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How to complain about aged care and get the result you want

<a href="https://theconversation.com/profiles/jacqueline-wesson-1331752">Jacqueline Wesson</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> It can be hard to know what to say, or who to talk to, if you notice something isn’t right for you or a loved one in residential aged care. You might have concerns about personal or medical care, being adequately consulted about changes to care, or be concerned about charges on the latest bill. You could also be concerned about theft, neglect or abuse. Here’s how you can raise issues with the relevant person or authority to improve care and support for you or your loved one. <h2>Keep records</h2> You can complain about any aspect of care or service. For instance, if medical care, day-to-day support or financial matters do not meet your needs or expectations, you can complain. It is best to act as soon as you notice something isn’t right. This may prevent things from escalating. Good communication helps get better results. Make written notes about what happened, including times and dates, and take photos. Try to focus on facts and events. You can also keep a record of who was involved and their role. Keep track of how the provider responded or steps taken to resolve the issue. Write notes of conversations and keep copies of emails. <h2>Who do I complain to?</h2> Potential criminal matters If you have concerns about immediate, serious harm of a criminal nature then you should contact the police, and your provider immediately. These types of serious incidents include unreasonable use of force or other serious abuse or neglect, unlawful sexual contact, stealing or unexpected death. The provider may have already contacted you about this. They are required to report such <a href="https://www.agedcarequality.gov.au/consumers/serious-incident-response-scheme">serious incidents</a> to both the Aged Care Quality and Safety Commission within 24 hours, and to the police. Other matters For other matters, talk to the care staff involved. Try to find out more detail about what happened and why things went wrong. Think about what you expect in the situation. Then talk to the most senior person in charge, to see if they can make changes so things don’t go wrong in the future. This person may be called the nursing unit manager, care manager or care director. Providers must acknowledge and investigate your complaint, tell you their findings and actions taken, and follow up to see if you are satisfied. If you would like support to talk to the provider, the <a href="https://opan.org.au">Older Persons Advocacy Network</a> can help. This free service provides independent and confidential support to help find solutions with the aged-care provider. The network can also help you lodge a formal complaint. <h2>How to I lodge a formal complaint?</h2> If you are not satisfied with the way your provider responded, you can lodge a complaint with the <a href="https://www.agedcarequality.gov.au">Aged Care Quality and Safety Commission</a>. Be prepared to submit the facts and events, plus emails and correspondence, you have already collected. Think about what you want to happen to resolve the complaint. Each complaint is handled individually and prioritised depending on the risks to you or your loved one. The commission will start its processes within one business day when complaints are urgent. The resolution process took <a href="https://www.agedcarequality.gov.au/sites/default/files/media/acqsc-annual-report-2020-21.pdf">an average 40 days</a> in 2020-21. You can complain confidentially, or anonymously if you feel safer. But the commission may not be able to investigate fully if it’s anonymous. Also, there are limits to what the commission can do. It cannot ask providers to terminate someone’s employment, or provide direct clinical advice about treatment. Sometimes the commission has issued a “non-compliance” notice to the provider (for a failure to meet quality standards), and action may again <a href="https://www.abc.net.au/news/2022-05-02/aged-care-complaint-about-southern-cross-care-young/101009716">be limited</a>. So it is a good idea to check the <a href="https://www.myagedcare.gov.au/non-compliance-checker">non-compliance register</a> beforehand to see if your provider is listed. <h2>What do others complain about?</h2> From October to December 2021, <a href="https://www.agedcarequality.gov.au/sites/default/files/media/acqs-sector-performance-data-oct-dec-2021.pdf">about a third</a> of Australian nursing homes had a complaint made to the commission against them. Some had more than one complaint. More than half of these complaints were lodged by family, friends or other consumers. The top reasons for complaints were about: <ul> <li> adequacy of staffing </li> <li> medication administration or management </li> <li> infectious diseases or infection control </li> <li> personal and oral hygiene </li> <li> how falls are prevented and managed </li> <li> consultation or communication with representatives and/or family members. </li> </ul> <h2>What if I’m still not happy?</h2> If you’re not happy when you receive the commission’s outcome, you can request a review with 42 days. You can also request the <a href="https://www.ombudsman.gov.au">Commonwealth Ombudsman</a> to review the complaint if you’re not satisfied with the commission’s decision or the way the commission handled your complaint. <h2>Remember, you have a right to complain</h2> The <a href="https://agedcare.royalcommission.gov.au">Aged Care Royal Commission</a> spotlighted the neglect and substandard care that can occur in nursing homes. Despite attempts to <a href="https://www.health.gov.au/resources/publications/concepts-for-a-new-framework-for-regulating-aged-care">lift the standard of aged care</a>, we know residents and carers still have concerns. Residents, and their representatives or families, have a legal <a href="https://www.agedcarequality.gov.au/consumers/standards/resources">right to speak up and complain</a>, free from reprisal or negative consequences. This right is also reflected in the <a href="https://www.agedcarequality.gov.au/consumers/consumer-rights">Charter of Aged Care Rights</a>, which providers are legally required to discuss with you and help you understand. <h2>Moving to another facility</h2> If you have exhausted all avenues of complaint or feel conditions have not improved, you may decide to move to another provider or facility, if available. This option may not be possible in rural areas. This is a difficult decision. It takes time, as well as financial and emotional resources. Starting again with a new provider can also be disruptive for everyone, but sometimes it may be the right choice. <hr /> Contact the <a href="https://opan.org.au">Older Persons Advocacy Network</a> on 1800 700 600, the <a href="https://www.agedcarequality.gov.au">Aged Care Quality and Safety Commission</a> on 1800 951 822 or the <a href="https://www.ombudsman.gov.au">Commonwealth Ombudsman</a> on 1300 362 072.<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/180036/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jacqueline-wesson-1331752">Jacqueline Wesson</a>, Senior Lecturer (Teaching and Research), Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/lee-fay-low-98311">Lee-Fay Low</a>, Professor in Ageing and Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-to-complain-about-aged-care-and-get-the-result-you-want-180036">original article</a>.

Retirement Life

Michael Schumacher’s son gives rare interview about his father

Michael Schumacher's son has shared a rare insight into his life after his dad's devastating skiing accident. Mick Schumacher, who was only 14 at the time of his dad’s accident, pursued his dream of reaching F1 without his father's guidance, and has spoken about how much his dad father continued to inspire him. In the new book Inside Mercedes F1 written by Matt Whyman, the author had unrestricted access to the team, with the book including a conversation with Mick about his father’s influence. The 25-year-old, who became a reserve driver for Mercedes in 2023, told Whyman, “I was a crazy kid — everything my dad did, I did." “He was really supportive and a lot of fun, but could also be challenging. One time in a karting race I braked very late going into a corner and gained a lot of time." “When I told him about it, he said, ‘Yes, but you should have braked like that in every corner!’." “Whenever he felt like I was not taking it seriously, he would say, ‘Mick, would you rather go and play football with your friends? If so, we do not need to do all of this’." “I insisted that I wanted to race and he said, ‘Okay, then let’s do it properly’. So we started doing more European karting and I was getting better.” Mick later explained that he learned “a lot of technical points” from his dad that he “still uses today”, adding, “I started racing in the Formula classes the year after the accident and from that point onwards, I had to find my own feet." “I started karting aged three. I was six when I first went scuba diving. Aged 10 I was skydiving." “My dad was always very open to me trying out whatever I wanted to do and racing is all I wanted to do, because I enjoyed it the most.” Image credits: Eric Alonso/DPPI/Shutterstock Editorial

Family & Pets

Readers response: What’s the best book you’ve read recently, and what did you love about it?

With hundreds of new books on the market, it's hard to know what are the best to recommend. We asked our readers what the best book they've read recently is and what did they love about it, and the response was overwhelming. Here's what they said. Helen Ulgekutt - The Venice Hotel by Tess Woods, loved it start to finish. Zoy Crizzle - The Little Paris Bookshop by Nina George. Great book, so easy to read and an interesting story line. I loved it. Keralie Stack - I have just finished Fallen Woman by Fiona McIntosh. A good read. Karen Peardon - The Borrowed Life of Frederick Fife by Anna Johnston. A great story. Nola Schmidt - The Perfect Passion Company by Alexander McCall Smith. It was clever, witty, and gentle. June Lennie - People of the Book by Geraldine Brooks. Interesting story set in different historical periods. Brilliantly written and researched. Christine Hayes - Where the Crawdads Sing, just beautiful. Sandra Moores - All That's Left Unsaid by Tracey Lien. A great debut based in Cabramatta, very compelling read. Greg Cudmore - 'To Alpha From Omega'. Although very much Australian, its themes are universal. Denise Zephyr - The Days I Loved You Most. Such a beautiful story and a beautiful ending. Marie Chong - Minding Frankie by Maeve Binchy. I love all her books, she tells a good story. Yvonne Bercov - The Nightingale by Kristin Hannah, couldn’t put it down. Image credits: Shutterstock

Books

New details about Queen Elizabeth's final hours revealed

The final hours of Queen Elizabeth's life have been shared in a tell-all new book about the royals, detailing how Her Majesty was forced to pull out of an important meeting before she died. In his book, Charles III: New King, New Court, author Robert Hardman shared that the day before her death, Queen Elizabeth had met the departing British prime minister, Boris Johnson, and his replacement, Liz Truss, at Balmoral and attended a drinks party that same evening. Hardman wrote that the Queen felt "buzzy" at the event, but her health quickly took a turn for the worst. “She was quite buzzy over pre-dinner drinks,” one guest at the party told Hardman. “But then she said she was going upstairs to have dinner alone.” The monarch then spent the next day in bed, but reportedly arranged with the Privy Council to dial in via video link for an important meeting. As her health deteriorated throughout the day, that was changed to allow for her to call from her bedroom in an audio-only capacity, according to Hardman. But just moments before the meeting was set to get underway, the Queen reportedly made the difficult decision to cancel entirely on “medical advice”. It was that evening that then-Prince Charles was advised by Princess Anne and his private secretary to make his way urgently to his mother’s bedside, with fears that the end was near. Hardman writes that the following day, Charles was told his mother had died over the phone, having briefly left her bedside to have a moment to himself outside. Sadly, most of the royal family didn't make it to Balmoral in time to see the Queen before she passed, with Prince William, Prince Andrew, and Prince Edward and his wife Sophie all landing 40 minutes later. Prince Harry shared in his own memoir Spare that he learned of his grandmother’s death by reading it in a BBC breaking news alert, moments after his own flight landed. The Queen died at 3:10pm on September 8th 2022, after more than 70 years on the throne. Image credits: Shutterstock

Caring

"Psycho": Biographer reveals truth about Queen Elizabeth's corgis

The late Queen Elizabeth's love for her corgis was well known throughout her reign, but a new book suggests the pups weren't as sweet as they seemed. The late monarch was a fan of corgis and dorgis – a mix breed between a corgi and dachshund, and she bred them from a young age, owning a total of 83 over 14 generations. In his new biography, A Voyage Around the Queen, Journalist Craig Brown has revealed that the Queen's dogs were actually "psycho" and known for their unpredictable temperament. While it was a common trait for their breed, Brown claims that the lineage bred by the Queen was particularly nightmarish, especially her first Corgi, Dookie. "Dookie did not restrict his aggression to humans: he would happily attack the dining room chairs at Royal Lodge, the family home in Windsor Great Park," he shared. He claimed that Dookie even once bit a politician who came to visit. According to Brown, the corgi's disposition for violence was passed down from generation to generation, even recalling what the Queen's first dorgi, Honey, was like. "In 1984, Piper, the great-great-great-grand dorgi of Honey sank his teeth in several victims, including the Queen Mother and Prince Edward," explained Brown. The journalist added that Piper was then handed over to Princess Anne, who allegedly has a "soft spot for nippers and biters." The late Queen did eventually figure out how to keep the violence at bay, although the method itself is a little strange. "Coincidentally, the way to scare off a belligerent corgi is the same as for a belligerent human being: a blast from the bagpipes," Brown wrote. "Happily, the Queen always kept a set of bagpipes at hand." Images: Instagram/ thequeenscorgis

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

Music and dementia: researchers are still making discoveries about how songs can help sufferers

<a href="https://theconversation.com/profiles/rebecca-atkinson-1288605">Rebecca Atkinson</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/ming-hung-hsu-2215063">Ming-Hung Hsu</a>, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> Music is woven into the fabric of our everyday lives. Whether it’s lifting our spirits, pushing us to run faster or soothing us to sleep, we can all <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.713818/full">recognise its power</a>. So it’s no wonder it is increasingly being used in medical treatment. As well as proving very useful in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863265/">cancer treatment</a>, managing <a href="https://www.sciencedirect.com/science/article/pii/S1526590022000153">chronic pain</a> and even helping the brain <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2014.00245/full">recover after a stroke</a>, researchers have also been making great strides in using music to help patients with dementia. It reduces patients’ <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003477/full">anxiety and depression</a>, and <a href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00401-7/fulltext">improves wellbeing</a> both for them and their carers <a href="https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/individual-music-therapy-for-depression-randomised-controlled-trial/A1CD72904929CECCB956F4F3B09605AF">by enhancing</a> everyone’s ability to adapt and cope with adversity or stress. <a href="https://www.bamt.org">Music therapy</a> in the form of playing, singing or listening to music can also have a <a href="https://journals.sagepub.com/doi/abs/10.1177/1362361309105660">positive effect</a> on cognitive function – particularly for <a href="https://link.springer.com/article/10.1186/1472-6882-10-39">older adults</a> either with dementia or memory issues. So why does music appear to have such a powerful effect for people with dementia? <h2>Music and the brain</h2> About a decade ago, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1053811911013000">researchers discovered that</a> when people listened to music, multiple areas of the brain were involved in processing it. These included the limbic (which processes emotions and memory), cognitive (involved with perception, learning and reaction) and motor areas (responsible for voluntary movement). This challenged preconceptions that music was processed more narrowly in the brain – and helped explain why it has such a unique neurological impact. Not only that, research has shown that music might help <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306987708002880">regenerate the brain</a> and its connections. Many <a href="https://www.nhs.uk/conditions/dementia/about-dementia/causes/">causes of dementia</a> centre around cell death in the brain, raising the possibility that music could help people with dementia by mending or strengthening damaged neural connections and cells. It’s not just any music that has a regenerative effect on the brain, though. <a href="https://www.frontiersin.org/articles/10.3389/fnhum.2016.00103/full">Familiar and favourite music</a> has been shown to have the biggest impact on the way we feel, and is closely linked with memory and emotions. This is because listening to our favourite songs <a href="https://www.nature.com/articles/nn.2726">releases feel-good hormones</a> that give us a sense of pleasure. Curated music playlists of favourite music could be the key in helping us deal with the <a href="https://journals.sagepub.com/doi/full/10.1177/10298649211030318">stress of everyday life</a>. This is relevant to Alzheimer’s and other forms of dementia because researchers have discovered that parts of the brain linked with <a href="https://academic.oup.com/brain/article/138/8/2438/330016">musical memories</a> are less affected by these conditions than other areas of the brain. This explains why memories and experiences that are linked to <a href="https://link.springer.com/article/10.14283/jpad.2018.19">favourite music</a> are often preserved for people with such conditions. Listening to music can also <a href="https://pubmed.ncbi.nlm.nih.gov/34346261/">help manage</a> their experiences of distress, agitation and “<a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/sundowning">sundowning</a>” – where a person is more confused in the afternoon and evening. In a <a href="https://www.sciencedirect.com/science/article/pii/S0197457224002209?utm_campaign=STMJ_219742_AUTH_SERV_PA&utm_medium=email&utm_acid=224973760&SIS_ID=&dgcid=STMJ_219742_AUTH_SERV_PA&CMX_ID=&utm_in=DM500444&utm_source=AC_">small study</a> conducted by us and our colleagues at the Cambridge Institute for Music Therapy Research, we showed just how great of an effect listening to music can have for people with dementia. We found that when people with dementia repeatedly listened to their favourite music, their heart rate and movements changed in direct response. This showed that people’s physical responses were affected by musical features like rhythm and arrangement. Their heart rate also changed when they sang along to music, or when they began reminiscing about old memories or stories while listening to a song or thinking about the music. These changes are important because they show how music affects movement, emotions and memory recall. Studies have also shown that during and after listening to music, people with dementia <a href="https://www.mdpi.com/2076-3425/13/7/1103">experienced less agitation</a>, aggression and anxiety, and their general mood was improved. They even needed less medication when they had regular music sessions. Other researchers have even begun testing the effects of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/gps.4721?casa_token=VufeKQP7aNsAAAAA%3AMSOgiwUQYKqmmrLsUFv9glmSnc5BMxoqeMmmt3HX4BJX2Fs2UKeXjnN2850o1Umz0j1NvmrpQ3W3Pw">music training programmes</a> to support cognition for people with dementia. Results have been promising so far – with adults in the study showing improved executive functioning (problem solving, emotion regulation and attention) compared to those who took part in just physical exercise. So, music is likely to continue to be a useful medical treatment for people with dementia. But based on what we know so far, it’s important that it comes from the patient’s own music collection – and is used alongside other management techniques such as using drugs that can slow the progression of dementia or help manage symptoms to support self-care and wellbeing.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239446/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/rebecca-atkinson-1288605">Rebecca Atkinson</a>, Researcher in Music Therapy, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin University</a> and <a href="https://theconversation.com/profiles/ming-hung-hsu-2215063">Ming-Hung Hsu</a>, Senior Research Fellow, Music Therapy, <a href="https://theconversation.com/institutions/anglia-ruskin-university-1887">Anglia Ruskin 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/music-and-dementia-researchers-are-still-making-discoveries-about-how-songs-can-help-sufferers-239446">original article</a>.

Mind

"Happy wives, happy social lives?" Men are more emotionally disconnected than women – what can be done about it?

<a href="https://theconversation.com/profiles/roger-patulny-94836">Roger Patulny</a>, <a href="https://theconversation.com/institutions/hong-kong-baptist-university-2801">Hong Kong Baptist University</a> Many of us are worried about loneliness and isolation, and both <a href="https://theconversation.com/dont-be-fooled-loneliness-affects-men-too-15545">decade-old</a> and <a href="https://www.relationshipsnsw.org.au/blog/how-many-australians-are-lonely/">recent data</a> suggest they impact men more than women. Loneliness predicts health outcomes including <a href="https://journals.sagepub.com/doi/10.1177/1745691614568352">early mortality</a>, greater <a href="https://hqlo.biomedcentral.com/articles/10.1186/s12955-022-01946-6">psychological distress</a>, and more <a href="https://www.nature.com/articles/s41572-022-00355-9">cardiovascular, metabolic and neurological problems</a>. New research also links loneliness to <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18770-w">more intolerant attitudes towards women</a>. These findings raise concerns over the causes and impacts of men’s loneliness and isolation. <h2>A deep dive into loneliness</h2> I recently analysed more than 50 indicators from a decade of data collected by the <a href="https://www.acspri.org.au/aussa">Australian Social Attitudes Survey</a>, from 2011–12, 2015–16, 2017–18, and 2022–23. My statistical models produced results for (self-identified) men and women, after controlling for the impacts of age, employment and partner status. I confirmed that Australian men are more likely to be socially and emotionally disconnected than women. I also found some reasons why this might be the case. I found men appear to focus their emotional energies primarily on their nuclear families and partners. Consequently, they over-rely on their female partners for intimate support and develop more distant, limited and transactional relationships with other people – and other men. <h2>Men are more emotionally disconnected</h2> The data show men continue to lack emotional support on a range of indicators. This puts them at greater risk of health impacts and potentially encourages more toxic attitudes towards women. A significantly greater proportion of men than women reported: <ul> <li>receiving no support from their closest friend</li> <li>receiving fun/practical advice over emotional support from close friends</li> <li>having less contact with a close friend</li> <li>not having anyone for emotional support</li> <li>not feeling “very close” to their closest friend</li> <li>not feeling “love” as their most commonly experienced emotion in the last week.</li> </ul> <h2>Men have more distant, transactional relationships</h2> Why are men in this situation? Masculinity roles are clearly influential. Traditional masculinity encourages men to appear capable, controlled and independent, avoid displays of “vulnerable” emotions or male-to-male affection (like hugging, touch or crying), and embrace the hetero-normative ideal of male provision and leadership. Such norms have been found to constrain male intimacy <a href="https://pubmed.ncbi.nlm.nih.gov/37531906/">by disallowing vulnerability</a>. My data show men tend to develop looser, transactional ties with more distant people. This may reduce the quality of the connection and its potential to reduce loneliness. I have found men are more likely than women to: <ul> <li>think it is OK to befriend someone just because they’ll make a “useful” contact</li> <li>feel obligated to repay favours immediately (foregoing longer-term connections)</li> <li>be kind to others because they “value doing the right thing”, rather than because they empathically connect with or care about the person</li> <li>give and receive kindness from strangers (rather than more familiar people)</li> <li>seek help with household jobs from more distant family or friends</li> <li>seek practical support (money, advice) from private and commercial sources (rather than friends or family)</li> <li>not seek help from family or friends for emotional, sickness or care issues.</li> </ul> This means many men retain an individualist masculine desire to remain emotionally aloof. <hr /> <iframe id="TBJfz" class="tc-infographic-datawrapper" style="border: 0px none currentcolor;" src="https://datawrapper.dwcdn.net/TBJfz/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>Appearing in control but becoming dependent?</h2> So where do men turn for intimate, emotional connection? Most often, their families. Prior studies show partnered men are <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18770-w">less lonely than single men</a>. My data show men revere the nuclear family institution and the core supportive role of women and female partners. Men are more likely than women to: <ul> <li>believe having children increases their social standing</li> <li>believe family is more important than friends</li> <li>rely on family over friends for support</li> <li>have mixed-gender friendships (in contrast to womens’ predominately female friendships)</li> <li>see their (predominantly female) partner as their closest friend</li> <li>emotionally support their (predominantly female) partner ahead of supporting others.</li> </ul> However, the masculine desire to be a “good nuclear family man” <a href="https://pubmed.ncbi.nlm.nih.gov/37531906/">can both support and impede</a> men’s social connection. Partnered men might feel less lonely but that doesn’t mean they give or gain sufficient emotional support from their nuclear families. My data show men are less likely than women to: <ul> <li>plan or organise social and family activities</li> <li>have at least weekly contact with non-nuclear family or friends</li> <li>emotionally support their friends, family or children ahead of their partners</li> <li>have their partner support them ahead of others (women were more likely to support their children first).</li> </ul> This raises several issues. If men cling to the notion that their primary role is to provide for and support their (female) partner – while she in turn emotionally supports everyone else – they risk becoming personally isolated through diminished networks and outmoded expectations. In this context, men who believe they should earn more than their partners <a href="https://theconversation.com/loneliness-in-the-workplace-is-greatest-among-men-with-traditional-views-about-being-the-breadwinner-230535">are lonelier</a> than other men. It also risks pushing the burden of maintaining social and emotional connections onto <a href="https://www.harpersbazaar.com/culture/features/a27259689/toxic-masculinity-male-friendships-emotional-labor-men-rely-on-women/">women and partners</a>, and men becoming socially and emotionally dependent on them. And it can “bake in” hetero-normative family-to-family interactions (organised by female partners) as the most “legitimate” form of socialising for men. This can be highly exclusionary for LGBTQIA+ people, along with single men and single fathers, who register among <a href="https://www.relationships.org.au/relationship-indicators/">the highest rates of loneliness in Australia</a>. <hr /> <iframe id="qCmHw" class="tc-infographic-datawrapper" style="border: 0px none currentcolor;" src="https://datawrapper.dwcdn.net/qCmHw/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>How can men become more emotionally connected?</h2> Feelings shouldn’t be seen as just a <a href="https://www.harpersbazaar.com/culture/features/a27259689/toxic-masculinity-male-friendships-emotional-labor-men-rely-on-women/">“female thing”</a>. Younger men’s more inclusive masculine attitudes can allow them to <a href="https://theconversation.com/he-is-always-there-to-listen-friendships-between-young-men-are-more-than-just-beers-and-banter-200301">subvert the “rules” of masculinity</a>, express emotion and embrace <a href="https://theconversation.com/he-is-always-there-to-listen-friendships-between-young-men-are-more-than-just-beers-and-banter-200301">“bromances”</a>. Men can also connect emotionally with other men through <a href="https://theconversation.com/he-is-always-there-to-listen-friendships-between-young-men-are-more-than-just-beers-and-banter-200301">jokes and humour</a> and participating in shared activities <a href="https://theconversation.com/lost-touch-with-friends-during-lockdown-heres-how-to-reconnect-and-let-go-of-toxic-ones-172853">that allow incidental communication</a>, like Men’s Sheds. The following initiatives may well help men broaden their intimate networks beyond the nuclear family. We could:<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/239194/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <ul> <li>help men into caring roles through more <a href="https://theconversation.com/loneliness-in-the-workplace-is-greatest-among-men-with-traditional-views-about-being-the-breadwinner-230535">family friendly employment and care-leave policies</a></li> <li>support initiatives such as <a href="https://meninmind.movember.com/">Movember Men in Mind</a> that encourage men to seek help, and improve their emotional expression and support skills</li> <li>encourage partnered, heterosexual men to broaden and diversify their intimate networks beyond the nuclear family bubble, and be more inclusive of single men, single fathers, and LGBTQIA+ people. <a href="https://thephn.com.au/news/the-mens-table-successful-mental-health-initiative-expanding-across-seven-new-regions">Men’s Table initiatives</a> could be of great value here</li> <li>encourage the development of more online <a href="https://theconversation.com/he-is-always-there-to-listen-friendships-between-young-men-are-more-than-just-beers-and-banter-200301">safe spaces</a> to form intimate bonds while avoiding toxic online masculine spaces.</li> </ul> <a href="https://theconversation.com/profiles/roger-patulny-94836">Roger Patulny</a>, Professor, Academy of Geography, Sociology and International Studies, <a href="https://theconversation.com/institutions/hong-kong-baptist-university-2801">Hong Kong Baptist 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/happy-wives-happy-social-lives-men-are-more-emotionally-disconnected-than-women-what-can-be-done-about-it-239194">original article</a>.

Mind

Are older adults more vulnerable to scams? What psychologists have learned about who’s most susceptible, and when

<a href="https://theconversation.com/profiles/natalie-c-ebner-1527554">Natalie C. Ebner</a>, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> and <a href="https://theconversation.com/profiles/didem-pehlivanoglu-1527551">Didem Pehlivanoglu</a>, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> About 1 in 6 Americans <a href="https://www.census.gov/library/stories/2023/05/2020-census-united-states-older-population-grew.html">are age 65 or older</a>, and that percentage <a href="https://www.ncoa.org/article/get-the-facts-on-older-americans">is projected to grow</a>. Older adults often hold positions of power, have retirement savings accumulated over the course of their lifetimes, and make important financial and health-related decisions – all of which makes them attractive targets for financial exploitation. In 2021, there were more than 90,000 older victims of fraud, according to the FBI. These cases resulted in <a href="https://www.ic3.gov/Media/PDF/AnnualReport/2021_IC3ElderFraudReport.pdf">US$1.7 billion in losses</a>, a 74% increase compared with 2020. Even so, that may be a significant undercount, since embarrassment or lack of awareness <a href="https://assets.aarp.org/rgcenter/econ/fraud-victims-11.pdf">keeps some victims from reporting</a>. <a href="https://ncea.acl.gov/elder-abuse#gsc.tab=0">Financial exploitation</a> represents one of the most common forms of elder abuse. Perpetrators are often individuals in the victims’ inner social circles – family members, caregivers or friends – but can also be strangers. When older adults experience financial fraud, they typically <a href="https://public.tableau.com/app/profile/federal.trade.commission/viz/AgeandFraud/Infographic">lose more money</a> than younger victims. Those losses can have <a href="https://doi.org/10.1057/sj.2012.11">devastating consequences</a>, especially since older adults have limited time to recoup – dramatically reducing their independence, health and well-being. But older adults have been largely neglected in research on this burgeoning type of crime. We are <a href="https://ebnerlab.psych.ufl.edu/natalie-c-ebner-phd/">psychologists who study social cognition</a> and <a href="https://ebnerlab.psych.ufl.edu/didem-pehlivanoglu/">decision-making</a>, and <a href="https://ebnerlab.psych.ufl.edu/">our research lab</a> at the University of Florida is aimed at understanding the factors that shape vulnerability to deception in adulthood and aging. <h2>Defining vulnerability</h2> Financial exploitation involves a variety of exploitative tactics, such as coercion, manipulation, undue influence and, frequently, some sort of deception. The majority of current research focuses on <a href="https://doi.org/10.1002/acp.3052">people’s ability to distinguish between truth and lies</a> during interpersonal communication. However, deception occurs in many contexts – increasingly, over the internet. Our lab conducts laboratory experiments and real-world studies to measure susceptibility under various conditions: investment games, lie/truth scenarios, phishing emails, text messages, fake news and deepfakes – fabricated videos or images that are created by artificial intelligence technology. To study how people respond to deception, we use measures like surveys, brain imaging, behavior, eye movement and heart rate. We also collect health-related biomarkers, such as being a carrier of <a href="https://pubmed.ncbi.nlm.nih.gov/8346443/">gene variants</a> that increase risk for Alzheimer’s disease, to identify individuals with particular vulnerability. And <a href="https://doi.org/10.20900/agmr20230007">our work</a> shows that an older adult’s ability to detect deception is not just about their individual characteristics. It also depends on how they are being targeted. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=339&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=339&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=339&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=426&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=426&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593784/original/file-20240513-16-j9zy1i.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=426&fit=crop&dpr=3 2262w" alt="A figure with two circles and an arrow between them. One circle shows icons that symbolize individual susceptibility to deception -- like a brain, and a walking cane -- while the other has icons of types of deception, like mail or a text message." /></a><figcaption>Vulnerability depends not only on the person, but also the type of fraud being used. Natalie Ebner and Didem Pehlivanoglu</figcaption></figure> <h2>Individual risk factors</h2> Better cognition, social and emotional capacities, and brain health are all associated with less susceptibility to deception. Cognitive functions, such as how quickly our brain processes information and how well we remember it, <a href="https://doi.org/10.1177/1745691619827511">decline with age</a> and impact decision-making. For example, among people around 70 years of age or older, declines in analytical thinking are associated with <a href="https://doi.org/10.1037/xap0000426">reduced ability to detect false news stories</a>. Additionally, low memory function in aging is associated with <a href="https://doi.org/10.1093/geronb/gby036">greater susceptibility to email phishing</a>. Further, according to recent <a href="https://osf.io/preprints/osf/6f2y9">research</a>, this correlation is specifically pronounced among older adults who carry a gene variant that is a genetic risk factor for developing Alzheimer’s disease later in life. Indeed, some research suggests that greater financial exploitability may serve as <a href="https://doi.org/10.1016/j.neubiorev.2022.104773">an early marker</a> of disease-related cognitive decline. Social and emotional influences are also crucial. Negative mood can enhance somebody’s ability to detect lies, while <a href="https://doi.org/10.1037/xap0000426">positive mood in very old</a> age can impair a person’s ability to detect fake news. Lack of support and loneliness exacerbate susceptibility to deception. Social isolation during the COVID-19 pandemic has led to <a href="https://doi.org/10.1093/gerona/glaa077">increased reliance on online platforms</a>, and older adults with lower digital literacy are <a href="https://doi.org/10.1093/geront/gnac188">more vulnerable to fraudulent emails and robocalls</a>. Finally, an individual’s brain and body responses play a critical role in susceptibility to deception. One important factor is <a href="https://doi.org/10.1016/j.tins.2020.10.007">interoceptive awareness</a>: the ability to accurately read our own body’s signals, like a “gut feeling.” This awareness is correlated with <a href="https://doi.org/10.1093/geroni/igad104.3714">better lie detection</a> in older adults. According to <a href="https://doi.org/10.1093/gerona/glx051">a first study</a>, financially exploited older adults had a significantly smaller size of insula – a brain region key to integrating bodily signals with environmental cues – than older adults who had been exposed to the same threat but avoided it. Reduced insula activity is also related to greater difficulty <a href="https://doi.org/10.1073/pnas.1218518109">picking up on cues</a> that make someone appear less trustworthy. <h2>Types of effective fraud</h2> Not all deception is equally effective on everyone. <a href="https://doi.org/10.1145/3336141">Our findings</a> show that email phishing that relies on reciprocation – people’s tendency to repay what another person has provided them – was more effective on older adults. Younger adults, on the other hand, were more likely to fall for phishing emails that employed scarcity: people’s tendency to perceive an opportunity as more valuable if they are told its availability is limited. For example, an email might alert you that a coin collection from the 1950s has become available for a special reduced price if purchased within the next 24 hours. There is also evidence that as we age, we have greater difficulty detecting the “wolf in sheep’s clothing”: someone who appears trustworthy, but is not acting in a trustworthy way. In <a href="https://doi.org/10.1038/s41598-023-50500-x">a card-based gambling game</a>, we found that compared with their younger counterparts, older adults are more likely to select decks presented with trustworthy-looking faces, even though those decks consistently resulted in negative payouts. Even after learning about untrustworthy behavior, older adults showed greater difficulty overcoming their initial impressions. <h2>Reducing vulnerability</h2> Identifying who is especially at risk for financial exploitation in aging is crucial for preventing victimization. We believe interventions should be tailored, instead of a one-size-fits-all approach. For example, perhaps machine learning algorithms could someday determine the most dangerous types of deceptive messages that certain groups encounter – such as in text messages, emails or social media platforms – and provide on-the-spot warnings. Black and Hispanic consumers are <a href="https://www.ftc.gov/system/files/documents/reports/combating-fraud-african-american-latino-communities-ftcs-comprehensive-strategic-plan-federal-trade/160615fraudreport.pdf">more likely to be victimized</a>, so there is also a dire need for interventions that resonate with their communities. Prevention efforts would benefit from taking a holistic approach to help older adults reduce their vulnerability to scams. Training in <a href="https://doi.org/10.1007/s40520-019-01259-7">financial, health</a> and <a href="https://www.nature.com/articles/s41598-022-08437-0.pdf">digital literacy</a> are important, but so are programs to <a href="https://doi.org/10.1186/s12889-021-10363-1">address loneliness</a>. People of all ages need to keep these lessons in mind when interacting with online content or strangers – but not only then. Unfortunately, financial exploitation often comes from individuals close to the victim.<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/227991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/natalie-c-ebner-1527554">Natalie C. Ebner</a>, Professor of Psychology, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> and <a href="https://theconversation.com/profiles/didem-pehlivanoglu-1527551">Didem Pehlivanoglu</a>, Postdoctoral Researcher, Psychology, <a href="https://theconversation.com/institutions/university-of-florida-1392">University of Florida</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-older-adults-more-vulnerable-to-scams-what-psychologists-have-learned-about-whos-most-susceptible-and-when-227991">original article</a>.

Money & Banking

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

<a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even <a href="https://pubmed.ncbi.nlm.nih.gov/38337682/">more crucial</a> as we age. New guidelines from the international Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommend</a> people aged 75 and over should consider taking vitamin D supplements. But why is vitamin D so important for older adults? And how much should they take? <h2>Young people get most vitamin D from the sun</h2> In Australia, it is possible for most people under 75 to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun for a few minutes on most days. The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer. But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommends</a> people get 800 IU (international units) of vitamin D a day from food or supplements. <h2>Why you need more as you age</h2> This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D. Overall, older adults also tend to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/">less exposure</a> to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors. As we age, our skin also becomes <a href="https://pubmed.ncbi.nlm.nih.gov/18290718/">less efficient</a> at synthesising vitamin D from sunlight. The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889852913000145">harder for the body to maintain</a> adequate levels of the vitamin. All of this combined means older adults need more vitamin D. <h2>Deficiency is common in older adults</h2> Despite their higher needs for vitamin D, people over 75 may not get enough of it. Studies <a href="https://www.abs.gov.au/articles/vitamin-d">have shown</a> one in five older adults in Australia have vitamin D deficiency. In higher-latitude parts of the world, such as the United Kingdom, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627050/">almost half</a> don’t reach sufficient levels. This increased risk of deficiency is partly due to <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">lifestyle factors</a>, such as spending less time outdoors and insufficient dietary intakes of vitamin D. It’s difficult to get enough vitamin D from food alone. <a href="https://dietitiansaustralia.org.au/health-advice/vitamin-d">Oily fish, eggs and some mushrooms</a> are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference. In some countries such as the <a href="https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/">United States</a>, most of the dietary vitamin D comes from fortified products. However, in <a href="https://pubmed.ncbi.nlm.nih.gov/35253289">Australia</a>, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it. <h2>Why vitamin D is so important as we age</h2> Vitamin D <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367643/">helps the body absorb calcium</a>, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis. Keeping bones healthy is crucial. Studies <a href="https://pubmed.ncbi.nlm.nih.gov/28726112/">have shown</a> older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured. Vitamin D may also help <a href="https://pubmed.ncbi.nlm.nih.gov/28202713/">lower the risk</a> of respiratory infections, which can be more serious in this age group. There is also emerging evidence for other potential benefits, including <a href="https://pubmed.ncbi.nlm.nih.gov/29233204/">better brain health</a>. However, this requires more research. According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">moderate evidence</a> to suggest vitamin D supplementation can lower the risk of premature death. The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all. <h2>Should we get our vitamin D levels tested?</h2> The Endocrine Society’s guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">suggest</a> routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75. There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders. Routine <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498906">testing</a> can also be expensive and inconvenient. In most cases, the <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommended approach</a> to over-75s is to consider a daily supplement, without the need for testing. You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation. Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231820/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, PhD Candidate - Nutrition and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-you-over-75-heres-what-you-need-to-know-about-vitamin-d-231820">original article</a>.

Body

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

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

Body

Readers response: What’s the most unexpected thing you’ve learned about yourself through travel?

When it comes to travelling, it's not uncommon to have revelations about yourself while self-reflecting in a new place. We asked our readers what the most unexpected thing they've learned about themselves is through travel, and the response was overwhelming. Here's what they said. Penny Corbin - I don't need the cathedrals, monuments, the tours, I just love walking in the space and finding my own beauty wherever it leads me. Dom Cimino - That I really love meeting people of all backgrounds. Jenny Halkett - To treat it as an adventure, and don’t be afraid to ask a qualified person for advice. Kristeen Collison - That I’m more adventurous than I thought. Angie Jansen - That I love it. Just new places, culture, food, history, the wonderful people, the adventures you have and the memories, it’s the experiencing new things and learning, exploring, being amazed. Just so grateful I can still do it. Palma Hemer - To have a sense of humour, rain hail or shine. Anne Jenkin - That I can enjoy the travel by myself but I do like meeting new people on these trips. Kath Sheppard - To try to learn basic phrases when travelling. It's definitely appreciated. Kerry Fischer - Soak up the vibe wherever you are! Every place has beauty! Jacqueline Buchanan - That a smile speaks many languages. Martin Drake - That there is just too much to see and not enough time. Image credits: Shutterstock

Travel Tips

Fresh claims about Queen Elizabeth's health in her final days

Former British Prime Minister Boris Johnson has shared a sad claim about Queen Elizabeth and her secret health battle that she was going through before her death in 2022. Johnson reflected on his relationship with the former monarch in his upcoming memoir, Unleashed, detailing his final meeting with the Queen at Balmoral Castle just days before she died. In the book, he explained that the Queen had been battling bone cancer and was worried about the deterioration of her condition. “I had known for a year or more that she had a form of bone cancer, and her doctors were worried that at any time she could enter a sharp decline,” Johnson wrote in an excerpt obtained by the <a href="https://www.dailymail.co.uk/news/article-13901877/BORIS-JOHNSON-meeting-Queen-inspirational-words-wisdom.html">Daily Mail</a>. Before their meeting, Johnson claimed the Queen’s private secretary, Edward Young, warned him that her health had “gone down quite a bit over the summer.” “She seemed pale and more stooped, and she had dark bruising on her hands and wrists, probably from drips or injections,” Johnson wrote. He continued, “But her mind – as Edward had also said – was completely unimpaired by her illness, and from time to time in our conversation she still flashed that great white smile in its sudden mood-lifting beauty.” Queen Elizabeth died just two days after their final meeting. According to Johnson, the Queen “had known all summer that she was going, but was determined to hang on and do her last duty” by overseeing the “peaceful and orderly transition” of power from him to his successor Liz Truss. Johnson isn’t the first person to have claimed the late monarch was diagnosed with cancer during her final years, as royal author Gyles Brandreth wrote about rumours Her Majesty had a rare form of myeloma, a bone marrow cancer, in his book, Elizabeth: An Intimate Portrait. He explained that the diagnosis “would explain her tiredness and weight loss and those ‘mobility issues’ we were often told about during the last year or so of her life.” However, the Queen’s official cause of death was listed as “old age” and the palace has never disclosed any other medical records. Image credits: Andrew Parsons/No 10 Downing Street/UPI/Shutterstock Editorial

Caring

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

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

Body

Readers response: How do you feel about online shopping compared to traditional in-store shopping?

When it comes to shopping for things we want and need, many people have a preference over whether they shop in a physical store or online. We asked our readers which they prefer when shopping for food, clothes or anything else their hearts desire, and the response was overwhelming. Here's what they said. Ellen Polsen - Why would one buy online? I like to feel and see the things I purchase, particularly garments, as fabrics today are mostly rubbish. Jennie Craven - I do a little of each. But usually use stores that I know or brands where the sizing is correct for me. I always use a payment system that I understand. Gail Ladds - I love online shopping! I often forget that I’ve bought something then get a nice surprise when it arrives lol. Debra Coats - Online is okay when you cant go to the store. I did online shopping for about 8 months after open heart surgery but when i was given the all clear to shop and drive, I was in my element as its a moment of getting out of the house and seeing others around me. Karen Peardon - I have done some online shopping (mainly craft supplies) only because I have been very ill for months but I love in-store shopping more. Retail therapy!! Christine Whyte - Have not and will not ever do it, very old school and too wary of the dangers out there, besides I like getting out and choosing for myself. Helga Bonello - I like to see feel and touch products before I buy. Online scammers are a worry, besides we need a reason to go out and be sociable. Olimpia Palumbo - My family does on line shopping and usually end up with the worst fruit and sometimes the wrong items. Image credits: Shutterstock

Money & Banking

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

<a href="https://theconversation.com/profiles/gabrielle-weidemann-91497">Gabrielle Weidemann</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/justin-mahlberg-1634725">Justin Mahlberg</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard? High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928395/">activate</a> the brain’s reward system because in the past they were <a href="https://doi.org/10.1037/a0030684">rare</a>. Now, they’re all around us. In wealthy modern societies we are bombarded by <a href="https://theconversation.com/junk-food-is-promoted-online-to-appeal-to-kids-and-target-young-men-our-study-shows-234285">advertising</a> which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering <a href="https://doi.org/10.1111/obr.12354">an intense urge</a> to eat them. Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods. <h2>What causes cravings?</h2> A food craving is an intense desire or urge to eat something, <a href="https://pubmed.ncbi.nlm.nih.gov/15589112/">often focused on a particular food</a>. We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt. Something that <a href="https://doi.org/10.1111/obr.12354">reminds us</a> of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to <a href="https://doi.org/10.1111/obr.12354">crave it</a>. The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control. <h2>What else influences our choices?</h2> While the effect of cues on our physical response is relatively automatic, what we do next is influenced by <a href="https://journals.sagepub.com/doi/pdf/10.1177/1090198107303308">complex</a> factors. Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals. But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the <a href="https://doi.org/10.1016/j.physbeh.2010.04.029">pleasure of eating</a>, over one that’s delayed or abstract – including health goals that will make us feel good in the long term. <a href="https://doi.org/10.1016/S0022-3999(00)00076-3">Stress</a> can also make us eat more. When hungry, we <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8656885/">choose larger portions</a>, underestimate calories and find eating more <a href="https://www.sciencedirect.com/science/article/pii/S0195666315000793">rewarding</a>. <h2>Looking for something salty or sweet</h2> So what if a cue prompts us to look for a certain food, but it’s not available? <a href="https://doi.org/10.1016/j.appet.2014.04.005">Previous research</a> suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol. But our <a href="https://doi.org/10.1016/j.appet.2024.107640">new research</a> has confirmed something you probably knew: it’s more specific than that. If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy. <h2>Food cues and mindless eating</h2> Your <a href="https://core.ac.uk/download/pdf/161283824.pdf">eating history</a> and <a href="https://doi.org/10.1002/eat.24179">genetics</a> can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is <a href="https://doi.org/10.1016/j.appet.2015.01.004">hard</a> for almost everyone. Food cues are so powerful they can prompt us to <a href="https://doi.org/10.1177/0956797613484043">seek</a> out a certain food, even if we’re not overcome by a particularly <a href="https://doi.org/10.1177/0956797613484043">strong urge</a> to eat it. The effect is more intense if the food is easily available. This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we <a href="https://doi.org/10.1016/0031-9384(81)90310-3">eat</a>. Sometimes we use finishing the packet as the signal to stop <a href="https://doi.org/10.1016/j.physbeh.2015.03.025">eating</a> rather than hunger or desire. <h2>Is there anything I can do to resist cravings?</h2> We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in. <ul> <li> Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit. </li> <li> Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle. </li> <li> At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment. </li> <li> Make sure your goals for eating are <a href="https://www.aafp.org/pubs/fpm/issues/2018/0300/p31.html">SMART</a>. This means they are specific, measurable, achievable, relevant and time-bound. </li> <li> Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237035/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> </li> </ul> <a href="https://theconversation.com/profiles/gabrielle-weidemann-91497">Gabrielle Weidemann</a>, Associate Professor in Psychological Science, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> and <a href="https://theconversation.com/profiles/justin-mahlberg-1634725">Justin Mahlberg</a>, Research Fellow, Pyschology, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-causes-food-cravings-and-what-can-we-do-about-them-237035">original article</a>.

Food & Wine

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

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

Body

Billy Connolly shares candid admission about Parkinson's battle

Billy Connolly has shared his candid thoughts around death as he discussed his ongoing battle with Parkinson's. The comedian and actor, 81, recalled how he was told to "confront his illness" after being diagnosed with Parkinson's and prostate cancer on the same day. "You just confront it and make decisions based on it," he told <a href="https://www.mirror.co.uk/3am/celebrity-news/sir-billy-connolly-reveals-first-33564191" target="_blank" rel="noopener">The Mirror</a>. <div> <div id="adspot-mobile-mobile-3-above"></div> </div> "You just have to think 'Don't think you are being badly treated [in life] or you have the bad pick of the straws. You are one of millions'." "Then you then realise death is not the big thing everyone has made it out to be. It is nothing. It is just a sudden nothing." Despite the dual diagnosis, Connolly reflected on the "funny week", as he said, "On the Monday, I had hearing aids. On the Tuesday I got pills for heart burn, which I have to take all the time, and on the Wednesday I got news that I had prostate cancer and Parkinson's." The star then joked that he probably got the disease following his several appearances on Michael Parkinson's chat show, saying, "I just thought 'I have got Parkinson's. I wish he (Michael) had kept it to himself!' It was easy (making fun of it)." Earlier this year, Billy issued a health update in which he said being sick feels "strange", telling GB News in February, "Being unwell is strange. Everybody else is OK and you've got this thing that's wrong... you're out of step." Two years ago, ahead of receiving an award, he told <a title="bafta.org" href="https://www.bafta.org/" target="_blank" rel="noopener">Bafta.org</a> he's determined to not let the condition "dictate" who he is and is determined to not let it get him down. "It's really important to work, to draw, to write, to walk silly for your grandchildren," he said at the time. "Doing the same thing you've always done is good for you. I don't let the Parkinson's dictate who I am – I just get on with it. I've had a very successful career and I have no regrets at all." Image credits: Joanne Davidson/Shutterstock Editorial

Caring

How long does back pain last? And how can learning about pain increase the chance of recovery?

<a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Back pain is common. One in thirteen people have it right now and worldwide a staggering 619 million people will <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">have it this year</a>. Chronic pain, of which back pain is the most common, is the world’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186678/">most disabling</a> health problem. Its economic impact <a href="https://www.ncbi.nlm.nih.gov/books/NBK92510/">dwarfs other health conditions</a>. If you get back pain, how long will it take to go away? We scoured the scientific literature to <a href="https://www.cmaj.ca/content/cmaj/196/2/E29.full.pdf">find out</a>. We found data on almost 20,000 people, from 95 different studies and split them into three groups: <ul> <li>acute – those with back pain that started less than six weeks ago</li> <li>subacute – where it started between six and 12 weeks ago</li> <li>chronic – where it started between three months and one year ago.</li> </ul> We found 70%–95% of people with acute back pain were likely to recover within six months. This dropped to 40%–70% for subacute back pain and to 12%–16% for chronic back pain. Clinical guidelines point to graded return to activity and pain education under the guidance of a health professional as the best ways to promote recovery. Yet these effective interventions are underfunded and hard to access. <h2>More pain doesn’t mean a more serious injury</h2> Most acute back pain episodes are <a href="https://www.racgp.org.au/getattachment/75af0cfd-6182-4328-ad23-04ad8618920f/attachment.aspx">not caused</a> by serious injury or disease. There are rare exceptions, which is why it’s wise to see your doctor or physio, who can check for signs and symptoms that warrant further investigation. But unless you have been in a significant accident or sustained a large blow, you are unlikely to have caused much damage to your spine. Even very minor back injuries can be brutally painful. This is, in part, because of how we are made. If you think of your spinal cord as a very precious asset (which it is), worthy of great protection (which it is), a bit like the crown jewels, then what would be the best way to keep it safe? Lots of protection and a highly sensitive alarm system. The spinal cord is protected by strong bones, thick ligaments, powerful muscles and a highly effective alarm system (your nervous system). This alarm system can trigger pain that is so unpleasant that you cannot possibly think of, let alone do, anything other than seek care or avoid movement. The messy truth is that when pain persists, the pain system becomes more sensitive, so a widening array of things contribute to pain. This pain system hypersensitivity is a result of neuroplasticity – your nervous system is becoming better at making pain. <h2>Reduce your chance of lasting pain</h2> Whether or not your pain resolves is not determined by the extent of injury to your back. We don’t know all the factors involved, but we do know there are things that you can do to reduce chronic back pain: <ul> <li> understand how pain really works. This will involve intentionally learning about modern pain science and care. It will be difficult but rewarding. It will help you work out what you can do to change your pain </li> <li> reduce your pain system sensitivity. With guidance, patience and persistence, you can learn how to gradually retrain your pain system back towards normal. </li> </ul> <h2>How to reduce your pain sensitivity and learn about pain</h2> Learning about “how pain works” provides the most sustainable <a href="https://www.bmj.com/content/376/bmj-2021-067718">improvements in chronic back pain</a>. Programs that combine pain education with graded brain and body exercises (gradual increases in movement) can reduce pain system sensitivity and help you return to the life you want. These programs have been in development for years, but high-quality clinical trials <a href="https://jamanetwork.com/journals/jama/fullarticle/2794765">are now emerging</a> and it’s good news: they show most people with chronic back pain improve and many completely recover. But most clinicians aren’t equipped to deliver these effective programs – <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">good pain education</a> is not taught in most medical and health training degrees. Many patients still receive ineffective and often risky and expensive treatments, or keep seeking temporary pain relief, hoping for a cure. When health professionals don’t have adequate pain education training, they can deliver bad pain education, which leaves patients feeling like they’ve just <a href="https://www.jpain.org/article/S1526-5900(23)00618-1/fulltext">been told it’s all in their head</a>. Community-driven not-for-profit organisations such as <a href="https://www.painrevolution.org/">Pain Revolution</a> are training health professionals to be good pain educators and raising awareness among the general public about the modern science of pain and the best treatments. Pain Revolution has partnered with dozens of health services and community agencies to train more than <a href="https://www.painrevolution.org/find-a-lpe">80 local pain educators</a> and supported them to bring greater understanding and improved care to their colleagues and community. But a broader system-wide approach, with government, industry and philanthropic support, is needed to expand these programs and fund good pain education. To solve the massive problem of chronic back pain, effective interventions need to be part of standard care, not as a last resort after years of increasing pain, suffering and disability.<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/222513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/sarah-wallwork-1361569">Sarah Wallwork</a>, Post-doctoral Researcher, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/lorimer-moseley-1552">Lorimer Moseley</a>, Professor of Clinical Neurosciences and Foundation Chair in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-long-does-back-pain-last-and-how-can-learning-about-pain-increase-the-chance-of-recovery-222513">original article</a>.

Body

What your nose can tell you about your health

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</a> Thanks to a quirk known as <a href="https://www.psychologytoday.com/us/blog/brain-babble/201502/is-how-the-brain-filters-out-unimportant-details">unconscious selective attention</a>, your brain has learned to ignore your nose. A prominent feature that’s positioned closely to the eyes, the schnoz could get in the way of our vision – but the nervous system cleverly filters it out. You can choose to look for your nose though. Either close one eye or look left, right or downwards and it’ll pop into view. But, although your brain works hard to stop your nose from interfering with your line of vision, your snout is not something to ignore. Like <a href="https://theconversation.com/navel-gazing-checking-your-belly-button-can-tell-you-a-lot-about-your-health-228759">many other</a> parts of your body, examining the nose can help diagnose external skin conditions – and internal diseases. <h2>Acne</h2> While there are a <a href="https://www.nhs.uk/conditions/acne/">number of forms</a> of <a href="https://patient.info/skin-conditions/acne-leaflet">acne</a>, <a href="https://dermnetnz.org/topics/acne-vulgaris">acne vulgaris</a> is the most common – and it often affects the nose. This skin condition develops from the clogging of tiny glands in the skin that secrete protective oils, which leads to <a href="https://www.medicalnewstoday.com/articles/comedonal-acne#outlook">open and closed comedones</a>. Open comedones – better known as blackheads – develop a dark coloured plug, whereas closed comedones are whiteheads that form when the pore is blocked completely. Clogged pores can also develop into larger lumps and bumps which can become infected, inflamed and and pus-filled and can even scar the skin. <a href="https://dermnetnz.org/topics/rosacea">Acne rosacea</a> has a different appearance. It is an inflammatory skin condition that causes erythema – or reddening of the skin – most often across the nose and cheeks. Rosacea <a href="https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/rosacea/#:%7E:text=Although%20rosacea%20can't%20be,you%20can%20stop%20treatment%20temporarily.">is currently incurable</a> but it can be managed, often with long-term treatment. Patients with rosacea may often develop a rash papules and pustules that resembles acne – and also have visible blood vessels that appear as thin red or purplish lines across the nose and cheeks. In some cases, rosacea can cause the skin of the nose to grow and thicken. This condition is referred to as <a href="https://patient.info/doctor/rosacea-and-rhinophyma">rhinophyma</a>, and, like other visible skin conditions, can result in profound changes to appearance and seriously affect self-esteem in sufferers. <figure><iframe src="https://www.youtube.com/embed/cO9pa0aGBTY?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> Both acne vulgaris and rosacea have been connected with <a href="https://pubmed.ncbi.nlm.nih.gov/32238884/">various risk factors</a> and health conditions, though some links are stronger than others. In the case of rosacea, the list includes <a href="https://pubmed.ncbi.nlm.nih.gov/32621366/">high blood pressure and cholesterol</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/29107339/">diabetes and rheumatoid arthritis</a>. <h2>Wolf’s nose</h2> <a href="https://www.sarcoidosisuk.org/information-hub/what-is-sarcoidosis/">Sarcoidosis</a>, is an inflammatory disease that can affect any of the body’s tissues – though mainly the lungs and lymph nodes. The condition can generate patches of bluish or purplish rashes, particularly on the body’s extremities where the skin is typically cooler. This includes the ears, the fingers and toes, and of course, the nose. When sarcoidosis affects the nose, it’s known as <a href="https://dermnetnz.org/topics/lupus-pernio">lupus pernio</a>, although the name is a misnomer because this condition is not the same as the <a href="https://lupusuk.org.uk/the-symptoms/">autoimmune disease known as lupus</a>. Regular lupus is a completely different condition where the body attacks its own tissues. It takes its name from the Latin word for “wolf” and the name dates back to <a href="https://pubmed.ncbi.nlm.nih.gov/32380218/">medieval times</a> when the associated skin rash was said to resemble the bite of a wolf. When lupus, rather than sarcoidosis, affects the skin it generates a <a href="https://www.medicalnewstoday.com/articles/321594">butterfly rash</a> – or <a href="https://www.ncbi.nlm.nih.gov/books/NBK555981/">malar rash</a>, which fans across the cheeks and nasal bridge. This rash can look very similar to rosacea. In fact, lupus is known as <a href="https://www.nature.com/articles/nm1103-1337a">“the great imitator”</a> because it shares similar symptoms to many different diseases. <h2>Trigeminal trophic syndrome</h2> <a href="https://dermnetnz.org/topics/trigeminal-trophic-syndrome">Trigeminal trophic syndrome</a> is a rare condition triggered by damage to the <a href="https://teachmeanatomy.info/head/cranial-nerves/trigeminal-nerve/">trigeminal nerve</a>, which controls chewing but also gives sensation to the face. When the smaller nerve branches supplying the area of skin around the nostrils are damaged, sensation is affected. The patient notices either the skin becoming desensitised, or numb – or that it prickles, like pins and needles, creating an urge to pick or scratch. Repeated damage to the skin can <a href="https://rarediseases.org/rare-diseases/trigeminal-trophic-syndrome/">cause ulcers</a> to develop around the nostrils. This condition differs from <a href="https://theconversation.com/skin-picking-is-often-trivialised-as-a-bad-habit-but-dermatillomania-can-be-dangerous-224659">skin picking disorder</a> – or dermatillomania – when a psychological compulsion drives the desire to pick at the skin. So, close one eye every now and then in order to admire your hooter, or, even better have a good look at it in the mirror. It deserves more recognition than the blind spot your brain allows.<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/228760/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/dan-baumgardt-1451396">Dan Baumgardt</a>, Senior Lecturer, School of Physiology, Pharmacology and Neuroscience, <a href="https://theconversation.com/institutions/university-of-bristol-1211">University of Bristol</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-your-nose-can-tell-you-about-your-health-228760">original article</a>. </div>

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