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Why do some people need less sleep than others?

<div class="theconversation-article-body"> Have you ever noticed how some people bounce out of bed after just a few hours of sleep, while others can barely function without a solid eight hours? Take Margaret Thatcher, for example. The former British prime minister was known for sleeping <a href="https://www.bbc.com/news/magazine-22084671">just four hours a night</a>. She worked late, rose early, and seemed to thrive on little sleep. But for most of us, that kind of sleep schedule would be disastrous. We’d be groggy, unfocused, and reaching for sugary snacks and caffeinated drinks by mid-morning. So why do some people seem to need less sleep than others? It’s a question that’s fascinated scientists for years. Here’s what we know so far. <h2>Natural short sleepers</h2> There is a small group of people who don’t need much sleep. We call them <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6879540/">natural short sleepers</a>. They can function perfectly well on just four to six hours of sleep each night, often for their entire lives. Generally they <a href="https://academic.oup.com/sleep/article/44/Supplement_2/A154/6260529">don’t feel tired</a>, they don’t nap, and they don’t suffer the usual negative consequences of sleep deprivation. Scientists call this the natural short sleep phenotype – a biological trait that allows people to get all the benefits of sleep in less time. In 2010 researchers discovered genetic mutations that help explain this phenomenon. Natural short sleepers carry rare variants <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2884988/">in certain genes</a>, which seem to make their sleep more efficient. More recently, a <a href="https://www.pnas.org/doi/epub/10.1073/pnas.2500356122">2025 study</a> assessed a woman in her 70s with one of these rare mutations. Despite sleeping just six hours a night for most of her life, she remained physically healthy, mentally sharp, and led a full, active life. Her body, it seems, was simply wired to need less sleep. We’re still learning about how common these genetic mutations are and why they occur. <h2>Not everyone who sleeps less is a natural short sleeper</h2> But here’s the catch: most people who think they’re natural short sleepers aren’t. They’re just chronically sleep-deprived. Often, their short sleep is due to long work hours, social commitments, or a belief sleeping less is a sign of strength or productivity. In today’s hustle culture, it’s common to hear people boast about getting by on only a few hours of sleep. But for the average person, that’s not sustainable. The effects of short sleep build up over time, creating what’s known as a “sleep debt”. This <a href="https://www.sciencedirect.com/science/article/pii/S0149763417301641">can lead to</a> poor concentration, mood swings, micro-sleeps (brief lapses into sleep), reduced performance and even <a href="https://www.sciencedirect.com/science/article/pii/S1389945716301381">long-term health risks</a>. For example, short sleep has been linked to an increased risk of obesity, diabetes, high blood pressure and cardiovascular disease (heart disease and stroke). <h2>The weekend catch-up dilemma</h2> To make up for lost sleep during the week, many people try to “catch up” on weekends. This can help repay some of the sleep debt that has accumulated in the short term. Research <a href="https://www.sciencedirect.com/science/article/pii/S2352721823001663?via%3Dihub">suggests</a> getting one to two extra hours of sleep on the weekend or taking naps when possible may help reduce the negative effects of short sleep. However, it’s not a perfect fix. Weekend catch-up sleep and naps may not fully resolve sleep debt. The topic remains one of ongoing scientific debate. A recent <a href="https://academic.oup.com/sleep/article/47/11/zsae135/7696120">large study</a> suggested weekend catch-up sleep may not offset the cardiovascular risks associated with chronic short sleep. What’s more, large swings in sleep timing can disrupt your body’s <a href="https://www.nature.com/articles/s41598-017-03171-4">internal clock</a>, and sleeping in too much on weekends may make it harder to fall asleep on Sunday night, which can mean starting the working week less rested. Increasing evidence indicates <a href="https://academic.oup.com/sleep/article/47/1/zsad253/7280269">repeated cycles of irregular sleep</a> may have an important influence on general health and the risk of early death, potentially even more so than how long we sleep for. Ultimately, while moderate catch-up sleep might offer some benefits, it’s no substitute for consistent, high-quality sleep throughout the week. That said, maintaining such regularity can be particularly challenging for people with non-traditional schedules, such as shift workers. <h2>So, was Thatcher a true natural short sleeper?</h2> It’s hard to say. Some reports suggest <a href="https://www.theguardian.com/lifeandstyle/2021/aug/27/from-aristotle-to-einstein-a-brief-history-of-power-nappers">she napped during the day</a> in the back of a car between meetings. That could mean she was simply sleep-deprived and compensating for an accumulated sleep debt when she could. Separate to whether someone is a natural short sleeper, there are a range of other reasons people may need more or less sleep than others. Factors <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need">such as age</a> and underlying health conditions can significantly influence sleep requirements. For example, older adults often experience changes in their circadian rhythms and are more likely to suffer from fragmented sleep due to conditions <a href="https://link.springer.com/article/10.1007/s00702-019-02067-z">such as arthritis</a> or <a href="https://link.springer.com/article/10.1007/s11886-023-01939-x">cardiovascular disease</a>. Sleep needs vary from person to person, and while a lucky few can thrive on less, most of us need <a href="https://www.sleephealthfoundation.org.au/sleep-topics/how-much-sleep-do-you-really-need">seven to nine hours</a> a night to feel and function our best. If you’re regularly skimping on sleep and relying on weekends to catch up, it might be time to rethink your routine. After all, sleep isn’t a luxury – it’s a biological necessity.<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/256342/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> By <a href="https://theconversation.com/profiles/kelly-sansom-2390567">Kelly Sansom</a>, Research Associate, College of Medicine and Public Health, Flinders University; Research Associate, Centre for Healthy Ageing, <a href="https://theconversation.com/institutions/murdoch-university-746">Murdoch University</a> and <a href="https://theconversation.com/profiles/peter-eastwood-2316718">Peter Eastwood</a>, Deputy Vice Chancellor, Research and Innovation, <a href="https://theconversation.com/institutions/murdoch-university-746">Murdoch University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-some-people-need-less-sleep-than-others-a-gene-variation-could-have-something-to-do-with-it-256342">original article</a>. Image: </div>

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"Have some decency": Appalling reaction to Magda's health news

Australian comedian and national treasure Magda Szubanski has revealed her battle with a rare and aggressive blood cancer – only to be met with a wave of online vitriol and conspiracy theories, drawing widespread condemnation for the lack of compassion. On Thursday, the 64-year-old star <a href="https://www.oversixty.com.au/health/caring/magda-szubanski-shares-devastating-health-news" target="_blank" rel="noopener">announced she had been diagnosed with Mantle Cell Lymphoma</a>, a rare form of stage-4 blood cancer. The diagnosis came unexpectedly during a routine breast screening, prompting Szubanski to begin the “Nordic protocol”, which she described as “one of the best treatments available”. In a candid Instagram video, the Kath & Kim actress addressed her followers with honesty and humour. “Hello, my lovelies. The head is shaved in anticipation of it all falling out in a couple of weeks,” she said. “It’s pretty confronting… But new treatments keep coming down the pipeline all the time.” Despite the seriousness of her condition, Szubanski reassured fans that she was in good hands, supported by her loved ones and an exceptional medical team. “To be honest, I’ve been feeling pretty ratsh*t for ages. So I asked for extra bloods and – voila!” However, the warmth of her message was quickly overshadowed by a torrent of cruel remarks and baseless conspiracy theories on social media platform X (formerly Twitter). Some users linked her cancer diagnosis to her vocal support for COVID-19 vaccinations during the pandemic, reviving the discredited “turbo cancer” myth – a fringe theory suggesting COVID vaccines cause rapid-onset cancers. “Very sad to hear another experimental vaccine pusher has been diagnosed with something horrible,” one user tweeted. Others echoed similar sentiments, with one post reading, “Zero sympathy,” and another claiming, “It’s good to see that karma still works.” Szubanski was a prominent proponent of vaccination during the pandemic, even donning her beloved character Sharon Strzelecki in a government campaign to encourage Victorians to get the jab. That effort, once celebrated, is now being weaponised by some online as supposed justification for her illness. The backlash sparked swift condemnation from more compassionate voices on the platform. “As if cancer didn’t exist before Covid and vaccinations. You guys are seriously cooked,” wrote one user. Another added, “Classless of you to post this. Why drop to the level?” Many others pointed out the lack of basic human decency in mocking someone for a life-threatening diagnosis. “The posts here are highly disrespectful… Have some decency. BTW, these things can happen to anyone.” Szubanski’s diagnosis has drawn an outpouring of support from fans, friends, and fellow celebrities who praised her courage and vulnerability in going public. As she begins treatment, the beloved entertainer remains focused on her recovery and grateful for the support surrounding her. “I’ll be lying very low while my immune system takes a hammering,” she said. “For now, just know I’m in good hands, good spirits – but I reserve my human right to be a cranky old moll.” Image: Supplied

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Why do some people get a curved back as they age and what can we do to avoid it?

<div class="theconversation-article-body"> As we age, it’s common to notice posture changes: shoulders rounding, head leaning forward, back starting to curve. You might associate this with older adults and wonder: will this happen to me? Can I prevent it? It’s sometimes called “hunchback” or “roundback”, but the medical term for a curved back is kyphosis. When the curve is beyond what’s considered normal (greater than 40 degrees), we refer to this as hyperkyphosis. In more <a href="https://www.jospt.org/doi/10.2519/jospt.2010.3099#_i12:%7E:text=gold%2Dstandard%20radiograph.-,Clinical%20Consequences%20of%20Hyperkyphosis,-Functional%20Limitations">severe cases</a>, it may lead to pain, reduced mobility and physical function, or lower quality of life. Here’s how it happens, and how to reduce your risk. <h2>What causes a curved back?</h2> A healthy spine has an elongated s-shape, so a curve in the upper spine is completely normal. But when that curve becomes exaggerated and fixed (meaning you can’t stand up straight even if you try), it can signal a problem. One common cause of a curved back is poor posture. This type, called postural kyphosis, usually develops over time due to muscle imbalances, particularly in younger people who spend hours: <ul> <li>hunched over a desk</li> <li>slouched in a chair, or</li> <li>looking down at a phone.</li> </ul> Fortunately, this kind of curved back is often reversible with the right exercises, stretches and posture awareness. Older adults often develop a curved back, known as age-related kyphosis or hyperkyphosis. This is usually due to wear and tear in the spine, including vertebral compression fractures, which are tiny cracks in the bones of the spine (vertebrae). These cracks are most often caused by osteoporosis, a condition that makes bones more fragile with age. In these cases, it’s not just bad posture – it’s a structural change in the spine. <h2>How can you tell the difference?</h2> Signs of age-related hyperkyphosis include: <ul> <li>your back curves even when you try to stand up straight</li> <li>back pain or stiffness</li> <li>a loss of height (anything greater than 3-4 centimetres compared to your peak adult height may be considered outside of “normal” ageing).</li> </ul> Other causes of a curved back include: <ul> <li><a href="https://pubmed.ncbi.nlm.nih.gov/30407981/">Scheuermann’s kyphosis</a> (which often develops during adolescence when the bones in the spine grow unevenly, leading to a forward curve in the upper back)</li> <li><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4347150/">congenital kyphosis</a> (a rare condition present from birth, caused by improper formation of the spinal bones. It can result in a more severe, fixed curve that worsens as a child grows)</li> <li>scoliosis (where the spine curves sideways into a c- or s-shape when viewed from behind), and</li> <li>lordosis (an excessive inward curve in the lower back, when viewed from the side).</li> </ul> In addition to these structural conditions, arthritis, and in rare cases, spinal injuries or infections, can also play a role. <h2>Should I see a doctor about my curved back?</h2> Yes, especially if you’ve noticed a curve developing, have ongoing back pain, or have lost height over time. These can be signs of vertebral fractures, which can occur in the absence of an obvious injury, and are often painless. While one in five older adults have a vertebral fracture, as many as two-thirds of these fractures are <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002934315010128?casa_token=DzXngmS6GIoAAAAA:3ub0V4PuHbKjrqO9xYDo8vx2m9k6tbOtmz4yIVzkQvH-VylhgO_KnKaTYDLXpiHc9_4Jz0iNdQ">not diagnosed and treated</a>. In Australia, the Royal Australian College of General Practitioners and Healthy Bones Australia <a href="https://healthybonesaustralia.org.au/wp-content/uploads/2022/12/oa-racgp-osteoporosis-clinical-guidelines-2nd-ed.pdf">recommend</a> a spine x-ray for: <ul> <li>people with kyphosis</li> <li>height loss equal to or more than 3 centimetres, or</li> <li>unexplained back pain.</li> </ul> <h2>What can I do to reduce my risk?</h2> If you’re young or middle-aged, the habits you build today matter. The best way to prevent a curved back is to keep your bones strong, muscles active, and posture in check. That means: <ul> <li>doing regular resistance training, especially targeting upper back muscles</li> <li>staying physically active, aiming for at least <a href="https://www.who.int/initiatives/behealthy/physical-activity">150 minutes per week</a></li> <li>getting enough protein, calcium, and vitamin D to support bone and muscle health</li> <li>avoiding smoking and limiting alcohol to reduce risk factors that worsen bone density and overall wellbeing</li> </ul> Pay attention to your posture while sitting and standing. Position your head over your shoulders and shoulders over your hips. This reduces strain on your spine. <h2>What exercises help prevent and manage a curved back?</h2> Focus on <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5112023/">exercises that strengthen the muscles</a> that support an upright posture, particularly the upper back and core, while improving mobility in the chest and shoulders. In general, you want to prioritise extension-based movements. These involve straightening or lifting the spine and pulling the shoulders back. Repeated forward-bending (or flexion) movements may make things worse, especially in people with osteoporosis or spinal fractures. Good exercises include: <ul> <li>back extensions (gently lift your chest off the floor while lying face down)</li> <li>resistance exercises targeting the muscles between your shoulder blades</li> <li>weight-bearing activities (such as brisk walking, jogging, stair climbing, or dancing) to keep bones strong and support overall fitness</li> <li>stretching your chest and hip flexors to open your posture and relieve tightness.</li> </ul> Flexibility and balance training (such as yoga and pilates) can be <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3700806/">beneficial</a>, particularly for posture awareness, balance, and mobility. But <a href="https://pubmed.ncbi.nlm.nih.gov/31034509/">research</a> increasingly supports muscle strengthening as the cornerstone of prevention and management. Muscle strengthening exercises, such as weight lifting or resistance training, reduces spinal curvature while enhancing muscle and bone mass. If you suspect you have kyphosis or already have osteoporosis or a vertebral fracture, consult a health professional before starting an exercise program. There may be some activities to avoid. <h2>Can a curved back be reversed?</h2> If it’s caused by poor posture and muscle weakness, then yes, it’s possible. But if it’s caused by bone changes, especially vertebral fractures, then full reversal is unlikely. However, treatment can reduce pain, improve function, and slow further progression. Protecting your posture isn’t just about appearance. It’s about staying strong, mobile and independent as you age.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/252811/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> By <a href="https://theconversation.com/profiles/jakub-mesinovic-2351870">Jakub Mesinovic</a>, Research Fellow at the Institute for Physical Activity and Nutrition, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/david-scott-1258511">David Scott</a>, Associate Professor (Research) and NHMRC Emerging Leadership Fellow, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-some-people-get-a-curved-back-as-they-age-and-what-can-i-do-to-avoid-it-252811">original article</a>. Image: Life Care Home Health </div>

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Who will the next pope be? Here are some top contenders

<div class="theconversation-article-body"> The death of Pope Francis marks the end of a <a href="https://theconversation.com/pope-francis-has-died-aged-88-these-were-his-greatest-reforms-and-controversies-229111">historic papacy</a> and the beginning of a significant transition for the Catholic Church. As the faithful around the world mourn his passing, attention now turns to the next phase: the election of a new pope. This election will take place through a process known as <a href="https://theconversation.com/how-will-a-new-pope-be-chosen-an-expert-explains-the-conclave-250506">the conclave</a>. Typically held two to three weeks after a pope’s funeral, the conclave gathers the College of Cardinals in the Vatican’s Sistine Chapel. Here, through prayer, reflection and secret ballots, they must reach a two-thirds majority to choose the next Bishop of Rome. While, in theory, any baptised Catholic man can be elected, for the past seven centuries the role has gone to a cardinal. That said, the outcome can still be unpredictable – sometimes even surprising the electors themselves. <h2>An unlikely candidate</h2> Cardinal Jorge Mario Bergoglio – who became Pope Francis – wasn’t among the front-runners in 2013. Nonetheless, after five rounds of voting, he emerged as the top candidate. Something similar could happen again. This conclave will take place during a time of tension and change within the church. Francis sought to decentralise Vatican authority, emphasised caring for the poor and the planet, and tried to open dialogue on sensitive issues such as <a href="https://time.com/7267052/pope-francis-impact-on-the-lgbtq-community/">LGBTQIA+ inclusion</a> and <a href="https://www.reuters.com/world/abuse-victims-say-they-saw-progress-under-pope-francis-just-not-enough-2025-04-22/">clerical abuse</a>. The cardinals must now decide whether to continue in this direction, or steer towards a more traditional course. There is historical precedent to consider. For centuries, Italians dominated the papacy. Of the 266 popes, 217 have <a href="https://worldpopulationreview.com/country-rankings/popes-by-country">been Italian</a>. However, this pattern has shifted in recent decades: Francis was from Argentina, John Paul II (1978–2005) from Poland, and Benedict XVI (2005–2013) from Germany. <h2>The top papabili</h2> As with any election, observers are speaking of their “favourites”. The term papabile, which in Italian means “pope-able”, or “capable of becoming pope”, is used to describe cardinals who are seen as serious contenders. Among the leading papabili is Cardinal <a href="https://en.wikipedia.org/wiki/Pietro_Parolin">Pietro Parolin</a>, aged 70, the current Secretary of State of Vatican City. Parolin has long been one of Francis’ closest collaborators and has led efforts to open dialogue with difficult regimes, <a href="https://catholicweekly.com.au/vatican-diplomat-discusses-china/">including the Chinese Communist Party</a>. Parolin is seen as a centrist figure who could appeal to both reform-minded and more conservative cardinals. Yet some <a href="https://www.politico.eu/article/pope-francis-death-who-succeed-parolin-pizzaballa-tagle-turkson-besungu-burke-spengler-erdo/">observers argue</a> he lacks the charismatic and pastoral presence that helped define Francis’ papacy. Another name to watch is Cardinal <a href="https://en.wikipedia.org/wiki/Pierbattista_Pizzaballa">Pierbattista Pizzaballa</a>, the Latin Patriarch of Jerusalem. At 60, he is younger than many of his colleagues, but brings extensive experience in interfaith dialogue in the Middle East. His fluency in Hebrew and his long service in the Holy Land could prove appealing. Then again, his relative youth may cause hesitation among those concerned about electing a pope who could serve for decades. As the papacy of John Paul II demonstrated, such long reigns can have a profound impact on the church. Cardinal <a href="https://en.wikipedia.org/wiki/Luis_Antonio_Tagle">Luis Antonio Tagle</a> of the Philippines is also frequently mentioned. Now 67, Tagle is known for his deep commitment to social justice and the poor. He has spoken out against human rights abuses in his home country and has often echoed Francis’ pastoral tone. But some cardinals may worry that his outspoken political views could complicate the church’s diplomatic efforts. Cardinal <a href="https://en.wikipedia.org/wiki/Peter_Turkson">Peter Turkson</a> of Ghana, now 76, was a prominent figure during the last conclave. A strong voice on environmental and economic justice, he has served under both Benedict XVI and Francis. Turkson has largely upheld the church’s traditional teachings on matters such as male-only priesthood, marriage between a man and a woman, and sexuality. He is also a strong advocate for transparency, and has spoken out against corruption and in defence of human rights. Though less widely known among the public, Cardinal <a href="https://en.wikipedia.org/wiki/Mykola_Bychok">Mykola Bychok</a> of Melbourne may also be considered. His election would be as surprising (and perhaps as symbolically powerful) as that of John Paul II in 1978. A Ukrainian-Australian pope, chosen during the ongoing war in Ukraine, would send a strong message about the church’s concern for suffering peoples and global peace. Other names that may come up are Cardinal <a href="https://en.wikipedia.org/wiki/Fridolin_Ambongo_Besungu">Fridolin Ambongo Besungu</a> from the Democratic Republic of the Congo, and Cardinal <a href="https://en.wikipedia.org/wiki/Jaime_Spengler">Jaime Spengler</a> of Brazil – both of whom lead large and growing Catholic communities. Although news reports don’t always list them among the top contenders, their influence within their regions – and the need to recognise the church’s global demographic shifts – means their voices will matter. On the more conservative side is American Cardinal <a href="https://en.wikipedia.org/wiki/Raymond_Leo_Burke">Raymond Burke</a>, who had been one of Francis’ most vocal critics. But his confrontational stance makes him an unlikely candidate. More plausible would be Cardinal <a href="https://en.wikipedia.org/wiki/P%C3%A9ter_Erd%C5%91">Péter Erdő</a> of Hungary, aged 71. Erdő is a respected canon lawyer with a more traditional theological orientation. He was mentioned in 2013 and may reemerge as a promising candidate among conservative cardinals. <figure class="align-right zoomable"><a href="https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=237&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=792&fit=crop&dpr=1 600w, https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=792&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=792&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=996&fit=crop&dpr=1 754w, https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=996&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/663322/original/file-20250423-56-vunzyq.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=996&fit=crop&dpr=3 2262w" alt="" /></a><figcaption>Cardinal Péter Erdő was ordained as a priest in 1975 and has a doctorate in theology. He will be a top pick among conservatives. Wikimedia, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></figcaption></figure> <h2>One tough act to follow</h2> Although Francis appointed many of the cardinals who will vote in the conclave, that doesn’t mean all of them supported his agenda. Many come from communities with traditional values, and may be drawn to a candidate who emphasises older church teachings. The conclave will also reflect broader questions of geography. The church’s growth has shifted away from Europe, to Asia, Africa and Latin America. A pope from one of these regions could symbolise this change, and speak more directly to the challenges faced by Catholic communities in the Global South. Ultimately, predicting a conclave is impossible. Dynamics often change once the cardinals enter the Sistine Chapel and begin voting. Alliances shift, new names emerge, and consensus may form around someone who was barely discussed beforehand. What is certain is that the next pope will shape the church’s future: doctrinally, diplomatically and pastorally. Whether he chooses to build on Francis’ legacy of reform, or move in a new direction, he will need to balance ancient traditions with the urgent realities of the modern world.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/255006/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/darius-von-guttner-sporzynski-112147">Darius von Guttner Sporzynski</a>, Historian, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/who-will-the-next-pope-be-here-are-some-top-contenders-255006">original article</a>. Image: Rawpixel.com </div>

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Despite some key milestones since 2000, Australia still has a long way to go on gender equality

<div class="theconversation-article-body"> Australia has a gender problem. Despite social, economic and political reform aimed at improving opportunities for women, gender gaps are increasing and Australia is falling behind other countries. The World Economic Forum currently places Australia 24th among 146 countries, down from 15th in 2006. At the current rate of change, the forum suggests it will take <a href="https://www.weforum.org/publications/global-gender-gap-report-2024/">more than 130 years</a> to achieve gender equality globally. Australia has taken important steps forward in some areas, while progress in other areas remains painfully slow. So how far have we come since 2000, and how much further do we have to go? <h2>The good stuff</h2> There are now more women in <a href="https://www.aigroup.com.au/resourcecentre/research-economics/factsheets/factsheet-gender-and-the-australian-labour-market/#:%7E:text=Female%20labour%20market%20participation%20was,gender%20participation%20gap%20of%208%25.">the labour market</a>, in <a href="https://www.abs.gov.au/statistics/measuring-what-matters/measuring-what-matters-themes-and-indicators/cohesive/representation-parliament">parliament</a>, and leading <a href="https://www.forbes.com.au/lists/people/women-of-the-asx/">large companies</a> than at any other time. Over the past 25 years, there have been major social and political milestones that indicate progress. These include the appointment of Australia’s first female governor-general in 2008 and prime minister in 2010, the introduction of universal paid parental leave in 2011, a high-profile inquiry into workplace sexual harassment in 2020, and new legislation requiring the public reporting of gender pay gaps in 2023. <h2>Timeline of equality milestones</h2> <ul id="timelineList"> <li> <h2>2000</h2> Child Care Benefit introduced, subsidising cost of children for eligible families </li> <li> <h2>2008</h2> First female Governor-General (Dame Quentin Bryce) </li> <li> <h2>2010</h2> First female Prime Minister elected (Julia Gillard) First Aboriginal woman from Australia elected to UN Permanent Forum on Indigenous Issues (Megan Davis) Australia’s first national paid parental leave scheme </li> <li> <h2>2012</h2> Julia Gillard misogyny speech Workplace Gender Equality Act becomes law, Workplace Gender Equality Agency established </li> <li> <h2>2013</h2> Dad or Partner Pay Leave commenced </li> <li> <h2>2016</h2> First Indigenous woman elected to House of Representatives (Linda Burney) </li> <li> <h2>2017</h2> Launch of Women’s Australian Football League #metoo movement spreads globally to draw attention to sexual harassment and assault </li> <li> <h2>2020</h2> Respect@Work National Inquiry into sexual harassment in the Australian workplace chaired by Kate Jenkins released. </li> <li> <h2>2021</h2> Grace Tame named Australian of the Year for her advocacy in sexual violence/harassment campaigns Independent review into Commonwealth parliamentary workplaces launched </li> <li> <h2>2022</h2> National plan to end violence against women is finalised </li> <li> <h2>2023</h2> Closing the Gender Pay Gap Bill passes parliament </li> <li> <h2>2024</h2> Superannuation on government-funded paid parental leave from July 1, 2025 Parental leave to be increased to 26 weeks from July 2026. </li> </ul> There are, however, other areas where progress is agonisingly slow. <h2>Violence and financial insecurity</h2> Women are <a href="https://www.wgea.gov.au/newsroom/wgea-bcec-gender-equity-insights-2024-report">more likely</a> to be in casual and part-time employment than men. This is part of the reason women retire with <a href="https://www.abc.net.au/news/2019-02-21/carer-credits-proposal-aims-to-reduce-superannuation-gap/10826246">about half</a> the superannuation savings of men. This is also linked to financial insecurity later in life. Older women are among the <a href="https://humanrights.gov.au/our-work/age-discrimination/projects/risk-homelessness-older-women">fastest-growing groups</a> of people experiencing homelessness. The situation for First Nations women is even more severe. The <a href="https://www.niaa.gov.au/news-and-media/closing-gap-report-released">most recent</a> Closing the Gap report indicates First Nations women and children are 33 times more likely to be hospitalised due to violence compared with non-Indigenous women. They are also <a href="https://theconversation.com/indigenous-women-are-dying-violent-preventable-deaths-endless-inquiries-wont-help-unless-we-act-244815">seven times more likely</a> to die from family violence. Improving outcomes for Indigenous women and children requires tackling the long-term effects of colonisation, removal from Country, the Stolen Generations, incarceration and intergenerational trauma. This means challenging not only gender inequality but also racism, discrimination and violence. At work, <a href="https://www.wgea.gov.au/publications/employer-gender-pay-gaps-report">the latest data</a> from the Workplace Gender Equality Agency suggests the gender pay gap is narrowing, with 56% of organisations reporting improvements. On average, though, the pay gap is still substantial at 21.8% with women earning only 78 cents for every $1 earned by men. This totals an average yearly shortfall of $28,425. There are also some notable organisations where the gender pay gap has widened. <h2>The burden of unpaid work</h2> Another measure of inequality that has proved stubbornly slow to change is women’s unequal responsibilities for unpaid domestic and care work. Without real change in gender divisions of time spent on unpaid housework and care, our capacity to move towards equality in pay gaps and employment is very limited. Australian women undertake almost 70% of unpaid household labour. The latest Australian Bureau of Statistics <a href="https://www.abs.gov.au/statistics/people/people-and-communities/how-australians-use-their-time/latest-release">time use data</a> show that of those who participate in domestic labour, women spend an average of 4.13 hours per day on unpaid domestic and care work, compared with men’s 2.14 hours. This gap equates to more than a third of a full-time job. If we add up all work (domestic, care and paid), mothers have the longest working week by about 10 hours. This has changed very little over time. These charts, based on analyses of data from the Households, Income and Labour Dynamics in Australia (HILDA) study, show what drives this gap. Women respond to increased demand for care and domestic work by doing more, while men do not. Parenthood significantly increases the time women spend on unpaid care and housework, while also reducing their time in employment. <hr /> <iframe id="115GU" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/115GU/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> Men increase their time in unpaid care after a birth, but the jump is minor compared with women, and there is no change to men’s employment hours. Not surprisingly given these patterns, parenthood is associated with substantial declines in women’s <a href="https://aifs.gov.au/research/research-reports/employment-patterns-and-trends-families-children">employment hours</a>, earnings, <a href="https://www.mdpi.com/2076-328X/14/4/275">career progression</a>, and <a href="https://onlinelibrary.wiley.com/doi/10.1111/jomf.12531">mental health and wellbeing</a>. <h2>The way forward</h2> Current policy priorities primarily incentivise women to remain in employment, while continuing to undertake a disproportionate share of unpaid family work, through moving to part-time employment or making use of other forms of workplace flexibility. This approach focuses on “fixing” women rather than on the <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-psych-032620-030938">structural roots of the problem</a>. There is limited financial or cultural encouragement for men to step out of employment for care work, or reduce their hours, despite the introduction of a two-week Dad and Partner Pay scheme <a href="https://www.wgea.gov.au/parental-leave">in 2013</a> and more recent changes to expand support and access. Fathers who wish to be more actively involved in care and family life face significant financial barriers, with current schemes only covering a basic wage. If one member of the family has to take time out or reduce their hours, it usually makes financial sense for this to be a woman, given the gender earning gap. The benefits of enabling men to share care work will not only be improvements for women, but will also improve family relationships and outcomes for children. <a href="https://theconversation.com/roses-are-red-violets-are-blue-ill-stay-forever-if-you-scrub-out-the-loo-72793">Research shows</a> relationship conflict declines when men do more at home. Time spent with fathers has been found to be especially beneficial for children’s <a href="https://psycnet.apa.org/record/2018-48232-001">cognitive development</a>. Fixing the gender problem is not just about helping women. It’s good for everyone. Gender inequality costs the Australian economy <a href="https://womensagenda.com.au/business/the-us225-billion-a-year-australia-could-benefit-from-with-a-focus-on-women/">$225 billion annually</a>, or 12% of gross domestic product. Globally, the World Bank <a href="https://openknowledge.worldbank.org/server/api/core/bitstreams/fd676a12-7ee4-5c6a-ab2b-83365ed25bf1/content">estimates</a> gender inequality costs US$160.2 trillion. We can’t afford to slip further behind or to take more than a century to fix the problem. <hr /> This piece is part of a series on how Australia has changed since the year 2000. You can read other pieces in the series <a href="https://theconversation.com/au/topics/first-quarter-of-the-century-series-172070">here</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/250250/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> By <a href="https://theconversation.com/profiles/janeen-baxter-611570">Janeen Baxter</a>, Director, ARC Life Course Centre and ARC Kathleen Fitzpatrick Laureate Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/despite-some-key-milestones-since-2000-australia-still-has-a-long-way-to-go-on-gender-equality-250250">original article</a>. Image: </div>

Legal

From sunscreen to essential oils, why some personal care products could be harmful to your health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/asit-kumar-mishra-1458839">Asit Kumar Mishra</a>, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> Each time you apply sunscreen to your face, you may inhale somewhere between <a href="https://www.mdpi.com/1660-4601/20/11/5944">10 to 30 milligrams of ethanol</a>, the type of alcohol used in alcoholic drinks. While the ethanol in sunscreen may not give you a buzz, it could make you think about what other chemicals you might be exposed to from personal care products. Products that are applied to the face, like sunscreen, can increase the inhalation of some chemicals by ten times or more than you would inhale from your <a href="https://pubmed.ncbi.nlm.nih.gov/34816489/">home air in the entire day</a>. The levels of ethanol in cosmetics and skincare products may be reasonably safe – although it can still dry out the skin, causing pain, redness and swelling, and <a href="https://www.gov.uk/government/publications/ethanol-properties-uses-and-incident-management/ethanol-general-information">irritate the eyes</a>, causing tears, burning and stinging – but personal care products such as shampoos, skin creams, deodorants, cosmetics and perfumes contain fragrances and other volatile organic compounds (VOCs), which can be inhaled, absorbed through skin or ingested and some are more toxic than others. Unfortunately, manufacturers of personal care products <a href="https://link.springer.com/article/10.1007/s11869-015-0327-6">do not have to disclose</a> every fragrance compound used. This is concerning when you consider the potential effects of toxic compounds that <a href="https://pubmed.ncbi.nlm.nih.gov/34816489/">have been detected</a> in the air from personal care products. For example, hair-smoothing products have released formaldehyde, a toxic chemical that can cause <a href="https://www.ncbi.nlm.nih.gov/books/NBK597627/">a range of symptoms</a> from dermatitis to low sperm count. Some perfumes and deodorants have generated monoterpenes, chemicals which <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8912113/#sec1-molecules-27-01716">can prove toxic</a> for some users. <figure><iframe src="https://www.youtube.com/embed/cfloNXKeyX8?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Some of the VOCs found in personal care products <a href="https://pubmed.ncbi.nlm.nih.gov/36976159/">may trigger</a> skin irritation, headaches – and difficulty breathing, which can develop into an asthma attack in some users. The highest or peak concentration of these VOCs are likely to <a href="https://pubmed.ncbi.nlm.nih.gov/22406137/">occur within ten minutes</a> of application. But these concentrations may take up to <a href="https://pubmed.ncbi.nlm.nih.gov/34816489/">two hours to decrease to background levels</a>, depending on your home’s ventilation. <h2>Natural doesn’t mean risk free</h2> But even if the levels of <a href="https://pubmed.ncbi.nlm.nih.gov/20659630/">VOCs in personal care products</a> are kept <a href="https://pubmed.ncbi.nlm.nih.gov/22406137/">within safe limits</a>, they can still cause discomfort and a variety of health issues, including irritation of the eyes and airways, migraines and asthmatic reactions, in those who’re <a href="https://enveurope.springeropen.com/articles/10.1186/s12302-020-00311-y">fragrance sensitive</a>. In the UK, <a href="https://link.springer.com/article/10.1007/s11869-018-00655-8">27% of the population</a> self reports as fragrance sensitive. It makes sense then that some people attempt to avoid potentially toxic synthetic chemicals in cosmetics by opting for “natural” or “clean” personal care products. But, <a href="https://enveurope.springeropen.com/articles/10.1186/s12302-020-00311-y">natural does not mean safer</a>. For instance, essential oils are often used in “natural” personal care products as fragrance. Essential oils, though, are a source of terpenes, some of which can be <a href="https://www.lung.org/blog/essential-oils-harmful-or-helpful">toxic if absorbed, inhaled or swallowed</a>. Indoor concentration of terpenes are often at levels where you can smell them but not high enough to cause <a href="https://pubmed.ncbi.nlm.nih.gov/28126407/">eye or respiratory tract irritation</a>. However, the terpenes from essential oils can react with other chemicals, such as ozone from outdoor air, producing <a href="https://pubmed.ncbi.nlm.nih.gov/32162221/">byproducts like formaldehyde, a known carcinogen</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/22250748/">allergens</a>. <h2>Beauty salon safety</h2> Beauty salons can be particularly risky environments for exposure to VOCs. <a href="https://www.mdpi.com/1660-4601/19/7/4176">Studies have found</a> contaminants such as formaldehyde, ammonia and <a href="https://www.gov.uk/government/publications/toluene-properties-incident-management-and-toxicology/toluene-toxicological-overview">toluene</a>, a potentially harmful ingredient used in many personal care products, at high levels in salons, putting staff who work there at the highest risk. Formaldehyde levels in some salons have reached <a href="https://pubmed.ncbi.nlm.nih.gov/31321727/">above safety limits</a>. <a href="https://www.dcceew.gov.au/environment/protection/npi/substances/fact-sheets/methyl-methacrylate#tabs-2">Methyl methacrylate</a>, which can cause skin irritation, allergic reactions and potential <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3072694/">respiratory issues</a> has been <a href="https://pubmed.ncbi.nlm.nih.gov/30276513/">detected in the air of nail salons</a>. <figure><iframe src="https://www.youtube.com/embed/ydRklqO01fE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> These contaminants are not necessarily limited to the places in a salon <a href="https://pubmed.ncbi.nlm.nih.gov/23765035/">where a certain product is being used</a>. Beauty salons with poor ventilation are likely to expose workers and customers to <a href="https://pubmed.ncbi.nlm.nih.gov/29494285/">much higher levels of contaminants</a>. Some of the components of personal care products are known, harmful contaminants and carcinogens. Regulations specifically related to ventilation in environments where large volumes of these products are used do reduce exposures. For instance, studies show that after ventilation regulations came into effect in Boston, US in 2011, the <a href="https://pubmed.ncbi.nlm.nih.gov/31622145/">air quality inside nail salons improved</a>. When visiting your nail salon or hair stylist, check with them about their ventilation system and other steps they are taking to reduce exposure to VOCs. To limit exposure to potential VOCs at home when using personal care products, try to open windows and use extractor fans in wet rooms. Be especially careful when applying products to the face or when using a high temperature application – <a href="https://occup-med.biomedcentral.com/articles/10.1186/s12995-018-0213-x">high temperatures can increase emissions</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/248273/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/asit-kumar-mishra-1458839">Asit Kumar Mishra</a>, Research Fellow in School of Public of Health, <a href="https://theconversation.com/institutions/university-college-cork-1321">University College Cork</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/from-sunscreen-to-essential-oils-why-some-personal-care-products-could-be-harmful-to-your-health-248273">original article</a>. </div>

Body

Some vegetables are pretty low in fibre. So which veggies are high-fibre heroes?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Many people looking to improve their health try to boost fibre intake by eating more vegetables. But while all veggies offer health benefits, not all are particularly high in fibre. You can eat loads of salads and vegetables and still fall short of your recommended daily fibre intake. So, which vegetables pack the biggest fibre punch? Here’s what you need to know. <h2>What is fibre and how much am I supposed to be getting?</h2> Fibre, or dietary fibre, refers to the parts of plant foods that our bodies cannot digest or absorb. It passes mostly unchanged through our stomach and intestines, then gets removed from the body through our <a href="https://www.sciencedirect.com/science/article/abs/pii/S0268005X09002501">stool</a>. There are two types of fibre which have different functions and health benefits: soluble and insoluble. Soluble fibre dissolves in water and can help lower blood cholesterol levels. Food sources include fruit, vegetables and legumes. Insoluble fibre adds bulk to the stool which helps move food through the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0924224418300499">bowels</a>. Food sources include nuts, seeds and wholegrains. Both types are beneficial. Australia’s healthy eating guidelines <a href="https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/dietary-fibre">recommend</a> women consume 25 grams of fibre a day and men consume 30 grams a day. However, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5986479/">research</a> shows most people do not eat enough fibre. Most adults get about <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5986479/">21 grams</a> a day. <h2>4 big reasons to increase fibre</h2> Boosting fibre intake is a manageable and effective way to improve your overall health. Making small changes to eat more fibrous vegetables can lead to: 1. Better digestion Fibre helps maintain regular bowel movements and can alleviate <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/apt.13167?casa_token=HTtHw4dBjtQAAAAA:HI22rAfowUBLRsg7UxeAPumvq32hnKLjxJRZZbu-26S2rxVWhmteYZ01F4_3JFJDjOTTMVRcntrecg">constipation</a>. 2. Better heart health Increasing soluble fibre (by eating foods such as fruit and vegetables) can help lower cholesterol levels, which can <a href="https://www.bmj.com/content/347/bmj.f6879.short">reduce your risk of heart disease</a>. 3. Weight management High-fibre foods are filling, which can help people feel fuller for longer and <a href="https://www.mdpi.com/2072-6643/9/2/149">prevent overeating</a>. 4. Reducing diabetes risk and boosting wellbeing Fibre-rich diets are linked to a reduced risk of chronic conditions such as <a href="https://idp.springer.com/authorize/casa?redirect_uri=https://link.springer.com/article/10.1007/s00394-015-0831-3&casa_token=skn6pDaWHcYAAAAA:w8PDhyb-G1gDAiflBK6-l5fgFEy_1955V7nTDIKTg6GOzmEzpRaJO3ErLzryemjf2C4Yo_ybQSaj2Yc">type 2 diabetes</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0959804901002544">colorectal cancer</a>. Recent <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext">research</a> published in prestigious medical journal The Lancet provided some eye-opening stats on why fibre matters. The researchers, who combined evidence from clinical trials, found people who ate 25–29 grams of fibre per day had a 15–30% lower risk of life-threatening conditions like heart disease, stroke, high blood pressure, and type 2 diabetes compared to those who consumed fewer than 15 grams of fibre per day. <h2>So which vegetables are highest in fibre?</h2> Vegetables are excellent sources of both soluble and insoluble fibre, along with essential vitamins, minerals, and antioxidants. The following veggies are some of the <a href="https://afcd.foodstandards.gov.au/foodsbynutrientsearch.aspx?nutrientID=AOACDFTOTW">highest</a> in fibre: <ul> <li>green peas</li> <li>avocado</li> <li>artichokes</li> <li>parsnips</li> <li>brussels sprouts</li> <li>kale</li> <li>sweet potatoes</li> <li>beetroot</li> <li>carrots</li> <li>broccoli</li> <li>pumpkin</li> </ul> <h2>Which vegetables are low in fibre?</h2> Comparatively lower fibre veggies include: <ul> <li>asparagus</li> <li>spinach (raw)</li> <li>cauliflower</li> <li>mushrooms</li> <li>capsicum</li> <li>tomato</li> <li>lettuce</li> <li>cucumber</li> </ul> These vegetables have lots of health benefits. But if meeting a fibre goal is your aim then don’t forget to complement these veggies with other higher-fibre ones, too. <h2>Does it matter how I prepare or cook the vegetables?</h2> Yes. The way we <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3614039/#:%7E:text=Influence%20of%20different%20processing%20treatments,gravimetric%20and%20enzymic%E2%80%94chemical%20methods.">prepare vegetables</a> can impact their fibre content, as cooking can cause structural changes in the dietary fibre components. Some <a href="https://www.sciencedirect.com/science/article/abs/pii/S0308814602002595">research</a> has shown pressure cooking reduces fibre levels more greatly than roasting or microwave cooking. For optimal health, it’s important to include a mix of both cooked and raw vegetables in your diet. It’s worth noting that juicing removes most of the fibre from vegetables, leaving mostly sugars and water. For improved fibre intake, it’s better to eat whole vegetables rather than relying on juices. <h2>What about other, non-vegetable sources of fibre?</h2> To meet your fibre recommendations each day, you can chose from a variety of fibre-rich foods (not only vegetables) including: <ul> <li>legumes and pulses (such as kidney beans and chickpeas)</li> <li>wholegrain flour and bread</li> <li>fruits</li> <li>wholegrains (such oats, brown rice, quinoa, barley)</li> <li>nuts and seeds (such as flaxseeds and chia seeds)</li> </ul> A fibre-rich day that meets a recommended 30 grams would include: <ul> <li>breakfast: 1⁄2 cup of rolled oats with milk and 1⁄2 cup of berries = about 6 grams of fibre</li> <li>snack: one banana = about 2 grams</li> <li>lunch: two cups of salad vegetables, 1⁄2 cup of four-bean mix, and canned tuna = about 9 grams</li> <li>snack: 30 grams of almonds = about 3 grams</li> <li>dinner: 1.5 cups of stir-fried vegetables with tofu or chicken, one cup of cooked brown rice = about 10 grams</li> <li>supper: 1⁄2 a punnet of strawberries with some yoghurt = about 3 grams.</li> </ul> <h2>Bringing it all together</h2> Vegetables are a key part of a healthy, balanced diet, packed with fibre that supports digestion, blood glucose control, weight management, and reduces risk of chronic disease. However, the nutritional value of them can vary depending on the type and the cooking method used. By understanding the fibre content in different veggies and how preparation methods affect it, we can make informed dietary choices to improve our overall health.<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/246238/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/some-vegetables-are-pretty-low-in-fibre-so-which-veggies-are-high-fibre-heroes-246238">original article</a>. </div>

Food & Wine

Why do some people’s hair and nails grow quicker than mine?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/michelle-moscova-310728">Michelle Moscova</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Throughout recorded history, our hair and nails played an important role in signifying who <a href="https://www.psychiatrictimes.com/view/gender-culture-and-social-constructs-in-body-focused-repetitive-behaviors">we are and our social status</a>. You could say, they separate the caveman from businessman. It was no surprise then that many of us found a new level of appreciation for our hairdressers and nail artists during the COVID lockdowns. Even Taylor Swift reported <a href="https://abcnews.go.com/GMA/Culture/taylor-swift-reveals-shes-cutting-hair-covid-19/story?id=74757540&t">she cut her own hair during lockdown</a>. So, what would happen if all this hair and nail grooming got too much for us and we decided to give it all up. Would our hair and nails just keep on growing? The answer is yes. The hair on our head grows, on average, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9917549/">1 centimeter per month</a>, while our fingernails grow an average of just <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11436330/">over 3 millimetres</a>. When left unchecked, our hair and nails can grow to impressive lengths. Aliia Nasyrova, known as the Ukrainian Rapunzel, holds the world record for the longest locks on a living woman, which measure an <a href="https://www.youtube.com/watch?v=1TdlEIQdVwo&t=81s">impressive 257.33 cm</a>. When it comes to record-breaking fingernails, Diana Armstrong from the United States holds that record <a href="https://www.youtube.com/watch?v=nwql937j-7Q">at 1,306.58 cm</a>. Most of us, however, get regular haircuts and trim our nails – some with greater frequency than others. So why do some people’s hair and nails grow more quickly? <h2>Remind me, what are they made out of?</h2> Hair and nails are made mostly from keratin. Both grow from matrix cells below the skin and grow through different patterns of cell division. Nails grow steadily from the matrix cells, which sit under the skin at the base of the nail. These cells divide, pushing the older cells forward. As they grow, <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5383514/">the new cells slide</a> along the nail bed – the flat area under the fingernail which looks pink because of its rich blood supply. A hair also starts growing from the matrix cells, eventually forming the visible part of the hair – the shaft. The hair shaft grows from a root that sits under the skin and is wrapped in a sac known as the hair follicle. This sac has a nerve supply (which is why it hurts to pull out a hair), oil-producing glands that lubricate the hair and a tiny muscle that <a href="https://www.ncbi.nlm.nih.gov/books/NBK546248/">makes your hair stand up</a> when it’s cold. At the follicle’s base is the hair bulb, which contains the all-important hair papilla that supplies blood to the follicle. Matrix cells near the papilla divide to produce new hair cells, which then harden and form the hair shaft. As the new hair cells are made, the hair is pushed up above the skin <a href="https://www.jidonline.org/article/S0022-202X(15)41553-2/fulltext">and the hair grows</a>. But the papilla also plays an integral part in regulating hair growth cycles, as it sends signals to the stem cells to move to the base of the follicle and form a hair matrix. Matrix cells then get signals to divide and start a new growth phase. <h2>Unlike nails, our hair grows in cycles</h2> Scientists have identified <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9917549/">four phases of hair growth</a>, the: <ol> <li> anagen or growth phase, which lasts between two and eight years </li> <li> catagen or transition phase, when growth slows down, lasting around two weeks </li> <li> telogen or resting phase, when there is no growth at all. This usually lasts two to three months </li> <li> exogen or shedding phase, when the hair falls out and is replaced by the new hair growing from the same follicle. This starts the process all over again. </li> </ol> <figure class="align-center "><img src="https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=308&fit=crop&dpr=1 600w, https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=308&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=308&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=387&fit=crop&dpr=1 754w, https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=387&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/637402/original/file-20241210-15-gtv259.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=387&fit=crop&dpr=3 2262w" alt="Stages of hair growth graphic" /><figcaption>Hair follicles enter these phases at different times so we’re not left bald. <a class="source" href="https://www.shutterstock.com/image-vector/stages-hair-growth-cycle-vector-isolated-2433656865">Mosterpiece/Shutterstock</a></figcaption></figure> Each follicle goes through this cycle <a href="https://www.longdom.org/open-access/a-note-on-the-human-hair-follicle-from-the-origin-to-the-death-93871.html?t">10–30 times in its lifespan</a>. If all of our hair follicles grew at the same rate and entered the same phases simultaneously, there would be times when we would all be bald. That doesn’t usually happen: at any given time, only one in ten hairs is in the resting phase. While we lose about <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9917549/">100–150 hairs daily</a>, the average person has <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9917549/">100,000 hairs</a> on their head, so we barely notice this natural shedding. <h2>So what affects the speed of growth?</h2> Genetics is the most significant factor. While hair growth rates vary between individuals, they tend to be <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4201279/">consistent among family members</a>. Nails are also influenced by genetics, as siblings, especially identical twins, tend to have <a href="https://link.springer.com/referenceworkentry/10.1007/978-3-319-26594-0_121-1">similar nail growth rates</a>. But there are also other influences. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9917549/">Age makes a difference</a> to hair and <a href="https://link.springer.com/referenceworkentry/10.1007/978-3-319-26594-0_121-1">nail</a> growth, even in healthy people. Younger people generally have faster growth rates because of the slowing metabolism and cell division that comes with ageing. <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7432488/">Hormonal changes</a> can have an impact. Pregnancy often <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7432488/">accelerates</a> hair and nail growth rates, while menopause and high levels of the stress hormone cortisol can <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7432488/">slow growth rates</a>. Nutrition also changes <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6380979/">hair</a> and <a href="https://ijdvl.com/nails-in-nutritional-deficiencies/?t">nail</a> strength and growth rate. While hair and nails are made mostly of keratin, they also contain water, fats and various minerals. As hair and nails keep growing, these minerals need to be replaced. That’s why a balanced diet that includes sufficient nutrients to support your hair and nails is essential for maintaining their health. Nutrient deficiencies may contribute to hair loss and nail breakage by disrupting their growth cycle or weakening their structure. Iron and zinc deficiencies, for example, have both been linked to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6380979/">hair loss</a> and <a href="https://ijdvl.com/nails-in-nutritional-deficiencies/?t">brittle nails</a>. This may explain why thick hair and strong, well-groomed nails have long been associated with perception of good health and high status. However, not all perceptions are true. <h2>No, hair and nails don’t grow after death</h2> A persistent myth that may relate to <a href="https://www.britannica.com/topic/vampire">the legends of vampires</a> is that hair and nails continue to grow after we die. In reality, they only appear to do so. As the body dehydrates after death, the skin shrinks, making hair and nails <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC2151163/">seem longer</a>. Morticians are well aware of this phenomenon and some <a href="https://www.adomonline.com/mortuary-man-reveals-how-he-handles-nails-of-the-dead/?t">inject tissue filler</a> into the deceased’s fingertips to minimise this effect. So, it seems that living or dead, there is no escape from the never-ending task of caring for our hair and nails.<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/241556/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michelle-moscova-310728">Michelle Moscova</a>, Adjunct Associate Professor, Anatomy, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-some-peoples-hair-and-nails-grow-quicker-than-mine-241556">original article</a>. </div>

Body

Some ancient Romans got to retire with a pension at 42, but retirement’s changed a bit over the centuries

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/anthony-asher-247115">Anthony Asher</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Over the ages, there have been broadly three reasons why people have retired. Some are forced to by poor health – theirs or someone they care for. Others have alternative income sources, meaning they don’t rely on a regular pay cheque. And some are made to retire by an employer who wants to overhaul staffing. But where did the idea of retirement come from? And how was it handled in ancient times? <h2>Origins of support</h2> Retirement support – which these days comes in the form of superannuation or a government pension – dates back to ancient history in various forms. Some forms of retirement support were funded by local taxes or tithes, others by donations. Some systems were corrupt and the coverage was patchy. Records are not readily available from other cultures, but we know a little about ancient Rome and English history since then. Emperor Augustus, who ruled after Julius Caesar died, set up a <a href="https://pensionresearchcouncil.wharton.upenn.edu/wp-content/uploads/2020/01/03Chap3.pdf">scheme</a> for Roman soldiers more than 2,000 years ago. The scheme aimed to ensure they retired while still strong and healthy, and would be less likely to cause trouble. The scheme paid a decent amount for soldiers after 25 years of service, so retirement age could be as young as 42. Pensions for older people in need also have ancient origins. The New Testament <a href="https://biblehub.com/1_timothy/5-9.htm">Bible</a> records the churches had schemes for needy widows right from the beginning. In the early Middle Ages, monasteries often provided for the needy, but Henry VIII famously <a href="https://en.wikipedia.org/wiki/Dissolution_of_the_monasteries">closed them</a> and took their assets. A fair share of their assets ended up with <a href="https://en.wikipedia.org/wiki/John_Russell,_1st_Earl_of_Bedford">high government officials</a> after the king’s takeover. Industry funds can also be seen to date back <a href="https://www.britannica.com/money/friendly-society">at least to the Middle Ages</a>, where the trade guilds provided for members and their families who fell on hard times. Retail funds mainly began as <a href="https://www.google.com/search?client=firefox-b-d&q=history+of+life+insurance">mutual life insurance companies</a> that began more than 200 years ago. In the 18th century, the East India Company and the Bank of England began <a href="https://sas-space.sas.ac.uk/9224/1/McIlvenna%20PhD%20final.pdf">offering pensions</a>. These were at first discretionary based on need and loyalty, but later covered all employees. This idea then spread to other larger companies such railways and banks. As modern states developed the capacity to collect income taxes, it became feasible to provide comprehensive retirement benefits funded by central government. Beginning with <a href="https://www.ssa.gov/history/ottob.html">Germany in 1889</a>, developed countries began introducing universal national age pension arrangements. Unfortunately, a number of countries, such as <a href="https://www.uncdf.org/article/8799/governor-innovation-key-to-expanding-insurance-and-pension-coverage-in-png">Papua New Guinea</a>, still do not have the capacity to provide a universal safety net to cover older people. <h2>Retirement in Australia</h2> Three Australian states <a href="https://treasury.gov.au/publication/economic-roundup-centenary-edition-2001/article-3-towards-higher-retirement-incomes-for-australians-a-history-of-the-australian-retirement-income-system-since-federation">began schemes</a> in 1900, and the federal government provided a universal (but means tested) scheme from 1909. Most Australian retirees seem to enjoy a favourable standard of living. The <a href="https://grattan.edu.au/news/5-key-takeaways-from-the-retirement-income-review/">Grattan Institute</a> finds that the poorest 30% are, in fact, better off in retirement. Massive house price and rental inflation in the last 30 years, however, has gutted the living standards of those who don’t own their own homes. This gap in the safety net needs to be addressed. <h2>Retirement ages</h2> The Roman army model persists in some countries to this day: retirement from the US military is available <a href="https://sgp.fas.org/crs/misc/RL34751.pdf">after 20 years</a> of service. Retirement this early is obviously very expensive. The church scheme mentioned in the New Testament had a minimum age of 60, which is still the normal retirement age in many countries. The <a href="https://www.oecd.org/en/publications/2023/12/pensions-at-a-glance-2023_4757bf20.html">OECD</a> reports the average age of retirement in their 38 member countries is just under 64 for women, and just over 64 for men. Australians now qualify for the <a href="https://www.servicesaustralia.gov.au/who-can-get-age-pension?context=22526">age pension</a> at 67, which is slightly older than average. Retirement ages are, however, rising to allow for “population ageing”, a longer life expectancy and lower birth rates. Life expectancy at retirement age is the important number when calculating the cost of pensions. In ancient Rome it was about seven years and was <a href="https://www-cambridge-org.wwwproxy1.library.unsw.edu.au/core/services/aop-cambridge-core/content/view/30ED00A164475432670833C87D2F9E97/S2046164X00000405a.pdf/contributions_to_the_history_of_insurance_and_of_the_theory_of_life_contingencies_with_a_restoration_of_the_grand_pensionary_de_wits_treatise_on_life_annuities_concluded_from_no_vi.pdf">about the same</a> in Sweden in the middle of the 18th century. In Australia, the life expectancy of a 65 year old woman has risen from 12 years in 1895 to <a href="https://aga.gov.au/sites/aga.gov.au/files/2020-07/Australian%20Life%20Tables%202015-17%20v5.pdf">23 years on average</a>. <h2>Earnings-related pensions</h2> The <a href="https://www.ssa.gov/history/ottob.html">1889 German scheme</a> paid a minimum pension, plus an earnings-related component. Workers had a book for stamps for each week’s earnings. The Australian age pension has always just paid a minimum “liveable” amount. This has been subject to different means tests over time, but retirees have been able to supplement it with their own savings. Until 1987, only 40% of Australian employees were covered by employer sponsored schemes. Then in 1992, the <a href="https://www.apra.gov.au/superannuation-australia-a-timeline">Superannuation Guarantee Scheme</a> was introduced. Under this, employers were required to contribute 3% into all exployees’ super. The standard rate will rise to 12% in July next year. <h2>The future</h2> A growing ageing population will mean the Australian government and superannuation industry will need to adjust current support systems. <a href="https://treasury.gov.au/consultation/c2023-441613">Over the next decade</a>, about 2.5 million Australians will move from accumulation (where you’re building up your super) to join the 1.6 million already receiving super benefits. We can expect more people to be living into their nineties and needing pensions for life. One government <a href="https://treasury.gov.au/sites/default/files/2023-12/c2023-441613-dp.docx">priority</a> is to make lifetime pensions as much part of the Australian system as they are in <a href="https://www.mercer.com/en-au/about/newsroom/mercer-cfa-institute-global-pension-index-2024/">the rest of the world</a> And after 30 years of growing complexity in the rules covering superannuation, regulators are <a href="https://www.alrc.gov.au/publication/superannuation-and-the-legislative-framework-for-financial-services-fsl11/">counting the cost</a>, and <a href="https://www.brokernews.com.au/news/breaking-news/asic-targets-regulation-overhaul-286067.aspx">planning some simplification</a>. <hr /> This article is part of The Conversation’s retirement series, in which experts examine issues including how much money we need to retire, retiring with debt, the psychological impact of retiring and the benefits of getting financial advice. Read the rest of the series <a href="https://theconversation.com/au/topics/retirement-series-2024-168372">here</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241121/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anthony-asher-247115">Anthony Asher</a>, Associate Professor in the UNSW Business School, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/some-ancient-romans-got-to-retire-with-a-pension-at-42-but-retirements-changed-a-bit-over-the-centuries-241121">original article</a>. </div>

Retirement Income

Readers response: What are some things older generations did as couples that we rarely see today?

We asked our readers what simple acts of romance they encountered in their lives, that younger generations don't partake in anymore, and the response was overwhelming. Here's what they said. Sharon Watson - Men would walk on the outside of the lady on the road. Also, walking hand in hand and doors & car doors were opened by men for women. Jo Hoffman - Went to cabarets for old time ballroom dancing to beautiful music! Ann MacCann - Taking walks holding hands. Judith Turpin - Ate breakfast and evening meal at the table as family. We communicated! Margaret Gerlach - Visited family and in-laws every week. Lorna Johnson - Gentlemen tipped their hats at ladies and held the door open for you. Jan Bradley - Dancing at the town hall, drive in movies, stayed together. Jane Reynolds - Spending time together as a family, playing games, talking to each other. No phones, writing and receiving letters, supporting each other, staying together, caring and helping each other. Myfawny Jones - One partner read the road map while the other drived, often on corrugated gravel roads. Lindi Williams - Played cards together. Cherylyn Thornton - Went to the drive in movies. Patricia Sutton - We had children because we wanted them, not because of the economy or that we couldn't afford them! Di Richardson - Shotgun marriages! Image credits: Shutterstock

Relationships

What causes the itch in mozzie bites? And why do some people get such a bad reaction?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Are you one of these people who loathes spending time outdoors at dusk as the weather warms and mosquitoes start biting? Female mosquitoes <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-ento-120811-153618">need blood</a> to develop their eggs. Even though they take a tiny amount of our blood, they can leave us with itchy red lumps that can last days. And sometimes something worse. So why does our body react and itch after being bitten by a mosquito? And why are some people more affected than others? <h2>What happens when a mosquito bites?</h2> Mosquitoes are attracted to warm blooded animals, including us. They’re attracted to the <a href="https://www.cambridge.org/core/journals/bulletin-of-entomological-research/article/abs/role-of-carbon-dioxide-in-hostfinding-by-mosquitoes-diptera-culicidae-a-review/2506B86EF63852B2D02EC3FCEE1E3B8B">carbon dioxide</a> we exhale, our body temperatures and, most importantly, <a href="https://www.abc.net.au/news/2024-11-08/mosquitoes-climate-change-skin/104548122">the smell of our skin</a>. The <a href="https://www.cell.com/trends/parasitology/abstract/S1471-4922(21)00237-3">chemical cocktail</a> of odours from bacteria and sweat on our skin <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(23)00532-8">sends out a signal</a> to hungry mosquitoes. <a href="https://www.sciencedirect.com/science/article/pii/S2667114X21000522">Some people’s</a> skin smells more appealing to mosquitoes, and they’re more likely to be bitten than others. Once the mosquito has made its way to your skin, things get a little gross. The mosquito pierces your skin with their “proboscis”, their feeding mouth part. But the proboscis isn’t a single, straight, needle-like tube. There are multiple tubes, <a href="https://www.npr.org/sections/health-shots/2016/06/07/480653821/watch-mosquitoes-use-6-needles-to-suck-your-blood">some designed</a> for sucking and some for spitting. Once their mouth parts have been inserted into your skin, the mosquito will inject some saliva. This contains a mix of chemicals that gets the blood flowing better. There has even been a suggestion that future medicines could be inspired by the <a href="https://www.sydney.edu.au/news-opinion/news/2018/03/29/mosquito-saliva-vital-to-the-discovery-of-future-drugs.html">anti-blood clotting properties</a> of mosquito saliva. It’s not the stabbing of our skin by the mosquito’s mouth parts that hurts, it’s the mozzie spit our bodies don’t like. <h2>Are some people allergic to mosquito spit?</h2> Once a mosquito has injected their saliva into our skin, a variety of reactions can follow. For the lucky few, nothing much happens at all. For most people, and irrespective of the type of mosquito biting, <a href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.1024559/full">there is some kind of reaction</a>. Typically there is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0161589023002304?via%3Dihub">redness and swelling of the skin</a> that appears within a few hours, but often more quickly, after just a few minutes. Occasionally, the reaction can cause pain or discomfort. Then comes the <a href="https://www.abc.net.au/news/health/2023-01-20/mosquito-bites-itchy-calamine-heat-ice-antihistamine-toothpaste/101652608">itchiness</a>. Some people do suffer severe reactions to mosquito bites. It’s a condition often referred to as “<a href="https://www.webmd.com/allergies/what-is-skeeter-syndrome">skeeter syndrome</a>” and is an allergic reaction caused by the protein in the mosquito’s saliva. This can cause large areas of swelling, blistering and fever. The chemistry of mosquito spit hasn’t really been well studied. But it has been shown that, for those who do suffer allergic reactions to their bites, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0091674904022183">reactions may differ</a> depending on the type of mosquito biting. We all probably get more tolerant of mosquito bites as we get older. Young children are certainly more likely to suffer more following mosquito bites. But as we get older, the reactions are less severe and may pass quickly without too much notice. <h2>How best to treat the bites?</h2> Research into treating bites <a href="https://linkinghub.elsevier.com/retrieve/pii/S0161589023002304">has yet to provide</a> a single easy solution. There are many <a href="https://www.healthline.com/health/outdoor-health/home-remedies-for-mosquito-bites">myths and home remedies</a> about what works. But there is little scientific evidence supporting their use. The best way to treat mosquito bites is by applying a cold pack to reduce swelling and to keep the skin clean to avoid any secondary infections. Antiseptic creams and lotions may also help. There is some evidence that <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10309056/">heat may alleviate</a> some of the discomfort. It’s particularly tough to keep young children from scratching at the bite and breaking the skin. This can form a nasty scab that may end up being worse than the bite itself. Applying an anti-itch cream may help. If the reactions are severe, <a href="https://www.healthdirect.gov.au/insect-bites-and-stings">antihistamine medications</a> may be required. <h2>To save the scratching, stop the bites</h2> Of course, it’s better not to be bitten by mosquitoes in the first place. Topical <a href="https://theconversation.com/insect-repellents-work-but-there-are-other-ways-to-beat-mosquitoes-without-getting-sticky-171805">insect repellents</a> are a safe, effective and affordable way to reduce mosquito bites. Covering up with loose fitted long sleeved shirts, long pants and covered shoes also provides a physical barrier. <a href="https://theconversation.com/are-mosquito-coils-good-or-bad-for-our-health-88548">Mosquito coils and other devices</a> can also assist, but should not be entirely relied on to stop bites. There’s another important reason to avoid mosquito bites: millions of people around the world suffer from mosquito-borne diseases. More than <a href="https://www.who.int/news-room/fact-sheets/detail/malaria">half a million people die</a> from malaria each year. In Australia, <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005070">Ross River virus</a> infects more than 5,000 people every year. And in recent years, there have been cases of serious illnesses caused by <a href="https://www.science.org/content/article/how-rains-pigs-and-waterbirds-fueled-shocking-disease-outbreak-australia">Japanese encephalitis</a> and <a href="https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1256149/full">Murray Valley encephalitis</a> viruses. <a href="https://theconversation.com/profiles/cameron-webb-6736">Cameron Webb</a>, Clinical Associate Professor and Principal Hospital Scientist, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-causes-the-itch-in-mozzie-bites-and-why-do-some-people-get-such-a-bad-reaction-243044">original article</a>. </div>

Body

Balance declines with age, but exercise can help stave off some of the risk of falling

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a> My wife and I were in the grocery store recently when we noticed an older woman reaching above her head for some produce. As she stretched out her hand, she lost her balance and began falling forward. Fortunately, she leaned into her grocery cart, which prevented her from falling to the ground. Each year, about <a href="https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm">1 in every 4 older adults experience a fall</a>. In fact, falls are the leading cause of injuries in adults ages 65 and older. Falls are the <a href="https://doi.org/10.1007/bf00298717">most common cause of hip fractures</a> and <a href="https://doi.org/10.1111/j.1553-2712.2000.tb00515.x">traumatic brain injuries</a>. Injuries like those are also <a href="https://doi.org/10.1056/NEJM199710303371806">risk factors for placement in a nursing home</a>, where the fall risk is <a href="https://doi.org/10.7326/0003-4819-121-6-199409150-00009">nearly three times higher than for people living in the community</a>. A number of physical changes with aging often go unseen preceding falls, including muscle weakness, decreased balance and changes in vision. I am a <a href="https://facultyprofiles.tufts.edu/evan-papa">physical therapist</a> and <a href="https://scholar.google.com/citations?user=T9B_dHQAAAAJ&hl=en">clinical scientist focused on fall prevention</a> in older adults, commonly ages 65 and older. I’ve spent most of my career investigating why older adults fall and working with patients and their families to prevent falls. <h2>Why aging leads to increased risk of falls</h2> Aging is a process that affects the systems and tissues of every person. The rate and magnitude of aging may be different for each person, but overall physical decline is an inevitable part of life. Most people think aging starts in their 60s, but in fact we spend most of our life span <a href="https://doi.org/10.1093%2Fgeront%2Fgnv130">undergoing the process of decline</a>, typically beginning in our 30s. Older adults are more prone to falling for various reasons, including age-related changes in their bodies and vision changes that leave them vulnerable to environmental factors such as curbs, stairs and carpet folds. <figure><iframe src="https://www.youtube.com/embed/ztPbKP68P2Q?wmode=transparent&start=24" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Some straightforward measures to improve the safety of the home environment for older adults can significantly lower the risk of falls.</figcaption></figure> Based on my experience, here are some common reasons older adults may experience falls: First, <a href="https://my.clevelandclinic.org/health/diseases/23167-sarcopenia">aging leads to a natural loss of muscle strength</a> and flexibility, making it more challenging to maintain balance and stability. The loss of strength and poor balance are two of the most common causes of falls. Second, older adults often have chronic conditions such as arthritis, Parkinson’s disease or diabetes that can affect their mobility, coordination and overall stability. In addition, certain medications commonly taken by older adults, <a href="https://doi.org/10.4088/jcp.18f12340">such as sedatives</a> or <a href="https://doi.org/10.1001/jamainternmed.2013.14764">blood pressure drugs</a>, can cause dizziness, drowsiness or a drop in blood pressure, leading to an increased risk of falls. Age-related vision changes, such as reduced depth perception and peripheral vision and difficulty in differentiating colors or contrasts, can make it harder to navigate and identify potential hazards. Hazards in the environment, such as uneven surfaces, slippery floors, inadequate lighting, loose rugs or carpets or cluttered pathways, can <a href="https://doi.org/10.1186/s12877-021-02499-x">significantly contribute to falls among older adults</a>. Older adults who lead a sedentary lifestyle or have limited physical activity may also experience reduced strength, flexibility and balance. And finally, such conditions as dementia or Alzheimer’s disease can affect judgment, attention and spatial awareness, leading to increased fall risk. <h2>Theories of aging</h2> There are numerous theories about why we age but there is no one unifying notion that explains all the changes in our bodies. A large portion of aging-related decline is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295054/">caused by our genes</a>, which determine the structure and function of bones, muscle growth and repair and visual depth perception, among other things. But there are also numerous lifestyle-related factors that influence our rate of aging including diet, exercise, stress and exposure to environmental toxins. A recent advance in scientific understanding of aging is that there is a difference between your <a href="https://theconversation.com/are-you-a-rapid-ager-biological-age-is-a-better-health-indicator-than-the-number-of-years-youve-lived-but-its-tricky-to-measure-198849">chronological age and your biological age</a>. Chronological age is simply the number of years you’ve been on the Earth. Biological age, however, refers to how old your cells and tissues are. It is based on physiological evidence from a blood test and is related to your physical and functional ability. Thus, if you’re healthy and fit, your biological age may be lower than your chronological age. However, the reverse can also be true. I encourage patients to focus on their biological age because it empowers them to take control over the aging process. We obviously have no control over when we are born. By focusing on the age of our cells, we can avoid long-held beliefs that our bodies are destined to develop cancer, diabetes or other conditions that <a href="https://doi.org/10.1016/j.cub.2012.07.024">have historically been tied to how long we live</a>. And by taking control of diet, exercise, sleep and other lifestyle factors you can actually <a href="https://doi.org/10.1111%2Facel.13538">decrease your biological age</a> and improve your quality of life. As one example, our team’s research has shown that moderate amounts of aerobic exercise <a href="https://doi.org/10.1371/journal.pone.0188538">can slow down motor decline</a> even when a person begins exercise in the latter half of the life span. <h2>Fall prevention</h2> Adopting lifestyle changes such as regular, long-term exercise can <a href="https://doi.org/10.1001/jamainternmed.2018.5406">reduce the consequences of aging</a>, including falls and injuries. Following a healthy diet, managing chronic conditions, reviewing medications with health care professionals, maintaining a safe home environment and getting regular vision checkups can also help reduce the risk of falls in older adults. There are several exercises that physical therapists use to improve balance for patients. It is important to note however, that before starting any exercise program, everyone should consult with a health care professional or a qualified physical therapist to determine the most appropriate exercises for their specific needs. Here are five forms of exercise I commonly recommend to my patients to improve balance: <ol> <li> Balance training can help improve coordination and <a href="https://www.sciencedirect.com/topics/neuroscience/proprioception">proprioception</a>, which is the body’s ability to sense where it is in space. By practicing movements that challenge the body’s balance, such as standing on one leg or walking heel-to-toe, the nervous system becomes better at coordinating movement and maintaining balance. A large research study analyzing nearly 8,000 older adults found that balance and functional exercises <a href="https://doi.org/10.1002/14651858.cd012424.pub2">reduce the rate of falls by 24%</a>. </li> <li> Strength training exercises involve lifting weights or using resistance bands to increase muscle strength and power. By strengthening the muscles in the legs, hips and core, older adults can improve their ability to maintain balance and stability. Our research has shown that strength training can also lead to <a href="https://doi.org/10.2147/cia.s104674">improvements in walking speed and a reduction in fall risk</a>. </li> <li> Tai chi is a gentle martial art that focuses on slow, controlled movements and shifting body weight. Research shows that it can improve balance, strength and flexibility in older adults. Several combined studies in tai chi have demonstrated a 20% reduction in the <a href="https://doi.org/10.1002/14651858.cd012424.pub2">number of people who experience falls</a>. </li> <li> Certain yoga poses can enhance balance and stability. Tree pose, warrior pose and mountain pose are examples of poses that can help improve balance. It’s best to <a href="https://theconversation.com/yoga-modern-research-shows-a-variety-of-benefits-to-both-body-and-mind-from-the-ancient-practice-197662">practice yoga</a> under the guidance of a qualified instructor who can adapt the poses to individual abilities. </li> <li> Flexibility training involves stretching the muscles and joints, which can improve range of motion and reduce stiffness. By improving range of motion, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3990889/">older adults can improve their ability to move safely</a> and avoid falls caused by limitations in mobility. </li> <li> Use of assistive devices can be helpful when strength or balance impairments are present. Research studies involving the evaluation of canes and walkers used by older adults confirm that <a href="https://doi.org/10.1016/j.apmr.2004.04.023">these devices can improve balance and mobility</a>. Training from a physical or occupational therapist in the proper use of assistive devices is an important part of improving safety. </li> </ol> When I think back about the woman who nearly fell in the grocery store, I wish I could share everything we have learned about healthy aging with her. There’s no way to know if she was already putting these tips into practice, but I’m comforted by the thought that she may have avoided the fall by being in the right place at the right time. After all, she was standing in the produce aisle.<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/204174/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/evan-papa-1433146">Evan Papa</a>, Associate Professor of Physical Therapy and Rehabilitation Science, <a href="https://theconversation.com/institutions/tufts-university-1024">Tufts University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/balance-declines-with-age-but-exercise-can-help-stave-off-some-of-the-risk-of-falling-204174">original article</a>. </div>

Body

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/glenys-caswell-142188">Glenys Caswell</a>, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a> It seems so obvious that no one should die alone that we never talk about it, but people do often die when they are alone. Sometimes they die in a way that suggests they prefer to be alone as they are coming to the end of their lives. So is it really such a bad thing to be alone when you die? When a person is dying in a hospital or a care home it is common for the nurses caring for them to summon their family. Many people will have the experience of trying to <a href="http://journals.sagepub.com/doi/abs/10.2190/OM.55.3.d">keep vigil beside a family member</a>. It is hard – as everyday life goes on regardless – and it can be emotionally exhausting. Sometimes, the relative will die when their family have gone to make a phone call or get a cup of tea, leaving the family feeling distressed and guilty for not being there when they died. There is plenty of research literature, from many countries, devoted to trying to decide <a href="http://www.sciencedirect.com/science/article/pii/S0885392415001578">what makes a good death</a>. There are differences to be found between countries, but similarities too. One similarity is a belief that <a href="http://www.sciencedirect.com/science/article/pii/S106474811600138X?via%3Dihub">no one should die alone</a>. This idea sits well with the view of dying that can be found in many different places. When interviewed as research participants, health professionals – and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904589/">nurses in particular</a> – commonly say that no one should die alone. There are also many cultural references that suggest that to die alone is a bad thing. Consider, for example, the death of Ebenezer Scrooge in Dickens’s <a href="https://www.gutenberg.org/files/46/46-h/46-h.htm">A Christmas Carol</a>, or the death of Nemo, the law writer in <a href="http://www.gutenberg.org/files/1023/1023-h/1023-h.htm">Bleak House</a>. These are both sad, dark, lonely deaths of a kind to be avoided. Celebrity deaths, such as those of comedian and actress <a href="https://www.theguardian.com/culture/2016/apr/20/victoria-wood-dies-aged-62-comedian">Victoria Wood</a> or <a href="http://www.bbc.co.uk/news/entertainment-arts-35278872">David Bowie</a>, are described in the news as peaceful or good when they are surrounded by family. Ordinary people who die alone make the news when the person’s body is undiscovered for a long time. When this happens the death is likely to be described in <a href="http://www.sciencedirect.com/science/article/pii/S027795360300577X?via%3Dihub">negative terms</a>, such as shocking, lonely, tragic or as a sad indictment of society. <h2>Some people prefer to be alone</h2> Of course, it may be the case that many people would prefer to have their family around them when they are dying. But there is <a href="http://www.tandfonline.com/doi/full/10.1080/21582041.2015.1114663">evidence</a> that suggests that some people would <a href="http://www.sciencedirect.com/science/article/pii/S0277953615003482?via%3Dihub">prefer to be alone </a> as they are coming to the end of their lives. My own <a href="http://www.tandfonline.com/doi/full/10.1080/13576275.2017.1413542">research</a> found that while hospice-at-home nurses believe that no one should die alone, they had seen cases where a person died after their family members had left the bedside. The nurses believed that some people just want to be on their own when they are dying. They also thought that people may have a measure of control over when they die, and choose to do so when their family are not around. In the same study, I also talked to older people who were living alone to find out their views about dying alone. I was intrigued to learn that dying alone was not seen as something that is automatically bad, and for some of the older people it was to be preferred. For some people in this group, dying was not the worst thing that could happen – being trapped in a care home was considered to be far worse than dying alone. Cultural representations of dying suggest that being alone while dying is a dreadful thing. This view is supported by healthcare policy and the practices of health professionals, such as nurses. But we all know people who prefer to be left alone when they are ill. Is it so surprising then that some might wish to be alone when they are dying? It is time we began to talk about this and to accept that we want different things in our dying as we do in our living. Openness created through discussion might also help to remove some of the guilt that family members feel when they miss the moment of their relative’s death.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/90034/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/glenys-caswell-142188">Glenys Caswell</a>, Senior Research Fellow, <a href="https://theconversation.com/institutions/university-of-nottingham-1192">University of Nottingham</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/for-some-people-dying-alone-is-not-such-a-bad-thing-heres-why-90034">original article</a>. </div>

Caring

Offering end of life support as part of home care is important – but may face some challenges

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Earlier this month, the government announced <a href="https://theconversation.com/the-government-has-a-new-plan-for-residential-aged-care-heres-whats-changing-238765">major changes</a> to aged care in Australia, including a A$4.3 billion <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">investment in home care</a>. Alongside a shake up of home care packages, the Support at Home program will include an important addition – an <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">end of life pathway</a> for older Australians. This pathway will allow access to a <a href="https://www.health.gov.au/our-work/support-at-home/features">higher level</a> of in-home aged care services to help Australians stay at home as they come to the end of their life. Specifically, it will provide an extra A$25,000 for palliative support when a person has three months or less left to live. This is a positive change. But there may be some challenges to implementing it. <h2>Why is this important?</h2> Older people have made clear their preference to remain in their homes as they age. For <a href="https://journals.sagepub.com/doi/10.1177/0269216313487940">most people</a>, home is where they would like to be during their last months of life. The space is personal, familiar and comforting. However, data from the <a href="https://www.abs.gov.au/statistics/research/classifying-place-death-australian-mortality-statistics">Australian Bureau of Statistics</a> shows most people who die between the ages of 65 and 84 die in hospital, while most people aged 85 and older die in residential aged care. This apparent gap may reflect a lack of appropriate services. Both palliative care services and GPs have an important role in providing medical care to people living at home with a terminal illness. However, being able to <a href="https://grattan.edu.au/wp-content/uploads/2014/09/815-dying-well.pdf">die at home</a> relies on the availability of ongoing support including hands-on care and assistance with daily living. Family members and friends often provide this support, but this is not always possible. Even when it is, carers may <a href="https://pubmed.ncbi.nlm.nih.gov/38533612/">lack confidence and skills</a> to provide the necessary care, and may not have enough support for and respite from their carer role. The palliative care funding offered within Support at Home should help an older person to remain at home and die at home, if that is their preference. Unless someone dies suddenly, care needs are likely to increase at the end of a person’s life. Supports at home may involve help with showering and toileting, assessing and addressing symptoms, developing care plans, managing medications, wound dressing, domestic tasks, preparing meals, and communicating with the person’s family. Occupational therapists and physiotherapists can assist with equipment requirements and suggest home modifications. End of life supports may also involve clarifying goals of care, contacting services such as pharmacists for medications or equipment, liaising with organisations about financial matters, respite care or funeral planning, as well as acknowledging grief and offering spiritual care. But we don’t know yet exactly what services the $25,000 will go towards. <h2>What do we know about the scheme so far?</h2> The Support at Home program, including the end of life pathway, is scheduled to start from <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">July 1 2025</a>. We know the funding is linked to a prognosis of three months or less to live, which will be determined <a href="https://www.abc.net.au/news/2024-09-15/new-payment-aims-to-make-it-easier-for-people-to-die-at-home/104347984">by a doctor</a>. Further information has indicated that an older person can be referred to a <a href="https://www.health.gov.au/our-work/support-at-home/features">high-priority assessment</a> to access the end of life pathway. We don’t know yet what this means, however they don’t need to be an existing Support at Home participant to be eligible. The pathway will allow 16 weeks to use the funds, possibly to provide some leeway around the three-month timeline. Although more details are coming to light, there are still some things which remain unclear. Home care providers will be looking for details on what can be covered by this funding and how they will work alongside primary care providers and health-care services. Older people and their families will want to know the processes to apply for this funding and how long applications will take to be reviewed. Everyone will want to know what happens if the person doesn’t die within three months. <h2>Some challenges</h2> Ready availability of appropriate supports and services will be crucial for older people accessing this pathway. Home care providers will therefore need to assess how an end of life pathway fits into their operational activities and how they can build the necessary skills and capacity. Demand for nurses with palliative care skills and allied health professionals is likely to increase. Providing end of life care can be <a href="https://pubmed.ncbi.nlm.nih.gov/33096682/">especially taxing</a> so strategies will be needed to prevent staff burnout and encourage self-care. How pathways are implemented in rural and remote areas and in different cultural and community groups will need to be monitored to ensure all older people benefit. Effective coordination and communication between home care, primary care and specialist palliative providers care will be key. Digital health systems that connect the sectors could be helpful. Family engagement will also be very important. Escalation pathways and referral pathways should be established to enable appropriate responses to emergencies, unexpected deterioration, and family distress. Finally, <a href="https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-023-01155-y">accurately determining</a> when someone will die can be difficult. Knowing when the last three months of life starts may not be easy, particularly where frailty, cognitive issues and multiple health concerns may be present. This might mean some people are not seen as being ready for this pathway. Others may not be willing to accept this prognosis. An older person may also be expected to live with a terminal illness for many months or years. Their palliative care needs would not be met under this pathway. Despite these challenges, the announcement of an end of life pathway within the home care program is timely and welcome. As a population we are living longer and dying older. More details will help us be better prepared to implement this scheme.<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/239296/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jennifer-tieman-378102">Jennifer Tieman</a>, Matthew Flinders Professor and Director of the Research Centre for Palliative Care, Death and Dying, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/offering-end-of-life-support-as-part-of-home-care-is-important-but-may-face-some-challenges-239296">original article</a>. </div>

Retirement Life

Why do I need to take some medicines with food?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to? There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food. To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food. Different brands of the same medicine may also have different recommendations when it comes to taking it with food. <h2>Food impacts drug absorption</h2> Food can affect how fast and how much a drug is absorbed into the body in up to <a href="https://academic.oup.com/jpp/article-abstract/71/4/510/6122024?login=false">40% of medicines</a> taken orally. When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption. Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505616/">gastric emptying</a>. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption. Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly. But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach. <h2>Food can make medicines more tolerable</h2> Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets. Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452716/">one in four users affected</a>. To combat these side effects, it is generally recommended to be taken with food. The same <a href="https://amhonline.amh.net.au/auth">advice</a> is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline). Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed. <h2>Can food make medicines safer?</h2> Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use <a href="https://www.abs.gov.au/statistics/health/health-conditions-and-risks/medications/latest-release">within a two-week period</a>. While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of <a href="https://www.tandfonline.com/doi/full/10.1586/14737175.6.11.1643#d1e212">bleeding, ulceration and perforation</a> with long-term use. But there <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">isn’t enough research</a> to show taking ibuprofen with food reduces this risk. Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration. The <a href="https://amhonline.amh.net.au/auth">Australian Medicines Handbook</a>, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574824/">A systematic review published in 2015</a> found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses. To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs">non-steroidal anti-inflammatory medicines</a> at the same time. For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a <a href="https://australianprescriber.tg.org.au/articles/peptic-ulcer-disease-and-non-steroidal-anti-inflammatory-drugs.html">proton pump inhibitor</a>, a medicine that reduces stomach acid and protects the stomach lining. <h2>How much food do you need?</h2> When you need to take a medicine with food, how much is enough? Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone. However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised. Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.<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/235782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mary-bushell-919262">Mary Bushell</a>, Clinical Associate Professor in Pharmacy, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-i-need-to-take-some-medicines-with-food-235782">original article</a>. </div>

Body

Why are some people happy when they are dying?

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

Caring

Cancer diagnosis can be devastating, but for some it gives permission to live more radically

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/kevin-dew-577291">Kevin Dew</a>, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/chris-cunningham-1534054">Chris Cunningham</a>, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/elizabeth-dennett-1532423">Elizabeth Dennett</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>; <a href="https://theconversation.com/profiles/kerry-chamberlain-103714">Kerry Chamberlain</a>, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/richard-egan-400188">Richard Egan</a>, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a> A diagnosis of life-limiting cancer can be overwhelming and cause feelings of panic and anxiety. But for some people, it provides a license to live life differently, including quitting toxic jobs and becoming more adventurous. In our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13797">recently published research</a>, we sought to understand the impact of a cancer diagnosis and subsequent experiences for cancer survivors. We talked with 81 New Zealanders (23 Māori and 58 non-Māori) who had lived longer than expected with a life-limiting or terminal diagnosis of cancer (four to 32 years since first diagnosis), and 25 people who were identified as their supporters. We found there are vastly different ways in which people experience and respond to a cancer diagnosis, but for some it’s a prompt to make significant changes. Of the 81 participants, 26 expressed the view, unsolicited, that cancer had some positive impact on their lives – without downplaying the negative impacts it could have as well. <h2>A licence to change</h2> Being told you only have limited time left to live can undoubtedly be a shock. But it can lead to profound change. It’s not uncommon for people who receive a serious diagnosis to draw up a “<a href="https://theconversation.com/paris-in-spring-bali-in-winter-how-bucket-lists-help-cancer-patients-handle-life-and-death-225682">bucket list</a>”. Some people in our study took the opportunity to travel or move to a new home. For others, the diagnosis provided a chance to rethink their lives and make more significant changes to the way they lived. They decided to be culturally more adventurous and to take up new skills. Many of these people quit their jobs or changed to jobs that suited them better. Many changed their relationships with the people around them. One talked about showing more affection for his children, another was kinder and stopped fretting over small things. Some decided to be more selective and no longer be around people who were negative. Others took up new hobbies or crafts which they felt were healing. For one person, the cancer diagnosis provided the impetus to look at things and people differently, which they thought would not have happened otherwise. Individuals could also undergo a transformation to become what they felt they were meant to be in life. One person, given two months to live, embraced rongoā (Māori traditional healing), including its spiritual side. They now love their “journey” and feel this was what they were “supposed to do”. For many, a diagnosis of cancer gave them license to be different people and to resist conforming to social norms, including having a job, being thrifty or not taking risks. <h2>Disrupting diagnoses</h2> One person, given only months to live, moved out of her flat, gave away her possessions, quit her job that she described was toxic, and returned home to say goodbye to her family. Most importantly for her, she worked on experiencing “joy” – after receiving the diagnosis, she realised she had lost it. But she continues to live many years later. After a while, she had to find a new flat, get a new job and the recovery of her joy was challenged: <blockquote> I had to start working again. And, of course, with working again, joy goes down, time goes down, rest goes down, spirituality goes down. </blockquote> But not everyone has the opportunity to change. Some peoples’ lives were limited because of the physical effects of the cancer, its treatment, or because of their personal, social or financial resources. Some go to great lengths to ensure their lives change as little as possible after diagnosis to maintain a sense of normality. <h2>Why we need to know</h2> Given the fear a cancer diagnosis can elicit, it is important to see there are different ways of responding. It is also worth knowing there are people who live longer than expected. Many people in our study were given just months to live, but one woman was still alive 12 years after being told she had a year left. Beyond that, this research documents how the disruption produced by a cancer diagnosis can prompt people to breach social norms. Where people have the capacity and resources to change, those around them and their health professionals can support them in taking opportunities to live life differently. We heard people say they think of their cancer as a friend or an amazing opportunity. Some even felt thankful. The possibility of cancer providing opportunities for some in no way diminishes the grief or a sense of loss, fear and anxiety that can accompany such diagnoses. Our research supports a reframing of cancer narratives, to consider ways of tempering the negative impacts of a diagnosis – while remaining cognisant of the struggle that can follow such news, and the variability in people’s capacity to engage with that struggle.<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/233782/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kevin-dew-577291">Kevin Dew</a>, Professor of Sociology, <a href="https://theconversation.com/institutions/te-herenga-waka-victoria-university-of-wellington-1200">Te Herenga Waka — Victoria University of Wellington</a>; <a href="https://theconversation.com/profiles/alex-broom-121063">Alex Broom</a>, Professor of Sociology & Director, Sydney Centre for Healthy Societies, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/chris-cunningham-1534054">Chris Cunningham</a>, Professor of Maori & Public Health, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>; <a href="https://theconversation.com/profiles/elizabeth-dennett-1532423">Elizabeth Dennett</a>, Associate Professor in Surgery, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a>; <a href="https://theconversation.com/profiles/kerry-chamberlain-103714">Kerry Chamberlain</a>, Professor of Social and Health Psychology, <a href="https://theconversation.com/institutions/te-kunenga-ki-purehuroa-massey-university-806">Te Kunenga ki Pūrehuroa – Massey University</a>, and <a href="https://theconversation.com/profiles/richard-egan-400188">Richard Egan</a>, Associate Professor in Health Promotion, <a href="https://theconversation.com/institutions/university-of-otago-1304">University of Otago</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/cancer-diagnosis-can-be-devastating-but-for-some-it-gives-permission-to-live-more-radically-233782">original article</a>. </div>

Body

Poor sleep is really bad for your health. But we found exercise can offset some of these harms

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Despite the well-known links between poor sleep and poorer health, getting enough good quality sleep has become a luxury in modern society. Many of us struggle to improve our sleep, while amid the COVID pandemic and recurring lock-downs, <a href="https://theconversation.com/were-sleeping-more-in-lockdown-but-the-quality-is-worse-155797">our sleep has deteriorated</a>. But <a href="https://doi.org/10.1136/bjsports-2021-104046">our new study</a>, published today in the British Journal of Sports Medicine, bears some encouraging news. We found doing enough physical activity (including exercise such as running or going to the gym) may counter some of the adverse health effects of unhealthy sleep patterns. Let us explain. <h2>Does poor sleep really harm our health?</h2> Unhealthy sleep patterns include: <ul> <li> not sleeping for long enough (less than seven hours per night for adults) </li> <li> sleeping for too long (more than nine hours per night for adults) </li> <li> snoring </li> <li> insomnia </li> <li> being a night owl, also known as “late chronotype”. This is people who naturally feel most awake and motivated in the evening, and are sluggish in the morning. </li> </ul> They are <a href="https://doi.org/10/ggjqrt">all associated</a> with poorer health. Recent research shows poor sleep may: <ul> <li> cause <a href="https://doi.org/10.1038/s41577-019-0190-z">inflammation</a> </li> <li> impair the metabolism of glucose (also known as blood sugar) and reduce the number of calories burned, thereby increasing the risk of <a href="https://theconversation.com/why-sleep-is-so-important-for-losing-weight-145058">obesity</a> </li> <li> increase the risk of <a href="https://doi.org/10/gg6x87">heart disease</a> and <a href="https://doi.org/10/ggnw5h">premature death</a>. </li> </ul> However, very few studies have examined how sleep and physical activity interact and impact our health. We set out to answer the question: if I have poor sleep but I do quite a lot of physical activity, can that offset some of the harms of my poor sleep in the long-term? Or would this not make any difference? <h2>What did we do?</h2> We analysed the information provided by 380,055 middle-aged adults in the UK Biobank study, recruited between 2006 and 2010. Participants reported their level of physical activity and five aspects of their sleep. We grouped people based on their sleep behaviour into healthy, intermediate or poor. We categorised people’s level of physical activity based on <a href="https://bjsm.bmj.com/content/54/24/1451">the World Health Organization (WHO) guidelines</a>. People who met the upper bounds of the guidelines did 300 minutes of moderate intensity physical activity a week, or 150 minutes of vigorous exercise, or a combination of both. Those who met the lower bound did 150 minutes of moderate intensity exercise a week, or 75 minutes of vigorous exercise, or a combination. Moderate intensity physical activity usually makes you slightly out of breath if sustained for a few minutes and includes brisk walking or cycling at a leisurely pace. Vigorous exercise usually makes you breath hard and can include running, swimming, and playing sports like tennis, netball, soccer or footy. <figure class="align-center "><img src="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=409&fit=crop&dpr=1 600w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=409&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=409&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=515&fit=crop&dpr=1 754w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=515&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/408096/original/file-20210624-15-1qfe1ay.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=515&fit=crop&dpr=3 2262w" alt="" /><figcaption>Doing at least 150 minutes of moderate intensity physical activity a week, or 75 minutes of vigorous exercise, can offset some of the health harms of poor sleep. <a class="source" href="https://apps.who.int/iris/bitstream/handle/10665/336656/9789240015128-eng.pdf?sequence=1&isAllowed=y">World Health Organization, CC BY-NC-SA 3.0 IGO</a></figcaption></figure> <h2>What did we find?</h2> We followed up with the participants after 11 years. By May 2020, 15,503 participants had died, of which 4,095 died from heart disease and 9,064 died from cancer. <a href="https://doi.org/10.1136/bjsports-2021-104046">We found</a> that, compared to healthy sleepers, people with poor sleep had a 23% higher risk of premature death, a 39% higher risk of dying from heart disease, and a 13% higher risk of dying from cancer. We then compared the data of people who slept well with those who slept poorly, and how much they exercised. We found people who had the highest risk of dying from heart disease and cancer were those who had poor sleep and didn’t meet the WHO physical activity guidelines. On the other hand, those who had poor sleep but did enough physical activity to meet the WHO guidelines didn’t have as high a risk of dying from heart disease or cancer, compared to those who slept poorly and didn’t meet the physical activity guidelines. For example, let’s look at the risk of dying from cancer. Those who had poor sleep and did no physical activity had a 45% higher risk of dying from cancer compared to those who had healthy sleep and exercised a lot. But among those who met the physical activity guidelines, despite poor sleep, they didn’t really have a higher risk of dying from cancer any more. We found physical activity levels which met at least the bottom threshold of the WHO guidelines could reduce or eliminate some of the health harms of poor sleep. So people who did at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise per week were to some extent protected against the detrimental health effects of poor sleep. Those who had both poor sleep and did no moderate-to-vigorous intensity physical activity had the highest risks of premature death. Our study wasn’t designed to find out how and why physical activity may counteract some of the bad physiological impacts of poor sleep. But other research provides theories. For example, adequate physical activity may <a href="https://doi.org/10.1249/MSS.0000000000001179">reduce inflammation, help maintain a healthy glucose metabolism</a>, and <a href="https://doi.org/10.1016/j.pcad.2018.07.014">increase the number of calories burned</a>. It’s important to note our study was what’s called an “observational study”. It shows an association between adequate physical activity and reduced harms from poor sleep, but we must be careful in interpreting causation. It can’t conclusively say adequate physical activity causes the reduction of harms from poor sleep, though there’s strong evidence for an association in the right direction. Our study offers a hopeful message, that even if you haven’t been able to improve your sleep, you can still offset some of the health harms by doing enough exercise. <a href="https://www.sciencedirect.com/science/article/abs/pii/S009174352030339X">Our previous research</a> has also shown physical activity may help improve poor sleep patterns, which are a serious health problem across the world. In addition to combating some of the negative outcomes of poor sleep, physical activity can also provide many other health benefits and extend our lives. For example, a 2019 study found people who met WHO’s physical activity target above <a href="https://doi.org/10.1186/s12916-019-1339-0">lived three years longer on average</a> than those who didn’t. During lockdowns, access to parks, gyms, and swimming pools might be limited in many places. But there are still many ways to <a href="https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/noncommunicable-diseases/stay-physically-active-during-self-quarantine">to stay fit and active at home during the coronavirus</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/163270/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/bo-huei-huang-1243280">Bo-Huei Huang</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/emmanuel-stamatakis-161783">Emmanuel Stamatakis</a>, Professor of Physical Activity, Lifestyle, and Population Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/poor-sleep-is-really-bad-for-your-health-but-we-found-exercise-can-offset-some-of-these-harms-163270">original article</a>. </div>

Body

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

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

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

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

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