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Readers response: What do you regret not appreciating more when you were younger?

When it comes to ageing, we often learn to appreciate things that we often dismissed when we were younger. We asked our readers what they have only truly started to appreciate with age, and the response was overwhelming. Here's what they said. Ross Forbes - Being brought up on a farm in a family environment where I was taught excellent work ethics and the value of community. Alice McMurdo - The beauty of the scenery in Scotland and not taking the opportunity to see more of the beautiful countryside when I had the chance. Pat Isaacs - My health and energy. Esther Miller - Not having to pay bills. I now understand why my daddy was always telling us cut off the light, shut the door, stop wasting food, do not pour more milk than you are going to drink. I remember him saying "wait till you have to pay for it yourselves". Lesson learned. Marie Chong - My parents. Rosalie Jones - Movement without pain. Michelle Nightingale - My family. Sally O'Neill - Being happy and free, not having any responsibilities to worry about. Chris Gray - My mum. If only I had known what I now know. Margie Buckingham - My ability to always be employed and buy my first house at 21. Also, my upbringing and great start my parents gave me by ensuring I went to a good school and studied hard. Kerri Anderson - Being younger. Linda Kauffman - My mother. Image credits: Shutterstock

Family & Pets

Readers response: What's a pain you can't truly explain until you've endured it?

When it comes to experiencing pain, many of us are used to hearing people say "I know how you feel" while they're empathising with your suffering. However, there are some kinds of pain - either physical or emotional - that cannot be understood until you experience them yourself. We asked our readers what pain you can't truly explain until you've endured it yourself, and the response was overwhelming. Here's what they said. Anne Hare - Shingles! Absolutely excruciating. I seriously considered topping myself until I was finally prescribed Lyrica. Took five months to recover as misdiagnosed twice so antivirals prescribed too late. Have the shot! Karen Ambrose - Childbirth. 15.5 hours of agony. Annette Maree - Pain from a dying nerve in a tooth. Royce Jowett - The worst pain is always the one you are currently experiencing, especially as you get older and forgetful. Julia Santos - Hip pain is hard to explain how it affects your whole day. Even trying to sleep is an adventure. And sneezing while your hips are inflamed is always fun. Betty Weller Edwards - Gallbladder stones. I would rather go through labor for 12 hours than have 4 hours off gallbladder pain. Sandra Morris - The loss of your child. Kevin Chapman - Chronic arthritis. The pain is 24/7, it never goes away. Danny Bennett - Divorce. Patricia White - Dislocated shoulder. Jill Harker - A couple of bulging discs in my back! Linda Charlton - Clot in the lungs, couldn't breathe thought I was having a heart attack in my 30's. Other than that, definitely childbirth. George Dworcowyi - Back spasms after a 7 hour operation on my broken spine. Maxine Cuevas - Losing two adult children at separate times. Josephine Broughton - White tail spider bite. Shelley Woolley - Ruptured ovarian cysts. Image credits: Shutterstock

Body

Readers response: What movie have you rewatched the most?

We all have our favourite movies. The ones that make us feel comforted and happy each time we rewatch them. We asked our readers what movies they have rewatched the most, and the response was overwhelming. Here's what they said. Heather Fuchs - Pretty Woman, The Shawshank Redemption and The Green Mile. Nola Schmidt - Gone with the Wind, Sound of Music and Breakfast at Tiffanys. Isabel Pritchard - Love Actually, watched it every Christmas since it was released. Angela Chapman - The Notebook, Back to the Future trilogy, The Sound of Music, Grease, Sleepless in Seattle, and Sweet Home Alabama. Margie Grass - Grease! Was watched over and over and over, would finish watching and go "oh let’s do it again". My kids knew the words by heart and did a running commentary when they replayed it again. Naomi Thacker - The Rise of Skywalker, Star Wars. I must have seen it 10 or more times. Terri Cameron - The Lion King with my eldest grandson who was very young then and is 30 now. Neither of us seemed to tire of it. It was just a wonderful film. Beverley Hoffman - LOTR, Harry Potter, The Ten Commandments. Christine Thompson - Sound of Music, Sleepless in Seattle, Pretty Woman. Anything that you would class as a “chick flick” really. Maggie Geeves - Steel Magnolias. Rhonda Woods - The Castle. Image credits: Shutterstock

Movies

Readers response: What was/is your biggest waste of money?

As the cost of living continues to take hold on people's everyday spending, we find ourselves being more careful pinching our pennies. However, despite our efforts, sometimes it's hard to not feel like you're wasting your cash. We asked our readers what was, or is, their biggest waste of money, and the response was overwhelming. Here's what they said. Billy Smooth - Rent and insurance. Felicity Jill Murphy - Many meals that I could not get through. Barry Lenny - Rates and taxes. I get bugger all for the enormous amounts of money I have to pay. Norbert Kratz - Lottery tickets. Sue Meers - The monthly fee for living in a retirement village. Magda Klopper - Craft stuff and clothes I did not wear. Gaynor Hall - Alcohol! Going to stop buying it now. Paula Fortune - Use to be smokes up until I finally quit for good in January 2005! Good thing I did considering how expensive they are now. Sue Brown Leete - A speeding fine I just got. Sandii Smith - Too many things to mention. Image credits: Shutterstock

Money & Banking

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

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

Mind

Readers response: What is the most expensive place you've visited?

When it comes to travelling, there are some destinations around the world that are definitely more expensive than others. We asked our readers which place left them the most out of pocket, and the response was overwhelming. Here's what they said. Angela Budden - Switzerland for sure. Vera Hunt - Italy, but it's a beautiful place so worth every cent. Pat Isaacs - Probably London, back in 2011. Such a contrast to Bali, in 2013. Had two weeks there, total cost was under $1600, including air fare, accommodation, food etc. Just the air fare to London was more than the total cost of my time in Bali. Eileen Dunford - The Amalfi Coast. Roz Harris - Ashford Castle in Ireland, but I would give anything to go back again and stay for longer. Valerie Southam - Iceland and Finland. Peter Connolly - I think Qatar, although the Netherlands wasn't that far behind. Marirose Piciucco - Tahiti and Copenhagen. Maree Newhouse - Iceland, I just came back from there. $48 for a bowl of lamb soup and $52 for a hamburger! Gail Ladds - Positano in Italy. Cost me $25 for a milkshake about $7 years ago. It was the cost of the view I think. Kevin Chapman - Hawaii, but worth every penny. Peter Brady - Everywhere in the US given the lousy exchange rate, the plethora of additional government taxes, and the mandatory 20% tip. Chaz Maree - Scandinavian countries are very expensive to visit but so beautiful, so who cares. Catherine Cotterell - Venice, where the traders sting you as fiercely as the mosquitos. Image credits: Shutterstock

Travel Trouble

Readers response: What is one country you'll never go to?

When it comes to travelling, everyone has a list of places they are dying to go to. In the same token, lots of travellers have placed they have no interest of ever seeing. We asked our readers what country they will never go to, and the response was overwhelming. Here's what they said. Kathy Yeo - Saudi Arabia or any other country where women have few rights and are treated as possessions. Irene Dodds - USA. Jim Cormack - Indonesia, in particular Bali. Roz Eberhard-Swan - After 132 countries, I can say that I will never return to Russia, China & Cuba. And will now add Afghanistan to that list. Sadly, the USA also is now out of control with their gun laws and politics so probably unlikely to go back there either. Carole Harris - Russia. I have been and wanted to go back, but never will now. Kath Wilkinson - Afghanistan. Their treatment of women should turn anyone off! Karen Ambrose - Probably America due to their pathetic gun laws. Debra Joy - Spain. I'll never go while they still do bull fighting. Disgusting and abhorrent. George Quinn - Egypt. Never again! After 35 countries, it's the only place I never felt safe. Janice Brigg - Bali. Never been here and it is of no interest to us. There are so many other beautiful other places to visit. So far travelled to 58 counties. Image credits: Shutterstock

Travel Trouble

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

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> The craze for new drugs in the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analogue class, better known under the trade names Ozempic and Wegovy, is remarkable, but it’s not totally unprecedented in the history of pharmaceutical blockbusters. The volume of prescriptions and the budget allocated to them by public health insurance schemes are exploding, as are the <a href="https://www.forbes.com/sites/roberthart/2024/05/02/ozempic-maker-novo-nordisk-beats-profit-forecasts-amid-weight-loss-drug-frenzy/">profits of the companies that manufacture them</a>. Part of the popularity of these drugs owes to social networks, but these are not always the best source for health information. When it comes to the subject of weight loss, both fantasy and prejudice come into play. This works to the detriment of everyone’s well-being, but particularly those who are already stigmatized. As specialists in the philosophy of medicine (Université de Montréal), nutrition and food science (Université Laval), the sociology of medication (Université de Montréal) and endocrinology (Institut de recherches cliniques de Montréal), we feel it’s necessary to step back and take stock of both the promises and the limitations of these new treatments. <h2>The best of both worlds</h2> GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in people with Type 2 diabetes, thereby preventing the complications associated with this disease. When studies were carried out to assess their safety and efficacy, it was discovered that these drugs also led to weight loss. This prompted new research which showed that at higher doses, the drugs could lead to <a href="https://pubmed.ncbi.nlm.nih.gov/38078870/">very significant weight loss</a>, from 15 to 25 per cent of the starting weight. The mode of action of these drugs on blood sugar regulation is clear: they simulate incretin hormones which, in turn, increase insulin secretion. Weight loss, on the other hand, was only explained after the fact: in addition to the pancreas, these molecules also act on the brain by regulating the sensation of satiety and, indirectly, on the stomach by slowing gastric emptying. These two combined effects reduce appetite and lead to weight reduction. This is how a new use for the drug appeared, at which point the company Novo Nordisk began marketing the same drug under two different names: Ozempic to treat Type 2 diabetes, and <a href="https://theconversation.com/considering-taking-wegovy-to-lose-weight-here-are-the-risks-and-benefits-and-how-it-differs-from-ozempic-237308">Wegovy to manage obesity</a>. <h2>A new era</h2> GLP-1/GIP analogues are a welcome therapeutic breakthrough at a time when the <a href="https://www.diabetes.ca/advocacy---policies/advocacy-reports/national-and-provincial-backgrounders/diabetes-in-canada">prevalence of Type 2 diabetes</a> and <a href="https://www.statcan.gc.ca/o1/en/plus/5742-overview-weight-and-height-measurements-world-obesity-day">obesity</a> is exploding and affecting people younger and younger. These diseases particularly affect women, members of racialized groups and socio-economically disadvantaged populations. The physical and mental suffering these cause and the costs associated with treating them are both considerable. So the arrival of new weapons in the therapeutic arsenal is a source of hope. Draconian changes in lifestyle are certainly effective. But they are very difficult to implement and maintain over time for reasons that go beyond the individual sphere; on the one hand, genetic predisposition plays a major role in the development of Type 2 diabetes and obesity; on the other, because these conditions are <a href="https://obesitycanada.ca/managing-obesity/">multifactorial</a>, management of them must be comprehensive to be effective and long lasting: it must combine medical interventions but also nutritional, functional, psycho-social, environmental and even institutional interventions. Support services of this kind do exist, but only in large university hospital centres to which many people do not have access. Nor do many people have easy access to <a href="https://health-infobase.canada.ca/health-inequalities/index">healthy and varied food options</a>, sports facilities or social and psychological support. <h2>Treating the effects but not the causes</h2> To be effective over the long term, GLP-1/GIP analogues must be taken continuously: without drastic lifestyle changes, the <a href="https://pubmed.ncbi.nlm.nih.gov/35441470/">weight that was lost is regained within a year of stopping</a>, and glycemic control is compromised once again. In other words, the drugs treat the effects of Type 2 diabetes and obesity but not their causes. And yet some of these causes are modifiable: for example, according to <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">Statistics Canada</a>, less than half the Canadian population (49.2 per cent for adults; 43.9 per cent for young people and children) achieves the recommended amount of weekly physical activity. According to the same source, <a href="https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00013-eng.htm">food insecurity</a> affects around 14 per cent of the Québec population (22 per cent in Alberta). Pharmacological treatment, even if it allows an individual to eat less, does not necessarily mean that person will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837702/">eat better</a>. Similarly, losing weight does not mean one will become more active or healthier. So these new drugs do not cure Type 2 diabetes or obesity. Nor do they prevent these diseases from developing, although they do help to limit the many complications to which they give rise. <h2>Prescribe and treat</h2> A drug such as Mounjaro is as effective at weight loss as bariatric surgery. Much easier to administer and much less risky, it could be a real game changer in the treatment of obesity. Prescribed directly by family doctors and dispensed in pharmacies, it would also be much more accessible and easier to administer for those who need it. This raises the question of costs and reimbursement, but not only that: prescribing is not the same as treating. Here, the manufacturers are following the recommendations of the health authorities: this treatment must be preceded by a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748770/">careful assessment</a>, then management, and above all a close and regular monitoring of diet, physical activity, mental health, and if necessary, socio-economic assistance. This requires not only time that GPs do not have, but also co-ordination with other players in the health-care network. The problem is not whether the treatment will be effective, but what can happen if it is. Losing 25 per cent of your body weight in just a few months has serious consequences, which are not always beneficial: it involves a loss of body fat, but also of muscle mass, which is associated with intense fatigue. Nor should we underestimate the <a href="https://pubmed.ncbi.nlm.nih.gov/37990685/">challenge of adapting physically and psychologically</a> to a body transformation of this scale. Losing weight doesn’t solve everything, and expectations must remain realistic. <h2>What lessons can we learn?</h2> The clinical effectiveness of GLP-1/GIP analogues in reducing the complications associated with Type 2 diabetes and obesity is indisputable. However, these drugs are not suitable for everyone, and they are certainly not miracle cures that will make it possible for one to regain health without making any changes to lifestyle or environment. We must bear in mind that their success, both commercial and medical, is also the result of a failure: that of our societies to prevent these diseases, to promote healthy lifestyles and to develop environments conducive to the health of all.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238484/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/aude-bandini-1488512">Aude Bandini</a>, Professeure agrégée, Philosophie (épistémologie et philosophie de la médecine), <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>; <a href="https://theconversation.com/profiles/jean-philippe-drouin-chartier-1533338">Jean-Philippe Drouin-Chartier</a>, Professeur agrégé, Faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-laval-1407">Université Laval</a>; <a href="https://theconversation.com/profiles/pierre-marie-david-1375228">Pierre-Marie David</a>, Professeur adjoint à la faculté de pharmacie, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a>, and <a href="https://theconversation.com/profiles/remi-rabasa-lhoret-1533515">Rémi Rabasa-Lhoret</a>, Professeur de médecine et de nutrition, <a href="https://theconversation.com/institutions/universite-de-montreal-1743">Université de Montréal</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ozempic-wegovy-rybelsus-are-we-losing-sight-of-overall-health-heres-what-the-science-says-238484">original article</a>. </div>

Body

Readers response: What are your tips for saving money effectively?

During a time where many people are struggling with the cost of living crisis, many are finding different ways to pinch the pennies. We asked our readers for their top tips for saving money efficiently, and the response was overwhelming. Here's what they said. Anita Thornton - Every month the bank takes a specified amount out of my current account and puts it in a goal saver account! It soon mounts up. Jo Davidson - Do your own cooking, cleaning and anything that you can do yourself. Barry Webber - Know the difference between spending money and wasting money. Peter Connolly - Save first, and spend afterwards. Heather O'Flynn - Take care of the pennies and the pounds will take care of themselves, even if it's a bit outdated now. You can ask your bank to move a set amount from your everyday account into a progress saver account each week and if you set it and forget it, you will get good compounding interest. Erlinda Nabong Mayers - Shop as you need, not as you want. Margie Buckingham - Have a goal to aim for. Len Rawlings - Don't spend if you don't need to. Image credits: Shutterstock

Money & Banking

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

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> We may think of air pollution as an outdoor problem, made up of car exhaust and smog. But if the air inside our homes is polluted, this can also affect our health. In Australia, around 12% of childhood asthma can <a href="https://pubmed.ncbi.nlm.nih.gov/29642816/">be attributed</a> to gas stoves and the toxic chemicals they release into the air. And while there’s a growing push to phase out gas indoors, some 38% of Australian households <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">rely on natural gas</a> for cooking. Recommended interventions – such as replacing a gas stove with electric – may not be possible for those who are renting or struggling with the cost of living. This is important because, as our <a href="https://ghrp.biomedcentral.com/articles/10.1186/s41256-024-00361-2">research</a> shows, childhood asthma is more common in socioeconomically disadvantaged areas. If you’re living with gas, here’s how it can affect you or your child’s asthma, and what you can do to improve air quality. <h2>What is asthma?</h2> Asthma is the most common chronic condition in Australian children. The respiratory condition affects <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">almost</a> 400,000 of those aged aged 14 and under – close to 9% of that age group. Asthma narrows the airways and obstructs airflow, making it hard to breath. Many people manage the condition with inhalers and <a href="https://asthma.org.au/manage-asthma/asthma-action-plan/">asthma action plans</a>. But it can be serious and even fatal. Australian emergency departments saw <a href="https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma">56,600 presentations</a> for asthma in 2020-21. While there is no single cause for asthma, both indoor and outdoor air pollution play a <a href="https://pubmed.ncbi.nlm.nih.gov/38247719/">significant role</a>. Being exposed to small <a href="https://aafa.org/asthma/asthma-triggers-causes/air-pollution-smog-asthma/#:%7E:text=Air%20pollution%20can%20increase%20your,if%20you%20already%20have%20asthma.&text=Small%20airborne%20particles%2C%20found%20in,%E2%80%9Cparticulate%20matter%E2%80%9D%20or%20PM.">airborne particles</a> increases your risk of getting asthma, and can aggravate symptoms if you already have it. <h2>Gas stoves release nitrogen dioxide</h2> The gas stoves commonly found in Australian homes release toxic chemicals into the air. They include carbon monoxide (CO), PM₂.₅ (small particles, often from <a href="https://www.epa.vic.gov.au/for-community/environmental-information/air-quality/pm25-particles-in-the-air">smoke</a>), benzene, formaldehyde and nitrogen dioxide (NO₂). All are harmful, but nitrogen dioxide in particular is <a href="https://go.gale.com/ps/i.do?id=GALE%7CA656312383&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=00220892&p=AONE&sw=w&userGroupName=anon%7E7027bb9f&aty=open-web-entry">associated</a> with asthma developing and getting <a href="https://www.atsjournals.org/doi/10.1164/rccm.200408-1123OC">worse</a>. Gas heaters can also <a href="https://pubmed.ncbi.nlm.nih.gov/9731022/">produce</a> nitrogen dioxide. As nitrogen dioxide is a tasteless, invisible gas, it’s difficult to know how much is in your air at home unless you have an air monitor. However one US <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662932/">study</a> showed houses with gas stoves can have nitrogen dioxide levels three times higher than houses with electric stoves. This is particularly concerning for households with children, given children tend to spend <a href="https://pubmed.ncbi.nlm.nih.gov/11477521/">most</a> of their time indoors. <h2>Banning gas</h2> There is a growing push across Australia to replace gas stoves with electric stoves, which are more energy efficient and can reduce indoor air pollution. <a href="https://www.premier.vic.gov.au/new-victorian-homes-go-all-electric-2024">Victoria</a> and the <a href="https://www.climatechoices.act.gov.au/energy/canberras-electrification-pathway/preventing-new-gas-network-connections">Australian Capital Territory</a> have announced bans on gas connections in new homes from 2024. Sydney’s Waverley council recently made a similar <a href="https://www.waverley.nsw.gov.au/environment/climate_resilience_and_reducing_emissions/go_electric">move</a>. But until a ban on using household gas appliances is implemented across the country, the problem persists for children who are currently living in old homes or rented properties with gas stoves. <h2>Do exhaust fans in the kitchen help?</h2> Using a high-efficiency <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">exhaust hood</a> placed over an existing gas cooktop can be effective. They can <a href="https://www.mja.com.au/journal/2018/208/7/damp-housing-gas-stoves-and-burden-childhood-asthma-australia">capture</a> more than 75% of air pollutants and direct them outside. Cooking on the back burner – rather than the front burner – can also <a href="https://pubmed.ncbi.nlm.nih.gov/24750219/">improve their efficiency</a>. However exhaust hoods with lower flow rates, or hoods that don’t vent the air outside, are less effective. And an exhaust hood only improves air quality if you use it. One <a href="https://pubmed.ncbi.nlm.nih.gov/10520075/">study</a> in Melbourne found more than 40% of people didn’t use an exhaust hood regularly while cooking. For many people, installing high-efficiency exhaust hoods will not be practical – especially for those renting or experiencing socio-economic disadvantage. <h2>Natural ventilation</h2> There is a free way to ventilate your home. Keeping windows open during and after cooking will increase air flow and <a href="https://pubmed.ncbi.nlm.nih.gov/32970538/">evidence shows</a> this can improve overall air quality. However this is not always possible, especially during cooler months of the year which can be especially chilly in places such as Victoria and Tasmania. Unfortunately, people are also more likely to use gas heaters during those cooler months. <h2>What about heaters?</h2> There are two kinds of gas heaters, flued and unflued. Like cooking with gas, unflued gas heaters release air pollutants including nitrogen dioxide directly into the home. Flued heaters are better for air quality because they use a chimney, or “flue”, to send emissions outside. If you can, replacing your unflued gas heater with a flued one – or even better, an electric heater – can significantly <a href="https://pubmed.ncbi.nlm.nih.gov/15075170/">alleviate</a> asthma symptoms. If you can’t replace your unflued gas heater, <a href="https://www.health.nsw.gov.au/environment/factsheets/Pages/unflued-gas-heaters.aspx">do not use it overnight</a> in the room where you or your children sleep. Asthma can’t be cured, but its symptoms can be controlled by managing triggers – and this may be easier to do indoors than out. Improving air quality, even in a rented or old property, can help people with asthma breathe more easily.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238787/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nusrat-homaira-1199433">Nusrat Homaira</a>, Senior Lecturer, School of Clinical Medicine, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/your-gas-stove-might-be-making-your-asthma-worse-heres-what-you-can-do-about-it-238787">original article</a>. </div>

Body

What is ‘health at every size’ lifestyle counselling? How does it compare with weight-focused treatments?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Health at every size (or HAES) is a lifestyle counselling approach that promotes mindful eating and lifestyle behaviours to pursue health and wellness, without focusing on weight loss. Weight loss is seen as a <a href="https://www1.racgp.org.au/newsgp/clinical/understanding-the-%E2%80%98health-at-every-size%E2%80%99-paradigm">beneficial side effect</a>, rather than a goal. The <a href="https://www.sizeinclusivehealth.org.au/What-is-HAES">Association for Size Diversity and Health</a> first developed the approach in 2003 and revised it in 2013 and 2024. Its current <a href="https://asdah.org/haes/">core principles</a> promote: <ul> <li>minimising weight discrimination</li> <li>encouraging body acceptance</li> <li>intuitive eating</li> <li>enjoyable physical activities.</li> </ul> It also aims to address <a href="https://theobesitycollective.org.au/our-work/#weight-stigma-awareness">stigma and discrimination</a> that people in larger bodies may experience when seeking medical care. Internationally, a <a href="https://asdah.org/listing/">range of health professionals</a> have incorporated the HAES approach into their treatment and services. Some organisations, such as <a href="https://obesitycanada.ca/guidelines/nutrition/">Obesity Canada</a>, have included HAES in their <a href="https://pubmed.ncbi.nlm.nih.gov/32753461/">guidelines for obesity treatment</a>. <h2>How does it compare with weight-focused treatments?</h2> We conducted a <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">systematic review and meta-analysis</a> of all the research studies published until November 2022 that had used HAES-based programs. Across 19 scientific papers, we compared the outcomes of people living in larger bodies who used HAES-based programs <a href="https://pubmed.ncbi.nlm.nih.gov/38563692/">with</a>: <ul> <li>conventional weight loss programs (six studies)</li> <li>people on waiting lists receiving no treatment at all (six studies)</li> <li>groups where people received weekly social support in groups (four studies).</li> </ul> We evaluated the program’s impact on appetite, weight, physical health measurements including cholesterol and blood pressure, and also wellbeing and mental health. Our analysis found HAES interventions were beneficial in reducing susceptibility to hunger more than other approaches, meaning people had less subjective perceptions of hunger or eating in response to emotions. However, compared to control interventions, HAES did not show superior results for improving any other physical health outcome – weight loss, blood cholesterol levels, blood pressure – or wellbeing or mental health outcomes. Given the results to date, the choice about whether to use a HAES-based approach (or not) will depend on each person’s preference, needs and goals. <h2>Don’t get your health advice from influencers</h2> While HAES has been used in clinical practice for many years, some United States and Canadian anti-diet practitioner’s motives have been scrutinised because of their links <a href="https://www.washingtonpost.com/wellness/2024/04/03/diet-culture-nutrition-influencers-general-mills-processed-food/">with processed food companies</a>. The spotlight was put on the <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">very small number</a> of dietitian “influencers” (roughly 20 from a membership of more than 80,000 dietitians in the US and Canada) promoting “eat what you feel like” and discouraging people from making weight loss attempts, under the banner of HAES. They failed to mention they were being paid to promote products sold by food, beverage or supplement companies. US <a href="https://nutritionbycarrie.com/2024/04/washington-post-dietitians.html">author and dietitian Carrie Dennet</a> urges people to not look to influencers for health advice. Instead, seek non-judgemental health care from your GP. <h2>What might treatment look like?</h2> When improving your health is a treatment goal, a good place to start your journey is to have a health check-up with your doctor, as well as to assess your relationship with food. A healthy relationship with food means being able to eat appropriate amounts and variety of foods to meet your nutritional, health and wellbeing goals. This might include strategies such as: <ul> <li>keeping a <a href="https://theconversation.com/what-does-having-a-good-relationship-with-food-mean-4-ways-to-know-if-youve-got-one-202622">food mood diary</a></li> <li>reflecting on factors that influence your eating</li> <li>practising <a href="https://theconversation.com/thinking-youre-on-a-diet-is-half-the-problem-heres-how-to-be-a-mindful-eater-99207">mindful eating</a></li> <li>learning about nutrient needs</li> <li>focusing on food enjoyment and the pleasure that comes from preparing, sharing and eating with others.</li> </ul> If you need more help to develop this, ask your doctor to refer you to a health practitioner who can assist. <h2>What if your goal is weight loss?</h2> When it comes to medical nutrition therapy to treat weight-related health conditions, such as high blood pressure and type 2 diabetes, the approach will depend on individual needs and expectations. Broadly, there are three graded energy intake target levels: <ol> <li> a reduced-energy diet where the goal is to lower energy intake by 2,000 to 4,000 kilojoules (kJ) per day by identifying food substitutions, like swapping soft drinks and other sugar-sweetened drinks for zero or diet versions or water. </li> <li> a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">low-energy diet</a>, which uses an energy intake goal in the range of 4,200-5,000 kJ, up to 7,000 kJ per day depending on an individual’s energy expenditure. </li> <li> the most restricted regime is a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a>, has an energy intake target less than 2,500 kJ/day, achieved using formulated meal replacement products. </li> </ol> The aim of a <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">very low-energy diet</a> is to facilitate rapid weight loss when this is essential to improve health acutely such as poorly controlled type 2 diabetes. Such a diet should be used under supervision by your doctor and dietitian. When selecting an initial <a href="https://theconversation.com/health-check-whats-the-best-diet-for-weight-loss-21557">strategy</a>, seek a balance between energy intake goals and your ability to stick to it. Your approach may change over time as your health needs change. If you need personalised nutrition advice, ask for a referral to an accredited practising dietitian. The <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">register of service providers though Dietitians Australia</a> allows you to view their expertise and location. Regardless of whether your practitioner uses a HAES approach or not, your health providers should always treat you with respect and address your personal health and wellbeing.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/234376/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/clare-collins-7316">Clare Collins</a>, Laureate Professor in Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/erin-clarke-1314081">Erin Clarke</a>, Postdoctoral Researcher, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>; <a href="https://theconversation.com/profiles/jordan-stanford-1631336">Jordan Stanford</a>, Post Doctorate Fellow, Nutrition and Dietetics, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a>, and <a href="https://theconversation.com/profiles/maria-gomez-martin-1218567">María Gómez Martín</a>, Dietitian and early career researcher, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-health-at-every-size-lifestyle-counselling-how-does-it-compare-with-weight-focused-treatments-234376">original article</a>. </div>

Body

What the government’s home care changes mean for ageing Australians

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> The Albanese government has this week announced it will introduce one of the <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">largest reforms</a> to Australia’s aged-care sector to date. The package includes a A$4.3 billion investment in home care, now called “<a href="https://www.health.gov.au/our-work/support-at-home">Support at Home</a>”, to come into effect from July 2025. This reflects both the desire of many people to remain living at home as they age, and the government’s desire to reduce the costs of residential aged care. So what changes is the government making to home care packages? And what will these changes mean for ageing Australians? <h2>Reducing waiting times</h2> One of the major complaints about the current home care system is the long waiting times. Estimates suggest there’s a <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">6–to-12-month wait</a> for the higher level 3 and 4 home care packages. For people with the highest needs, this is far too long. As of March this year, around <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">45,000 people</a> were waiting for any level of home care. An additional 14,000 were already receiving a package, but on a lower level of home care than they were entitled to. With additional funding, the new system will <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">support more participants</a>. It aims to shorten wait times to <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">an average of three months</a> from July 2027. <h2>Changes to services</h2> The new system will replace the current four levels of home care packages with <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">eight classifications</a> of funding for services. When participants are assessed, they will be assigned the most suitable category. There’s currently very limited information on what these classifications are, but the idea is they will provide more targeted services. A number of short-term supports will also be available. These include assistive technology (such as mobility aids) and home modifications. Some people will be able to access 12 weeks of restorative care – a more intensive program designed to build function after injury or illness – as well as palliative care support. The way different types of services are subsidised is also changing. Previously, the same means-tested co-contribution applied regardless of the type of service. Under the new system, services are categorised into clinical care (for example, physiotherapy or wound care), independence (such as help with bathing or cooking) and everyday living (for example, gardening or home maintenance). The new reforms fully subsidise clinical services regardless of income, whereas independence and everyday living services will attract co-contributions based on means testing. For example, <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-support-at-home.pdf">a self-funded retiree</a> would pay nothing out of pocket for physiotherapy, but would pay 50% for help with showering and 80% towards gardening costs. A full pensioner would also pay nothing for physiotherapy, but pay 5% for help with showering and 17.5% of the cost of gardening. This is a positive change. Our research has previously highlighted a tendency for people with home care packages to choose everyday living services <a href="https://onlinelibrary.wiley.com/doi/full/10.1155/2023/4157055">such as gardening</a> and cleaning and refuse clinical care such as allied health and nursing as these types of services were more expensive. These changes should make older people more likely to choose allied health and clinical care services, which will help them maintain their function and stay fitter for longer. <h2>Some challenges</h2> For the government’s reforms to deliver faster and better support at home, a number of issues need to be addressed. As people stay at home for longer, we also see that these <a href="https://academic.oup.com/ageing/article/52/5/afad058/7147101">people are frailer</a> and have more health conditions than in the past. This requires a different and more highly skilled home care workforce. The current <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">home care workforce</a> consists largely of personal care and domestic support workers alongside a much smaller skilled workforce of registered nurses and allied health professionals. But with the changing profile of people receiving care at home, there will need to be a greater focus on maintaining functional capacity. This might mean more allied health input will be required, such as from physiotherapists and occupational therapists. It’s difficult to source an appropriately skilled workforce across the sector, and almost impossible in <a href="https://www.ruralhealth.org.au/sites/default/files/publications/fact-sheet-allied-health.pdf">rural and remote areas</a>. Alternative models, such as training personal care workers to act as allied health assistants, and effectively using technology such as telehealth, will be necessary to meet demand without compromising on quality of care. One example of the need for upskilling in specific areas relates to caring for people with dementia. The majority of people who are living with dementia at home receive care from family carers, supported by home care workers. It’s vital that these care workers have adequate knowledge and skills specific to dementia. However, research has shown the home care workforce may <a href="https://pubmed.ncbi.nlm.nih.gov/31646701/">lack the knowledge and skills</a> to provide best-practice care for people living with dementia. Specialised <a href="https://onlinelibrary.wiley.com/doi/10.1002/gps.6140">dementia training</a> for home care workers is effective in improving knowledge, attitudes and sense of competence in providing care. It should be rolled out across the sector. <h2>What about unpaid care at home?</h2> Unpaid carers, such as family members, provide <a href="https://www.pmc.gov.au/resources/draft-national-strategy-care-and-support-economy/goal-1-quality-care-and-support/support-for-informal-carers">significant amounts of care</a> for older people. The value of this unpaid care is estimated to be in the billions. As older people stay at home for longer, this is set to increase even further. However, carers with high care burdens are particularly vulnerable to <a href="https://www.sciencedirect.com/science/article/pii/S2352827316300283#s0025">poor physical and mental health</a>. Without adequate support, we may find extra caring pressures lead to a breakdown in caring relationships and an increase in other health-care costs for both the carer and care recipient. So we need to ensure carers have adequate financial, psychological and practical support. But the currently available detail on the reforms doesn’t indicate this has been adequately addressed. With careful implementation and ongoing evaluation, these reforms have the potential to significantly enhance the home care system. However, their success will depend on addressing workforce challenges, ensuring adequate support for unpaid carers, and maintaining a focus on the holistic needs of older Australians. More information about Support at Home is <a href="https://www.health.gov.au/our-work/support-at-home/about">available online</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/238890/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, Executive Director, National Ageing Research Institute; Professor, Centre for Health Services Research, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, Director Clinical Gerontology & Senior Principal Research Fellow, National Ageing Research Institute, <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/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">original article</a>. </div>

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What causes food cravings? And what can we do about them?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/gabrielle-weidemann-91497">Gabrielle Weidemann</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/justin-mahlberg-1634725">Justin Mahlberg</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard? High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928395/">activate</a> the brain’s reward system because in the past they were <a href="https://doi.org/10.1037/a0030684">rare</a>. Now, they’re all around us. In wealthy modern societies we are bombarded by <a href="https://theconversation.com/junk-food-is-promoted-online-to-appeal-to-kids-and-target-young-men-our-study-shows-234285">advertising</a> which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering <a href="https://doi.org/10.1111/obr.12354">an intense urge</a> to eat them. Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods. <h2>What causes cravings?</h2> A food craving is an intense desire or urge to eat something, <a href="https://pubmed.ncbi.nlm.nih.gov/15589112/">often focused on a particular food</a>. We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt. Something that <a href="https://doi.org/10.1111/obr.12354">reminds us</a> of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to <a href="https://doi.org/10.1111/obr.12354">crave it</a>. The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control. <h2>What else influences our choices?</h2> While the effect of cues on our physical response is relatively automatic, what we do next is influenced by <a href="https://journals.sagepub.com/doi/pdf/10.1177/1090198107303308">complex</a> factors. Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals. But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the <a href="https://doi.org/10.1016/j.physbeh.2010.04.029">pleasure of eating</a>, over one that’s delayed or abstract – including health goals that will make us feel good in the long term. <a href="https://doi.org/10.1016/S0022-3999(00)00076-3">Stress</a> can also make us eat more. When hungry, we <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656885/">choose larger portions</a>, underestimate calories and find eating more <a href="https://www.sciencedirect.com/science/article/pii/S0195666315000793">rewarding</a>. <h2>Looking for something salty or sweet</h2> So what if a cue prompts us to look for a certain food, but it’s not available? <a href="https://doi.org/10.1016/j.appet.2014.04.005">Previous research</a> suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol. But our <a href="https://doi.org/10.1016/j.appet.2024.107640">new research</a> has confirmed something you probably knew: it’s more specific than that. If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy. <h2>Food cues and mindless eating</h2> Your <a href="https://core.ac.uk/download/pdf/161283824.pdf">eating history</a> and <a href="https://doi.org/10.1002/eat.24179">genetics</a> can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is <a href="https://doi.org/10.1016/j.appet.2015.01.004">hard</a> for almost everyone. Food cues are so powerful they can prompt us to <a href="https://doi.org/10.1177/0956797613484043">seek</a> out a certain food, even if we’re not overcome by a particularly <a href="https://doi.org/10.1177/0956797613484043">strong urge</a> to eat it. The effect is more intense if the food is easily available. This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we <a href="https://doi.org/10.1016/0031-9384(81)90310-3">eat</a>. Sometimes we use finishing the packet as the signal to stop <a href="https://doi.org/10.1016/j.physbeh.2015.03.025">eating</a> rather than hunger or desire. <h2>Is there anything I can do to resist cravings?</h2> We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in. <ul> <li> Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit. </li> <li> Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle. </li> <li> At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment. </li> <li> Make sure your goals for eating are <a href="https://www.aafp.org/pubs/fpm/issues/2018/0300/p31.html">SMART</a>. This means they are specific, measurable, achievable, relevant and time-bound. </li> <li> Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.<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/237035/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/gabrielle-weidemann-91497">Gabrielle Weidemann</a>, Associate Professor in Psychological Science, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/justin-mahlberg-1634725">Justin Mahlberg</a>, Research Fellow, Pyschology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-causes-food-cravings-and-what-can-we-do-about-them-237035">original article</a>. </div>

Food & Wine

Readers response: What’s your most memorable birthday party?

One of the best parts of birthdays is celebrating with your loved ones, whether it's a milestone birthday or not. We asked our readers to share the stories from their most memorable birthday parties, and the response was overwhelming. Here's what they said. Jill Harker - My 80th birthday last November! My family organised it! Had no idea who was coming! I'm a big Elvis fan and when I got to the hotel for lunch everybody was holding up an Elvis face in front of their face so I still had no idea who was there! When they took the faces down there were all my family from Queensland including grandchildren and great grandchildren! Plus my 2 sons organised a birthday video message from Tex Walker my favourite footballer! Plus my granddaughter organised a ride in a Cadillac for me! So many wonderful surprises! It was fantastic! Judi Baker - My 21st. My Mum and Dad were there. Plus my late Mum's 70th and 80th. Both so funny. Annette Guernier Clay - In 2007 when two good friends and I celebrated our 60th birthdays with a party at the old Cairns Yacht Club. Live band, lots of dancing, loads of friends. Lesley Peacock - My 21st, as it was the only one I had. Christine Whyte - Never had children’s birthday party as mine was always with immediate family, but had a memorable 70th last year with my family and 3 grandkids in Townsville. Barbara Jaramenko - Didn’t have one as there was no money, but just had a homemade birthday cake with siblings which was lovely. Margie Buckingham - On my 40th, I was a single mum and I held a combined party- my 40th, end of 3rd term (teacher) & taking leave service leave, the Parliamentary election & going overseas! I took a cruise from Singapore for a week, beginning with a Singapore Gin Sling in the Long Bar at the Raffles Hotel. that was pretty memorable. <div dir="auto">Image credits: Shutterstock </div>

Family & Pets

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

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

Body

The Princess of Wales wants to stay cancer-free. What does this mean?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>; <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>, and <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a> Catherine, Princess of Wales, <a href="https://www.theguardian.com/uk-news/article/2024/sep/09/princess-of-wales-cancer-free-after-completing-chemotherapy">has announced</a> she has now completed a course of preventive chemotherapy. The news comes nine months after the princess first <a href="https://www.bbc.com/news/uk-68641441">revealed</a> she was being treated for an unspecified form of cancer. In the new <a href="https://www.youtube.com/watch?v=QSrDEq8QFkc">video message</a> released by Kensington Palace, Princess Catherine says she’s focused on doing what she can to stay “cancer-free”. She acknowledges her cancer journey is not over and the “path to recovery and healing is long”. While we don’t know the details of the princess’s cancer or treatment, it raises some questions about how we declare someone fully clear of the disease. So what does being – and staying – “cancer-free” mean? <h2>What’s the difference between being cancer-free and in remission?</h2> Medically, “cancer-free” <a href="https://www.mdanderson.org/cancerwise/remission--cancer-free--no-evidence-of-disease--what-is-the-difference-when-talking-about-cancer-treatment-effectiveness-and-results.h00-159460845.html">means</a> two things. First, it means no cancer cells are able to be detected in a patient’s body using the available testing methods. Second, there is no cancer left in the patient. These might sound basically the same. But this second aspect of “cancer-free” can be complicated, as it’s essentially impossible to be sure no cancer cells have survived a treatment. It only takes a few surviving cells for the cancer to <a href="https://theconversation.com/how-does-cancer-spread-to-other-parts-of-the-body-219616">grow back</a>. But these cells may not be detectable via testing, and can lie dormant for some time. The possibility of some cells still surviving means it is more accurate to say a patient is “in remission”, rather than “cancer-free”. Remission means there is no detectable cancer left. Once a patient has been in remission for a certain period of time, they are often considered to be fully “cancer-free”. Princess Catherine was not necessarily speaking in the strict medical sense. Nonetheless, she is clearly signalling a promising step in her recovery. <h2>What happens during remission?</h2> During remission, patients will usually undergo surveillance testing to make sure their cancer hasn’t returned. Detection tests can vary greatly depending on both the patient and their cancer type. Many <a href="https://www.cancer.gov/about-cancer/screening/screening-tests">tests</a> involve simply looking at different organs to see if there are cancer cells present, but at varying levels of complexity. Some cancers can be detected with the naked eye, such as skin cancers. In other cases, technology is needed: colonoscopies for colorectal cancers, X-ray mammograms for breast cancers, or CT scans for lung cancers. There are also molecular tests, which test for the presence of cancer cells using protein or DNA from blood or tissue samples. For most patients, testing will continue for years at regular intervals. Surveillance testing ensures any returning cancer is caught early, giving patients the best chance of successful treatment. Remaining in remission for five years can be a huge milestone in a patient’s cancer journey. For most types of cancer, the <a href="https://pubmed.ncbi.nlm.nih.gov/31231898/">chances of cancer returning</a> drop significantly after five years of remission. After this point, surveillance testing may be performed less frequently, as the patients might be deemed to be at a lower risk of their cancer returning. <h2>Measuring survival rates</h2> Because it is very difficult to tell when a cancer is “cured”, clinicians may instead refer to a “five-year survival rate”. This measures how likely a cancer patient is to be alive five years after their diagnosis. For example, data shows the <a href="https://ncci.canceraustralia.gov.au/outcomes/relative-survival-rate/5-year-relative-survival-diagnosis">five-year survival rate</a> for <a href="https://cancer.org.au/cancer-information/types-of-cancer/bowel-cancer">bowel cancer</a> among Australian women (of all ages) is around 70%. That means if you had 100 patients with bowel cancer, after five years you would expect 70 to still be alive and 30 to have succumbed to the disease. These statistics can’t tell us much about individual cases. But comparing five-year survival rates between large groups of patients after different cancer treatments can help clinicians make the often complex decisions about how best to treat their patients. The likelihood of cancer coming back, or recurring, is influenced by many factors which can vary over time. For instance, approximately 30% of people with lung cancer <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061059/">develop a recurrent disease</a>, even after treatment. On the other hand, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933127/">breast cancer recurrence</a> within two years of the initial diagnosis is approximately 15%. Within five years it drops to 10%. After ten, it falls below 2%. These are generalisations though – recurrence rates can vary greatly depending on things such as what kind of cancer the patient has, how advanced it is, and whether it has spread. <h2>Staying cancer-free</h2> Princess Catherine <a href="https://www.theguardian.com/uk-news/article/2024/sep/09/princess-of-wales-cancer-free-after-completing-chemotherapy">says</a> her focus now is to “stay cancer-free”. What might this involve? How a cancer develops and whether it recurs can be <a href="https://nature.com/articles/s41467-018-05467-z">influenced</a> by things we can’t control, such as age, ethnicity, gender, genetics and hormones. However, there are sometimes <a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/substances">environmental factors</a> we can control. That includes things like exposure to UV radiation from the sun, or inhaling carcinogens like tobacco. Lifestyle factors also play a role. Poor diet and nutrition, a lack of exercise and excessive alcohol consumption can all <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925935">contribute to cancer development</a>. Research estimates more than half of all cancers could <a href="https://www.canceraustralia.gov.au/resources/position-statements/lifestyle-risk-factors-and-primary-prevention-cancer/recommendations">potentially be prevented</a> through <a href="https://www.health.gov.au/topics/cancer/screening-for-cancer">regular screening</a> and maintaining a healthy lifestyle (not to mention preventing other chronic conditions such as heart disease and diabetes). Recommendations to reduce cancer risk are the same for everyone, not just those who’ve had treatment like Princess Catherine. They include not smoking, eating a nutritious and balanced diet, exercising regularly, cutting down on alcohol and staying sun smart.<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/238681/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/amali-cooray-1482458">Amali Cooray</a>, PhD Candidate in Genetic Engineering and Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>; <a href="https://theconversation.com/profiles/john-eddie-la-marca-1503690">John (Eddie) La Marca</a>, Senior Research Officer, Blood Cells and Blood Cancer, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research) </a>, and <a href="https://theconversation.com/profiles/sarah-diepstraten-1495268">Sarah Diepstraten</a>, Senior Research Officer, Blood Cells and Blood Cancer Division, <a href="https://theconversation.com/institutions/wehi-walter-and-eliza-hall-institute-of-medical-research-822">WEHI (Walter and Eliza Hall Institute of Medical Research)</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-princess-of-wales-wants-to-stay-cancer-free-what-does-this-mean-238681">original article</a>. </div>

Caring

Pay-by-weight airfares are an ethical minefield. We asked travellers what they actually think

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/denis-tolkach-11345">Denis Tolkach</a>, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/stephen-pratt-335188">Stephen Pratt</a>, <a href="https://theconversation.com/institutions/university-of-central-florida-1925">University of Central Florida</a> Imagine checking in for a flight with your two teenage children. At the counter, you are told that your youngest teenager’s suitcase is two kilograms over the limit. You get slapped with a $75 penalty for their excess luggage. This penalty feels arbitrary and unfair. The youngest weighs about 45 kg, and their luggage weighs 25 kg, making their total payload on the flight 70 kg. Their older sibling, on the other hand, weighs 65 kg, and has brought 23 kg of luggage to check in. Their total weight is higher – 88 kg – yet they receive no penalty. Obviously, things aren’t that simple. Charging passengers based on their weight is highly controversial for many reasons. But that hasn’t stopped some airlines <a href="https://theweek.com/articles/466035/should-airlines-charge-passengers-by-weight">experimenting</a> with such policies. Imagine checking in for your flight only to have the staff tell you to <a href="https://edition.cnn.com/travel/article/plus-size-travelers-slam-airline-seat-policies/index.html">purchase an extra seat</a> as you are a plus-size passenger. You feel discriminated against because you are using the same service as other passengers and your weight is beyond your control. But despite the lived experience of many and hot debate in the media, there has not been a formal study into what passengers themselves think about this matter. Our recently published <a href="https://doi.org/10.1002/jtr.2691">research</a> examined air passengers’ views on alternative airfare policies to understand whether the public finds them acceptable and what ethical considerations determine their views. Though we found a range of ethical contradictions, most travellers were guided by self-interest. <h2>A controversial but important topic</h2> The issue of whether airlines should weigh passengers is an ethical minefield with no easy answers. Despite its sensitivity, the aviation industry can’t ignore passenger weight. Airlines intermittently undertake <a href="https://www.forbes.com/sites/marisagarcia/2024/02/11/despite-backlash-heres-why-airlines-need-to-weigh-passengers/?sh=5f07623e1bfa">passenger weight surveys</a> as they need to accurately calculate payload to ensure flight safety and estimate fuel consumption. The evidence shows passengers are <a href="https://www.forbes.com/sites/marisagarcia/2024/02/11/despite-backlash-heres-why-airlines-need-to-weigh-passengers/?sh=5f07623e1bfa">getting heavier</a>. Airlines including the now-defunct <a href="https://theweek.com/articles/466035/should-airlines-charge-passengers-by-weight">Samoa Air</a> and <a href="https://www.theguardian.com/us-news/2016/oct/23/hawaiian-airlines-american-samoa-weight-passengers">Hawaiian Airlines</a> have taken things one step further and experimented with weighing passengers regularly. Samoa Air, for example, became the first airline to introduce a “pay-as-you-weigh” policy, where the cost of your ticket was directly proportional to the combined weight of you and your luggage. In contrast, Canada has now long had a “<a href="https://otc-cta.gc.ca/eng/publication/additional-seating-and-one-person-one-fare-requirement-domestic-travel-a-guide">one person, one fare</a>” policy. It is prohibited and deemed discriminatory to force passengers living with a disability to purchase a second seat for themselves if they require one, including those with functional disability due to obesity. To complicate matters further, the issue of passenger and luggage weight is not only ethical and financial, but also environmental. More weight on an aircraft leads to more jet fuel being burned and more carbon emissions. About <a href="https://www.nature.com/articles/s41467-021-24091-y">5%</a> of human-driven climate change can be attributed to aviation, and the industry faces enormous pressure to reduce fuel consumption while it waits for low carbon substitutes to become available. <h2>What do passengers actually think?</h2> To get a better sense of how the public actually feels about this issue, we surveyed 1,012 US travellers of different weights, presenting them with three alternatives: <ul> <li>standard policy – currently the most widely used policy with passengers paying a standard price, irrespective of their weight</li> <li>threshold policy – passengers are penalised if they are over a threshold weight</li> <li>unit of body weight policy – passengers pay a personalised price based on their own body weight, per each pound.</li> </ul> The standard policy was the most acceptable for participants of differing weight, although the heavier the passenger, the more they preferred the standard policy. This can be partially explained by status quo bias. Generally, people are likely to choose a familiar answer. The threshold policy was the least acceptable. This policy was seen to violate established social norms and be generally less fair. The unit of body weight policy was preferred to the threshold policy, although participants raised concerns about whether it would be accepted by society. Perhaps unsurprisingly, we found that self-interest played a clear role in determining whether respondents considered a policy acceptable. Younger, male, financially well-off travellers with lower personal weight generally found the alternative policies more acceptable. <h2>An ethical conflict</h2> Alternative airfare policies that are based on passenger weight bring environmental and ethical concerns into conflict. Obviously, the effect isn’t from any one traveller, in particular, but averages over the entire industry. Interestingly, respondents that were more concerned about the environment – “ecocentric” – preferred air fare policies that would reduce the carbon emissions. This made them more open to the controversial alternatives. While the threshold policy was clearly rejected by many respondents as discriminatory, environmental concern played a role in the level of acceptance of the unit of body weight policy. It’s important to apply a critical lens here. These ecocentric travellers were also generally younger and had lower personal weights, so many would benefit from the alternative policies financially. For policymakers overall, our study suggests when it comes to controversial ticketing policies, the public is more likely to be swayed by self-interest than anything else.<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/237856/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/denis-tolkach-11345">Denis Tolkach</a>, Senior Lecturer, <a href="https://theconversation.com/institutions/james-cook-university-1167">James Cook University</a> and <a href="https://theconversation.com/profiles/stephen-pratt-335188">Stephen Pratt</a>, Professor, <a href="https://theconversation.com/institutions/university-of-central-florida-1925">University of Central Florida</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/pay-by-weight-airfares-are-an-ethical-minefield-we-asked-travellers-what-they-actually-think-237856">original article</a>. </div>

Travel Trouble

Surcharges are added to most purchases, but what are the rules behind these extra fees?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/steve-worthington-138">Steve Worthington</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> You head to the register at the cafe to pay for your lunch, swipe your card and suddenly realise you’ve been hit with an extra small but unexpected charge. It might be listed on your receipt as a service or merchant fee, but either way it’s because you’ve used a credit or debit card. With the pandemic accelerating the use of cards instead of cash – <a href="https://www.rba.gov.au/publications/bulletin/2023/jun/cash-use-and-attitudes-in-australia.html#:%7E:text=Cash%20payments,-The%20CPS%20suggests&text=In%20value%20terms%2C%20the%20cash,cent%20by%20value%20in%202022.">only 13% of Australians use cash</a>, dropping from 27% in the last five years – these extra charges have become mainstream. However, as was highlighted by National Australia Bank chief executive Andrew Irvine during a <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Corporations_and_Financial_Services/FinancialAbuse">parliamentary inquiry</a> into bank charges last week, they are often applied, in varying amounts, by businesses for reasons not always in line with their original purpose. Irvine slammed as <a href="https://www.afr.com/companies/financial-services/credit-card-surcharges-should-be-banned-or-regulated-nab-boss-says-20240830-p5k6jm">“outrageous”</a> a 10% surcharge he was forced to pay when he recently bought a cup of coffee at a Sydney cafe. “I don’t like the lack of transparency and lack of consistency,” he said. But most Australians are making these extra payments every day, without question. So how did this end up happening – and what can you do about it? <h2>Card surcharges in Australia</h2> At the start of this century, payments for goods and services were mainly made by cash, paper cheques, credit and debit cards. The first two of these options would eventually be deposited into a bank account by the merchant who ran the business. The latter two would be processed by the bank or financial institution which would charge the business a merchant service fee. For debit cards this might be a fixed fee. But for credit cards it would be proportionate with the value of the goods or services. The Reserve Bank of Australia became concerned the use of credit cards was greater than that of debit cards and <a href="https://www.rba.gov.au/publications/consultations/201106-review-card-surcharging/background.html">introduced surcharging in January 2003</a>. The intention was to lower the cost to the merchant of accepting debit cards and change customer behaviour. This has been achieved, as both the volume and value of paying by debit cards now exceeds the volume and value of paying by credit cards. However, the reality in 2024 is that card surcharges have become commonplace, and in a wide variety of payment situations. <h2>It’s estimated to cost us billions</h2> It is difficult to calculate the total cost of surcharging to Australian consumers since they became legal more than 20 years ago, because the rates charged vary widely. But at last week’s inquiry, Labor MP Jerome Laxale suggested it added up to <a href="https://www.smh.com.au/money/banking/card-surcharges-are-costing-us-billions-but-can-they-be-avoided-20240830-p5k6o8.html">A$4 billion</a> in the last year. Surcharges can be imposed by small to medium enterprises such as your local cafe, doctor’s surgery, your energy supplier, or when you use a card to pay your council rates. As an example, my rates are payable by card, with a surcharge of 1.10% for Mastercard and Visa credit, and 0.55% for eftpos and Mastercard and Visa debit cards. <h2>When surcharges can be applied</h2> Many merchants charge the same rate for all their card payments and some fail to alert customers to the extra fee before accepting the payment at their terminal, which they are required to do. Indeed, even on a receipt for payment, the surcharge can be described by the merchant as a “handling” or “merchant” fee. The Australian Competition and Consumer Commission <a href="https://www.accc.gov.au/consumers/pricing/card-surcharges">(ACCC)</a> regulates surcharging and demands the merchant prove a surcharge is justified. Furthermore, the ACCC says if there is no way for a consumer to pay without paying a surcharge – that is, they can’t pay by cash or cheque – then the business must include the surcharge in <a href="https://www.accc.gov.au/business/pricing/price-displays#toc-display-of-surcharges">the displayed price</a>. <h2>Penalties for misuse</h2> The ACCC can take merchants to court to enforce these regulations and there have been some examples of this in recent history. In July 2021, <a href="https://www.accc.gov.au/media-release/nine-entertainment-pays-penalties-for-alleged-excessive-payment-surcharges#:%7E:text=The%20ACCC%20alleged%20that%20these,Deputy%20Chair%20Mick%20Keogh%20said.">Nine Entertainment paid penalties totalling $159,840</a>, plus $450,000 redressing customers, for charging subscribers and advertisers excessive surcharges. The ACCC specifies that the surcharge must not be more than it costs the merchant to use that payment type. As guidance to the merchants, it also offers <a href="https://www.accc.gov.au/consumers/pricing/card-surcharges">the average costs for different payment types</a>: eftpos less than 0.5%, Mastercard and Visa Debit 0.5%–1% and Mastercard and Visa credit 1%–1.5%. However, despite the ACCC setting guidelines for the amounts that can be charged, many surcharges are above this guidance and in some cases more than 2.0% for all cards. Some merchants do charge different surcharging rates, depending on the cards they accept, be it eftpos, Mastercard or Visa. In theory, the surcharge rate is meant to be determined by the merchant service fee, which is negotiated between the merchant and their bank. Larger merchants, such as the supermarkets, department stores and energy companies, can negotiate low rates (reportedly as low as one cent a transaction). But smaller merchants with less negotiating clout will have higher service fees. The arrival of new payment players, such as <a href="https://www.forbes.com/advisor/business/software/square-vs-stripe/">Square and Stripe</a>, has offered businesses an alternative banker of card payments, which can then use surcharging as part of their merchant service fees. <h2>Surcharging overseas</h2> The <a href="https://europa.eu/youreurope/business/finance-funding/making-receiving-payments/electronic-cash-payments/index_en.htm">European Union</a> already has a long-standing ban on surcharging, while in the United States, surcharging is illegal in some states. Other countries, including the United Kingdom, have tried surcharging on card payments, only to abandon them as it was rorted by some merchants and became an unnecessary expense for consumers. <a href="https://bluenotes.anz.com/posts/2023/07/anz-news-surcharge-steve-worthington-australia#:%7E:text=In%202018%20the%20UK%20Treasury,their%20hard%2Dearned%20money%E2%80%9D.">A statement</a> released by the UK Treasury when it banned the practice in 2018 described surcharges as <blockquote> Hidden charges for paying with a debit or credit card, which will help millions of UK consumers to avoid rip-off fees when spending their hard earned money. </blockquote> <h2>What can you do about it?</h2> Before surcharging was allowed by the Reserve Bank in January 2003, acceptance by merchants of payments was just another cost of doing business. And it seems many consumers have just accepted surcharges as part of their transactions. There are ways to avoid them, the most obvious being to use cash. Using eftpos involves charges, but they are less than those imposed on credit and debit cards. The Reserve Bank is working on implementing a so-called <a href="https://www.rba.gov.au/payments-and-infrastructure/debit-cards/least-cost-routing/#:%7E:text=What%20is%20least%2Dcost%20routing,'merchant%2Dchoice%20routing'.">“least-cost routing”</a> system that defaults to the lowest cost network when processing payments. Unfortunately, this is yet to be widely adopted by businesses.<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/237964/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steve-worthington-138">Steve Worthington</a>, Adjunct Professor, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/surcharges-are-added-to-most-purchases-but-what-are-the-rules-behind-these-extra-fees-237964">original article</a>. </div>

Money & Banking

Readers response: What airline will you always prefer to travel with?

When it comes to travelling, many people have their preferences of their favourite airline after past good experiences. Many seasoned travellers always opt to fly with their preferred airline (when it's possible), instead of running the risk of an uncomfortable experience. We asked our readers which airline they will always prefer to travel with, and the response was overwhelming. Here's what they said. Irene Hood - Singapore Airlines. Lovely cabin crew, smooth flights every time. David Slattery - Had quite a few nice flights with Turkish, both short and long haul. Sue Packer - Just came back from Europe with Emirates, great service, great food and the plane left on time! Rick Kehoe - Qantas if available. I have never had a bad flight experience after many flights both domestic and international. Anita Thornton - Finnair is a great airline! Diane Green - For overseas travel, Japan airlines gave the best service. For domestic, Virgin. George Jan Cafcakis - Qatar! It’s definitely the best. Russell Campbell - Singapore, but I just travelled on Vietnam Airlines and they were also good. Goldie Kilford - Air New Zealand for sure. Peter King - Safety: Qantas. Service: Qatar. On time: Lufthansa & Swiss. Friendly Crews: Fiji Air and Air New Zealand. Best Cattle Class Seat Pitches: All Nippon, Korean, Japan. Worst Airline: Jetstar! Image credits: Shutterstock

Travel Tips

What’s a recession – and how can we tell if we’re in one?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/leonora-risse-405312">Leonora Risse</a>, <a href="https://theconversation.com/institutions/university-of-canberra-865">University of Canberra</a> Today’s <a href="https://www.abs.gov.au/statistics/economy/national-accounts/australian-national-accounts-national-income-expenditure-and-product/latest-release">economic data</a> shows that, outside of the pandemic, the Australian economy has slowed down to its lowest annual rate of growth since the early-1990s recession. That’s prompting the dreaded question: are we headed for another one? Any mention of the “R” word can trigger anxiety. Recessions bring job losses and financial strain, and put serious pressure on people’s mental health. These impacts can be especially severe for people who are already experiencing disadvantage and vulnerabilities. But what exactly does it mean to be in a recession? What are the different ways we define them? And are these current approaches the best way to measure people’s economic pain? <h2>What’s a recession?</h2> A bit like the waves of the ocean, our economy is characterised by ebbs and flows in overall activity. Spending and business growth can swell during times of confidence, but slow down when optimism deflates or the economy is hit by an unexpected shock such as a pandemic or climate disaster. This pattern is what economists describe as “the business cycle”. Most of the time, our economy is constantly growing, even if the pace varies. Conventionally, we measure this pace by tracking changes in the level of <a href="https://www.rba.gov.au/education/resources/explainers/economic-growth.html">gross domestic product</a> (GDP) – the overall volume of items and services being produced, bought and sold in the economy. The <a href="https://www.abs.gov.au/statistics/economy/national-accounts/australian-national-accounts-national-income-expenditure-and-product/jun-2024">latest economic growth rates</a> of 0.2% for the June quarter, and 1% over the past year, tell us that the Australian economy is still growing, even if at a slower pace than previous years. Occasionally, the economy slows down to such a grind that economic activity, from one quarter to the next, shrinks. When this happens, the GDP measurements come out negative. When we have two negative measurements of GDP in a row, this is defined as a <a href="https://www.rba.gov.au/education/resources/explainers/recession.html">technical recession</a>. This is what happened to most countries around the globe during the COVID-19 pandemic. Prior to the pandemic, Australia hadn’t experienced a technical recession since 1991. The latest figures tell us Australia is staying afloat for now. But that doesn’t mean it doesn’t feel like a recession to many people. Some other metrics show why. <h2>Other measures of recession</h2> Growth in economic activity is fuelled, in part, by a growing population. Dividing total economic output by the population size, GDP per capita can offer a more accurate picture of people’s economic reality. This population-adjusted measure of economic growth has long fallen into negative territory. Today’s figures tell us that Australia’s GDP per person has been shrinking for 18 months. Our annual per capita growth rate is now -1.5%. <figure class="align-right zoomable"></figure> In the United States, recessions are measured differently again. Recessions are officially declared by the National Bureau of Economic Research (<a href="https://www.nber.org/research/business-cycle-dating">NBER</a>). Unlike technical recessions, these aren’t based on a simple rule. NBER considers a range of measures beyond GDP – including personal income, employment, personal consumption, wholesale and retail sales, and industrial production across multiple sectors – when deciding whether to declare a US recession. <h2>Is Australia heading for a recession?</h2> This is a challenging question to answer because the GDP figures economists conventionally use to diagnose the situation only come to light after a recession hits. Today’s economic figures from the ABS are for the June 2024 quarter – now more than two months old. Measurements of the current economic climate won’t come through in official statistics for some time. If it occurs, by the time a recession is officially diagnosed, we’re usually well and truly in it. A similar limitation applies to the retrospective approach of the <a href="https://www.nber.org/research/business-cycle-dating">NBER</a>, which “waits until it is confident that a recession has occurred”. It’s like a weather forecaster declaring a cyclone has hit only after the wind gusts have blown your roof away. But we can use other metrics to alert ourselves to recession risks before the eye of the storm hits. <h2>Using jobs numbers as a recession alert</h2> One approach is the <a href="https://fred.stlouisfed.org/series/SAHMCURRENT">Sahm Rule</a>, named after its creator, US economist Claudia Sahm. By analysing patterns in the monthly unemployment data that preceded past recessions, Sahm devised a <a href="https://stayathomemacro.substack.com/p/the-sahm-rule-step-by-step">formula</a> to detect when increases in the current unemployment rate were rapid enough to pose a recession risk. The advantage of this approach is that unemployment statistics come out more quickly and frequently than GDP numbers. Many would also argue that monitoring unemployment, rather than GDP, is a more meaningful metric to reflect people’s everyday experiences of the economy and wellbeing. The Sahm approach tracks how quickly the national unemployment rate is currently rising compared to the past year. It’s calculated by comparing the current three-month moving average of the national unemployment rate to this figure’s lowest value in the previous 12 months. This “moving average” approach smooths out the bumpiness of monthly figures. A jump of 0.5% or more signals the economy’s current pattern is on the cusp of recession. While the Sahm formula was developed for the US economy, it does a fairly good job of waving a red flag where recessions previously occurred in the Australian economy, too. Australia’s latest unemployment rate – inching up to 4.2% in July 2024 – pushed the Sahm value up to 0.5%. <iframe id="3d239" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/3d239/5/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> This indicator doesn’t necessarily mean that a recession will occur. But it suggests policymakers should be on high alert. The Sahm indicator also validates the experiences of job seekers who – despite official definitions that the economy is not in recession – are personally feeling the pressures of a slowing economy and shrinking job opportunities. As our approaches to measuring and managing the ups and downs of the economy continue to evolve, these people-centred metrics are an increasingly important part of our toolkit.<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/238199/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/leonora-risse-405312">Leonora Risse</a>, Associate Professor in Economics, <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/whats-a-recession-and-how-can-we-tell-if-were-in-one-238199">original article</a>. </div>

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