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What is ‘doll therapy’ for people with dementia? And is it backed by science?

<a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> The way people living with dementia <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-changes-perception">experience the world</a> can change as the disease progresses. Their sense of reality or place in time can become distorted, which can cause <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/restlessness">agitation and distress</a>. One of the best ways to support people experiencing changes in perception and behaviour is to <a href="https://www.dementia.org.au/professionals/designing-dementia-friendly-care-environments">manage their environment</a>. This can have profound benefits including <a href="https://www.agedcarequality.gov.au/resource-library/reducing-use-sedatives-aged-care-video">reducing the need for sedatives</a>. One such strategy is the use of dolls as comfort aids. <h2>What is ‘doll therapy’?</h2> More appropriately referred to as “<a href="https://www.dementia.com.au/resource-hub/the-use-of-dolls-in-dementia-care">child representation</a>”, lifelike dolls (also known as empathy dolls) can provide comfort for some people with dementia. Memories from the <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/memory-loss#:%7E:text=Older%20memories%20%E2%80%93%20which%20have%20been,detailed%20memories%20from%20earlier%20life.">distant past</a> are often more salient than more recent events in dementia. This means that past experiences of parenthood and caring for young children may feel more “real” to a person with dementia than where they are now. <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/hallucinations#:%7E:text=Visual%20hallucinations%20are%20more%20common,hallucinating%20and%20how%20others%20respond.">Hallucinations or delusions</a> may also occur, where a person hears a baby crying or fears they have lost their baby. Providing a doll can be a tangible way of reducing distress without invalidating the experience of the person with dementia. <h2>Some people believe the doll is real</h2> A recent case involving <a href="https://www.theguardian.com/australia-news/2024/nov/06/deplorable-nurse-slammed-therapy-doll-dementia-patient-believed-was-real-baby-on-table-nsw-tribunal-hears">an aged care nurse mistreating a dementia patient’s therapy doll</a> highlights the importance of appropriate training and support for care workers in this area. For those who do become attached to a therapeutic doll, they will treat the doll as a real baby needing care and may therefore have a profound emotional response if the doll is mishandled. It’s important to be guided by the person with dementia and only act as if it’s a real baby if the person themselves believes that is the case. <h2>What does the evidence say about their use?</h2> Evidence shows the use of empathy dolls may help <a href="https://www.sciencedirect.com/science/article/pii/S0197457223002677">reduce agitation and anxiety</a> and <a href="https://www.mdpi.com/2039-4403/14/4/200">improve overall quality of life</a> in people living with dementia. Child representation therapy falls under the banner of <a href="https://www.sciencedirect.com/science/article/pii/S0149763423004761">non-pharmacological approaches to dementia care</a>. More specifically, the attachment to the doll may act as a form of <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6494367/">reminiscence therapy</a>, which involves using prompts to reconnect with past experiences. Interacting with the dolls may also act as a form of <a href="https://www.health.vic.gov.au/dementia-friendly-environments/sensory-stimulation">sensory stimulation</a>, where the person with dementia may gain comfort from touching and holding the doll. Sensory stimulation may <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.13169?casa_token=ro96fxe2VPoAAAAA%3AKOS10VkTdcrf0yTI_F9p6cI5Kpbj85ZTFq13PQ56YHxi0i3-5BOnFQfW1WFWqiCZ8-mk5sp_EGkGtKM">support emotional well-being and aid commnication</a>. However, not all people living with dementia will respond to an empathy doll. The <a href="https://www.alzheimerswa.org.au/wp-content/uploads/2017/07/2.00-Guidlines-for-Use-of-Dolls-and-Mechanized-Pets-as-a-Therapeutic-Tool-4-pages.pdf">introduction of a therapeutic doll</a> needs to be done in conjunction with careful observation and consideration of the person’s background. Empathy dolls may be inappropriate or less effective for those who have not previously cared for children or who may have experienced past birth trauma or the loss of a child. Be guided by the person with dementia and how they respond to the doll. <h2>Are there downsides?</h2> The approach has <a href="https://pubmed.ncbi.nlm.nih.gov/33125455/">attracted some controversy</a>. It has been suggested that child representation therapy “infantilises” people living with dementia and may increase negative stigma. Further, the attachment may become so strong that the person with dementia will <a href="https://www.dementiauk.org/information-and-support/living-with-dementia/doll-therapy/">become upset if someone else picks the doll up</a>. This may create some difficulties in the presence of grandchildren or when cleaning the doll. The introduction of child representation therapy may also require additional staff training and time. Non-pharmacological interventions such as child representation, however, have been shown to be <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10180718/">cost-effective</a>. <h2>Could robots be the future?</h2> The use of more <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8247474/#:%7E:text=Therefore%2C%20an%20interactive%20baby%20robot,mental%20support%20for%20older%20adults.">interactive empathy dolls</a> and <a href="https://journals.sagepub.com/doi/full/10.1177/14713012231155985">pet-like robots</a> is also gaining popularity. While robots have been shown to be <a href="https://www.sciencedirect.com/science/article/pii/S1568163722000757">feasible and acceptable in dementia care</a>, there remains some contention about their benefits. While some studies have shown <a href="https://academic.oup.com/innovateage/article/5/2/igab013/6249558?login=false">positive outcomes</a>, including reduced agitation, others show <a href="https://www.sciencedirect.com/science/article/pii/S1568163722000757">no improvement</a> in cognition, behaviour or quality of life among people with dementia. Advances in artificial intelligence are also being used to help support people living with dementia and <a href="https://journals.sagepub.com/doi/full/10.1177/1471301221998888">inform</a> the community. <a href="https://feel-lab.org/research_projects/ai-viv-and-friends/">Viv and Friends</a>, for example, are AI companions who appear on a screen and can interact with the person with dementia in real time. The AI character Viv has dementia and was co-created with women living with dementia using verbatim scripts of their words, insights and experiences. While Viv can share her experience of living with dementia, she can also be programmed to talk about common interests, such as gardening. These companions are currently being trialled in some residential aged care facilities and to help educate people on the lived experience of dementia. <h2>How should you respond to your loved one’s empathy doll?</h2> While child representation can be a useful adjunct in dementia care, it requires sensitivity and appropriate consideration of the person’s needs. People living with dementia <a href="https://pubmed.ncbi.nlm.nih.gov/38325063/">may not perceive the social world the same way</a> as a person without dementia. But a person living with dementia is not a child and should never be treated as one. Ensure all family, friends and care workers are <a href="https://www.alzheimerswa.org.au/wp-content/uploads/2017/07/2.00-Guidlines-for-Use-of-Dolls-and-Mechanized-Pets-as-a-Therapeutic-Tool-4-pages.pdf">informed about the attachment to the empathy doll</a> to help avoid unintentionally causing distress from inappropriate handling of the doll. If using an interactive doll, ensure spare batteries are on hand. Finally, it is important to reassess the attachment over time as the person’s response to the empathy doll may change.<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/243589/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> 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-doll-therapy-for-people-with-dementia-and-is-it-backed-by-science-243589">original article</a>.

Mind

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

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

Body

Hospice nurse reveals people's last words before they die

A hospice nurse has revealed the number one thing people say in their final moments before they die. Healthcare expert Julie McFadden, who makes online videos discussing death to help break the taboo around dying, has shared the three most common regrets patients share on their death beds. Speaking to NHS surgeon Dr Karan Rajan on his podcast, Julie said these final discussions tend to centre around what they've taken for granted. "The first one I hear all the time is that they regret not appreciating their health while they had it," Ms McFadden said, reflecting on her 15 years of working in the health sector. "That's the number one thing people say to me, I wish I would have understood how amazing it is to have a working body." The second regret she often hears is people admitting they "worked too much" and wish they hadn't worked their life away, and rather spent time doing things that brought them joy. Finally, she revealed in the clip shared to Instagram, that many dying patients have regrets about relationships. The nurse explained people either wish they had maintained certain relationships and friendships, or regret holding grudges. Dr Rajan responded to Ms McFadden's insight with a story of a young patient that made him realise we are not 'immortal' and we should not take our life "for granted". In the clip shared with his 1.5million followers he said, "A few years ago when I saw a young woman come in with pancreatitis in her 20s, within three hours this young woman is in the intensive care unit, she's intubated, ventilated, and the next day, she had passed away." "That just made me think wow, I'm in my 30s now, I'm 34, life can just go in a flash. So yes, truly don't take it for granted, we sometimes have this tendency to walk around like we're immortal." Image credits: YouTube

Caring

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

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

Caring

"I’m coming home from a party, and I don’t want to end up getting arrested": do driving apps help people break road rules?

<a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft University of Technology</a> Apps such as Google Maps, Apple Maps and Waze can tell drivers when they are approaching speed cameras or random breath testing stations. Countries such as Germany, France and Switzerland have banned apps from displaying these enforcement locations. But what effect are these apps having in Australia – are they helping drivers break road rules? Our new <a href="https://www.sciencedirect.com/science/article/pii/S0925753524002972">paper</a>, published in the journal Safety Science, examined this question. We found this technology can, in some cases, contribute to people thinking they are invincible on the roads. However, we also found they can sometimes help people drive more safely. <h2>Being made aware of enforcement can help road safety</h2> We conducted focus groups and interviews with a total of 58 drivers from Queensland, to understand how the use of this technology influences perceptions of being caught for breaking road rules. One driver told us: "If I know it’s coming up, I’ll put my phone down. If I was, say, texting or checking something, but then like once a good few 100 metres away, I sort of pick it up again, depending though." Another said: "It sort of depends where I am driving, I guess. Like, if I am driving on a country road and there is a speed camera there I would probably slow down for the speed camera and then sort of speed up again once I am sort of past that; it sort of depends on the circumstances." We also found that, for some people, being made aware of enforcement locations can help drivers better regulate their speed. This helped them comply with road rules more consistently. Waze also shows the speed limit in the area, which further assisted some drivers to stick to the speed limit. One driver told us: "I’m a bit careful if I just look at the speedo and just double check that I’m on the right amount of speed." Another said: "It just gives you a warning like, ‘OK, you need to check your speed.’ Just to double-check you’re going on the right speed perhaps or when it’s a camera coming up." <h2>Concerning behaviours</h2> Concerningly, we also found some drivers who use these apps are looking at and touching their screens more than they otherwise would. This can distract drivers and increase their <a href="https://www.sciencedirect.com/science/article/pii/S0925753524001097">risk of crashing</a>. One driver told us they post traffic updates on the app they use while driving, “which I know is wrong.” Another said: "Just hit the button on the phone. Just two steps after I go past the camera." Another driver told us: "It’s so helpful […] Especially if it’s, say, late night and I’m coming home from a party, and I don’t want to end up getting arrested." One driver said: "I probably feel slightly more invincible, which is probably not a good thing." When asked why these apps are used, one driver said: "I guess the drug and the drink-driving." <h2>Apps can help and hinder road safety</h2> We know breaking road rules significantly contributes to <a href="https://www.who.int/teams/social-determinants-of-health/safety-and-mobility/global-status-report-on-road-safety-2023">crashes and road fatalities</a>, with deaths on Australian roads continuing to <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">increase</a> over time. On the one hand, when drivers are aware of enforcement measures like cameras and police, they are more likely to stop breaking the rules in those areas. That’s particularly true for behaviours such as speeding and using a phone while driving, we found. Using apps that flag where cameras and police are located also means drivers would be more exposed to enforcement activities than they otherwise would be on a normal drive. On the other hand, our results suggest some drivers are using these applications to break road rules more often in places where they think they won’t be caught. These apps are also not always completely accurate. For instance, even though Waze can display some police operation locations such as roadside breath testing, it can’t capture all on-road police activities. Further, camera locations are not always up to date or accurate. <h2>Weighing benefits against risks</h2> While these apps do have some benefits, it’s important to weigh these against the risks. It’s also important to recognise traffic enforcement isn’t just there to make you comply with road rules at a specific point; it is meant to remind you of the constant risk of being caught and to encourage consistent rule compliance. The goal is to ensure that drivers are following the traffic rules across the entire network, not just in isolated spots. With road fatalities at some of the <a href="https://www.bitre.gov.au/publications/ongoing/road_deaths_australia_monthly_bulletins">highest rates we’ve seen in recent years</a>, we need everyone to work together to stop more preventable deaths and injuries.<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/237664/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/verity-truelove-1237331">Verity Truelove</a>, Senior Research Fellow in Road Safety Research, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>; <a href="https://theconversation.com/profiles/michelle-nicolls-1299069">Michelle Nicolls</a>, PhD Candidate, <a href="https://theconversation.com/institutions/university-of-the-sunshine-coast-1068">University of the Sunshine Coast</a>, and <a href="https://theconversation.com/profiles/oscar-oviedo-trespalacios-1417150">Oscar Oviedo-Trespalacios</a>, A/Professor Responsible Risk Management, <a href="https://theconversation.com/institutions/delft-university-of-technology-1040">Delft 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/im-coming-home-from-a-party-and-i-dont-want-to-end-up-getting-arrested-do-driving-apps-help-people-break-road-rules-237664">original article</a>.

Legal

6 reasons why people enjoy horror movies

<a href="https://theconversation.com/profiles/shane-rogers-575838">Shane Rogers</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>; <a href="https://theconversation.com/profiles/coltan-scrivner-1475716">Coltan Scrivner</a>, <a href="https://theconversation.com/institutions/arizona-state-university-730">Arizona State University</a>, and <a href="https://theconversation.com/profiles/shannon-muir-2237282">Shannon Muir</a>, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> The creeping shadows and haunting decorations transform the everyday into something eerie at Halloween. And you might be thinking about scaring yourself with a <a href="https://editorial.rottentomatoes.com/guide/best-horror-movies-of-all-time/">good horror movie</a>. Grotesque imagery, extreme violence, startling jump scares and menacing characters are common elements, making viewers feel fear, dread and disgust. We generally aim to avoid these <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1321053/full">negative emotions</a> in our everyday lives. So why would some people seek them out, and enjoy them, in horror movies? <h2>1. Fear can be thrilling</h2> There is lots of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763423002063">overlap</a> between the emotions of fear and <a href="https://www.nature.com/articles/s41598-024-53533-y">excitement</a>. In both, <a href="https://www.annualreviews.org/content/journals/10.1146/annurev.neuro.051508.135620">stress hormones</a> are released that can produce physical symptoms such as increased heart and breathing rates, sweating and muscle tension. People also feel <a href="https://www.verywellmind.com/the-psychology-of-fear-2671696">more alert</a> and “on edge”. Research has <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.02298/full">consistently shown</a> people with personalities that crave intense emotional experiences, including fear and excitement, tend to enjoy horror movies. But for more fearful people, the jump scares and violent scenes can be <a href="https://doi.org/10.1093/oso/9780197535899.001.0001">too intense</a>. This can result in <a href="https://journals.sagepub.com/doi/full/10.1177/0956797620972116">coping behaviours</a> such as looking away or putting their hands over the ears, especially if they are <a href="https://doi.org/10.1037/ebs0000152">highly immersed</a> in the movie. Although, if they also happen to enjoy intense emotion, they may still enjoy the thrill of the ride. <figure><iframe src="https://www.youtube.com/embed/llpsjbNQIns?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Movie makers work hard to get these ‘jump scares’ just right. And viewers enjoy the thrill.</figcaption></figure> <h2>2. There’s a sense of relief</h2> People may enjoy horror movies because of a <a href="https://osf.io/preprints/psyarxiv/7uh6f">sense of relief</a> after a <a href="https://www.the-scientist.com/ts-digest/issue/science-experiments-from-the-afterlife-24-14?utm_campaign=TS_TS%20Digest%202.0%20Promotion&utm_medium=email&_hsmi=329250194&utm_content=329250194&utm_source=hs_email#why-do-some-people-enjoy-horror-movies-72181">scary moment has passed</a>. Watching a horror movie can be a bit of an emotional rollercoaster, with distinct <a href="https://www.sciencedirect.com/science/article/pii/S1053811920300094">peaks and troughs</a> of fear and relief over the course of the film. For example, in the <a href="https://www.imdb.com/title/tt1396484/">2017 movie It</a> the main protagonists survive a series of scary encounters with a demonic clown. The scary moments are separated by calmer scenes, prompting a rollercoaster of emotions. In the classic <a href="https://www.imdb.com/title/tt0073195/">1975 movie Jaws</a>, viewers experience relief from the scary moments, only to be scared again and again. <figure><iframe src="https://www.youtube.com/embed/yFXG5QQYOvg?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Jaws is a rollercoaster of emotions.</figcaption></figure> <h2>3. They satisfy our morbid curiosity</h2> Many horror movies feature supernatural themes and characters such as zombies, werewolves and vampires. So horror movies can help satiate a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0191886921005183">morbid curiosity</a>. The violence, death, destruction and grotesque elements can provide curious people a safe space to explore things that are not safe (or socially appropriate) in the real world. <figure><iframe src="https://www.youtube.com/embed/ZbdMMI6ty0o?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Horror movies can help people satisfy their curiosity about death. But why are they curious in the first place?</figcaption></figure> <h2>4. We can work out our limits</h2> Horror movies can reflect our deepest fears and prompt introspection about our personal thresholds of fear and disgust. So some people may enjoy watching them to get a <a href="https://osf.io/preprints/psyarxiv/sdxe6">better understanding</a> of their own limits. Watching horror might also be a way to push personal boundaries to potentially become <a href="https://osf.io/preprints/psyarxiv/7uh6f">less fearful</a> or grossed out by things in real life. In a <a href="https://doi.org/10.1016/j.paid.2020.110397">study</a> one of us (Coltan) conducted, horror movie fans reported less psychological distress during the early months of the COVID pandemic compared with people not identifying as a horror movie fan. <h2>5. They can be social</h2> Some people say the <a href="https://doi.org/10.1037/ebs0000152">social aspect</a> of watching horror movies with others is a big part of their appeal. Watching with others might help some people feel safer. Alternatively, this might help <a href="https://osf.io/preprints/psyarxiv/b8tgs">amplify</a> the emotional experience by <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223259">feeding off the emotions</a> of people around them. Horror movies are also a common pick as a <a href="https://www.imdb.com/list/ls023286138/">date night</a> movie. Being <a href="https://doi.org/10.1037/0022-3514.51.3.586">scared together</a> gives a good excuse to snuggle and take comfort in each other. <h2>6. They give us pleasure in other people’s misery</h2> Horror movies can provide the pleasurable emotion we feel when witnessing the misfortune of others, known as <a href="https://www.sciencedirect.com/topics/neuroscience/schadenfreude">schadenfreude</a>. This occurs most when we feel the person experiencing misfortune deserves it. In many horror movies the characters that suffer a gruesome fate are only side characters. Much of the time these unfortunate souls are made out to be unlikeable and often make foolish choices before their grisly end. For example, in the 1996 teen witch movie <a href="https://www.imdb.com/title/tt0115963/">The Craft</a>, the character Chris Hooker is portrayed as being cruel to women. Then he dies by being blasted out of a window. Despite the grisly nature of horror movies, a <a href="https://psycnet.apa.org/record/2024-43893-001">study</a> by one of us (Coltan) found horror fans seem to have the same levels of empathy as anyone else. <figure><iframe src="https://www.youtube.com/embed/ZvLmyts6cEY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>In The Craft, viewers enjoy witnessing the misfortune of others, particularly if the character is a ‘baddy’.</figcaption></figure> <h2>What do I make of all this?</h2> Horror movies allow us to confront our deepest fears through the <a href="https://doi.org/10.1027/1864-1105/a000354">safety of make-believe</a>. People enjoy them for lots of different reasons. And the precise combination of reasons differs depending on the specific movie, and the person or people watching it. What is certain though, is the <a href="https://www.the-numbers.com/market/genres">increasing popularity</a> of horror movies, with <a href="https://editorial.rottentomatoes.com/guide/best-horror-movies-of-all-time/">many</a> to choose from.<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/241480/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/shane-rogers-575838">Shane Rogers</a>, Lecturer in Psychology, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a>; <a href="https://theconversation.com/profiles/coltan-scrivner-1475716">Coltan Scrivner</a>, Behavioral Scientist, <a href="https://theconversation.com/institutions/arizona-state-university-730">Arizona State University</a>, and <a href="https://theconversation.com/profiles/shannon-muir-2237282">Shannon Muir</a>, Lecturer in psychology, <a href="https://theconversation.com/institutions/edith-cowan-university-720">Edith Cowan University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/6-reasons-why-people-enjoy-horror-movies-241480">original article</a>.

Movies

Arguing with the people you love? How to have a healthy family dispute

<a href="https://theconversation.com/profiles/jessica-robles-617248">Jessica Robles</a>, <a href="https://theconversation.com/institutions/loughborough-university-1336">Loughborough University</a> Unlike Britain’s royal family, most of us don’t have the option to move to another country when we don’t see eye to eye. But most of us have likely experienced disagreements with loved ones. <a href="https://www.sscnet.ucla.edu/soc/faculty/heritage/Site/Publications_files/CA_as_SOCIAL_THEORY.pdf">Conversations are designed to</a> do things – to start some action, and complete it – whether it’s a service transaction, an invitation to coffee or reassurance on a bad day. Our <a href="https://books.google.co.uk/books?id=ZnhyDwAAQBAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false">uniquely complex communicative system</a> has evolved to help us get things done in the social world. Arguments are part of this complex system. They can be unavoidable, necessary or even productive. But they can also be difficult. It can be hard to know what to do when tensions are high and harsh words are flying, particularly when it involves someone you’re close to. But research on how disputes unfold – and conversation more generally – offers some ideas about the best way to handle one. <h2>What is a dispute?</h2> There are many words for disagreeing, and there are plenty of academic theories describing what disputes are and why they happen. But arguments are not abstract models. They’re lived in, breathed in, sweated in and talked (or sometimes shouted) into being. Research focusing on <a href="https://core.ac.uk/download/pdf/288351315.pdf">how disputes actually happen</a> shows they’re characterised by three types of features. First are the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0378216606000488">vocal features</a>, which include talking in a higher pitch, louder and faster. Then, there are <a href="https://journals.sagepub.com/doi/pdf/10.1177/1750481310395452?casa_token=MCNQWEQD6HwAAAAA:8nbyXh-cgjWzfL3syRrwybRFQl_ddHIMy9tRIAwPRAFADrgHtR2LSl9ZoUFsVlnzWPjWaKQZZ9XEVA">embodied features</a> such as aggressive gestures and avoidant stances, such as turning away from someone. Finally, there are <a href="https://www.tandfonline.com/doi/pdf/10.1080/01638539009544746?casa_token=BB9edpIE1oUAAAAA:FTK-JRJ2oCmG7BufkUAQX1k1_9C1Cvc12r5ynYPM6duFB-HDWhgef8Va-Rh5Z2XksR64oTcPmi4FAQ">interactional features</a> such as talking over each other, not listening or metatalk – <a href="https://www.tandfonline.com/doi/pdf/10.1080/08351813.2020.1826765?casa_token=isJl2NJbSIkAAAAA:Mh-dXMfkBSGvEeoOWAoxLDjzbZ_eF-zbND-D8q4RAP5WHadqg1KUZDF_UnySFAcyb3LD-DF3BbGq1A">comments about the conversation</a> as it’s happening. <a href="https://journals.sagepub.com/doi/pdf/10.1177/1354067X9953001?casa_token=Gje17vkyg_AAAAAA:ik_4Ze-4PIFLa6yjthOpztvJrtdVOokhRT73M8jDN4t1w0Bl7WzW2--d1vjZwanphorOH_r6jaVZdA">Displays of emotion</a> such as displeasure or anger, are also common. Participants might accuse each other of emotions or label their own emotions. Disputes happen for several reasons. What each person is doing can vary, from <a href="https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.530.8869&rep=rep1&type=pdf">complaints and accusations</a> to <a href="https://bpspsychub.onlinelibrary.wiley.com/doi/pdf/10.1348/014466610X500791?casa_token=r58ikQ5XFxEAAAAA:QR9wr0Fcz7q5BeSvL8soAIhKMNA1O9TcpcBaLleBKDvZ8Q5sPyX1OSg0OzSL5-xb8By5QbgNm9kHNhg">demands, threats or resistance</a>. They can be about many things – familial obligations, what to have for dinner, politics or how to plan a holiday. Luckily, disputes share elements <a href="https://books.google.co.uk/books?id=2NxaC7nSetAC&printsec=frontcover&source=gbs_atb#v=onepage&q&f=false">with each other</a> and with conversation generally – so you don’t have to invent new strategies every time you’re caught in one. <h2>Affiliation and alignment</h2> When bickering with a friend or family member, there are ways to make them feel like you’re still on their side even if you disagree. If you can keep these in mind, and use them at the right time, you might stop your dispute from escalating into something harder to mend. The first thing is <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/9781405198431.wbeal0196.pub2">affiliation</a>, which means support for the other person or their view of things. Affiliation involves phrasing what you say so it’s best <a href="https://www.tandfonline.com/doi/pdf/10.1080/08351810903471258?casa_token=yxnWxfDAEB8AAAAA:uoHEX2dlOS06wxwlHH7TOWmmfB51qMMbzg5tadx5SeRcf_5-vABUKQZtIt0Hchu4vUlFNfCX4qRi5A">understood and easier to respond to</a>. For example, saying “you’ve been to France before, right?” invites someone to share their experience – partly by including the tag “right” at the end, which at least requires a confirmation. It can also involve categorisation, the way we talk about or treat others as <a href="https://link.springer.com/content/pdf/10.1007/BF00142771.pdf">certain types or group members</a>. For example, if you reduce the other person to a stereotype through labelling – by saying something like “girls always say stuff like that” or “OK, boomer” – you risk provoking a response to the insult, not to the action in which that insult was embedded. The second thing we expect from any conversation is alignment – cooperating with the direction of the conversation, such as accepting or denying a request. The opposite, disalignment, might occur when a request is ignored. Alignment has more to do with the sequence of the conversation, how the dispute unfolds over time. Asking for clarification – a practice known as <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136100">repair</a> – or <a href="https://www.jbe-platform.com/content/journals/10.1075/prag.27.1.03rob?crawler=true">claiming a misunderstanding</a> can treat problems as fixable errors rather than moral failings or attacks. <a href="https://journals.sagepub.com/doi/pdf/10.1177/0261927X17744244">Humour can diffuse</a> conflict escalation. <h2>How to have a healthy dispute</h2> In the course of a dispute, you need to think about when to bring these tactics out. They’re more likely to yield better outcomes earlier in the dispute. By the time it’s escalated, your responses may be viewed through the prism of the dispute and <a href="https://books.google.co.uk/books?hl=en&lr=&id=eFSXDwAAQBAJ&oi=fnd&pg=PT200&ots=6tM3fJnXr1&sig=Zchtur1abh25W7ERN5Q49ASRaJc#v=onepage&q&f=false">any offensiveness</a> you’ve already displayed toward each other. In cases like this, teasing can come across as contempt, for example, and claims to misunderstand as bad-faith mockery. It can feel like disputes take on a life of their own – as if the conversation uses us rather than we use it – and this is partly because conversation can seemingly take us along for the ride (consider the difficulty of turning down invitations). We invest our identities into conversations so disputes can seem to threaten us and <a href="https://www.sciencedirect.com/science/article/pii/S0378216618304302?casa_token=1SbOpn_2k8MAAAAA:YQ2Yb9nt-ONsmBKmVzTCx8cfl76bS5nK6_Yd8zONBVJFdJ57vwgdBDJxsXfk0aUOhilRQAF-ABA">what we stand for</a> morally. This may be starker with family, whose opinions of us often matter more than friends or colleagues, for example. It’s always worth stopping to reflect on what a dispute is really for, whether what you’re saying lines up with your goals and whether taking a stand is worth it.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/159565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jessica-robles-617248">Jessica Robles</a>, Lecturer in Social Psychology, <a href="https://theconversation.com/institutions/loughborough-university-1336">Loughborough 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/arguing-with-the-people-you-love-how-to-have-a-healthy-family-dispute-159565">original article</a>.

Family & Pets

Elmo's chat about grief with famous actor goes viral

A heart-warming conversation between actor Andrew Garfield and Elmo has gone viral for their candid conversation about grief. While on a press tour to promote his new film We Live in Time, the English actor stopped by Sesame Street for a chat about his mourning journey after his mother died from pancreatic cancer in 2019. Sitting on a stoop beside Elmo, Garfield began the vulnerable conversation, that has been praised for being so open about the taboo of grief and death. “Elmo’s going around Sesame Street checking in on everybody,” Elmo told a smiling Garfield. “So, Elmo wants to know how Andrew’s doing?” With some encouragement from the Muppet, Garfield revealed that he’s been thinking about his mother, as he said, “She passed away not too long ago, and you know, I just miss her. Miss her a lot.” <iframe title="YouTube video player" src="https://www.youtube.com/embed/EVlXbiP4x2E?si=fFYYt5DJDiGAawXJ" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe> After Elmo responded apologetically, Garfield reassured Elmo that there’s no need to say sorry, and that “it’s actually kind of OK to miss somebody,” even if it invokes feelings of sadness. “That sadness is kind of a gift. It’s kind of a lovely thing to feel, in a way, because it means you really loved somebody when you miss them,” Garfield said, adding: “When I miss my mum, I remember all of the cuddles I used to get from her, all of the hugs I used to get from her.” Garfield finished his thoughts by saying that he can miss and celebrate his mother at the same time, as Elmo thanked Garfield for sharing his emotions, saying, “You know what, Elmo is gonna think about and celebrate your mommy, too.” The video quickly racked up millions of views and comments, with many saying how Andrew's thoughts were so poignant, and that they resonated with their own personal stories of grief. Many people called it a "touching conversation" that was "absolutely beautiful", while another person added, "I didn't expect a talk with Elmo to get this deep." Image credits: Sesame Street - YouTube

Mind

Popular names Generation Alpha believe are “for old people”

Today's youth have a very different idea of what constitutes an "old person" name, and one mum was left flabbergasted after a conversation she had with her six-year-old daughter about her classmates’ names. “You know what I find wild? I have an eight-year-old and a six-year-old, and the names of their friends, I can’t even pronounce some of them,” Australian entrepreneur and mum-of-two Steph Pase said in a now viral TikTok. “I asked her, so do you have anyone in your year called Sarah, Alex, Jack or Daniel? “She laughed and said ‘they’re old people names!’.” She then probed her daughter with a few other common names saying: “I asked, what about Steph … Michelle … she’s like no,” she laughed. “It just makes me realise, that we are that generation … our parents’ generation. Names like Helen, Karen or Joanna … now we’re that generation. “We have the old people names.” She captioned her video with the text "Millennial names are officially old" and many of her followers agreed with the upsetting revelation. “In my classes we have Vision, Stoney, Diesel, Hennesy, Blaze, Cruze, Kingdom, Ace, Boss, Oasis, Mercedes, Destiny,” one shared. “Luna, Harper & Arlo are the new Ashley, Jessica & Stephanie,” another said. “The names in my kids classes are Lamb, Honey, Hazard, Blu, Bambi,” another added. “My six year old has a girl in his class named ‘Summah’ and another called ‘Phox’ because Fox was too mainstream,” a fourth wrote. “My daughter has a Moses, Twayla, Lorde it’s wild …” a fifth commented. Baby name expert and CEO of Fifth Dimension Consulting Lyndall Spooner told news.com.au that there are a few reasons why there's been a shift in children's names over the years, including popularity, less pressure to follow traditional family names, and a trend towards more gender-neutral names. “Parents want their children to be unique and so they use nouns or verbs as names, or character names from books, TV shows, movies, shopping chains or cars," she said. And while the "millennial names" are not as common, "they are not extinct". “We will continue to see changes in baby names and the ‘recycling’ of older names that become popular again,” she told the publication. Images: TikTok

Family & Pets

World famous gay penguin dies

One half of the world famous gay penguin couple at Sydney's SEA LIFE Aquarium has died. In 2018, Gentoo penguin Sphen made international headlines when he coupled up with another male gentoo penguin, Magic. Shortly after meeting, the two male penguins began making a nest together out of pebbles ahead of breeding season, so the aquarium staff gave them a foster egg to care for. Sphen and Magic raised two foster chicks, Sphengic (Lara) in 2018 and Clancy in 2020, and are among the most strongly bonded gentoo penguin pairs at the aquarium. The penguins have inspired books, documentaries, new studies in the NSW syllabus and even featured on a float at the Sydney Mardi Gras parade. Earlier in August, Sphen passed away at the age of 12, which is considered a long life for a gentoo penguin. In order to help process the loss, the aquarium staff took Magic to see his partner's body to help with the understanding that Sphen would not be returning. He immediately started singing, which was reciprocated by the colony. "The loss of Sphen is heartbreaking to the penguin colony, the team and everyone who has been inspired or positively impacted by Sphen and Magic's story," SEA LIFE Sydney Aquarium's general manager, Richard Dilly, said in a statement. "Sphen and Magic's love story captivated the world and it's been an honour to welcome local and international fans, some of which travelled long distances to see them in real life." "The team's focus is now on Magic, who will soon prepare for his first breeding season without Sphen." Image credits: SEA LIFE Aquarium Sydney

Relationships

Readers response: Who’s the most interesting person you’ve met while travelling?

One of the best parts of travelling is the people you met along the way. Whether it's as part of a tour group or an interesting character you meet by chance, interacting with interesting people in interesting places can bring a lot to your travel experience. We asked our readers to tell us about the most interesting person they've encountered on their travels and the response was overwhelming. Here's what they said. Diana Jason - Cargo Holly Harrison. He walked 15000 miles from the bottom of South America to the top of Alaska. A truly fascinating man. Margie Buckingham - While caravanning around Oz, every night we would meet interesting ppl enjoying pre-dinner drinks & nibbles around the campfire. We all had personal stories to tell or the best places to camp. Ann Smith - Myself. Travelled to the UK and found my independence and confidence, two and a bit years after I lost love of my life to cancer. Pamela Cari - We met the lady who played the mother of Apollonia Vitelli in The Godfather when we were in Savoca. Rosalie Busch - A couple who grew up behind the wall in East Berlin. Sue Velvin - Shaquille O'Neal when my daughter and I had a holiday in the states a few years ago! Awesome man. Wendy Farnham - A Buddhist Nun in Cambodia who lost her husband and 6 of her 7 children to starvation under Pol Pot’s regime. Lyn Schuemaker - Everybody. They all have stories to tell. Image credits: Shutterstock

International Travel

Five people arrested over Matthew Perry's death

Five people have been arrested in connection with the death of Friends actor Matthew Perry, who died of a drug overdose in October 2023. Matthew Perry’s assistant Kenneth Iwamasa, two doctors, and two alleged drug dealers, including Jasveen Sangha, the so-called “Ketamine Queen of Los Angeles”, have been arrested over the star's death. All five suspectes are facing charges including “conspiracy to distribute ketamine” over allegations they supplied the 54-year-old with the illegal drugs in the final weeks of his life. In the last four days of his life, Mr Perry paid $100,000 AUD for 70 vials of ketamine. Three of the five people charged have pleaded guilty to several drug-related offences, while a licensed doctor and an alleged drug dealer arrested in California on Thursday are the lead defendants in a “broad, underground criminal network” to distribute ketamine to Mr Perry and others. “These defendants took advantage of Mr Perry’s addiction issues to enrich themselves. They knew what they were doing was wrong. They knew what they were doing was risking great danger to Mr Perry, but they did it anyway,” said US Attorney Martin Estrada. Following the arrests, Matthew Perry's stepfather has shared a message of gratitude to law enforcement and hoped justice would be served. Keith Morrison, a Canadian journalist, and other loved ones of the Friends star in a statement issued to NBC News say they are finding some solace in the legal system nine months on from his death. "We were and still are heartbroken by Matthew's death, but it has helped to know law enforcement has taken his case very seriously," they said. "We look forward to justice taking its course." Image credits: Matt Baron/BEI/Shutterstock Editorial

Legal

People who are bad with numbers often find it harder to make ends meet – even if they are not poor

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/wandi-bruine-de-bruin-275600">Wändi Bruine de Bruin</a>, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> and <a href="https://theconversation.com/profiles/paul-slovic-359838">Paul Slovic</a>, <a href="https://theconversation.com/institutions/university-of-oregon-811">University of Oregon</a> <h2>The big idea</h2> People who are bad with numbers are more likely to experience financial difficulties than people who are good with numbers. That’s according to <a href="https://doi.org/10.1371/journal.pone.0260378">our analyses</a> of the <a href="https://wrp.lrfoundation.org.uk/explore-the-poll">Lloyd’s Register Foundation World Risk Poll</a>. In this World Risk Poll, people from 141 countries were asked if 10% was bigger than, smaller than or the same as 1 out of 10. Participants were said to be bad with numbers if they did not provide the correct answer – which is that 10% is the same as 1 out of 10. <a href="https://doi.org/10.1371/journal.pone.0260378">Our analyses</a> found that people who answered incorrectly are often among the poorest in their country. Prior studies in the <a href="https://doi.org/10.1111/j.1468-0297.2010.02394.x">United States</a>, <a href="https://doi.org/10.1111/j.1475-5890.2007.00052.x">United Kingdom</a>, <a href="https://doi.org/10.1016/j.joep.2016.02.011">the Netherlands</a> and <a href="https://doi.org/10.1111/joca.12294">Peru</a> had also found that people who are bad with numbers are financially worse off. But <a href="https://doi.org/10.1371/journal.pone.0260378">our analyses of the World Risk Poll</a> further showed that people who are bad with numbers find it harder to make ends meet, even if they are not poor. When we say that they found it harder to make ends meet, we mean that they reported on the poll that they found it difficult or very difficult to live on their current income, as opposed to living comfortably or getting by on their current income. <a href="https://doi.org/10.1371/journal.pone.0260378">Our analyses</a> also indicate that staying in school longer is related to better number ability. People with a high school degree tend to be better with numbers than people without a high school degree. And college graduates do even better. But even among college graduates there are people who are bad with numbers – and they struggle more financially. <iframe id="yOIiX" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/yOIiX/3/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Of course, being good with numbers is not going to help you stretch your budget if you are very poor. <a href="https://doi.org/10.1371/journal.pone.0260378">We found</a> that the relationship between number ability and struggling to make ends meet holds across the world, except in low-income countries like Ethiopia, Somalia and Rwanda. <iframe id="RejA1" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/RejA1/8/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <h2>Why it matters</h2> The ability to understand and use numbers is also called <a href="http://doi.org/10.1093/oso/9780190861094.001.0001">numeracy</a>. Numeracy is <a href="https://doi.org/10.1787/1f029d8f-en">central to modern adult life</a> because numbers are everywhere. A lot of well-paying jobs involve working with numbers. People who are bad with numbers often perform worse in these jobs, including <a href="https://doi.org/10.1111/ecin.12873">banking</a>. It can therefore be hard for people who are bad with numbers to <a href="http://www.doi.org/10.1108/00400919710164125">find employment and progress in their jobs</a>. People who are bad with numbers are less likely <a href="https://www.pnas.org/content/116/39/19386.short">to make good financial decisions</a>. Individuals who can’t compute how interest compounds over time <a href="https://doi.org/10.1111/j.1540-6261.2009.01518.x">save the least and borrow the most</a>. People with poor numerical skills are also more likely <a href="https://doi.org/10.1037/0022-3514.41.3.586">to take on high-cost debt</a>. If you’re bad with numbers, it is hard to <a href="https://doi.org/10.1017/S1474747215000232">recognize</a> that paying the US$30 minimum payment on a credit card with a $3,000 balance and an annual percentage rate of 12% means it will never be paid off. <h2>What still isn’t known</h2> It is clear that people who are bad with numbers also tend to struggle financially. But we still need to explore whether teaching people math will help them to avoid financial problems. <h2>What’s next</h2> In her book “<a href="http://doi.org/10.1093/oso/9780190861094.001.0001">Innumeracy in the Wild</a>,” Ellen Peters, director of the Center for Science Communication Research at the University of Oregon, suggests that it is important for students to take math classes. American high school students who had to <a href="https://doi.org/10.3368/jhr.51.3.0113-5410R1">take more math courses</a> than were previously required had better financial outcomes later in life, such as avoiding bankruptcy and foreclosures. Successfully teaching numeracy also means helping students gain confidence in using numbers. People with <a href="https://doi.org/10.1073/pnas.1903126116">low numerical confidence</a> experience bad financial outcomes, such as a foreclosure notice, independent of their numeric ability. This is because they may not even try to take on complex financial decisions. Numerical confidence can be boosted in different ways. Among American <a href="https://doi.org/10.1037/0022-3514.41.3.586">elementary school children</a> who were bad with numbers, setting achievable goals led to better numerical confidence and performance. Among American <a href="https://doi.org/10.1371/journal.pone.0180674">undergraduate students</a>, a writing exercise that affirmed their positive values improved their numerical confidence and performance. Other important next steps are to find out whether training in numeracy can also be provided to adults, and whether training in numeracy improves the financial outcomes of people who do not live in high-income countries.<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/172272/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/wandi-bruine-de-bruin-275600">Wändi Bruine de Bruin</a>, Professor of Public Policy, Psychology and Behavioral Science, USC Sol Price School of Public Policy, <a href="https://theconversation.com/institutions/usc-dornsife-college-of-letters-arts-and-sciences-2669">USC Dornsife College of Letters, Arts and Sciences</a> and <a href="https://theconversation.com/profiles/paul-slovic-359838">Paul Slovic</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-oregon-811">University of Oregon</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/people-who-are-bad-with-numbers-often-find-it-harder-to-make-ends-meet-even-if-they-are-not-poor-172272">original article</a>. </div>

Money & Banking

Woman “bullied” on plane over budget seating trick

A young woman has recalled a flight from hell when she was “bullied” by a couple who were trying to utilise a seating hack that went viral on TikTok. The solo traveller took to Reddit to recount the story and ask social media users if she was in the wrong for her action. The woman began by saying she usually pays more to select her plane seat ahead of time, but a medical emergency on another plane had her waiting on standby and left with no option other than to sit in a middle seat. When she was finally able to board, she was greeted by a couple who had purchased both the window and aisle seats in a bid to have more space, utilising a travel “trick” that has been popular on TikTok. The method, which has been dubbed the 'poor man's business class', usually leaves travellers with an empty middle seat and more space, and few travellers opt to pick a middle seat. “When I got to my row the man and woman were chatting and sharing a snack... it was obvious they were together. I mentioned to the man that I'm in the middle, and he got up to let me in,” the unsuspecting traveller wrote on Reddit. “I asked them if they would prefer to sit together, I said I was totally okay with that. The woman reacted rudely to this and said ‘you're not supposed to be sitting here anyway’.” After noticing how the plane was full, she offered to show the pair her new ticket with the correct seat number on it. “She flicked her hand at my ticket and made a disgusted sound. I offered again if they wanted to sit together to which she didn't reply, her partner said it's okay and... made some small talk,” she continued. The man’s girlfriend then interrupted their conversation to ask,”'Did you use one of those third party websites to book your flight? It's so frustrating when people cheap out to inconvenience others.” The American woman explained that she had booked her flight directly and she had been placed on standby like everyone else and didn't choose the middle seat - she was assigned it. She then tried to keep the peace by refusing to engage with the furious woman. “I was so done with her attitude, I put my headphones on and attempted to do my own thing,” she explained. But the “entitled” girlfriend wasn't letting it go, as the woman explained, “This woman kept reaching over me and tapping her partner and trying to talk to him in a way that was super intrusive.” “I could tell even her partner was trying to engage her less so that she would hopefully stop, but she didn't.” “I think they tried to pull that tactic where they don't sit together on purpose...hoping no one will sit between them. But on full flights it doesn't work. And even so - it's not the other person's fault.” The traveller's post was met with hundreds of comments slamming the girlfriend’s behaviour, as one person wrote, “It's like a toddler having a tantrum.” “She was disappointed and a total a**hole. Gross entitled people,” another added. Another person applauded the traveller’s level-headed behaviour, writing, “Wow! You are my hero for keeping it classy - I’m afraid I would not have been as kind as you.” Image credits: Shutterstock

Travel Trouble

Why are some people happy when they are dying?

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

Caring

Is your smartwatch making you anxious? Wearables can lead people to stress more about their health

<a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Wearable trackers and monitors (such as smartwatches) are <a href="https://www.idtechex.com/en/research-report/wearable-technology-forecasts-2023-2033/928">increasingly popular and sophisticated</a>. For people living with heart conditions, they can provide important information, including updates about abnormalities in heart rate and rhythm. But a recent study published in the <a href="https://www.ahajournals.org/doi/10.1161/JAHA.123.033750">Journal of the American Heart Association</a> found using wearables to monitor heart conditions like atrial fibrillation – an irregular heartbeat – can actually make people more anxious about their health. It’s a catch-22 situation: the wearable device may help you better manage your chronic heart condition, but wearing it could make you anxious – which is bad for those conditions. So what are the tradeoffs? And how can we get the most out of wearables, without unnecessary worry? <h2>Wearables to monitor heart conditions</h2> Wearables are playing an increasing role in managing and <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1901183">detecting</a> conditions like atrial fibrillation, the <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013408.pub2/full">most common heart rhythm problem</a>. Atrial fibrillation <a href="https://www.aihw.gov.au/reports/heart-stroke-vascular-diseases/atrial-fibrillation-in-australia/contents/how-many-australians-have-atrial-fibrillation">affects</a> around 2% of the general population, and about 5% of those aged over 55. Symptoms may include palpitations, fatigue and shortness of breath, although some patients may live relatively symptom-free. Self management is important to improve quality of life and prevent complications, such as stroke and heart failure. People with atrial fibrillation also often experience high rates of <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013508.pub3/full">anxiety linked to their condition</a>. <a href="https://link.springer.com/article/10.1007/s11886-020-01396-w">Psychological distress</a> – including anxiety, depression and worry about symptoms – affects between 25% and 50% of those living with the condition. Wearable devices can help people understand and monitor their condition by providing heart rate and rhythm data and alerts to detect atrial fibrillation episodes. This can be helpful to understand the impact of their disease, particularly for those living with paroxysmal (or episodic) atrial fibrillation. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10800119/">One study</a> found smartwatches were very effective at detecting irregular heart rhythms – and could help manage and even prevent them. But any benefits of using wearables to monitor atrial fibrillation need to be balanced with the high rates of anxiety people with this condition experience, to make sure their use doesn’t exacerbate psychological distress. <h2>Wearables can empower patients</h2> For many people, the sense they are receiving reliable, objective and personalised health data can encourage <a href="https://www.cvdigitalhealthjournal.com/article/S2666-6936(21)00020-7/fulltext">feelings of confidence, safety and assurance</a>, especially when combined with symptom trackers or patient diaries. This may allow patients to self-manage their condition at home with their families, rather than spending time in hospital – reducing anxiety and stress. In a clinical setting, data may also encourage patients to take part in <a href="https://academic.oup.com/eurjcn/article/16/3/178/5924768">shared decision-making</a>. Interpreting health data together with doctors or other health-care professionals, they can develop goals and action plans, including when to seek help from a GP – and when to go to hospital. Patients who understand their condition <a href="https://www.tandfonline.com/doi/full/10.2147/JMDH.S19315">tend to report</a> fewer atrial fibrillation symptoms. <h2>But wearables can induce anxiety</h2> The study published by the Journal of the American Heart Association examined the behaviour and wellbeing of 172 people with atrial fibrillation over a nine-month period. It found the 83 people who used wearables to monitor their condition were more worried about their symptoms and treatment, with one in five experiencing “intense anxiety”. Chronic anxiety can contribute to stress, burnout and poor physical health, which in turn can <a href="https://www.jacc.org/doi/full/10.1016/j.jacep.2021.12.008">exacerbate heart conditions</a>. Previous <a href="https://link.springer.com/article/10.1186/s12911-017-0486-5">research</a> has also explored the impacts of wearables on patients with long-term conditions, including heart disease. Patients in this study similarly reported increased anxiety while using these devices, as one explained: <blockquote> I am one of these people who do worry about things. I do get concerned about myself […] and I just thought this is silly. This is reminding me every day, […] I wonder what my reading is, how good it is or how bad it is […]. Every time as soon I started thinking about it, I started thinking about my illness. </blockquote> Some people also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777278/">describe</a> being a “prisoner of the numbers”. They feel they “need to keep checking the device to know how they were doing, leading to the device dominating their lives”. The volume and frequency of notifications, alarms and vibrations from wearable devices can be overwhelming and make people worry about their health. Information overload can also discourage self-management, with notifications instead prompting people to seek health advice more often than they otherwise would. But this isn’t necessarily a bad thing. For other people, low levels of health or digital literacy – not knowing how to use the devices or interpret the data – may make them feel so stressed or anxious they <a href="https://link.springer.com/article/10.1186/s12911-017-0486-5">abandon wearables</a> altogether. <h2>The future of wearables</h2> In the future, digital devices may help paint a holistic picture of health and wellbeing through a “<a href="https://theconversation.com/digital-diagnosis-how-your-smartphone-or-wearable-device-could-forecast-illness-102385">digital phenotype</a>” that combines data like sleep patterns, weight changes and physical activity. But more research is needed to understand the effects of wearables – including their notifications and alarms – on patients’ anxiety levels. If you already use a wearable device for health monitoring, it can be helpful to regularly review the data and notification settings. You may wish to discuss how you are using your device to help you self-manage your condition with your doctor or nurse. With any chronic disease, having a management action plan is important. This includes discussing with your health-care professional when to seek care (such as attending the emergency department or GP). Meanwhile, there’s still work to be done to help make nurses and doctors feel more confident <a href="https://www.tandfonline.com/doi/full/10.1080/10376178.2018.1486943">integrating wearables</a> – and the data they provide – into patient care.<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/235596/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/caleb-ferguson-72">Caleb Ferguson</a>, Professor of Nursing; Director of Health Innnovations, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/is-your-smartwatch-making-you-anxious-wearables-can-lead-people-to-stress-more-about-their-health-235596">original article</a>.

Body

Brand Olympics: do the famous rings deliver value to host countries?

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/steven-greenland-2064">Steven Greenland</a>, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> and <a href="https://theconversation.com/profiles/robert-joseph-gill-1530152">Robert Joseph Gill</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> The cost of hosting Paris 2024, the 33rd Olympics, is predicted to be <a href="https://www.reuters.com/world/europe/paris-lean-olympics-wont-blow-any-budgets-credit-rating-firm-sp-says-2024-03-11/">more than A$14 billion</a>. So what’s in it for the French? Will this oldest of sporting events shine for them, or as has happened with some previous Olympics, will it prove to be <a href="https://www.abc.net.au/news/2021-08-07/what-japan-learned-from-olympic-white-elephants/100329488">a massive white elephant</a>? <h2>The power of the five rings</h2> The Olympic brand is <a href="https://olympics.com/ioc/news/the-olympic-brand-maintains-its-global-strength-and-recognition">massively powerful</a> and gives the host nation a global platform to strengthen their international reputation and standing. The Olympic brand heritage goes back 2,800 years to southern Greece, when games were held to honour the Greek god Zeus at Olympia. Starting in 776 BC, these ancient games were held every four years and continued for more than 1,000 years. <figure><iframe src="https://www.youtube.com/embed/VdHHus8IgYA?wmode=transparent&start=11" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>The Olympics began as part of a festival honouring Zeus in the rural Greek town of Olympia.</figcaption></figure> The modern Olympics began in 1896 in Athens. Since then, the games have been hosted in 23 cities and 20 countries. Paris 2024 will welcome around 10,500 athletes from more than 200 countries <a href="https://olympics.com/en/paris-2024/sports">competing in 32 different sports</a>. Around <a href="https://www.euromonitor.com/press/press-releases/nov-2023/olympic-games-2024-set-to-boost-tourism-spending-in-paris-by-up-to-eur4-billion-euromonitor-international">4 billion people will watch on</a> around the globe. The Olympics’ five rings (<a href="https://discover.sportsengineplay.com/olympics/history-of-they-rings#:%7E:text=They%20first%20appeared%20in%201913,to%20accept%20its%20fertile%20rivalries.">created by Frenchman Pierre de Coubertin 110 years ago</a>) is one of the most recognised logos on the planet. It represents unity across the five continents (Africa, the Americas, Asia, Europe and Oceania). It is this familiarity and <a href="https://www.emerald.com/insight/content/doi/10.1108/INTR-07-2018-0324/full/html">positive Olympic brand associations</a> – which include excitement, fairness and being elite – that some argue justifies the billions spent. Host nations hope this Olympic sparkle rubs off on their nation’s reputation – but that’s not always the case. <h2>Benefits of hosting an Olympics</h2> Broadcast rights, sponsorships and advertising from organisations that want to be associated with the Olympic brand can <a href="https://olympics.com/ioc/funding">generate huge revenue streams</a>. The Olympic brand adds considerable value for sponsors and advertisers, and there are also benefits that France (and the world) will gain long after the event. Responsible marketing and attracting sponsors that complement Olympic brand values can <a href="https://www.tandfonline.com/doi/full/10.1080/0965254X.2023.2230487">promote positive, sustainable attitudes and behaviour</a>. Examples of this include promoting unity, a sense of national pride, and social and health gains from <a href="https://theconversation.com/does-sports-participation-boom-during-or-before-or-after-the-olympics-227773">increased sports participation</a>. The event also generates huge revenue from domestic and international tourism – 15 million spectators are anticipated for Paris 2024. Most are locals and domestic day trippers but <a href="https://www.euromonitor.com/press/press-releases/nov-2023/olympic-games-2024-set-to-boost-tourism-spending-in-paris-by-up-to-eur4-billion-euromonitor-international">around 3 million additional visitors</a> are expected in Paris during the games. Increased infrastructure and updated civil works as a result of the city getting ready for the Olympics provides many lifestyle benefits: a reinvigorated host city can benefit from upgraded transport, accommodation, hospitality, sports facilities and streetscapes. Other significant benefits relate to strengthening the host country’s geographic and cultural brand. For France, this includes reinforcing and promoting many of its registered geographic indicator products that relate mainly to wine, agricultural products and foodstuffs, as well as spirits and beers. Champagne is perhaps the most widely recognised geographic indicator product. It illustrates how connection to its place of origin assures consumers about regional and French cultural values and <a href="https://theconversation.com/whats-in-a-name-quite-a-lot-if-its-prosecco-parmesan-or-mozzarella-209505">the products’ characteristics and quality</a>. <h2>What about the pitfalls?</h2> Many Olympics have failed to turn a profit, meaning countries and citizens are <a href="https://www.tandfonline.com/doi/full/10.1080/02665433.2019.1633948">left to pay off debts</a> for decades after the event (for example, Rio, <a href="https://www.theguardian.com/cities/2016/jul/06/40-year-hangover-1976-olympic-games-broke-montreal-canada">Montreal</a>, Beijing and Athens). Also, many cities are left with <a href="https://theconversation.com/looking-back-at-the-olympic-venues-since-1896-are-they-still-in-use-229606">purpose-built infrastructure</a> created specifically for the games but left idle afterwards, including athlete accommodation, aquatic centres and major stadiums. What will determine the success of Paris 2024 and justify the massive investment in hosting the event? <figure><iframe src="https://www.youtube.com/embed/_m1x5JaC37E?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Is hosting the Olympics worth the investment?</figcaption></figure> The success of the Olympics for the host is often determined by the financial revenue it can generate. The Olympic brand plays a significant role in generating this financial support. However, the brand’s reputation can be tarnished by issues leading up to and during the games, which may reduce the positive impacts. The Olympic brand’s reputation can be affected by issues like: <ul> <li> high-profile athletes and national teams cheating or doping </li> <li> world sporting authorities placing restrictions on competitors <a href="https://www.insidethegames.biz/articles/1143198/restrictions-transgender-paris2024-games">based on gender and status</a> </li> <li> incompatible sponsors jumping on the Olympic bandwagon. For example, manufacturers of harmful products whose negative brand associations could tarnish the Olympic brand, such as <a href="https://www.tandfonline.com/doi/full/10.1080/0965254X.2023.2176532">soft drink and alcohol sponsors</a> </li> <li> negative publicity associated with unethical practices of host and participating countries <a href="https://www.adweek.com/brand-marketing/sports-politics-brands-volatile-mix-olympic-games/">with human rights issues</a>. This includes others using the event to publicise these </li> <li> politicising the event – including “<a href="https://theconversation.com/is-saudi-arabia-using-sportswashing-to-simply-hide-its-human-rights-abuses-or-is-there-a-bigger-strategy-at-play-208468">sportswashing</a>”, protests, boycotts and image protection, as seen with <a href="https://www.tandfonline.com/doi/full/10.1080/13216597.2017.1347101">China</a>, <a href="https://www.washingtonpost.com/kidspost/2021/12/16/us-protest-olympics-is-nothing-new-politics-have-been-mixed-with-sports-decades/">the United States</a>, and <a href="https://olympics.com/ioc/news/declaration-by-the-ioc-against-the-politicisation-of-sport">Russia</a> </li> <li> unforeseeable events – the COVID pandemic delayed the Tokyo games and <a href="https://www.reuters.com/business/media-telecom/money-money-money-cost-tokyos-pandemic-delayed-olympics-2021-06-10/#:%7E:text=Organisers%20said%20last%20December%20that,has%20risen%20to%20%243%20billion">pushed the cost to A$18 billion</a> </li> <li> other negative associated risks for the host city such as <a href="https://theconversation.com/will-the-paris-olympics-be-a-terrorist-target-these-three-factors-could-be-key-229110">terrorism</a>, <a href="https://theconversation.com/extreme-heat-is-a-killer-for-outdoor-sporting-events-lets-plan-properly-to-keep-everyone-safe-229998">heat waves</a>, and civil unrest. </li> </ul> <h2>Fingers crossed for France</h2> With close to half the world watching Paris 2024, France’s National Olympic Committee will be anxiously hoping for positive outcomes to ensure a strong return on the A$14 billion invested. But since Sydney 2000, virtually every games host has suffered <a href="https://www.cfr.org/backgrounder/economi">significant financial blowouts</a>. For their sake, and the Olympics’ reputation, let’s hope the Paris games sparkle - or we may be left with a very limited number of potential future hosts with very deep pockets.<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/228497/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/steven-greenland-2064">Steven Greenland</a>, Professor in Marketing, <a href="https://theconversation.com/institutions/charles-darwin-university-1066">Charles Darwin University</a> and <a href="https://theconversation.com/profiles/robert-joseph-gill-1530152">Robert Joseph Gill</a>, Associate Professor in Media and Communication, Swinburne University of Technology, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a> Image credits: Artur Widak/NurPhoto/Shutterstock Editorial 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/brand-olympics-do-the-famous-rings-deliver-value-to-host-countries-228497">original article</a>. </div>

Money & Banking

Six people found dead in luxury hotel

A disturbing theory has emerged after six people were found dead in a luxury hotel room in central Bangkok. According to Bangkok’s Metropolitan Police commissioner Thiti Saengsawang, hotel staff at the Grand Hyatt Erawan discovered the bodies of six people in a fifth-floor room after they missed check out time by more than 24 hours. After concluding that the incident did not appear to be a robbery and none of the bodies showed any signs of physical violence, Thai Police are exploring the possibility that the people were poisoned. Police shared that they "needed to find out the motives", and that the deaths were the result of a "killing", not a suicide. Authorities conformed they are investigating the potential poisoning after Thiti said cups with traces of a white powder were located in the room, along with untouched food that had been ordered earlier. As police continue their investigation into the shocking deaths, they are currently searching for a seventh person who was part of the hotel booking and is now a possible suspect. Two of the dead were US citizens of Vietnamese background, while the other four were Vietnamese nationals. Thiti said police believe one member of the group had tried to reach the door to escape but fell and died before they could get there. The Thai government issued a statement after the killings, with Thai Prime Minister Srettha Thavisin saying, "There were no signs of a struggle," adding, "We need to conduct an autopsy." He also "ordered all agencies to urgently take action to avoid impact on tourism,” given that the luxury hotel is situated in a popular tourist area. Image credits: BBC / Royal Thai Police

Travel Trouble

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

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

Body

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

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

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