body heat continues to build and the core body temperature rises above 40°C, a much more severe heat stroke could begin. At this point, it’s a life-threatening emergency requiring immediate medical attention.</p> <p>At this temperature, our proteins start to denature (like an egg on a hotplate) and blood flow to the intestines stops. This makes the gut very leaky, allowing harmful substances such as endotoxins (toxic substances in some bacteria) and pathogens (disease causing microbes) to leak into the bloodstream.</p> <p>The liver can’t detoxify these fast enough, leading to the whole body becoming inflamed, organs failing, and in the worst-case scenario, death.</p> <h2>Who’s most at risk?</h2> <p>People doing strenuous exercise, especially if they’re not in great shape, are among those at risk of heat exhaustion or heat stroke. <a href="https://www.who.int/multi-media/details/main-heat-vulnerability-factors">Others at risk</a> include those exposed to high temperatures and humidity, particularly when wearing heavy clothing or protective gear.</p> <p>Outdoor workers such as farmers, firefighters and construction workers are at higher risk too. Certain health conditions, such as diabetes, heart disease, or lung conditions (such as COPD or chronic obstructive pulmonary disease), and people taking <a href="https://theconversation.com/is-my-medicine-making-me-feel-hotter-this-summer-5-reasons-why-199085">blood pressure medications</a>, can also be more vulnerable.</p> <p>Adults over 65, infants and young children are especially sensitive to heat as they are less able to physically cope with fluctuations in heat and humidity.</p> <h2>How are these conditions managed?</h2> <p>The risk of serious illness or death from heat-related conditions is very low if treatment starts early.</p> <p><a href="https://www.redcross.org.au/emergencies/prepare/heatstroke-and-heat-exhaustion/">For heat exhaustion</a>, have the individual lie down in a cool, shady area, loosen or remove excess clothing, and cool them by fanning, moistening their skin, or immersing their hands and feet in cold water.</p> <p>As people with heat exhaustion almost always are dehydrated and have low electrolytes (certain minerals in the blood), they will usually need to drink fluids.</p> <p>However, emergency hospital care is essential for heat stroke. In hospital, health professionals will focus on stabilising the patient’s:</p> <ul> <li><strong>airway</strong> (ensure no obstructions, for instance, vomit)</li> <li><strong>breathing</strong> (look for signs of respiratory distress or oxygen deprivation)</li> <li><strong>circulation</strong> (check pulse, blood pressure and signs of shock).</li> </ul> <p>Meanwhile, they will use rapid-cooling techniques including immersing the whole body in cold water, or applying wet ice packs covering the whole body.</p> <h2>Take home points</h2> <p>Heat-related illnesses, such as heat stroke and heat exhaustion, are serious health conditions that can lead to severe illness, or even death.</p> <p>With <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01208-3/fulltext">climate change, heat-related illness</a> will become more common and more severe. So recognising the early signs and responding promptly are crucial to prevent serious complications.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/240992/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/matthew-barton-1184088"><em>Matthew Barton</em></a><em>, Senior lecturer, School of Nursing and Midwifery, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> and <a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, Associate Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-heat-exhaustion-and-heat-stroke-ones-a-medical-emergency-240992">original article</a>.</em></p> </div>

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What’s the difference between gelato and ice cream? One contains more air

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>As the weather gets warmer, it’s the perfect time for ice cream or a gelato. Who am I kidding? It’s the perfect time year round.</p> <p>But what’s the difference between gelato and ice cream?</p> <p>Not everyone agrees. Some people say they’re made with <a href="https://www.foodandwine.com/gelato-vs-ice-cream-8609179">different amounts of fat</a>. Others say it’s all about the <a href="https://www.thespruceeats.com/whats-the-difference-between-gelato-and-ice-cream-909197#:%7E:text=Gelato%20is%20churned%20at%20a,much%20as%2050%20percent%20air.">air content</a>.</p> <p>To add to the confusion, gelato is the Italian word for any type of ice cream. But in Australia, gelato refers to the frozen dessert of Italian origin.</p> <h2>How are they similar?</h2> <p>Ice cream and gelato are both sweet desserts served cold. They both contain varying amounts of cream, milk, sugar, flavours, and sometimes eggs.</p> <p>The fat component from the cream provides the richness, smoothness and body. Eggs are normally associated with gelato but can also be added to ice cream to enhance the richness.</p> <p>Most commercial ice creams and gelato also contain <a href="https://theconversation.com/are-emulsifiers-bad-not-enough-evidence-to-say-we-should-stop-eating-them-121325">emulsifiers</a>. These are food additives that act as a stabiliser by preventing liquids that normally don’t mix from separating. Emulsifiers <a href="https://www.nature.com/articles/s41575-024-00893-5#Sec11">have been linked</a> to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11345991/">numerous gut symptoms</a>. However most of the evidence comes from laboratory and animal studies, and there is <a href="https://www.nature.com/articles/s41575-024-00893-5/tables/2">limited robust evidence of this in humans</a>.</p> <p>Ice cream and gelato are both made by churning (whipping) the ingredients, leading to air bubbles forming. In fact, it’s the air bubbles that allow us to eat these desserts frozen. It gives them a palatable texture and mouthfeel by making the mixture softer and lighter. Imagine how hard it would be to eat a hard lump of frozen dessert.</p> <p>Many people assume both ice cream and gelato are good sources of calcium, presumably because they’re made from dairy products. But due to the low proportions of milk (it’s mostly cream, which contains less calcium), they both only provide about 65 milligrams of calcium per half cup. That’s <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/calcium">about 7%</a> of the daily calcium requirements for adults aged 19-50.</p> <p>They also both contain small amounts of protein – about 2-3 grams per half cup. That’s only about 5% of your <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/protein">daily protein requirements</a>.</p> <p>So ice cream and gelato are not a valuable source of calcium and protein, making them of low nutritional value. That’s why they’re regarded as “<a href="https://www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating">sometimes</a>” foods.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=455&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=455&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=455&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=572&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=572&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/633714/original/file-20241121-15-36t0ln.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=572&amp;fit=crop&amp;dpr=3 2262w" alt="Gelato vs ice cream" /><figcaption><span class="attribution"><span class="source">The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure> <h2>How are they different?</h2> <p><strong>It’s about the air</strong></p> <p>The <a href="https://www.google.com.au/books/edition/On_Food_and_Cooking/bKVCtH4AjwgC?hl=en&amp;gbpv=1&amp;pg=PA8&amp;printsec=frontcover">speed</a> at which the mixture is churned can determine the amount of air it contains. This impacts the product’s thickness and smoothness.</p> <p>Ice cream is traditionally <a href="https://www.google.com.au/books/edition/On_Food_and_Cooking/bKVCtH4AjwgC?hl=en&amp;gbpv=1&amp;pg=PA8&amp;printsec=frontcover">churned faster</a> <a href="https://eu.venchi.com/blog/italian-gelato-vs-icecream">than gelato</a>. This means more air is incorporated, making it feel fluffy and creamy compared to gelato, which tends to feels thicker and richer.</p> <p><strong>It’s about the ice</strong></p> <p>Churning at a slower speed, as you would typically for gelato, also <a href="https://www.google.com.au/books/edition/On_Food_and_Cooking/bKVCtH4AjwgC?hl=en&amp;gbpv=1&amp;pg=PA8&amp;printsec=frontcover">increases the size of ice crystals</a>. Large ice crystals give a coarse icy texture, compared to a creamier texture from smaller ice crystals in ice cream.</p> <p><strong>How about the fat?</strong></p> <p>Although many websites say ice cream <a href="https://www.foodandwine.com/gelato-vs-ice-cream-8609179">contains more fat</a> than gelato, this is a tricky one to tease out.</p> <p>In Australia, <a href="https://www.legislation.gov.au/F2015L00424/latest/text">food standards</a> say ice cream should contain at least 100g milk fat per kilogram (or 10% milk fat).</p> <p>So products with less fat need to be called something else – frozen dessert, iced confection, even gelato. So, in theory, a lower-fat product made the same way as ice cream could be called gelato. Non-dairy products made the same way as ice cream could also be called gelato.</p> <p>So how much milk fat does gelato need to contain? I can’t find any legal requirements in Australia or elsewhere. <a href="https://www.masterclass.com/articles/ice-cream-vs-gelato-vs-sherbet-vs-sorbet">Cooking websites</a> often refer to it having 4-9% milk fat. But depending on the recipe, it could be higher.</p> <p>Fat content also differs from flavour to flavour. For example, if you compare the nutritional content of half a cup of vanilla ice cream with half a cup of vanilla gelato, the ice cream has 2g more fat. Other flavours will give different results.</p> <p><strong>How about the sugar or kilojules?</strong></p> <p>If we just compare half a cup of vanilla ice cream with half a cup of vanilla gelato, the gelato has about 3g more sugar. Again, different flavours will give different results. The difference in kilojoules is very small – 15kJ per half cup.</p> <h2>Overall, which one’s healthier?</h2> <p>Effectively there is little difference nutritionally between ice cream and gelato.</p> <p>But brands and flavours vary considerably. They each use different amounts of cream, eggs and other ingredients. So kilojoule, fat and sugar content can vary considerably too.</p> <p>Should you still eat them? Yes, absolutely if you enjoy them. However, both are classified as sometimes foods due to their added sugar and low level of nutrients. And perhaps limit your serve size.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/238988/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/evangeline-mantzioris-153250">Evangeline Mantzioris</a>, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-gelato-and-ice-cream-one-contains-more-air-238988">original article</a>.</em></p> </div>

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What’s the difference between MSG and table salt? A chemist explains

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/nathan-kilah-599082">Nathan Kilah</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a></em></p> <p>It’s dinner time. You’ve worked hard to prepare a nutritious and tasty meal. But after taking your first bite you feel something is missing. Perhaps you should have added more salt? Pepper? Or maybe even something more exotic like monosodium glutamate, better known as MSG?</p> <p>There are many <a href="https://theconversation.com/explainer-what-are-e-numbers-and-should-you-avoid-them-in-your-diet-43908">food additives</a> used in both home cooking and commercial products. These ingredients improve the flavour, smell, texture, appearance and longevity of foods.</p> <p>Salt and MSG are two well-known food additives. Both contain sodium, but there are plenty of differences which you can use to your benefit.</p> <h2>What is a salt?</h2> <p>Salts are made of positively and negatively charged components called ions. Salts generally dissolve in water, and are brittle. The names of salts often feature a metal (positively charged) followed by a non-metal (negatively charged).</p> <p>The common kitchen ingredient we call “salt” is just one type of salt. To distinguish it from all other salts, we should more specifically refer to it as “table salt”. Chemically, it’s sodium chloride.</p> <h2>Sodium chloride</h2> <p>After the quick chemistry lesson above, we can see that table salt, sodium chloride, contains a positively charged sodium and a negatively charged chlorine.</p> <p>These charged components are arranged in crystals of salt in a regular repeating pattern. Each sodium ion is surrounded by six chloride ions and each chloride ion is surrounded by six sodium ions. This arrangement gives the crystal a “cubic” form. If you look closely at salt, you may see cube-shaped crystals.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=600&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/617802/original/file-20240906-16-gk38c9.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=754&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption><span class="caption">The chemical structure of table salt forms a cube of sodium and chloride ions.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/sodium-chloride-nacl-structure-ionic-crystal-2417242373">Sandip Neogi/Shutterstock</a></span></figcaption></figure> <p>Sodium chloride is very abundant. It is found <a href="https://theconversation.com/i-have-always-wondered-why-is-the-sea-salty-83489">dissolved in Earth’s oceans</a>. Mineral deposits of salt, known as halite or rock salt, formed from the evaporation and crystallisation of ancient seas.</p> <p>Depending on the source, the salt may contain many other trace minerals that can even add colour to it, such as the pink-coloured Himalayan salt from Pakistan. Salt can also be fortified with <a href="https://www.who.int/publications/i/item/9789240053717">sodium iodide</a> as a public health measure.</p> <p>Describing the taste of salt is quite difficult without using the word “salty”. It’s a very common food additive, as it is so abundant and versatile. It is an essential ingredient for many traditional food preservation techniques for meats (pork and fish), vegetables (kimchi, sauerkraut and pickles), and dairy (cheese and butter).</p> <p>Salt is considered a universal flavouring agent. It can mask bitter flavours and bring out sweet, sour and <a href="https://theconversation.com/the-asian-roots-of-umami-the-fifth-taste-central-to-thanksgiving-fare-50699">umami</a> (savoury) ones.</p> <p>Despite popular depictions of <a href="https://theconversation.com/that-neat-and-tidy-map-of-tastes-on-the-tongue-you-learned-in-school-is-all-wrong-44217">taste maps</a>, there is no one place on the tongue where we taste salt. Other sodium salts can also give a “salty” taste, but the effect declines (and can even turn to bitter) with negatively charged components other than chloride.</p> <h2>MSG or monosodium glutamate</h2> <p>Monosodium glutamate is also a salt. The glutamate is the negatively charged form of glutamic acid, an amino acid that is found in nature as a building block of proteins.</p> <p>MSG, and more generally glutamates, are found in a wide range of foods including tomatoes, Parmesan cheese, soy sauce, dried seaweeds, Worcestershire sauce and protein-rich foods. All of these foods impart umami flavours, which are described as savoury or meaty.</p> <p>Commercial MSG is not extracted from the environment but produced by bacterial fermentation. Glucose is converted to glutamic acid, which is further processed by adding sodium hydroxide to form MSG (and water).</p> <p>MSG is sold as crystals, but they have a long, prismatic shape rather than the cubic form of sodium chloride. It’s worth tasting a few crystals of MSG directly to experience the native taste of umami.</p> <p>Despite decades of bad press and concern, <a href="https://theconversation.com/msg-is-back-is-the-idea-its-bad-for-us-just-a-myth-or-food-science-237871">MSG is considered safe</a> to consume in the concentrations typically found in or added to foods.</p> <p>Table salt and MSG both contain sodium, but at different percentages of the total weight: table salt has around 40% sodium, versus just 14% in MSG. You are also more likely to be routinely adding table salt to your food rather than MSG.</p> <p>Eating too much sodium is well known to be unhealthy. <a href="https://theconversation.com/this-salt-alternative-could-help-reduce-blood-pressure-so-why-are-so-few-people-using-it-221409">Potassium-enriched substitutes</a> have been suggested for a range of health benefits.</p> <h2>A flavour enhancer</h2> <p>The flavour of MSG can be elevated further by combining it with other food additives, known as sodium ribonucleotides.</p> <p>Japanese and Korean cooks figured this secret out long before chemists, as boiling dried fish and seaweed produces foundation stocks (dashi) containing a mix of naturally sourced glutamates and ribonucleotides.</p> <p>Ribonucleotides are classified as “generally considered as safe” by <a href="https://www.cfsanappsexternal.fda.gov/scripts/fdcc/index.cfm?set=FoodSubstances&amp;id=DISODIUMINOSINATE&amp;sort=Sortterm_ID&amp;order=ASC&amp;startrow=1&amp;type=basic&amp;search=disodium">food standards authorities</a>. Humans consume many grams of the natural equivalent in their diets.</p> <p>What can be more problematic are the carbohydrates- and fat-rich foods that have their flavours enhanced, which can potentially lead us to eat excessive calories.</p> <p>The combination of MSG and ribonucleotides produces a more-ish sensation. Next time you see a bag of potato chips or instant noodles, have a quick look to see if it contains both MSG (E621) and a ribonucleotide source (E627–E635).</p> <p>I personally keep a jar of MSG in my kitchen. A little goes a long way to elevate a soup, stew or sauce that isn’t quite tasting the way you want it to, but without adding too much extra sodium.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/237668/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nathan-kilah-599082">Nathan Kilah</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-msg-and-table-salt-a-chemist-explains-237668">original article</a>.</em></p> </div>

Food & Wine

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What’s the difference between liquid and powder laundry detergent? It’s not just the obvious

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/nathan-kilah-599082">Nathan Kilah</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a></em></p> <p>When shopping for a laundry detergent, the array of choices is baffling. All of the products will likely get your laundry somewhat cleaner. But what gets the best outcome for your clothes and your budget?</p> <p>Do you want whiter whites? Do you need enzymes? And what’s the difference between a powder and liquid detergent?</p> <p>As is often the case, knowing more about the chemistry involved will help you answer those questions.</p> <h2>What is a detergent?</h2> <p>The active ingredients in both laundry powders and liquids are “surfactants”, also known as detergents (hence the product name). These are typically charged or “ionic” molecules that have two distinct parts to their structure. One part interacts well with water and the other interacts with oils.</p> <p>This useful property allows surfactants to lift grease and grime from fabrics and suspend it in the water. Surfactants can also form bubbles.</p> <p>Metal salts dissolved in your water can limit the performance of the surfactants. So-called hard water contains lots of dissolved calcium and magnesium salts which can readily form soap scum.</p> <p>Modern laundry detergents therefore contain phosphates, water softeners and other metal “sequestrants” to stop the formation of soap scum. Phosphates can cause algal blooms in fresh water environments. This is why modern detergent formulations <a href="https://accord.asn.au/sustainability/phosphorus-standard/">contain smaller amounts of phosphates</a>.</p> <p>Many products also contain optical brighteners. These chemicals absorb ultraviolet light and release blue light, which provides the “whiter white” or “brighter colour” phenomenon.</p> <p>Laundry detergents typically contain fragrances. These aren’t essential to the chemistry of cleaning, but give the impression the clothes are fresh.</p> <p>Lastly, some laundry detergents contain enzymes – more on those later.</p> <h2>What’s in laundry powder?</h2> <p>While detergents and ingredients to avoid soap scum are the most important components, they aren’t the most abundant. The main ingredients in powders are salts (like sodium sulfate) that add bulk and stop the powder from clumping.</p> <p>Another common salt added to laundry powders is sodium carbonate, also known as washing soda. Washing soda (a chemical cousin of <a href="https://theconversation.com/vinegar-and-baking-soda-a-cleaning-hack-or-just-a-bunch-of-fizz-225177">baking soda</a>) helps to chemically modify grease and grime so they dissolve in water.</p> <p>Laundry powders also frequently contain oxidising agents like sodium percarbonate. This is a stable combination of washing soda and hydrogen peroxide. An additive known as tetraacetylethylenediamine activates the percarbonate to give a mild bleaching effect.</p> <p>Chemically, powders have an advantage – their components can be formulated and mixed but kept separate in a solid form. (You can usually see different types of granules in your laundry powder.)</p> <h2>What’s in laundry liquid?</h2> <p>The main ingredient of laundry liquid is water. The remaining ingredients have to be carefully considered. They must be stable in the bottle and then work together in the wash.</p> <p>These include similar ingredients to the powders, such as alkaline salts, metal sequestrants, water softeners and surfactants.</p> <p>The surfactants in liquid products are often listed as “ionic” (charged) and “non-ionic” (non-charged). Non-ionic surfactants can be liquid by default, which makes them inappropriate for powdered formulations. Non-ionic surfactants are good at suspending oils in water and don’t form soap scum.</p> <p>Liquid detergents also contain preservatives to prevent the growth of microbes spoiling the mixture.</p> <p>There are also microbial implications for inside the washing machine. Liquid products can’t contain the peroxides (mild bleaching agents) found in powdered products. Peroxides kill microbes. The absence of peroxides in liquid detergents makes it more likely for <a href="https://www.mdpi.com/1420-3049/27/1/195#B15-molecules-27-00195">mould biofilms to form</a> in the machine and for bacteria to be transferred between items of clothing.</p> <p>As an alternative to peroxides, liquids will typically contain only optical brighteners.</p> <p>Liquids do have one advantage over powders – they can be added directly to stains prior to placing the item in the wash.</p> <p>A recent “convenience” version of liquid formulas are highly concentrated detergent pods. Colourful and bearing a resemblance to sweet treats, these products have been found to be <a href="https://poisoncenters.org/track/laundry-detergent-packets">dangerous to young children and people with cognitive impairment</a>.</p> <p>Pods also remove the option to add less detergent if you’re running a smaller load or just want to use less detergent in general.</p> <h2>So, what about enzymes?</h2> <p>Enzymes are naturally evolved proteins included in laundry products to remove specific stains. Chemically, they are catalysts – things that speed up chemical reactions.</p> <p>Enzymes are named for the molecules they work on, followed by the ending “-ase”. For example, lipase breaks down fats (lipids), protease breaks down protein, while amylase and mannanase break down starches and sugars.</p> <p>These enzymes are derived from organisms found in cool climate regions, which helps them function at the low temperature of washing water.</p> <p>Running an excessively hot wash cycle can damage or denature the enzyme structure, stopping them from assisting in your wash. Think of an egg white <a href="https://theconversation.com/how-to-make-the-perfect-pavlova-according-to-chemistry-experts-196485">changing from translucent to white while cooked</a> – that’s protein denaturing.</p> <p>If your detergent contains enzymes, the washing temperature should be neither too hot nor too cold. As a guide, temperatures of 15–20°C are used in <a href="https://environment.ec.europa.eu/document/download/557d8ab5-4e75-41a4-a901-1548be7f685d_en">standard laundry tests</a>.</p> <h2>Is powder or liquid better?</h2> <p>We make consumer choices guided by performance, psychology, cost, scent, environmental considerations and convenience.</p> <p>It’s worth experimenting with different products to find what works best for you and fits your needs, household budget and environmental considerations, such as having <a href="https://theconversation.com/curious-kids-why-can-some-plastics-be-recycled-but-others-cant-229270">recyclable packaging</a>.</p> <p>Personally, I wash at 20°C with half the recommended dose of a pleasant-smelling laundry powder, packaged in recyclable cardboard, and containing a wide range of enzymes and an activated peroxide source.</p> <p>Knowing a little chemistry can go a long way to getting your clothes clean.</p> <p>However, laundry detergent manufacturers don’t always disclose the full list of ingredients on their product packaging.</p> <p>If you want more information on what’s in your product, you have to look at the product website. You can also dig a little deeper by reading documents called <a href="https://theconversation.com/a-new-tiktok-trend-has-people-drinking-toxic-borax-an-expert-explains-the-risks-and-how-to-read-product-labels-210278">safety data sheets</a> (SDS). Every product containing potentially hazardous chemicals must have an SDS.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><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/239850/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nathan-kilah-599082">Nathan Kilah</a>, Senior Lecturer in Chemistry, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-liquid-and-powder-laundry-detergent-its-not-just-the-obvious-239850">original article</a>.</em></p> </div>

Home & Garden

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3 key differences between an ocean and river cruise

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

Cruising

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

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/bruce-watt-1486350">Bruce Watt</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/katarina-fritzon-402205">Katarina Fritzon</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p>Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as <a href="https://psychologyeverywhere.com/articles/7-signs-your-boss-is-a-psychopath/">7 signs your boss is a psychopath</a> or <a href="https://www.elephantjournal.com/2022/08/how-to-avoid-the-sociopath-next-door-erica-leibrandt/">How to avoid the sociopath next door</a>.</p> <p>You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from <a href="https://www.imdb.com/title/tt0102926/">The Silence of the Lambs</a>.</p> <p>In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with <a href="https://psychiatryonline.org/doi/pdf/10.1176/appi.psychotherapy.2002.56.1.100">something else</a> entirely.</p> <p>So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts.</p> <h2>What’s a psychopath?</h2> <p>Psychopathy has been mentioned in the psychiatric literature <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/#:%7E:text=The%20term%20psychopathy%20comes%20from,which%20literally%20means%20suffering%20soul.">since the 1800s</a>. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">doesn’t list</a> it as a recognised clinical disorder.</p> <p><a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm#section_5">Since the 1950s</a>, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with <a href="https://www.ncbi.nlm.nih.gov/books/NBK546673/">antisocial personality disorder</a>, which is what we have today.</p> <p>Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions.</p> <p>To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves.</p> <p>US psychiatrist <a href="https://psycnet.apa.org/record/2018-37736-001">Hervey Cleckley</a> provided the first formal description of psychopathy traits in his 1941 book <a href="https://gwern.net/doc/psychology/personality/psychopathy/1941-cleckley-maskofsanity.pdf">The Mask of Sanity</a>. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame.</p> <p><a href="https://psych.ubc.ca/profile/robert-hare/">Canadian psychologist</a> Professor <a href="http://www.hare.org/">Robert Hare</a> refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM.</p> <p>When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others.</p> <p>Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions.</p> <h2>So how about a sociopath?</h2> <p>The term sociopath first appeared <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/#:%7E:text=The%20term%20psychopathy%20comes%20from,which%20literally%20means%20suffering%20soul.">in the 1930s</a>, and was attributed to US psychologist George Partridge. He <a href="https://psychiatryonline.org/doi/abs/10.1176/ajp.85.6.1053?journalCode=ajp">emphasised</a> the societal consequences of behaviour that habitually violates the rights of others.</p> <p>Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/#:%7E:text=The%20term%20psychopathy%20comes%20from,which%20literally%20means%20suffering%20soul.">preferred the term sociopath</a> because they said the public sometimes confused the word psychopath with psychosis.</p> <p>“Sociopathic personality disturbance” <a href="https://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf">was the term</a> used in the first edition of the DSM in 1952. This aligned with the <a href="https://journals.sagepub.com/doi/epdf/10.1177/0306624X01453005">prevailing views</a> at the time that antisocial behaviours were largely the product of the <em>social</em> environment, and that behaviours were only judged as deviant if they broke <em>social</em>, legal, and/or cultural rules.</p> <p>Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 <a href="https://pubmed.ncbi.nlm.nih.gov/26618655/">definition</a> of a psychopath.</p> <p>In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy.</p> <p>Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead.</p> <h2>Born or made?</h2> <p>Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes.</p> <p>For example, people with psychopathic traits have <a href="https://www.theguardian.com/science/2013/may/12/how-to-spot-a-murderers-brain">certain brain differences</a> especially <a href="https://psycnet.apa.org/record/2006-01001-014">in regions</a> associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their <a href="https://www.psypost.org/psychopathic-women-exhibit-low-cardiac-defense-responses-study-finds/">nervous system</a>, including a <a href="https://www.sciencedirect.com/science/article/pii/S0301051123001345?via%3Dihub">reduced heart rate</a>.</p> <p>However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to <a href="https://www.aic.gov.au/sites/default/files/2020-05/19-1415-FinalReport.pdf">run in families</a>. These behaviours has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801766/#:%7E:text=Childhood%20abuse%20is%20a%20risk,and%20psychopathic%20traits%20remain%20unclear">associated with</a> physical abuse and parental conflict.</p> <h2>What are the consequences?</h2> <p>Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series <a href="https://www.imdb.com/title/tt7016936/">Killing Eve</a> – <a href="https://www.psychologytoday.com/au/blog/making-evil/201902/what-we-get-wrong-about-psychopaths#:%7E:text=Most%20psychopaths%20are%20not%20offenders,extreme%20violence%20or%20serial%20killing.">not all people</a> with psychopathy or sociopathy traits are serial killers or are physically violent.</p> <p>But psychopathy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059069/">predicts</a> a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature.</p> <p>In the general population, psychopathy is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0160252709000028?casa_token=5lSd35qRO7oAAAAA:CTu-KkDXxsoYEPvpceItex9go1Fn_YlfBQSW9O9_MwNEX6NxlZ23GRcWnS5YYV_kAig24E4Ahdj7">associated with</a> drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250605/">failure to follow</a> COVID restrictions.</p> <p>But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour.</p> <h2>In a nutshell</h2> <p>Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics.</p> <p>Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment.</p> <p>Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/226714/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/bruce-watt-1486350">Bruce Watt</a>, Associate Professor in Psychology, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/katarina-fritzon-402205">Katarina Fritzon</a>, Associate Professor of Psychology, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-a-psychopath-and-a-sociopath-less-than-you-might-think-226714">original article</a>.</em></p> </div>

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

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p>In July 2023, rising US basketball star Bronny James collapsed on the court during practice and was sent to hospital. The 18-year-old athlete, son of famous LA Lakers’ veteran LeBron James, had experienced a <a href="https://apnews.com/article/bronny-james-cardiac-arrest-3953eee8789e83f3cccfb6dd798bc54e">cardiac arrest</a>.</p> <p>Many media outlets incorrectly referred to the event as a “<a href="https://en.as.com/nba/lebron-james-son-bronny-plays-for-the-usc-trojans-for-the-first-time-since-suffering-a-heart-attack-n/">heart attack</a>” or used the terms interchangeably.</p> <p>A cardiac arrest and a heart attack are distinct yet overlapping concepts associated with the heart.</p> <p>With some background in <a href="https://www.youtube.com/watch?v=uKrgEv7-rVM&amp;t=16s">how the heart works</a>, we can see how they differ and how they’re related.</p> <h2>Understanding the heart</h2> <p>The heart is a muscle that contracts to work as a pump. When it contracts it pushes blood – containing oxygen and nutrients – to all the tissues of our body.</p> <p>For the heart muscle to work effectively as a pump, it needs to be fed its own blood supply, delivered by the coronary arteries. If these arteries are blocked, the heart muscle doesn’t get the blood it needs.</p> <p>This can cause the heart muscle to become injured or die, and results in the heart not pumping properly.</p> <h2>Heart attack or cardiac arrest?</h2> <p>Simply put, a heart attack, technically known as a myocardial infarction, describes injury to, or death of, the heart muscle.</p> <p>A cardiac arrest, sometimes called a sudden cardiac arrest, is when the heart stops beating, or put another way, stops working as an effective pump.</p> <p>In other words, both relate to the heart not working as it should, but for different reasons. As we’ll see later, one can lead to the other.</p> <h2>Why do they happen? Who’s at risk?</h2> <p>Heart attacks typically result from blockages in the coronary arteries. Sometimes this is called coronary artery disease, but in Australia, we tend to refer to it as ischaemic heart disease.</p> <p>The underlying cause in about <a href="https://www.ncbi.nlm.nih.gov/books/NBK507799/#:%7E:text=It%20has%20been%20reported%20that,increases%20beyond%20age%2050%20years.">75% of people</a> is a process called <a href="https://youtu.be/jwL4lkSlvSA?si=H2as7dQkhbIqWWkU">atherosclerosis</a>. This is where fatty and fibrous tissue build up in the walls of the coronary arteries, forming a plaque. The plaque can block the blood vessel or, in some instances, lead to the formation of a blood clot.</p> <p>Atherosclerosis is a long-term, stealthy process, with a number of risk factors that can sneak up on anyone. High blood pressure, high cholesterol, diet, diabetes, stress, and your genes have all been implicated in this plaque-building process.</p> <p>Other causes of heart attacks include spasms of the coronary arteries (causing them to constrict), chest trauma, or anything else that reduces blood flow to the heart muscle.</p> <p>Regardless of the cause, blocking or reducing the flow of blood through these pipes can result in the heart muscle not receiving enough oxygen and nutrients. So cells in the heart muscle can be injured or die.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=338&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=338&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=338&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=424&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=424&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/597616/original/file-20240531-17-o2j0w.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=424&amp;fit=crop&amp;dpr=3 2262w" alt="Heart attack vs cardiac arrest" /></a><figcaption><span class="caption">Here’s a simple way to remember the difference.</span> <span class="attribution"><span class="source">Author provided</span></span></figcaption></figure> <p>But a cardiac arrest is the result of heartbeat irregularities, making it harder for the heart to pump blood effectively around the body. These heartbeat irregularities are generally due to <a href="https://www.youtube.com/watch?v=M_soKG-Tzh0&amp;t=903s">electrical malfunctions</a> in the heart. There are four distinct types:</p> <ul> <li> <p><strong>ventricular tachycardia:</strong> a rapid and abnormal heart rhythm in which the heartbeat is more than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10541285/">100 beats per minute</a> (normal adult, resting heart rate is generally 60-90 beats per minute). This fast heart rate prevents the heart from filling with blood and thus pumping adequately</p> </li> <li> <p><strong>ventricular fibrillation:</strong> instead of regular beats, the heart quivers or “fibrillates”, resembling a bag of worms, resulting in an irregular heartbeat greater than 300 beats per minute</p> </li> <li> <p><strong>pulseless electrical activity:</strong> arises when the heart muscle fails to generate sufficient pumping force after electrical stimulation, resulting in no pulse</p> </li> <li> <p><strong>asystole:</strong> the classic flat-line heart rhythm you see in movies, indicating no electrical activity in the heart.</p> </li> </ul> <p>Cardiac arrest can arise from numerous underlying conditions, both heart-related and not, such as drowning, trauma, asphyxia, electrical shock and drug overdose. James’ cardiac arrest was attributed to a <a href="https://www.espn.com.au/mens-college-basketball/story/_/id/38260006/bronny-james-cardiac-arrest-caused-congenital-heart-defect">congenital heart defect</a>, a heart condition he was born with.</p> <p>But among the many causes of a cardiac arrest, ischaemic heart disease, such as a heart attack, stands out as the most common cause, accounting <a href="https://pubmed.ncbi.nlm.nih.gov/11898927/">for 70%</a> of all cases.</p> <p>So how can a heart attack cause a cardiac arrest? You’ll remember that during a heart attack, heart muscle can be damaged or parts of it may die. This damaged or dead tissue can disrupt the heart’s ability to conduct electrical signals, increasing the risk of developing arrhythmias, possibly causing a cardiac arrest.</p> <p>So while a heart attack is a common cause of cardiac arrest, a cardiac arrest generally does not cause a heart attack.</p> <h2>What do they look like?</h2> <p>Because a cardiac arrest results in the sudden loss of effective heart pumping, the most common signs and symptoms are a sudden loss of consciousness, absence of pulse or heartbeat, stopping of breathing, and pale or blue-tinged skin.</p> <p>But the common signs and symptoms of a heart attack include chest pain or discomfort, which can show up in other regions of the body such as the arms, back, neck, jaw, or stomach. Also frequent are shortness of breath, nausea, light-headedness, looking pale, and sweating.</p> <h2>What’s the take-home message?</h2> <p>While both heart attack and cardiac arrest are disorders related to the heart, they differ in their mechanisms and outcomes.</p> <p>A heart attack is like a blockage in the plumbing supplying water to a house. But a cardiac arrest is like an electrical malfunction in the house’s wiring.</p> <p>Despite their different nature both conditions can have severe consequences and require immediate medical attention.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229633/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/michael-todorovic-1210507">Michael Todorovic</a>, Associate Professor of Medicine, <em><a href="https://theconversation.com/institutions/bond-university-863">Bond University</a></em> and <a href="https://theconversation.com/profiles/matthew-barton-1184088">Matthew Barton</a>, Senior lecturer, School of Nursing and Midwifery, <em><a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-a-heart-attack-and-cardiac-arrest-ones-about-plumbing-the-other-wiring-229633">original article</a>.</p> </div>

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

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

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

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

Caring

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What’s the difference between miscarriage and stillbirth?

<div class="theconversation-article-body"> <p><a href="https://theconversation.com/profiles/gita-mishra-286486">Gita Mishra</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em>; <a href="https://theconversation.com/profiles/chen-liang-1356342">Chen Liang</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em>, and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <em><a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Former US First Lady Michelle Obama <a href="https://www.pbs.org/newshour/nation/michelle-obama-reveals-she-had-a-miscarriage-used-ivf-to-conceive-daughters">revealed</a> in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has <a href="https://www.usmagazine.com/celebrity-news/news/lily-allen-shares-details-about-delivering-a-stillborn-baby/#:%7E:text=Lily%20Allen%20was%20six%20months,named%20George%20%E2%80%94%20did%20not%20survive.">gone on the record</a> about her stillbirth.</p> <p>Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.</p> <p>Here are some similarities and differences between miscarriage and stillbirth, and why they matter.</p> <h2>Let’s start with some definitions</h2> <p>In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).</p> <p>This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.</p> <p>However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.</p> <p>The Australian Institute of Health and Welfare <a href="https://www.aihw.gov.au/reports/mothers-babies/stillbirths-and-neonatal-deaths-in-australia/contents/technical-notes/definitions-used-in-reporting">defines stillbirth</a> as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.</p> <p>Internationally, definitions of stillbirth <a href="https://www.nhs.uk/conditions/stillbirth/">vary</a> <a href="https://www.cdc.gov/nchs/data/misc/itop97.pdf">depending on</a> <a href="https://www.who.int/data/gho/indicator-metadata-registry/imr-details/2444">the jurisdiction</a>.</p> <h2>How common are they?</h2> <p>It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.</p> <p><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">Studies</a> from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.</p> <p>Around <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">1–2%</a> of women have recurrent miscarriages. <a href="https://miscarriageaustralia.com.au/understanding-miscarriage/recurrent-miscarriage/">In Australia</a> this is when someone has three or more miscarriages with no pregnancy in between.</p> <p>Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% <a href="https://www.aihw.gov.au/reports/mothers-babies/stillbirths-and-neonatal-deaths">or around</a> seven per 1,000 pregnancies.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/608102/original/file-20240719-17-4ynpp.jpg?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Who’s at risk?</h2> <p>Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.</p> <p>Compared with women who have had a live birth, those who have had a stillbirth have <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04355-7">double the risk</a> of another. For those who have had recurrent miscarriages, the risk of another miscarriage is <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">four-fold</a> higher.</p> <p>Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.</p> <p>For instance, maternal age is a risk factor for both <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">miscarriage</a> and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00528-X/fulltext">stillbirth</a>, especially if under 20 years old or older than 35. Increasing age of the male is only a <a href="https://link.springer.com/article/10.1007/s10654-017-0237-z">risk factor</a> for stillbirth, especially for fathers over 40.</p> <p>Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">miscarriage</a> and <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00837-5/abstract?code=lancet-site&amp;rss=yes=">stillbirth</a> compared with those in the obese or underweight categories.</p> <p>Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.</p> <p>So it’s important to not only avoid smoking and alcohol while pregnant, but <em>before</em> getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.</p> <h2>Why do they happen?</h2> <p>Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00837-5/abstract?code=lancet-site&amp;rss=yes=">account for</a> only <a href="https://jamanetwork.com/journals/jama/fullarticle/1104720">7-14%</a> of stillbirths.</p> <p>Instead, stillbirths <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00837-5/abstract?code=lancet-site&amp;rss=yes=">often relate</a> directly to <a href="https://jamanetwork.com/journals/jama/fullarticle/1104720">pregnancy complications</a>, such as a prolonged pregnancy or problems with the umbilical cord.</p> <p><a href="https://www.nichd.nih.gov/health/topics/factsheets/pregnancyloss">Maternal health</a> at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.</p> <p>Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can <a href="https://www.nichd.nih.gov/health/topics/factsheets/pregnancyloss">increase the risk</a> of miscarriage.</p> <p>Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an <a href="https://www.nichd.nih.gov/health/topics/factsheets/stillbirth">increased risk</a> of stillbirth.</p> <p>In many cases, however, the specific cause of pregnancy loss is not known.</p> <h2>How about the long-term health risks?</h2> <p>Miscarriage and stillbirth can be <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00682-6/abstract">early indicators</a> of health issues later in life.</p> <p>For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of <a href="https://pubmed.ncbi.nlm.nih.gov/33028606/">cardiovascular disease</a> (such as heart disease or stroke).</p> <p>Our <a href="https://www.bmj.com/content/377/bmj-2022-070603.abstract">research</a> has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.</p> <p>Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.</p> <p>We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.</p> <p>Our data showed women with a history of recurrent miscarriages or stillbirths were at a <a href="https://thorax.bmj.com/content/79/6/508.abstract">36% or 67% higher risk</a> of COPD, respectively, even after accounting for a history of asthma.</p> <h2>Why is all this important?</h2> <p>Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.</p> <p>Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.</p> <hr /> <p><em>More information and support about miscarriage and stillbirth is available from <a href="https://www.sands.org.au">SANDS</a> and <a href="https://www.pinkelephants.org.au">Pink Elephants</a>.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225660/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/gita-mishra-286486">Gita Mishra</a>, Professor of Life Course Epidemiology, Faculty of Medicine, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/chen-liang-1356342">Chen Liang</a>, PhD student, reproductive history and non-communicable diseases in women, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>, and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, School of Public Health, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-miscarriage-and-stillbirth-225660">original article</a>.</em></p> </div>

Body

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

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/kim-davis-1535254">Kim Davis</a>, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a>; <a href="https://theconversation.com/profiles/alma-fulurija-1535255">Alma Fulurija</a>, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a>, and <a href="https://theconversation.com/profiles/myra-hardy-1535253">Myra Hardy</a>, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a></em></p> <p>the time of the year for coughs, colds and sore throats. So you might have heard people talk about having a “strep throat”.</p> <p>But what is that? Is it just a bad sore throat that goes away by itself in a day or two? Should you be worried?</p> <p>Here’s what we know about the similarities and differences between strep throat and a sore throat, and why they matter.</p> <h2>How are they similar?</h2> <p>It’s difficult to tell the difference between a sore throat and strep throat as they look and feel similar.</p> <p>People usually have a fever, a bright red throat and sometimes painful lumps in the neck (swollen lymph nodes). A throat swab can help diagnose strep throat, but the results can take a few days.</p> <p>Thankfully, both types of sore throat usually get better <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8655103/">by themselves</a>.</p> <h2>How are they different?</h2> <p>Most sore throats are caused by viruses such as common cold viruses, the flu (influenza virus), or the virus that causes glandular fever (Epstein-Barr virus).</p> <p>These viral sore throats can occur at any age. Antibiotics don’t work against viruses so if you have a viral sore throat, you won’t get better faster if you take antibiotics. You might even have some unwanted <a href="https://www.ncbi.nlm.nih.gov/books/NBK401243/#:%7E:text=People%20may%20then%20wonder%20whether,infection%2C%20such%20as%20bacterial%20tonsillitis.">antibiotic side-effects</a>.</p> <p>But strep throat is caused by <em>Streptococcus pyogenes</em> bacteria, also known as strep A. Strep throat is most common in <a href="https://www.tandfonline.com/doi/full/10.2217/fmb-2021-0077">school-aged children</a>, but can affect other age groups. In some cases, you may need antibiotics to avoid some rare but serious complications.</p> <p>In fact, the potential for complications is one key difference between a viral sore throat and strep throat.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=405&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=405&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=405&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=508&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=508&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/605956/original/file-20240710-19-irooun.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=508&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <p>Generally, a viral sore throat is <a href="https://www.bmj.com/content/347/bmj.f6867">very unlikely</a> to cause complications (one exception is those caused by Epstein-Barr virus which has been associated with illnesses such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893202/">chronic fatigue syndrome</a>, <a href="https://www.science.org/doi/10.1126/science.abj8222">multiple sclerosis</a> and certain <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00404-7/fulltext">cancers</a>).</p> <p>But strep A can cause invasive disease, a rare but serious complication. This is when bacteria living somewhere on the body (usually the skin or throat) get into another part of the body where there shouldn’t be bacteria, such as the bloodstream. This can make people extremely sick.</p> <p>Invasive strep A infections and deaths have been <a href="https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON429">rising in recent years</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786649/">around the world</a>, especially in young children and older adults. This may be due to a number of factors such as increased social mixing at this stage of the COVID pandemic and an increase in circulating common cold viruses. But overall the reasons behind the increase in invasive strep A infections are not clear.</p> <p>Another rare but serious side effect of strep A is autoimmune disease. This is when the body’s immune system makes antibodies that react against its own cells.</p> <p>The most common example is <a href="https://www.who.int/news-room/fact-sheets/detail/rheumatic-heart-disease">rheumatic heart disease</a>. This is when the body’s immune system damages the heart valves a few weeks or months after a strep throat or skin infection.</p> <p><a href="https://www.nejm.org/doi/10.1056/NEJMoa2102074?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub%20%200pubmed">Around the world</a> more than 40 million people live with rheumatic heart disease and more than 300,000 die from its complications every year, mostly in developing countries.</p> <p>However, parts of Australia have some of the <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50682">highest rates</a> of rheumatic heart disease in the world. <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/all-heart-stroke-and-vascular-disease/arf-and-rhd">More than 5,300</a> Indigenous Australians live with it.</p> <h2>Why do some people get sicker than others?</h2> <p>We know strep A infections and rheumatic heart disease <a href="https://link.springer.com/chapter/10.1007/82_2012_280">are more common</a> in low socioeconomic communities where poverty and overcrowding lead to increased strep A transmission and disease.</p> <p>However, we don’t fully understand why some people only get a mild infection with strep throat while others get very sick with invasive disease.</p> <p>We also don’t understand why some people get rheumatic heart disease after strep A infections when most others don’t. Our research team is trying to find out.</p> <h2>How about a vaccine for strep A?</h2> <p>There is no strep A vaccine but <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6028081/">many</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545125/">groups</a> in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6495378/">Australia</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902606/">New Zealand</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620221/">and</a> <a href="https://www.clinicalkey.com.au/#!/content/playContent/1-s2.0-S0264410X19316457?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0264410X19316457%3Fshowall%3Dtrue&amp;referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F">worldwide</a> are working towards one.</p> <p>For instance, Murdoch Children’s Research Institute and Telethon Kids Institute have formed the <a href="https://www.asavi.org.au">Australian Strep A Vaccine Initiative</a> to develop strep A vaccines. There’s also a <a href="https://savac.ivi.int/">global consortium</a> working towards the same goal.</p> <p>Companies such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10747066/">Vaxcyte</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696035/">GlaxoSmithKline</a> have also been developing strep A vaccines.</p> <h2>What if I have a sore throat?</h2> <p>Most sore throats will get better by themselves. But if yours doesn’t get better in a few days or you have ongoing fever, see your GP.</p> <p>Your GP can examine you, consider running some tests and help you decide if you need antibiotics.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230292/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kim-davis-1535254">Kim Davis</a>, General paediatrician and paediatric infectious diseases specialist, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a>; <a href="https://theconversation.com/profiles/alma-fulurija-1535255">Alma Fulurija</a>, Immunologist and the Australian Strep A Vaccine Initiative project lead, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a>, and <a href="https://theconversation.com/profiles/myra-hardy-1535253">Myra Hardy</a>, Postdoctoral Researcher, Infection, Immunity and Global Health, <a href="https://theconversation.com/institutions/murdoch-childrens-research-institute-1027">Murdoch Children's Research Institute</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-strep-throat-and-a-sore-throat-were-developing-a-vaccine-for-one-of-them-230292">original article</a>.</em></p> </div>

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

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

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

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Dog hair comes in many varieties, from shaggy to short, curly to straight. If you live with a dog, you live with their hair – on your couch, in your clothes, it’s everywhere!</p> <p>Beyond colour, have you ever wondered what’s behind the differences in coat type?</p> <p>We actually know quite a lot about why dogs have different coats, and it comes down to their genes.</p> <h2>What are the main coat types in dogs?</h2> <p>The three main features of dog coats are how long the hairs are, whether they are curly or straight, and whether they have extra flourishes. The flourishes are called “furnishings”, and can include a hairy moustache and shaggy eyebrows.</p> <p>Combinations of these three features result in seven different coat types in dogs: short, wire, wire and curly, long, long with furnishings, curly, and curly with furnishings.</p> <p>We know from a <a href="https://www.science.org/doi/abs/10.1126/science.1177808">study of more than 1,000 dogs with varying coats</a> that differences in only three genes are responsible for this variety.</p> <p>The gene responsible for long hair (called FGF5) is <a href="https://learn.genetics.utah.edu/content/basics/patterns">recessive</a>, meaning dogs must have two copies of the mutated gene to have long hair. <a href="https://doi.org/10.1073/pnas.1402862111">In humans</a>, the same gene has been identified in families with excessively long eyelashes.</p> <p>Curly coats in dogs are related to a gene called <a href="https://www.pawprintgenetics.com/products/tests/details/173/">KRT71</a>, which affects keratin, a protein involved in hair formation. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974189/">Mutations in this gene</a> in cats result in hairless (Sphynx) or curly-haired (Devon Rex) breeds.</p> <p>The gene responsible for furnishings (<a href="https://medlineplus.gov/genetics/gene/rspo2/">RSPO2</a>) is involved in establishing hair follicles. <a href="https://www.healthline.com/health/hair-follicle">Hair follicles</a> are small pockets in the skin that grow hair.</p> <p>Variations in these three genes could explain the coat type in most (but not all!) of the dogs tested. For example, the long coat of the Afghan hound is not explained by these three genes. Further study is needed to identify less common mutations and genes controlling the coat in these dogs.</p> <p>The earliest dog breeds would have been short-haired, as a result of the “wild-type” genes. Later changes would have arisen through mutation and deliberate selection <a href="https://theconversation.com/managing-mutations-of-a-species-the-evolution-of-dog-breeding-96635">through modern breeding practices</a>.</p> <p>If all three mutations are present, the dog has a long, curly coat with furnishings. An example is the Bichon Frisé.</p> <h2>What else varies in dog coats?</h2> <p>Dog coat types can also be single or double. In a double-coated breed such as a Labrador, there is a longer coarse layer of hairs and a softer and shorter undercoat. Wolves and ancestral dogs are single-coated, and the double coat is a result of a <a href="https://www.mdpi.com/2073-4425/10/5/323">mutation in chromosome 28</a>.</p> <p>In the Labrador, the mutation was probably selected for as they were bred to <a href="https://www.gov.nl.ca/releases/2023/exec/0525n07/">retrieve fishing nets in Canada</a>. The double coat is a great insulator and helps them to stay warm, even in icy water.</p> <h2>Why does it matter what kind of coat a dog has?</h2> <p>We know with climate change our world is going to get hotter. Dogs with a double coat are less able to tolerate heat stress, as their hair prevents heat loss.</p> <p>In a study of dogs <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/avj.13296">suffering heat-related illness</a>, most of the 15 breeds at higher risk had double coats. The death rate in these dogs was 23%. We can only imagine how it must feel going out on a 40 degree day wearing a thick fur coat.</p> <p>Dogs with a double coat shed more hair than dogs with a single coat. This means even short-haired breeds, like the Labrador retriever, can shed an astonishing amount of hair. If you can’t tolerate dog hair, then a dog with a double-coat may not suit you.</p> <p>When we think of wool we think of sheep, but in the past <a href="https://www.si.edu/stories/woolly-dog-mystery-unlocked">woolly dogs were kept for their wool</a> that was <a href="https://www.science.org/doi/10.1126/science.adi6549">woven by Indigenous groups</a> and used to make blankets.</p> <p>A dog’s coat also affects how much time and effort is needed for grooming. Dogs with long or curly hair with furnishings are likely to need more time invested in their care, or visits to a professional groomer.</p> <p>Designer dogs (cross-bred dogs often crossed with a poodle, such as groodles), are likely to be curly with furnishings. In a US study, people with designer dogs reported meeting their dogs’ maintenance and grooming requirements was <a href="https://www.mdpi.com/2076-2615/12/23/3247">much harder than they expected</a>.</p> <p>It’s not just bank balances and the time needed that can suffer. If people are unable to cope with the demands of grooming long-haired dogs, lack of grooming can cause welfare problems. A study of animal cruelty cases in New York found <a href="https://www.frontiersin.org/articles/10.3389/fvets.2022.827348/full">13% involved hair matting</a>, with some hair mats causing strangulation wounds and 93% of affected dogs having long hair.</p> <h2>How can you prevent problems?</h2> <p>If you have a curly- or long-haired breed of dog, it will help to train them to like being brushed from an early age. You can do this by counter-conditioning so they have a positive emotional response to being groomed, rather than feeling anxious. First show the brush or lightly brush them, then give them a treat. They learn to associate being brushed with something positive.</p> <p>If you take your dog to the groomer, it’s very important their first experience is positive. A scary or painful incident will make it much more difficult for future grooming.</p> <p>Is your dog difficult to groom or hard to get out of the car at the groomers? It’s likely grooming is scary for them. Consulting a dog trainer or animal behaviourist who focuses on positive training methods can help a lot.</p> <p>Keeping your dog well groomed, no matter their hair type, will keep them comfortable. More important than looking great, feeling good is an essential part of dogs living their best lives with us.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/232480/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/susan-hazel-402495">Susan Hazel</a>, Associate Professor, School of Animal and Veterinary Science, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> and <a href="https://theconversation.com/profiles/mia-cobb-15211">Mia Cobb</a>, Research Fellow, Animal Welfare Science Centre, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-dogs-have-different-coats-experts-explain-and-give-grooming-tips-for-different-types-232480">original article</a>.</em></p> </div>

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

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/michaela-rankin-1544784">Michaela Rankin</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Yesterday was July 1, the first day of the new financial year in Australia.</p> <p>Also called fiscal years, financial years are often abbreviated in print. The one that’s just begun in Australia – July 1 2024 to June 30 2025 – will typically be denoted by FY24/25 or FY25.</p> <p>As the name suggests, financial years are used for financial reporting, tax and budgeting purposes. Whether you are preparing an individual tax return or financial statements for a business, it is important to understand the difference between financial and calendar years.</p> <p>Both have 365 days. But the calendar year, based on the <a href="https://www.timeanddate.com/calendar/gregorian-calendar.html">Gregorian calendar</a>, runs from New Years’ Day on January 1 through to December 31.</p> <p>Australian financial years on the other hand run from July 1 of one year to June 30 the next.</p> <p>But this July to June financial year <a href="https://web.archive.org/web/20200430054150/https:/www.cia.gov/library/publications/the-world-factbook/fields/228.html">does not apply</a> in all countries. Many align their financial year with the calendar year, but others have further variations still.</p> <p>So why are they different, and what does that mean for businesses operating across borders?</p> <h2>Different around the world</h2> <p>In contrast to our own, the United Kingdom’s financial year starts on April 6 each year and runs to April 5 the next.</p> <p>The English and Irish New Year traditionally fell on March 25, when taxes and other accounts were due. But in the 18th century, the British empire switched from the Roman Julian calendar to the Gregorian calendar, and had to <a href="https://www.bowesbrooks.co.uk/why-does-the-tax-year-start-on-6th-april/">adjust the start date</a> to avoid losing tax revenue.</p> <p>India’s fiscal year runs from April 1 until March 31, for a <a href="https://www.idfcfirstbank.com/finfirst-blogs/finance/reasons-why-the-financial-year-starts-from-april">number of reasons</a>. Historically a country that was heavily focused on agriculture, this timeframe aligned with the crop cycle and allowed the government to develop financial plans for the sector.</p> <p>The British empire also influenced the April reporting schedule in India, as prior to independence many financial policies were based on the British system.</p> <h2>Government budgets play a role</h2> <p>In the United States, fiscal years once ran from July 1 to June 30, like Australia’s do now. But in 1974 this was <a href="https://www.federaltimes.com/management/budget/2022/09/20/why-the-us-federal-fiscal-year-2023-starts-in-october/">changed</a> to instead span October 1 to September 30, giving Congress more time to agree on a budget each year.</p> <p>In the US, however, companies can also <a href="https://www.business.com/articles/how-to-decide-on-fiscal-year/">choose their own</a> fiscal years. Some choose a calendar year, but others elect dates that better align with their business cycle.</p> <p>Walmart’s, for example, ends on January 31 each year to reflect its typically strong financial performance over the holiday period at the end of the year.</p> <p>In Australia, the financial year matches government reporting cycles.</p> <p>Unlike the northern hemisphere, our parliamentarians typically take holidays over summer in December and January, which makes meeting over November and December to approve government budgets difficult.</p> <p>The federal budget is issued in May for the following financial year, giving parliament time to consider it before the new fiscal year begins.</p> <h2>Comparing (and taxing) performance</h2> <p>Regardless of the time period over which a financial year operates, its primary purpose is to provide a standardised time frame for financial reporting.</p> <p>Financial years allow income and expenses to be tracked and compared over the same timeframe each year. This allows investors to compare business performance across consistent periods. They are also used to determine the collection of personal income tax.</p> <p>Our government uses this information to calculate the amount of tax it will collect through the Australian Taxation Office each year.</p> <p>Businesses with operations spanning multiple countries may have to contend with fiscal years that do not align. Where this is the case, they may need to choose one financial year for the whole company, typically that used by the parent company.</p> <p>Keeping track of the financial year is helpful for individuals, in knowing when tax returns need to be prepared (and when to expect end-of-financial-year sales).</p> <p>It is also important for businesses to consider the financial year in making budgeting, business and tax planning decisions. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/233655/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/michaela-rankin-1544784"><em>Michaela Rankin</em></a><em>, Professor and Head, Department of Accounting, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-are-financial-years-and-why-are-they-different-from-calendar-years-233655">original article</a>.</em></p> </div>

Money & Banking

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

<div class="theconversation-article-body"> <p><a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <em><a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Changes in thinking and memory as we age can occur for a variety of reasons. These changes are <a href="https://www.nia.nih.gov/health/memory-loss-and-forgetfulness/memory-problems-forgetfulness-and-aging#changes">not always cause for concern</a>. But when they begin to disrupt daily life, it could indicate the first signs of dementia.</p> <p>Another term that can crop up when we’re talking about dementia is Alzheimer’s disease, or Alzheimer’s for short.</p> <p>So what’s the difference?</p> <h2>What is dementia?</h2> <p>Dementia is an umbrella term used to describe a range of syndromes that result in changes in memory, thinking and/or behaviour due to degeneration in the brain.</p> <p>To meet the <a href="https://alz-journals.onlinelibrary.wiley.com/doi/epdf/10.1016/j.jalz.2011.03.005">criteria</a> for dementia these changes must be sufficiently pronounced to interfere with usual activities and are present in at least two different aspects of thinking or memory.</p> <p>For example, someone might have trouble remembering to pay bills and become lost in previously familiar areas.</p> <p>It’s less-well known that dementia can also occur in <a href="https://www.childhooddementia.org/what-is-childhood-dementia">children</a>. This is due to progressive brain damage associated with more than 100 rare genetic disorders. This can result in similar cognitive changes as we see in adults.</p> <h2>So what’s Alzheimer’s then?</h2> <p><a href="https://www.alz.org/alzheimers-dementia/what-is-alzheimers">Alzheimer’s</a> is the most common type of dementia, accounting for <a href="https://alz-journals.onlinelibrary.wiley.com/doi/full/10.1002/alz.12068">about 60-80%</a> of cases.</p> <p>So it’s not surprising many people use the terms dementia and Alzheimer’s interchangeably.</p> <p>Changes in memory are the most common sign of Alzheimer’s and it’s what the public <a href="https://alzres.biomedcentral.com/articles/10.1186/s13195-023-01219-4">most often</a> associates with it. For instance, someone with Alzheimer’s may have trouble recalling recent events or keeping track of what day or month it is.</p> <p>We still don’t know exactly what <a href="https://link.springer.com/article/10.1134/s002689332104004x">causes Alzheimer’s</a>. However, we do know it is associated with a build-up in the brain of two types of protein called <a href="https://www.dementiasplatform.uk/news-and-media/blog/amyloid-and-tau-the-proteins-involved-in-dementia">amyloid-β and tau</a>.</p> <p>While we all have some amyloid-β, when too much builds up in the brain it clumps together, forming plaques in the spaces between cells. These plaques cause damage (inflammation) to surrounding brain cells and leads to disruption in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468450/">tau</a>. Tau forms part of the structure of brain cells but in Alzheimer’s tau proteins become “tangled”. This is toxic to the cells, causing them to die. A <a href="https://content.iospress.com/articles/journal-of-alzheimers-disease/jad180583">feedback loop</a> is then thought to occur, triggering production of more amyloid-β and more abnormal tau, perpetuating damage to brain cells.</p> <p>Alzheimer’s can also occur with other forms of dementia, such as <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">vascular dementia</a>. This combination is the most common example of a <a href="https://www.dementiauk.org/information-and-support/types-of-dementia/mixed-dementia/">mixed dementia</a>.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/592838/original/file-20240508-18-6msd4.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Vascular dementia</h2> <p>The second most common type of dementia is <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">vascular dementia</a>. This results from disrupted blood flow to the brain.</p> <p>Because the changes in blood flow can occur throughout the brain, signs of vascular dementia can be more varied than the memory changes typically seen in Alzheimer’s.</p> <p>For example, vascular dementia may present as general confusion, slowed thinking, or difficulty organising thoughts and actions.</p> <p>Your <a href="https://www.mayoclinic.org/diseases-conditions/vascular-dementia/symptoms-causes/syc-20378793">risk of vascular dementia</a> is greater if you have heart disease or high blood pressure.</p> <h2>Frontotemporal dementia</h2> <p>Some people may not realise that dementia can also affect behaviour and/or language. We see this in different forms of frontotemporal dementia.</p> <p>The behavioural variant of <a href="https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.20090238#:%7E:text=The%20behavioral%20variant%20of%20frontotemporal,often%20delayed%20for%20several%20years.">frontotemporal dementia</a> is the second most common form (after Alzheimer’s disease) of <a href="https://www.healthdirect.gov.au/younger-onset-dementia">younger onset dementia</a> (dementia in people under 65).</p> <p>People living with this may have difficulties in interpreting and appropriately responding to social situations. For example, they may make uncharacteristically rude or offensive comments or invade people’s personal space.</p> <p><a href="https://www.sciencedirect.com/topics/neuroscience/semantic-dementia">Semantic dementia</a> is also a type of frontotemporal dementia and results in difficulty with understanding the meaning of words and naming everyday objects.</p> <h2>Dementia with Lewy bodies</h2> <p><a href="https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/dementia-with-lewy-bodies">Dementia with Lewy bodies</a> results from dysregulation of a different type of protein known as α-synuclein. We often see this in people with Parkinson’s disease.</p> <p>So people with this type of dementia may have altered movement, such as a stooped posture, shuffling walk, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428504/">changes in handwriting</a>. Other symptoms include changes in alertness, visual hallucinations and significant <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029467/">disruption to sleep</a>.</p> <h2>Do I have dementia and if so, which type?</h2> <p>If you or someone close to you is concerned, the first thing to do is to <a href="https://cdpc.sydney.edu.au/research/clinical-guidelines-for-dementia/">speak to your GP</a>. They will likely ask you some questions about your medical history and what changes you have noticed.</p> <p>Sometimes it might not be clear if you have dementia when you first speak to your doctor. They may suggest you watch for changes or they may refer you to a specialist for <a href="https://www.nia.nih.gov/health/alzheimers-and-dementia/what-dementia-symptoms-types-and-diagnosis#diagnosis">further tests</a>.</p> <p>There is no single test to clearly show if you have dementia, or the type of dementia. A diagnosis comes after multiple tests, including brain scans, tests of memory and thinking, and consideration of how these changes impact your daily life.</p> <p>Not knowing what is happening can be a challenging time so it is important to speak to someone about how you are feeling or to reach out to <a href="https://www.dementia.org.au/get-support/national-dementia-helpline">support services</a>.</p> <h2>Dementia is diverse</h2> <p>As well as the different forms of dementia, everyone experiences dementia in different ways. For example, the speed dementia progresses varies a lot from person to person. Some people will continue to <a href="https://livingwellwithdementia.org.au">live well with dementia</a> for some time while others may decline more quickly.</p> <p>There is still significant <a href="https://academic.oup.com/gerontologist/article-abstract/64/5/gnad130/7281753">stigma</a> surrounding dementia. So by learning more about the various types of dementia and understanding differences in how dementia progresses we can all do our part to create a more <a href="https://www.dementiafriendly.org.au/">dementia-friendly community</a>.</p> <hr /> <p><em>The <a href="https://www.dementia.org.au/get-support/national-dementia-helpline">National Dementia Helpline</a> (1800 100 500) provides information and support for people living with dementia and their carers. To learn more about dementia, you can take this <a href="https://www.utas.edu.au/wicking/understanding-dementia">free online course</a>.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225271/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-alzheimers-and-dementia-225271">original article</a>.</em></p> </div>

Mind

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What’s the difference between vegan and vegetarian?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>Vegan and vegetarian diets are <a href="https://link.springer.com/article/10.1007/s00394-023-03086-z">plant-based diets</a>. Both include plant foods, such as fruits, vegetables, legumes and whole grains.</p> <p>But there are important differences, and knowing what you can and can’t eat when it comes to a vegan and vegetarian diet can be confusing.</p> <p>So, what’s the main difference?</p> <h2>What’s a vegan diet?</h2> <p>A <a href="https://link.springer.com/article/10.1007/s00394-023-03086-z">vegan diet</a> is an entirely plant-based diet. It doesn’t include any meat and animal products. So, no meat, poultry, fish, seafood, eggs, dairy or honey.</p> <h2>What’s a vegetarian diet?</h2> <p>A <a href="https://link.springer.com/article/10.1007/s00394-023-03086-z">vegetarian diet</a> is a plant-based diet that generally excludes meat, poultry, fish and seafood, but can include animal products. So, unlike a vegan diet, a vegetarian diet can include eggs, dairy and honey.</p> <p>But you may be wondering why you’ve heard of vegetarians who eat fish, vegetarians who don’t eat eggs, vegetarians who don’t eat dairy, and even vegetarians who eat some meat. Well, it’s because there are variations on a vegetarian diet:</p> <ul> <li> <p>a <strong>lacto-ovo vegetarian</strong> diet excludes meat, poultry, fish and seafood, but includes eggs, dairy and honey</p> </li> <li> <p>an <strong>ovo-vegetarian</strong> diet excludes meat, poultry, fish, seafood and dairy, but includes eggs and honey</p> </li> <li> <p>a <strong>lacto-vegetarian</strong> diet excludes meat, poultry, fish, seafood and eggs, but includes dairy and honey</p> </li> <li> <p>a <strong>pescatarian</strong> diet excludes meat and poultry, but includes eggs, dairy, honey, fish and seafood</p> </li> <li> <p>a <strong>flexitarian</strong>, or semi-vegetarian diet, includes eggs, dairy and honey and may include small amounts of meat, poultry, fish and seafood.</p> </li> </ul> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/594474/original/file-20240516-16-wjg71m.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>Are these diets healthy?</h2> <p>A <a href="https://academic.oup.com/eurheartj/article/44/36/3423/7224412">2023 review</a> looked at the health effects of vegetarian and vegan diets from two types of study.</p> <p>Observational studies followed people over the years to see how their diets were linked to their health. In these studies, eating a vegetarian diet was associated with a lower risk of developing cardiovascular disease (such as heart disease or a stroke), diabetes, hypertension (high blood pressure), dementia and cancer.</p> <p>For example, in a <a href="https://www.sciencedirect.com/science/article/pii/S0002916523054497?via%3Dihub">study</a> of 44,561 participants, the risk of heart disease was 32% lower in vegetarians than non-vegetarians after an average follow-up of nearly 12 years.</p> <p>Further evidence came from randomised controlled trials. These instruct study participants to eat a specific diet for a specific period of time and monitor their health throughout. These studies showed eating a vegetarian or vegan diet led to reductions in weight, blood pressure, and levels of unhealthy cholesterol.</p> <p>For example, one <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1832195">analysis</a> combined data from seven randomised controlled trials. This so-called meta-analysis included data from 311 participants. It showed eating a vegetarian diet was associated with a systolic blood pressure (the first number in your blood pressure reading) an average 5 mmHg lower compared with non-vegetarian diets.</p> <p>It seems vegetarian diets are more likely to be healthier, across a number of measures.</p> <p>For example, a 2022 <a href="https://link.springer.com/article/10.1007/s00394-022-02942-8">meta-analysis</a> combined the results of several observational studies. It concluded a vegetarian diet, rather than vegan diet, was recommended to prevent heart disease.</p> <p>There is also <a href="https://link.springer.com/article/10.1007/s13668-024-00533-z">evidence</a> vegans are more likely to have bone fractures than vegetarians. This could be partly due to a lower body-mass index and a lower intake of nutrients such as calcium, vitamin D and protein.</p> <h2>But it can be about more than just food</h2> <p>Many vegans, where possible, do not use products that directly or indirectly involve using animals.</p> <p>So vegans would not wear leather, wool or silk clothing, for example. And they would not use soaps or candles made from beeswax, or use products tested on animals.</p> <p>The motivation for following a vegan or vegetarian diet can vary from person to person. Common motivations <a href="https://www.sciencedirect.com/science/article/pii/S2475299123157957">include</a> health, environmental, ethical, religious or economic reasons.</p> <p>And for many people who follow a vegan or vegetarian diet, this forms a central part of their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231820/">identity</a>.</p> <h2>So, should I adopt a vegan or vegetarian diet?</h2> <p>If you are thinking about a vegan or vegetarian diet, here are some things to consider:</p> <ul> <li> <p>eating more plant foods does not automatically mean you are eating a healthier diet. Hot chips, biscuits and soft drinks can all be vegan or vegetarian foods. And many <a href="https://theconversation.com/we-looked-at-700-plant-based-foods-to-see-how-healthy-they-really-are-heres-what-we-found-222991">plant-based alternatives</a>, such as plant-based sausages, can be high in added salt</p> </li> <li> <p>meeting the <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients">nutrient intake targets</a> for vitamin B12, iron, calcium, and iodine requires more careful planning while on a vegan or vegetarian diet. This is because meat, seafood and animal products are good sources of these vitamins and minerals</p> </li> <li> <p>eating a plant-based diet doesn’t necessarily mean <a href="https://theconversation.com/why-you-should-eat-a-plant-based-diet-but-that-doesnt-mean-being-a-vegetarian-78470">excluding</a> all meat and animal products. A healthy flexitarian diet prioritises eating more whole plant-foods, such as vegetables and beans, and less processed meat, such as bacon and sausages</p> </li> <li> <p>the <a href="https://www.eatforhealth.gov.au/guidelines/australian-dietary-guidelines-1-5">Australian Dietary Guidelines</a> recommend eating a wide variety of foods from the five food groups (fruit, vegetables, cereals, lean meat and/or their alternatives and reduced-fat dairy products and/or their alternatives). So if you are eating animal products, choose lean, reduced-fat meats and dairy products and limit processed meats.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225275/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> </li> </ul> <p><em><a href="https://theconversation.com/profiles/katherine-livingstone-324808">Katherine Livingstone</a>, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-vegan-and-vegetarian-225275">original article</a>.</em></p> </div>

Food & Wine

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What’s the difference between shyness and social anxiety?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/kayla-steele-1042011">Kayla Steele</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jill-newby-193454">Jill Newby</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations.</p> <p>However, <a href="https://theconversation.com/shyness-isnt-nice-but-shyness-shouldnt-stop-you-28010">feeling shy</a>, or having a shy personality, is not the same as experiencing <a href="https://theconversation.com/explainer-what-is-social-anxiety-disorder-36601">social anxiety</a> (short for “social anxiety disorder”).</p> <p>Here are some of the similarities and differences, and what the distinction means.</p> <h2>How are they similar?</h2> <p>It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others.</p> <p>For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations.</p> <p>People who are shy or socially anxious may <a href="https://theconversation.com/paralysed-with-fear-why-do-we-freeze-when-frightened-60543">respond with</a> “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “<a href="https://theconversation.com/what-is-fawning-how-is-it-related-to-trauma-and-the-fight-or-flight-response-205024">fawn</a>” (by trying to appease or placate others).</p> <p>A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety.</p> <p>For example, both <a href="https://link.springer.com/article/10.3758/s13415-021-00916-7">shy children</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428215/">adults with social anxiety</a> have neural circuits that respond strongly to stressful social situations, such as being excluded or left out.</p> <p>People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=456&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/592825/original/file-20240508-22-heev7f.png?ixlib=rb-4.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=573&amp;fit=crop&amp;dpr=3 2262w" alt="" /></a><figcaption></figcaption></figure> <h2>How are they different?</h2> <p>Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder.</p> <p>For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected.</p> <p>To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self.</p> <p>Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder.</p> <p>People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults.</p> <p>Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations.</p> <p>However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations.</p> <p>The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics.</p> <p>The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study.</p> <p>The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness.</p> <p>Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or <a href="https://theconversation.com/what-is-selective-mutism-and-is-it-a-lifelong-condition-219930">refuse to speak</a> in certain situations.</p> <p>If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and <a href="https://theconversation.com/back-to-school-blues-how-to-help-your-child-with-shyness-90228">parental support</a>, patience and guidance, children can be taught <a href="https://theconversation.com/7-tips-to-help-kids-feeling-anxious-about-going-back-to-school-139207">strategies</a> to overcome social anxiety.</p> <h2>Why does the distinction matter?</h2> <p>Social anxiety disorder is a mental health condition that <a href="https://link.springer.com/article/10.1186/s12916-017-0889-2?utm_source=getftr&amp;utm_medium=getftr&amp;utm_campaign=getftr_pilot">persists</a> for people who do not receive adequate support or treatment.</p> <p>Without treatment, it can lead to <a href="https://pubmed.ncbi.nlm.nih.gov/22306132/">difficulties</a> in education and at work, and in developing meaningful relationships.</p> <p>Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness.</p> <p>A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment.</p> <p>Different people have different support needs. However, <a href="https://www.nice.org.uk/guidance/cg159/chapter/Recommendations">clinical practice guidelines</a> recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with <a href="https://theconversation.com/explainer-what-is-exposure-therapy-and-how-can-it-treat-social-anxiety-64483#:%7E:text=Exposure%20therapy%20is%20where%20people,addresses%20the%20underlying%20unhelpful%20thoughts.">exposure therapy</a> (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective <a href="https://theconversation.com/explainer-what-is-exposure-therapy-and-how-can-it-treat-social-anxiety-64483#:%7E:text=Exposure%20therapy%20is%20where%20people,addresses%20the%20underlying%20unhelpful%20thoughts.">in-person</a>, <a href="https://www.semanticscholar.org/paper/Computer-therapy-for-the-anxiety-and-depression-is-Andrews-Basu/25e9ee98a1af8d2780ac3e1f687ebc40ebd1b47c">online</a> and in <a href="https://pubmed.ncbi.nlm.nih.gov/34534800/">brief treatments</a>.</p> <h2>For more support or further reading</h2> <p>Online resources about social anxiety include:</p> <ul> <li> <p>This Way Up’s <a href="https://thiswayup.org.au/programs/social-anxiety-program/">online program</a> for managing excessive shyness and fear of social situations</p> </li> <li> <p>Beyond Blue’s <a href="https://www.beyondblue.org.au/mental-health/anxiety/types-of-anxiety/social-anxiety-disorder">resources</a> on social anxiety</p> </li> <li> <p>a guide to <a href="https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Social-Anxiety">looking after yourself</a> if you have social anxiety, from the Western Australian health department</p> </li> <li> <p>social anxiety <a href="https://brave4you.psy.uq.edu.au/">online program for children and teens</a> from the University of Queensland</p> </li> <li> <p>inroads, a <a href="https://inroads.org.au/">self-guided online program</a> for young adults who drink alcohol to manage their anxiety.</p> </li> </ul> <hr /> <p><em>We thank the Black Dog Institute <a href="https://www.blackdoginstitute.org.au/about/who-we-are/lived-experience/">Lived Experience Advisory Network</a> members for providing feedback and input for this article and our research.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225669/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kayla-steele-1042011">Kayla Steele</a>, Postdoctoral research fellow and clinical psychologist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> and <a href="https://theconversation.com/profiles/jill-newby-193454">Jill Newby</a>, Professor, NHMRC Emerging Leader &amp; Clinical Psychologist, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-shyness-and-social-anxiety-225669">original article</a>.</em></p> </div>

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