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

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

Caring

How to rewire your brain to feel good on Monday

<a href="https://theconversation.com/profiles/cristina-r-reschke-1413051">Cristina R. Reschke</a>, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> and <a href="https://theconversation.com/profiles/jolanta-burke-315263">Jolanta Burke</a>, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> If you hate Mondays, you’re most certainly in good company. After a couple of days off, many of us have difficulty settling back into our routines and work duties. You may even have dread and anxiety that seeps into the weekend in the form of “<a href="https://theconversation.com/three-ways-to-tackle-the-sunday-scaries-the-anxiety-and-dread-many-people-feel-at-the-end-of-the-weekend-187313">Sunday scaries</a>”. You can’t always change your schedule or obligations to make Mondays more appealing, but you may be able to “reprogram” your brain to think about the week differently. Our brains love predictability and routine. Research has shown that lack of routine is associated with <a href="https://journals.sagepub.com/doi/full/10.1177/0003122418823184">decline in wellbeing and psychological distress</a>. Even though the weekend heralds a leisurely and pleasant time, our brain works hard to adjust to this sudden change to a routine. The good news is that the brain does not need to make too much effort when adjusting to the weekend’s freedom and lack of routine. However, it’s a different story when coming back to the less pleasant activities, such as a to-do list on Monday morning. One way to adjust to post-weekend change is introducing routines that last the whole week and have the power to make our lives <a href="https://journals.sagepub.com/doi/full/10.1177/0146167218795133">more meaningful</a>. These may include <a href="https://portal.research.lu.se/en/publications/routines-made-and-unmade">watching your favourite TV programme, gardening</a> or going <a href="https://pubmed.ncbi.nlm.nih.gov/22976286/">to the gym</a>. It is helpful to do these things at the same time every day. Routines improve our <a href="https://pubmed.ncbi.nlm.nih.gov/16448317/">sense of coherence</a>, a process that allows us to make sense of the jigsaw of life events. When we have an established routine, be it the routine of working five days and taking two days off or engaging in a set of actions every day, our lives become <a href="https://journals.sagepub.com/doi/full/10.1177/0146167218795133">more meaningful</a>. Another important routine to establish is your sleep routine. <a href="https://www.nature.com/articles/s41746-021-00400-z">Research shows</a> that keeping consistent sleep time may be as important for enjoying Mondays as how long your sleep lasts or its quality. Changes in sleep patterns during weekends trigger <a href="https://www.mdpi.com/2072-6643/13/12/4543">social jetlag</a>. For instance, sleeping in later than usual and for longer on free days may trigger a discrepancy between your body clock and socially-imposed responsibilities. This is linked to higher stress levels on Monday morning. Try to keep a set time for going to bed and waking up, avoid naps. You might also want to create a 30 minute “wind-down” routine before sleep, by turning off or putting away your digital devices and practising relaxation techniques. <h2>Hacking your hormones</h2> Hormones can also play a role in how we feel about Mondays. For instance, cortisol is a very important multifunction hormone. It helps our bodies to control our metabolism, regulate our sleep-wake cycle and our response to stress, among other things. It is usually released about an hour before we wake up (it helps us feel awake) and then its levels lower until the next morning, unless we’re under stress. Under acute stress, our bodies release not only cortisol, but also adrenaline in preparation for fight or flight. This is when the heart beats fast, we get sweaty palms and may react impulsively. This is our amygdala (a small almond-shaped area in the base of our brains) hijacking our brains. It creates a super fast emotional response to stress even before our brains can process and think whether it was needed. But as soon we can think – activating the brain’s prefrontal cortex, the area for our reason and executive thinking – this response will be mitigated, if there is no real threat. It is a constant battle between our emotions and reason. This might wake us up in the middle of the night when we’re too stressed or anxious. It shouldn’t be surprising then that cortisol levels, measured in saliva samples of full-time working individuals, tend to be higher on Mondays and Tuesdays, with the lowest levels reported on <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824866/">Sundays</a>. As a stress hormone, cortisol fluctuates daily, but not consistently. On weekdays, as soon as we wake up, <a href="https://psycnet.apa.org/record/2007-18151-008">cortisol levels soar</a> and variations tend to be higher than on <a href="https://pubmed.ncbi.nlm.nih.gov/11324714/">weekends</a>. To combat this, we need to trick the amygdala by training the brain to only recognise actual threats. In other words, we need to activate our prefrontal cortex as fast as possible. One of the best ways to achieve this and lower overall stress is through relaxation activities, especially on Mondays. One possibility is mindfulness, which is associated with a <a href="https://pubmed.ncbi.nlm.nih.gov/23724462/">reduction in cortisol</a>. <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00722/full">Spending time in nature</a> is another method – going outside first thing on Monday or even during your lunch hour can make a significant difference to how you perceive the beginning of the week. Give yourself time before checking your phone, social media and the news. It’s good to wait for cortisol peak to decrease naturally, which happens approximately one hour after waking up, before you expose yourself to external stressors. By following these simple tips, you can train your brain to believe that the weekdays can be (nearly) as good as the weekend.<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/199236/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/cristina-r-reschke-1413051">Cristina R. Reschke</a>, Lecturer in the School of Pharmacy and Biomolecular Sciences & Funded Investigator in the FutureNeuro Research Centre, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</a> and <a href="https://theconversation.com/profiles/jolanta-burke-315263">Jolanta Burke</a>, Senior Lecturer, Centre for Positive Health Sciences, <a href="https://theconversation.com/institutions/rcsi-university-of-medicine-and-health-sciences-788">RCSI University of Medicine and Health Sciences</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-rewire-your-brain-to-feel-good-on-mondays-199236">original article</a>.

Mind

Breakthrough study finds genetic link to Parkinson's and ADHD

A major scientific study has found a surprising link between the genes that control brain size and the risk of brain-related conditions. A Queensland Institute of Medical Research Associate Professor Miguel Renteria led an international team of experts who scanned DNA data and MRI scans from 76,000 participants. “Genetic variants associated with larger brain volumes in key brain regions also increase the risk of Parkinson’s disease, while variants linked to smaller brain volumes in key regions are associated with an increased risk of ADHD,” Renteria said. “It brings us closer to answering key questions about how genetics influence brain structure, and how we can potentially treat these conditions in future.” Parkinson’s Australia CEO Olivia Nassaris has celebrated the results of the study, saying the surprising results open the door to future treatment options for Parkinson’s, which currently has no cure or cause. “The more answers we have the closer we are to understanding this condition,” she said. Michael Wiseman, who has been living with Parkinson’s for eight years, said he is pleased more research is being done about the neurodegenerative condition. “I know it’s not going to benefit me in any way, as far as a cure or anything … I just hope they keep going, kicking some goals and finding results because it’s an insidious sort of thing, it’s a passenger I’ll have until I go to the grave.” Image credits: Shutterstock

Caring

Retiring early can be bad for the brain

<a href="https://theconversation.com/profiles/plamen-v-nikolov-1112610">Plamen V Nikolov</a>, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</a> The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work. <h2>The big idea</h2> People who retire early suffer from accelerated cognitive decline and may even encounter early onset of dementia, according to a I conducted with my doctoral student <a href="https://sites.google.com/binghamton.edu/alan-adelman/home">Alan Adelman</a>. To establish that finding, we examined the effects of a rural pension program China introduced in 2009 that provided people who participated with a stable income if they stopped working after the official retirement age of 60. We found that people who participated in the program and retired within one or two years experienced a cognitive decline equivalent to a drop in general intelligence of 1.7% relative to the general population. This drop is equivalent to about three IQ points and could make it harder for someone to <a href="https://doi.org/10.1017/S0033291700008412">adhere to a medication schedule</a> or <a href="https://doi.org/10.1111/j.1475-%205890.2007.00052.x">conduct financial planning</a>. The largest negative effect was in what is called “delayed recall,” which measures a person’s ability to remember something mentioned several minutes ago. Neurological research <a href="https://doi.org/10.1001/archneur.1991.00530150046016">links problems in this area to an early onset of dementia</a>. <h2>Why it matters</h2> Cognitive decline refers to when a person has trouble remembering, learning new things, concentrating or making decisions that affect their everyday life. Although some cognitive decline appears to be an inevitable byproduct of aging, faster decline can have profound adverse consequences on one’s life. Better understanding of the causes of this has powerful financial consequences. Cognitive skills – the mental processes of gathering and processing information to solve problems, adapt to situations and learn from experiences – are crucial for decision-making. They influence an individual’s ability to process information and <a href="https://www.jstor.org/stable/1818642">are connected to higher earnings</a> and a <a href="https://www.doi.org/10.1257/jep.25.1.159">better quality of life</a>. Retiring early and working less or not at all can generate large benefits, such as reduced stress, better diets and more sleep. But as we found, it also has unintended adverse effects, like fewer social activities and less time spent challenging the mind, that far outweighed the positives. While retirement schemes like the 401(k) and similar programs in other countries <a href="https://www.doi.org/10.1023/B:PUCH.0000035859.20258.e0">are typically introduced to ensure the welfare of aging adults</a>, our research suggests they need to be designed carefully to avoid unintended and significant adverse consequences. When people consider retirement, they should weigh the benefits with the significant downsides of a sudden lack of mental activity. A good way to ameliorate these effects is to stay engaged in social activities and continue to use your brains in the same way you did when you were working. In short, we show that if you rest, you rust. <h2>What still isn’t known</h2> Because we are using data and a program in China, the mechanisms of how retirement induces cognitive decline could be context-specific and may not necessarily apply to people in other countries. For example, cultural differences or other policies that can provide support to individuals in old age can buffer some of the negative effects that we see in rural China due to the increase in social isolation and reduced mental activities. Therefore, we can not definitively say that the findings will extrapolate to other countries. We are looking for data from other countries’ retirement programs, such as India’s, to see if the effects are similar or how they are different. <h2>How I do my research</h2> A big focus of the <a href="https://scholar.harvard.edu/pnikolov/my-research-group-1">economics research lab</a> I run is to <a href="http://www.nber.org/%7Enikolovp/research.html">better understand</a> the causes and consequences of changes in what economists call <a href="https://www.britannica.com/topic/human-capital">“human capital”</a> – especially cognitive skills – in the context of developing countries. Our lab’s mission is to generate research to inform economic policies and empower individuals in low-income countries to rise out of poverty. One of the main ways we do this is through the use of randomized controlled trials to measure the impact of a particular intervention, such as retiring early or access to microcredit, on education outcomes, productivity and health decisions. <a href="https://theconversation.com/profiles/plamen-v-nikolov-1112610">Plamen V Nikolov</a>, Assistant Professor of Economics, <a href="https://theconversation.com/institutions/binghamton-university-state-university-of-new-york-2252">Binghamton University, State University of New York</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/retiring-early-can-be-bad-for-the-brain-145603">original article</a>.

Mind

Controversial suicide capsule applications suspended amid investigation

Advocacy groups behind the suicide capsule have suspended the process of taking applications amid a criminal investigation into its first use in Switzerland. In a statement on Sunday, they said that 371 people were “in the process of applying” to use the device, known as the Sarco, as of September 23 and applications were suspended after its first use. The Sarco capsule is designed to allow the person inside to push a button that injects nitrogen gas from a tank underneath into the sealed chamber, allowing the person to fall asleep and then die of suffocation in a few minutes. On September 23, an unidentified 64-year-old woman from the US Midwest, became the first person to use the device in a forest in the northern Schaffhausen region. The president of Switzerland-based The Last Resort, Florian Willet, said at the time that the woman's death was "peaceful, fast, and dignified", although those claims could not be independently verified. On the same day as the woman's death, Swiss Health Minister Elisabeth Baume-Schneider told parliament that use of the Sarco would not be legal. Willet and several others were taken into custody following her death and prosecutors opened an investigation on suspicion of incitement and accessory to suicide. Willet is currently being held in pretrial detention, according to The Last Resort and Exit International, an affiliate founded in Australia over a quarter-century ago. The others who were detained were released from custody. Exit International also clarified that their lawyers in Switzerland believed the use of the device is legal. “Only after the Sarco was used was it learned that Ms Baume-Schneider had addressed the issue,” the advocacy groups said in the statement Sunday. “The timing was a pure coincidence and not our intention.” Switzerland has some of the most permissive laws when it comes to assisted suicide, but the first use of the Sarco has prompted debate among lawmakers. Laws in the country permit assisted suicide, as long as the person takes their own life with no “external assistance” and those who help the person die do not do so for “any self-serving motive”. Image: Exit International

Legal

The best exercises to boost your brain health after 60

<a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a> Have you ever thought about why we have a <a href="https://theconversation.com/fr/topics/cerveau-21903">brain</a>? The obvious answer might be “to think”. But scientist Daniel Wolpert came up with a completely different explanation at the <a href="https://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains">2011 meeting of the Society for Neuroscience</a>: <blockquote> “We have a brain for one reason and one reason only: to produce adaptable and complex movements” </blockquote> <h2>Use your brain to stay efficient</h2> The brain, in other words, is the orchestra conductor which orders the body’s movements. We call the faculties that allow us to interact with our environment cognitive abilities. These include concentrating, learning, reasoning, adapting and communicating with others. Every one of them is key in enabling us to go about our routine and help us maintain a good lifestyle. So, how can we best take care of our brains so that they can stay as efficient as long as possible? Contrary to popular belief, the brain does not deteriorate continuously with age. Instead, it only sees the number of its brain cells drop and connections deteriorate <a href="https://www.bmj.com/content/344/bmj.d7622">from the age of 45 onwards</a> as part of a normal ageing process. But cerebral plasticity, although reduced, is present until the end of life. Each individual will build up a cognitive reserve throughout their lives. The more positive, rich and stimulating the lifestyle, the more powerful and effective the reserve. In other words, it’s possible to moderate the effects of age on cognition. <h2>The benefits of physical activity on cognitive capacity after 60</h2> In fact, much research shows indeed that physical activity improves cognitive capacity, even after the age of 60. From increased memory, better reactivity to greater planning skills, the <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-clinpsy-072720-014213">benefits are endless</a>. Despite this, few older folks engage in <a href="https://theconversation.com/fr/topics/activite-physique-adaptee-apa-146288">physical education</a> adapted to their bodies on a regular basis. Poor motivation and access to these exercises are some of the factors don’t help. With that in mind, many carers might be tempted to offer older people monotonous, routine activities because of their diminishing physical, cognitive and sensory abilities. And indeed, for a long time, the range of sports on offer and research in this field revolved around the same triptych: gentle gymnastics, walking and yoga. However, you’ll reap more benefits by <a href="https://www-sciencedirect-com.ezproxy.u-paris.fr/science/article/abs/pii/B9780444633279000175">combining different training methods</a>. <h2>Three ingredients to train the brains of senior citizens</h2> Researchers are currently attempting to crack the winning formula that would flex older people’s cognitive, as well as physical muscles. It’ll consist of three main ingredients: First ingredient: complex physical and motor stimulation of at least moderate intensity. Moderate cardio workouts not only improve cardiorespiratory health but also make the brain more <a href="https://www.nature.com/articles/22682">efficient</a>. Overall improved cardiofitness, in turn, allows the brain to receive more oxygen and even to generate <a href="https://www.pnas.org/doi/full/10.1073/pnas.1015950108">new neurons in the hippocampus</a>, where memory is lodged. It therefore makes sense for programmes designed to boost cognitive function to include cardio. But it is also <a href="https://journals.sagepub.com/doi/abs/10.1111/1467-9280.t01-1-01430">necessary to combine them with muscle-strengthening, flexibility and balance exercises to achieve greater benefits</a>. In addition, the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763413001012">researchers</a> emphasise the importance of adding situations requiring complex motor skills and coordination, as these would have a significant impact on cognitive functions (e.g. memory, attention and mental flexibility), particularly in the elderly. Second ingredient: fire up those brain cells during exercises Incorporating cognitive stimulation, such as remembering information for a period of time and executing it, anticipating actions, or planning a move, is another winning strategy. When cognitive stimulation is combined with physical activity, it can produce <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">synergistic effects</a> and, as a result, be more effective on cognitive functions. _Third ingredient: group activities that lead to social interaction. _ Working out as part of a group has been shown to help us <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001756">persevere through it</a>. What this winning formula could look like in practice is still being researched. At present, there are two broad types of exercises that have caught our attention that could help older people stay sharp. <h2>Opting for cooperative and oppositional team sports</h2> Team sports offer much more than just physical exercise sessions. What’s particularly great about them is that they don’t only challenge cardiorespiratory balance, but tap into the whole body’s physical skill-set. Take basketball or handball, for example: to move around the court, dribble or score, balance, coordination and flexibility are essential. Muscular strength is also required for passing, recovering the ball and moving around. These team sports can be suitable even after the age of 60, provided they are properly supervised. From a cognitive point of view, these activities create situations that are always new, rich and stimulating. We call this double combination of stimuli <a href="https://www.tandfonline.com/doi/abs/10.1080/13825585.2011.645010">simultaneous training</a>. A number of researchers have highlighted the importance of this cognitive involvement in team sports and encourage their practice, particularly among the elderly. Recent studies, such as <a href="https://linkinghub.elsevier.com/retrieve/pii/S162748302100129X">the one carried out in 2022</a> by French researchers, have shown that participation in team sports improves short-term visuospatial memory (which enables people, for example, to remember the location of certain objects for a limited period of time) and planning skills in the elderly. <h2>Get your body moving with exergames</h2> Another promising avenue are exergames – video games that require players to move around to play. Named after the contraction of “exercise” and “games”, they grew popular in the 2000s thanks to Nintendo’s Wii and Switch and Microsoft’s Kinect. Exogames have been thought out to exercise different fitness skills, such as balance, endurance, strength, and coordination, while simultaneously stimulating cognitive functions. Among older people, <a href="https://psycnet.apa.org/record/2011-27707-001">several research studies</a> show that this type of training helps to improve many physical and cognitive abilities. In 2020, a new generation of exergames emerged, making use of interactive walls to create an even more immersive gaming experience, such as Neo Xperiences’ Neo-One, Sphery’s ExerCube and Lü’s Aire interactive. In these games combining real and virtual worlds, physical objects (such as balls) and digital objects coexist and interact in real time. A <a href="https://link.springer.com/article/10.1007/s11357-023-00952-w">recent study</a> compared an exergame programme assisted by an immersive wall with a walking and muscle-strengthening programme. Its results suggest that this new generation of exergames may be more effective on cognitive abilities than traditional training. Combining physical and cognitive exercises offers the best chance to keep one’s brain health while keeping fit. This is essential for an active and fulfilling life, whatever your age.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/neva-beraud-peigne-1418228">Neva Béraud-Peigné</a>, Doctorante en sciences du mouvement, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>; <a href="https://theconversation.com/profiles/alexandra-perrot-1531671">Alexandra Perrot</a>, Maitre de conférences HDR, <a href="https://theconversation.com/institutions/universite-paris-saclay-2174">Université Paris-Saclay</a>, and <a href="https://theconversation.com/profiles/pauline-maillot-1167901">Pauline Maillot</a>, Maître de conférences en STAPS, <a href="https://theconversation.com/institutions/universite-paris-cite-4263">Université Paris Cité</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/the-best-exercises-to-boost-your-brain-health-after-60-237162">original article</a>.

Body

Hospice nurse shares the four physical stages of dying

A hospice nurse has shared the four things that happen to your body in the months, weeks and days before you die. Julie McFadden, who specialises in end of life care, shares videos about death and dying on social media to open up the conversation on the taboo topic, to help better prepare people for death. In her latest video, a viewer asked Julie what the dying process actually looks like, as the nurse explained that it all depends on how, when and why you pass away. However, she said there are four things that happen to the body as the end draws near. The first stage of dying is slowing down, which can happen up to six months before you die, with the symptoms being very "generalised". Julie says, "For instance, you’re just going to be generally tired, generally lethargic, not eating and drinking as much, probably being less social." According to Julie, the second stage is a sharp decline in strength, as she explains, "The closer you get to death – let’s say three months out – you’re going to be more debilitated." "It’s going to be difficult for you to leave the house, you probably are eating and drinking very little throughout the day, and you’re sleeping more than you’re awake." <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">Before the last stage of life, Julie describes a period of "transitioning" which happens around a month before death and can include a phenomenon known as "visioning". <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">The nurse says, "This is when people will start seeing dead relatives, dead loved ones, dead pets, things like that." She says that typically, someone "can be up and having a normal conversation with their family", all the while "saying they’re seeing their dead father in the corner who is smiling and telling them he’s coming to get them soon and not to worry." <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">According to Julie, this final stage of death is considered the most "distinct time in the dying process" when the body starts to fully shut down. <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">"The actively dying phase is what scares people, because they’re not used to seeing it and they don’t know what the heck’s going on," she says. <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">‘Metabolic changes’ such as a difference in skin colour, high and low temperature, or the ‘death rattle’ – a gurgling noise (also known as terminal secretions) caused by a buildup of fluids in the throat and upper airways – follow before they later pass on. <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">However, while it’s natural to find these things upsetting, Julie assures people this stage is a "normal part of death and dying", and "it’s not hurting your loved one." <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">"It’s important to be educated about what death actually looks like. Movies and television don’t do it justice, then people see it in real life when it’s their loved ones and they freak out," she said. <p style="font-size: 1rem; border: 0px; font-stretch: inherit; line-height: 1.375rem; font-family: -apple-system, system-ui, BlinkMacSystemFont, 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; margin: 0px 0px 1.4rem; padding: 0px; vertical-align: baseline;">Image credits: YouTube / Instagram

Caring

Do mobile phones cause brain cancer? Science makes definitive call

The question of whether mobile phones - specifically the electromagnetic radiation or radio waves emitted by these devices - cause cancer has been debated and researched for a long time, and now scientists have made a definitive call. A new comprehensive review commissioned by the World Health Organization has found that mobile phones are NOT linked to brain and head cancers. The systematic review, led by the Australian Radiation Protection and Nuclear Safety Agency (Arpansa), examined over 5,000 studies, which included 63 observational studies on humans published between 1994 and 2022 and is "the most comprehensive review to date" according to review lead author, associate prof Ken Karipidis. “We concluded the evidence does not show a link between mobile phones and brain cancer or other head and neck cancers," he said. The review, which was published on Wednesday, focused on cancers of the nervous system, salivary gland and brain tumours. They found no overall association between mobile phone use and cancer, even if people have used it for a long time (over 10 years) or spend a lot of time on their phones. “I’m quite confident with our conclusion. And what makes us quite confident is … even though mobile phone use has skyrocketed, brain tumour rates have remained stable,” Karipidis continued. Despite emitting electromagnetic radiation, also known as radio waves, the exposure is relatively low. Karipidis said people hear the word radiation and assume it is similar to nuclear radiation, “and because we use a mobile phone close to the head when we’re making calls, there is a lot of concern.” He clarified that “radiation is basically energy that travels from one point to another. There are many different types, for example, ultraviolet radiation from the sun." “We’re always exposed to low-level radio waves in the everyday environment.” While exposure from mobile phones is still low, it is much higher than exposure from any other wireless technology sources since they are used close to the head, Karipidis said. The association between mobile phones and cancers came about from early studies comparing differences between those with and without brain tumours and asking about their exposure history. According to Karipidis, who is also the vice-chair of the International Commission on Non-Ionizing Radiation Protection, the results from these kind of studies tend to be biased, as the group with the tumour tend to overreport their exposure. Based on these early studies WHO’s International Agency for Research on Cancer (IARC) designated radio-frequency fields like those from mobile phones as a possible cancer risk, but Karipidis said "this classification doesn’t mean all that much”. This is because the IARC has different classifications of cancer risk, with some substances classified as a “definite” carcinogen (such as smoking), and others as “probable” or “possible” carcinogens. Tim Driscoll, a professor at the University of Sydney and chair of the Australian Cancer Council’s occupational and environmental cancers committee, also backed the systematic review. “I think people should feel reassured by this study … but it’s worthwhile just remembering that the studies aren’t perfect, but the weight of evidence certainly is that mobile phones should be considered safe to use in terms of any concerns about increased risk of cancer,” Driscoll said. Images: Shutterstock

Body

Can a 10-year-old be responsible for a crime? Here’s what brain science tells us

<a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> The age a child can be arrested, charged and jailed in Australia is back in the spotlight. Last year, the Northern Territory became the first jurisdiction to raise the age of criminal responsibility from ten to 12. Now its new, tough-on-crime government has pledged to <a href="https://www.sbs.com.au/nitv/article/incoming-chief-minister-says-age-of-criminal-responsibility-to-be-lowered-to-10-years-old/a1xm9jy9c">return it to ten</a>. It comes after Victoria <a href="https://www.abc.net.au/news/2024-08-13/victoria-youth-justice-reform-criminal-age/104217160">walked back</a> its earlier commitment to raise the age to 14, settling instead on 12. But the United Nations Committee on the Rights of the Child says 14 should be the absolute <a href="https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-24-2019-childrens-rights-child">minimum</a>. It raised this age from its earlier recommendation (in 2007) of 12, citing a decade of new research into child and adolescent development. So what does the science say? What happens to the brain between ten and 14? And how much can those under 14 understand the consequences of their actions? <h2>Who is an adolescent?</h2> Our research shows adolescence is a <a href="https://pubmed.ncbi.nlm.nih.gov/30169257/">critical period</a> for development. It’s the time children’s experiences and explorations shape how they develop cognitive skills (including critical thinking and decision making), as well as social and emotional skills (including moral reasoning). Adolescence also lasts longer than we tend to think. Important brain development begins during late childhood, around eight to nine years. Intense changes then follow during early adolescence (ages ten to 14). But these changes continue well into the twenties, and full cognitive and emotional maturity is not usually reached until around age 24. However, everyone’s brain matures at a different rate. That means there is no definitive age we can say humans reach “adult” levels of cognitive maturity. What we do know is the period of early adolescence is critical. <h2>What does puberty do to the brain?</h2> Puberty is a defining feature of early adolescence. Most of us are familiar with the changes that occur to the body and reproductive systems. But the increase in puberty hormones, such as testosterone and oestrogen, also trigger changes to the brain. These hormones <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306453017313252?via%3Dihub">increase most sharply</a> between ten and 15 years of age, although gradual changes continue into the early twenties. Puberty hormones change the structures in the brain which process emotions, including the amygdala (which encodes fear and stress) and ventral striatum (involved in reward and motivation). This makes adolescents particularly reactive to emotional rewards and threats. <a href="https://doi.org/10.1016/j.cortex.2019.04.024">Our research</a> has shown the brain’s sensitivity to emotions increases throughout early adolescence until around 14 or 15 years old. At the same time, changes in puberty have <a href="http://dx.doi.org/10.1037/pspp0000172">been linked</a> to increased sensation seeking and impulsive behaviours during early adolescence. This context is crucial when we discuss the behaviour of children in the ten to 14 age range. The way their brains change during this period makes them more sensitive and responsive to emotions, and more likely to be seeking experiences that are new and intense. <h2>How do adolescents make decisions?</h2> The emotional context of puberty influences how younger adolescents make decisions and understand their consequences. Decision making relies on several basic cognitive functions, including the brain’s flexibility, memory and ability to control impulses. These cognitive abilities – which together help us consider the consequences of our actions – undergo some of the <a href="https://doi.org/10.1523/JNEUROSCI.1741-13.2013">steepest development</a> between ages ten and 14. By age 15, the ability to make complex decisions has usually <a href="https://doi.org/10.1037/lhb0000315">reached adult maturity</a>. But adolescents at this age remain highly susceptible to emotions. So while their brain may be equipped to make a complex decision, their ability to think through the consequences, weighing up costs and benefits, can be clouded by emotional situations. For example, <a href="https://doi.org/10.1111/cdev.12085">research has shown</a> 13-14 year-olds were more distracted from completing a task and less able to control their behaviour when they viewed images that made them feel negative emotions. The social world of teenagers also has a significant impact on how they make decisions – especially in early adolescence. One study found that while older adolescents (aged 15-18) are more influenced by what adults think when weighing up risk, adolescents aged 12-14 <a href="https://journals.sagepub.com/doi/full/10.1177/0956797615569578">look to other teenagers</a>. Experiments <a href="https://doi.org/10.1177/0272431616648453">have also shown</a> adolescents aged 12-15 make riskier decisions when they are with peers than by themselves. Their brain responses also suggest they experience a greater sense of reward in taking those risks <a href="https://doi.org/10.1093/scan/nsy071">with peers</a>. <h2>How do teens understand the consequences of their actions?</h2> The concept of <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp2122/Quick_Guides/MinimumAgeCriminalResponsibility">criminal responsibility</a> is based on whether a person is able to understand their action and know whether it is wrong. Moral reasoning – how people think about right and wrong – depends on the ability to understand another person’s mental state and adopt their perspective. These skills are in development <a href="https://doi.org/10.1016/j.biopsych.2020.09.012">across adolescence</a>. Research suggests it may take more effort for adolescent brains to process <a href="https://doi.org/10.1162/jocn.2009.21121">“social” emotions</a> such as guilt and embarrassment, compared to adults. This is similar when they make <a href="https://doi.org/10.1080/17470919.2014.933714">moral judgements</a>. This evidence suggests teenage brains may have to work harder when considering other people’s intentions and desires. Young adolescents have the cognitive ability to appreciate they made a bad decision, but it is more mentally demanding. And social rewards, emotions and the chance to experience something new all have a strong bearing on their decisions and actions in the moment — possibly more than whether it is right or wrong. <h2>Early adolescence is critical for the brain</h2> There are also a number of reasons adolescent brains may develop differently. This includes various forms of neurodisability such as acquired brain injury, fetal alcohol spectrum disorder, attention-deficit hyperactivity disorder (ADHD) and intellectual disability, as well as exposure to trauma. Teenagers with neurodevelopmental disorders will likely cope differently with decision making, social pressure, impulse control and risk assessment, and face <a href="https://www.mcri.edu.au/images/research/strategic-collaborations/Flagships/Neurodevelopment/Neurodevelopment_Flagship_Brochure.pdf">extra difficulties</a>. Across the world, they are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30217-8/fulltext">disproportionately incarcerated</a>. In Australia, Indigenous children and adolescents are incarcerated <a href="https://www.indigenoushpf.gov.au/measures/2-11-contact-with-the-criminal-justice-system#:%7E:text=On%20an%20average%20day%20in%202021%E2%80%9322%2C%20there%20were%3A,AIHW%202023d%3A%20Table%20S76a">in greater numbers</a> than their non-Indigenous peers. Each child matures differently, and some face extra challenges. But for every person, the period between ten and 14 is critical for developing the cognitive, social and emotional skills they’ll carry through the rest of their life.<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/237552/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/susan-m-sawyer-109573">Susan M. Sawyer</a>, Professor of Adolescent Health The University of Melbourne; Director, Royal Children's Hospital Centre for Adolescent Health, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nandi-vijayakumar-1644262">Nandi Vijayakumar</a>, Research Fellow, School of Psychology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin 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/can-a-10-year-old-be-responsible-for-a-crime-heres-what-brain-science-tells-us-237552">original article</a>.

Mind

Why are some people happy when they are dying?

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

Caring

What happens in my brain when I get a migraine? And what medications can I use to treat it?

<div class="theconversation-article-body"> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Migraine is many things, but one thing it’s not is “just a headache”. “Migraine” <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1029040/">comes from</a> the Greek word “hemicrania”, referring to the common experience of migraine being predominantly one-sided. Some people experience an “aura” preceding the headache phase – usually a visual or sensory experience that evolves over five to 60 minutes. Auras can also involve other domains such as language, smell and limb function. Migraine is a disease with a <a href="https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30322-3/fulltext">huge personal and societal impact</a>. Most people cannot function at their usual level during a migraine, and anticipation of the next attack can affect productivity, relationships and a person’s mental health. <h2>What’s happening in my brain?</h2> The biological basis of migraine is complex, and varies according to the phase of the migraine. Put simply: The earliest phase is called the prodrome. This is associated with activation of a part of the brain called the hypothalamus which is thought to contribute to many symptoms such as nausea, changes in appetite and blurred vision. <figure class="align-center "><img src="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=485&fit=crop&dpr=1 600w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=485&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=485&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=610&fit=crop&dpr=1 754w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=610&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/608985/original/file-20240723-17-rgqc7v.jpg?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=610&fit=crop&dpr=3 2262w" alt="" /><figcaption>The hypothalamus is shown here in red. <a class="source" href="https://www.shutterstock.com/image-vector/brain-cross-section-showing-basal-ganglia-329843930">Blamb/Shutterstock</a></figcaption></figure> Next is the aura phase, when a wave of neurochemical changes occur across the surface of the brain (the cortex) at a rate of 3–4 millimetres per minute. This explains how usually a person’s aura progresses over time. People often experience sensory disturbances such as flashes of light or tingling in their face or hands. In the headache phase, the trigeminal nerve system is activated. This gives sensation to one side of the face, head and upper neck, leading to release of proteins such as CGRP (calcitonin gene-related peptide). This causes inflammation and dilation of blood vessels, which is the basis for the severe throbbing pain associated with the headache. Finally, the postdromal phase occurs after the headache resolves and commonly involves changes in mood and energy. <h2>What can you do about the acute attack?</h2> A useful way to conceive of <a href="https://www.migraine.org.au/factsheets">migraine treatment</a> is to compare putting out campfires with bushfires. Medications are much more successful when applied at the earliest opportunity (the campfire). When the attack is fully evolved (into a bushfire), medications have a much more modest effect. <iframe id="Pj1sC" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/Pj1sC/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> Aspirin For people with mild migraine, non-specific anti-inflammatory medications such as high-dose aspirin, or standard dose non-steroidal medications (NSAIDS) can be very helpful. Their effectiveness is often enhanced with the use of an anti-nausea medication. Triptans For moderate to severe attacks, the mainstay of treatment is a class of medications called “<a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1678146819/Factsheet_15_2023.pdf?1678146819">triptans</a>”. These act by reducing blood vessel dilation and reducing the release of inflammatory chemicals. Triptans vary by their route of administration (tablets, wafers, injections, nasal sprays) and by their time to onset and duration of action. The choice of a triptan depends on many factors including whether nausea and vomiting is prominent (consider a dissolving wafer or an injection) or patient tolerability (consider choosing one with a slower onset and offset of action). As triptans constrict blood vessels, they should be used with caution (or not used) in patients with known heart disease or previous stroke. Gepants Some medications that block or modulate the release of CGRP, which are used for migraine prevention (which we’ll discuss in more detail below), also have evidence of benefit in treating the acute attack. This class of medication is known as the “gepants”. Gepants come in the form of injectable proteins (monoclonal antibodies, used for migraine prevention) or as oral medication (for example, rimegepant) for the acute attack when a person has not responded adequately to previous trials of several triptans or is intolerant of them. They do not cause blood vessel constriction and can be used in patients with heart disease or previous stroke. Ditans Another class of medication, the “ditans” (for example, lasmiditan) have been approved overseas for the acute treatment of migraine. Ditans work through changing a form of serotonin receptor involved in the brain chemical changes associated with the acute attack. However, neither the gepants nor the ditans are available through the Pharmaceutical Benefits Scheme (PBS) for the acute attack, so users must pay out-of-pocket, at a <a href="https://www.migraine.org.au/cgrp#:%7E:text=While%20the%20price%20of%20Nurtec,%2D%24300%20per%208%20wafers.">cost</a> of approximately A$300 for eight wafers. <h2>What about preventing migraines?</h2> The first step is to see if <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043428/Factsheet_5_2023.pdf?1677043428">lifestyle changes</a> can reduce migraine frequency. This can include improving sleep habits, routine meal schedules, regular exercise, limiting caffeine intake and avoiding triggers such as stress or alcohol. Despite these efforts, many people continue to have frequent migraines that can’t be managed by acute therapies alone. The choice of when to start preventive treatment varies for each person and how inclined they are to taking regular medication. Those who suffer disabling symptoms or experience more than a few migraines a month <a href="https://www.nejm.org/doi/full/10.1056/NEJMra1915327">benefit the most</a> from starting preventives. Almost all migraine <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">preventives</a> have existing roles in treating other medical conditions, and the physician would commonly recommend drugs that can also help manage any pre-existing conditions. First-line preventives include: <ul> <li>tablets that lower blood pressure (candesartan, metoprolol, propranolol)</li> <li>antidepressants (amitriptyline, venlafaxine)</li> <li>anticonvulsants (sodium valproate, topiramate).</li> </ul> Some people have none of these other conditions and can safely start medications for migraine prophylaxis alone. For all migraine preventives, a key principle is starting at a low dose and increasing gradually. This approach makes them more tolerable and it’s often several weeks or months until an effective dose (usually 2- to 3-times the starting dose) is reached. It is rare for noticeable benefits to be seen immediately, but with time these drugs <a href="https://pubmed.ncbi.nlm.nih.gov/26252585/">typically reduce</a> migraine frequency by 50% or more. <hr /> <iframe id="jxajY" class="tc-infographic-datawrapper" style="border: 0;" src="https://datawrapper.dwcdn.net/jxajY/" width="100%" height="400px" frameborder="0" scrolling="no"></iframe> <hr /> <h2>‘Nothing works for me!’</h2> In people who didn’t see any effect of (or couldn’t tolerate) first-line preventives, new medications have been available on the PBS since 2020. These medications <a href="https://pubmed.ncbi.nlm.nih.gov/8388188/">block</a> the action of CGRP. The most common PBS-listed <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1708566656/Factsheet_16_2024.pdf?1708566656">anti-CGRP medications</a> are injectable proteins called monoclonal antibodies (for example, galcanezumab and fremanezumab), and are self-administered by monthly injections. These drugs have quickly become a game-changer for those with intractable migraines. The convenience of these injectables contrast with botulinum toxin injections (also <a href="https://www.migraine.org.au/botox">effective</a> and PBS-listed for chronic migraine) which must be administered by a trained specialist. Up to half of adolescents and one-third of young adults are <a href="https://deepblue.lib.umich.edu/bitstream/handle/2027.42/147205/jan13818.pdf">needle-phobic</a>. If this includes you, tablet-form CGRP antagonists for migraine prevention are hopefully not far away. Data over the past five years <a href="https://pubmed.ncbi.nlm.nih.gov/36718044/">suggest</a> anti-CGRP medications are safe, effective and at least as well tolerated as traditional preventives. Nonetheless, these are used only after a number of cheaper and more readily available <a href="https://assets.nationbuilder.com/migraineaus/pages/595/attachments/original/1677043425/Factsheet_2_2023.pdf?1677043425">first-line treatments</a> (all which have decades of safety data) have failed, and this also a criterion for their use under the PBS.<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/227559/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/mark-slee-1343982">Mark Slee</a>, Associate Professor, Clinical Academic Neurologist, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> and <a href="https://theconversation.com/profiles/anthony-khoo-1525617">Anthony Khoo</a>, Lecturer, <a href="https://theconversation.com/institutions/flinders-university-972">Flinders University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-in-my-brain-when-i-get-a-migraine-and-what-medications-can-i-use-to-treat-it-227559">original article</a>. </div>

Body

Think you’ve decided what to buy? Actually, your brain is still deciding – even as you put it in your basket

<a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a> You are standing in the cereal aisle, weighing up whether to buy a healthy bran or a sugary chocolate-flavoured alternative. Your hand hovers momentarily before you make the final grab. But did you know that during those last few seconds, while you’re reaching out, your brain is still evaluating the pros and cons – influenced by everything from your last meal, the health star rating, the catchy jingle in the ad, and the colours of the letters on the box? Our recently published <a href="https://www.nature.com/articles/s41598-024-62135-7">research</a> shows our brains do not just think first and then act. Even while you are reaching for a product on a supermarket shelf, your brain is still evaluating whether you are making the right choice. Further, we found measuring hand movements offers an accurate window into the brain’s ongoing evaluation of the decision – you don’t have to hook people up to expensive brain scanners. What does this say about our decision-making? And what does it mean for consumers and the people marketing to them? <h2>What hand movements tell us about decision-making</h2> There has been <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-psych-010419-051053">debate within neuroscience</a> on whether a person’s movements to enact a decision can be modified once the brain’s “motor plan” has been made. Our research revealed not only that movements can be changed after a decision – “in flight” – but also the changes matched incoming information from a person’s senses. To study <a href="https://doi.org/10.1038/s41598-024-62135-7">how our decisions unfold over time</a>, we tracked people’s hand movements as they reached for different options shown in pictures – for example, in response to the question “is this picture a face or an object?” When choices were easy, their hands moved straight to the right option. But when choices were harder, new information made the brain change its mind, and this was reflected in the trajectory of their hand movements. When we compared these hand movement trajectories to brain activity recorded using neuroimaging, we found that the timing and amount of evidence of the brain’s evaluation matched the movement pattern. Put simply, reaching movements are shaped by ongoing thinking and decision-making. By showing that brain patterns match movement trajectories, our research also highlights that large, expensive brain scanners may not always be required to study the brain’s decision evaluation processes, as movement tracking is much more cost-effective and much easier to test on a large scale. <h2>What does this mean for consumers and marketers?</h2> For consumers, knowing our brains are always reevaluating decisions we might think of as “final” can help us be more aware of our choices. For simple decisions such as choosing a breakfast cereal, the impact may be small. Even if you have preemptively decided on a healthy option, you might be tempted at the last minute by the flashy packaging of a less healthy choice. But for important long-term decisions such as choosing a mortgage, it can have serious effects. On the other side of the coin, marketers have long known that many purchase decisions are <a href="https://www.sciencedirect.com/science/article/pii/S0969698912000781">made on the spot</a>. They use strategies such as attractive packaging and strategic product placement to influence people’s decisions. New ways of studying how people’s brains process information – right up to the last minute – can help marketers design more effective strategies. <h2>Opportunities for further research</h2> Further research in this area could explore how different types of information, such as environmental cues or memories, affect this continuous decision evaluation process in different groups of people. For example, how do people of different ages process information while making decisions? Our finding – that hand movements reflect the inner workings of the brain’s decision making process – could make future studies cheaper and more efficient. The ability to fine-tune marketing in this way has implications beyond just selling products. It can also make public strategic messaging far more effective. This could include tailoring a public health campaign on vaping specifically for people aged under 30, or targeting messaging about superannuation scams more effectively at those of retirement age. The act of reaching for a product is not a simple consequence of a decision already made; it’s a highly dynamic process. Being aware of what influences our last-minute decision-making can help us make better choices that have better outcomes.<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/234167/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/tijl-grootswagers-954175">Tijl Grootswagers</a>, Senior Research Fellow in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>; <a href="https://theconversation.com/profiles/genevieve-l-quek-1447582">Genevieve L Quek</a>, Research Fellow, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney University</a>, and <a href="https://theconversation.com/profiles/manuel-varlet-156210">Manuel Varlet</a>, Associate Professor in Cognitive Neuroscience, <a href="https://theconversation.com/institutions/western-sydney-university-1092">Western Sydney 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/think-youve-decided-what-to-buy-actually-your-brain-is-still-deciding-even-as-you-put-it-in-your-basket-234167">original article</a>.

Mind

After 180 years, new clues are revealing just how general anaesthesia works in the brain

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773932/pdf/BLT.15.159293.pdf/">Over 350 million surgeries</a> are performed globally each year. For most of us, it’s likely at some point in our lives we’ll have to undergo a procedure that needs general anaesthesia. Even though it is one of the safest medical practices, we still don’t have a complete, thorough understanding of precisely how anaesthetic drugs work in the brain. In fact, it has largely remained a mystery since general anaesthesia was introduced into medicine over <a href="https://www.tandfonline.com/doi/full/10.3109/08941939.2015.1061826">180 years ago</a>. Our study published <a href="https://doi.org/10.1523/JNEUROSCI.0588-23.2024">in The Journal of Neuroscience today</a> provides new clues on the intricacies of the process. General anaesthetic drugs seem to only affect specific parts of the brain responsible for keeping us alert and awake. <h2>Brain cells striking a balance</h2> In a study using fruit flies, we found a potential way that allows anaesthetic drugs to interact with specific types of neurons (brain cells), and it’s all to do with proteins. Your brain has around <a href="https://onlinelibrary.wiley.com/doi/10.1002/cne.21974">86 billion neurons</a> and not all of them are the same – it’s these differences that allow general anaesthesia to be effective. To be clear, we’re not completely in the dark on <a href="https://linkinghub.elsevier.com/retrieve/pii/S0165614719300951">how anaesthetic drugs affect us</a>. We know why general anaesthetics are able to make us lose consciousness so quickly, thanks to a <a href="https://www.nature.com/articles/367607a0">landmark discovery made in 1994</a>. But to better understand the fine details, we first have to look to the minute differences between the cells in our brains. Broadly speaking, there are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6591655/">two main categories of neurons in the brain</a>. The first are what we call “excitatory” neurons, generally responsible for keeping us alert and awake. The second are “inhibitory” neurons – their job is to regulate and control the excitatory ones. In our day-to-day lives, excitatory and inhibitory neurons are constantly working and balancing one another. <a href="https://www.nature.com/articles/npp2017294">When we fall asleep</a>, there are inhibitory neurons in the brain that “silence” the excitatory ones keeping us awake. This happens <a href="https://askdruniverse.wsu.edu/2018/01/07/why-do-we-get-tired/">gradually over time</a>, which is why you may feel progressively more tired through the day. General anaesthetics speed up this process by directly silencing these excitatory neurons without any action from the inhibitory ones. This is why your anaesthetist will tell you that they’ll “put you to sleep” for the procedure: <a href="https://www.nature.com/articles/nrn2372">it’s essentially the same process</a>. <h2>A special kind of sleep</h2> While we know why anaesthetics put us to sleep, the question then becomes: “why do we stay asleep during surgery?”. If you went to bed tonight, fell asleep and somebody tried to do surgery on you, you’d wake up with quite a shock. To date, there is no strong consensus in the field as to why general anaesthesia causes people to remain unconscious during surgery. Over the last couple of decades, researchers have proposed several potential explanations, but they all seem to point to one root cause. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7709148/#:%7E:text=At%20presynaptic%20part%2C%20voltage%2Dgated,anesthetics%20to%20inhibiting%20neurotransmitter%20release.">Neurons stop talking to each other</a> when exposed to general anaesthetics. While the idea of “cells talking to each other” may sound a little strange, it’s a <a href="https://qbi.uq.edu.au/brain-basics/brain/brain-physiology/action-potentials-and-synapses">fundamental concept in neuroscience</a>. Without this communication, our brains wouldn’t be able to function at all. And it allows the brain to know what’s happening throughout the body. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.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/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/593888/original/file-20240514-16-5fletd.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="Two branching structures in orange, green, blue and yellow colours on a black background." /></a><figcaption>Colourised neurons in the brain of a fly. Adam Hines</figcaption></figure> <h2>What did we discover?</h2> Our new study shows that general anaesthetics appear to stop excitatory neurons from communicating, but not inhibitory ones. <a href="https://www.jneurosci.org/content/40/21/4103">This concept isn’t new</a>, but we found some compelling evidence as to why only excitatory neurons are affected. For neurons to communicate, proteins have to get involved. One of the jobs these proteins have is to get neurons to release molecules called <a href="https://my.clevelandclinic.org/health/articles/22513-neurotransmitters">neurotransmitters</a>. These chemical messengers are what gets signals across from one neuron to another: dopamine, adrenaline and serotonin are all neurotransmitters, for example. We found that general anaesthetics impair the ability of these proteins to release neurotransmitters, but only in excitatory neurons. To test this, we used <a href="https://www.eneuro.org/content/8/3/ENEURO.0057-21.2021">Drosophila melanogaster fruit flies</a> and <a href="https://imb.uq.edu.au/research/facilities/microscopy/training-manuals/microscopy-online-resources/image-capture/super-resolution-microscopy">super resolution microscopy</a> to directly see what effects a general anaesthetic was having on these proteins at a molecular scale. Part of what makes excitatory and inhibitory neurons different from each other is that they <a href="https://journals.physiology.org/doi/full/10.1152/physrev.00007.2012">express different types of the same protein</a>. This is kind of like having two cars of the same make and model, but one is green and has a sports package, while the other is just standard and red. They both do the same thing, but one’s just a little bit different. Neurotransmitter release is a complex process involving lots of different proteins. If one piece of the puzzle isn’t exactly right, then general anaesthetics won’t be able to do their job. As a next research step, we will need to figure out which piece of the puzzle is different, to understand why general anaesthetics only stop excitatory communication. Ultimately, our results hint that the drugs used in general anaesthetics cause massive global inhibition in the brain. By silencing excitability in two ways, these drugs put us to sleep and keep it that way.<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/229713/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adam-d-hines-767066">Adam D Hines</a>, Research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/after-180-years-new-clues-are-revealing-just-how-general-anaesthesia-works-in-the-brain-229713">original article</a>. </div>

Body

Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</a> <h2>The big idea</h2> Social ballroom dancing can improve cognitive functions and reduce brain atrophy in older adults who are at increased risk for Alzheimer’s disease and other forms of dementia. That’s the key finding of my team’s <a href="https://doi.org/10.1123/japa.2022-0176">recently published study</a> in the Journal of Aging and Physical Activity. In our study, we enrolled 25 adults over 65 years of age in either six months of twice-weekly ballroom dancing classes or six months of twice-weekly treadmill walking classes. None of them were engaged in formal dancing or other exercise programs. The overall goal was to see how each experience affected cognitive function and brain health. While none of the study volunteers had a dementia diagnosis, all performed a bit lower than expected on at least one of our dementia screening tests. We found that older adults that completed six months of social dancing and those that completed six months of treadmill walking improved their executive functioning – an umbrella term for planning, reasoning and processing tasks that require attention. Dancing, however, generated significantly greater improvements than treadmill walking on one measure of executive function and on processing speed, which is the time it takes to respond to or process information. Compared with walking, dancing was also associated with reduced brain atrophy in the hippocampus – a brain region that is key to memory functioning and is particularly affected by Alzheimer’s disease. Researchers also know that this part of our brain can undergo neurogenesis – or grow new neurons – <a href="https://doi.org/10.1073/pnas.0611721104">in response to aerobic exercise</a>. <figure><iframe src="https://www.youtube.com/embed/unmbhUvnGow?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Research shows those who regularly dance with a partner have a more positive outlook on life.</figcaption></figure> While several previous studies suggest that dancing has beneficial effects <a href="https://doi.org/10.1093/ageing/afaa270">on cognitive function in older adults</a>, only a few studies have compared it directly with traditional exercises. Our study is the first to observe both better cognitive function and improved brain health following dancing than walking in older adults at risk for dementia. We think that social dancing may be more beneficial than walking because it is physically, socially and cognitively demanding – and therefore strengthens a wide network of brain regions. While dancing, you’re not only using brain regions that are important for physical movement. You’re also relying on brain regions that are important for interacting and adapting to the movements of your dancing partner, as well as those necessary for learning new dance steps or remembering those you’ve learned already. <h2>Why it matters</h2> Nearly 6 million older adults in the U.S. and 55 million worldwide <a href="https://doi.org/10.1016/j.jalz.2019.01.010">have Alzheimer’s disease</a> or a <a href="https://www.who.int/news-room/fact-sheets/detail/dementia">related dementia</a>, yet there is no cure. Sadly, the efficacy and ethics surrounding recently developed drug treatments <a href="https://doi.org/10.1080/21507740.2022.2129858">are still under debate</a>. The good news is that older adults can potentially <a href="https://doi.org/10.1016/S0140-6736(20)30367-6">lower their risk for dementia</a> through lifestyle interventions, even later in life. These include reducing social isolation and physical inactivity. Social ballroom dancing targets both isolation and inactivity. In these later stages of the COVID-19 pandemic, a better understanding of the <a href="https://doi.org/10.1177/23337214211005223">indirect effects of COVID-19</a> – particularly those that increase dementia risk, such as social isolation – is urgently needed. In my view, early intervention is critical to prevent dementia from becoming the next pandemic. Social dancing could be a particularly timely way to overcome the adverse cognitive and brain effects associated with isolation and fewer social interactions during the pandemic. <h2>What still isn’t known</h2> Traditional aerobic exercise interventions such as treadmill-walking or running have been shown to lead to modest but reliable improvements in cognition – <a href="https://doi.org/10.1177/1745691617707316">particularly in executive function</a>. My team’s study builds on that research and provides preliminary evidence that not all exercise is equal when it comes to brain health. Yet our sample size was quite small, and larger studies are needed to confirm these initial findings. Additional studies are also needed to determine the optimal length, frequency and intensity of dancing classes that may result in positive changes. Lifestyle interventions like social ballroom dancing are a promising, noninvasive and cost-effective path toward staving off dementia as we – eventually – leave the COVID-19 pandemic behind.<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/194969/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helena-blumen-1231899">Helena Blumen</a>, Associate Professor of Medicine and Neurology, <a href="https://theconversation.com/institutions/albert-einstein-college-of-medicine-3638">Albert Einstein College of Medicine</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/kick-up-your-heels-ballroom-dancing-offers-benefits-to-the-aging-brain-and-could-help-stave-off-dementia-194969">original article</a>. </div>

Mind

Best-selling author diagnosed with "aggressive" brain cancer

Best-selling author Sophie Kinsella has shared that she has been fighting "aggressive" brain cancer since the end of 2022. The British writer took to Instagram to reveal she was diagnosed with glioblastoma 18 months ago, and shared why she chose to keep the devatstsing news out of the spotlight. The 54-year-old said she wanted to "make sure my children were able to hear and process the news in privacy and adapt to our new normal" before going public with her diagnosis. "I have been under the care of the excellent team at University College Hospital in London and have had successful surgery and subsequent radiotherapy and chemotherapy, which is still ongoing," she told her followers on Instagram. "At the moment all is stable and I am feeling generally very well, though I get very tired and my memory is even worse than it was before!" Kinsella said she is "so grateful to my family and close friends who have been an incredible support to me, and to the wonderful doctors and nurses who have treated me." She also thanked her readers for their "constant support", adding how the reception of her latest novel The Burnout, released in October 2023, "really buoyed me up during a difficult time." She ended her statement by saying, "To everyone who is suffering from cancer in any form I send love and best wishes, as well as to those who support them." "It can feel very lonely and scary to have a tough diagnosis, and the support and care of those around you means more than words can say." Image credits: Getty Images

Caring

Does intermittent fasting have benefits for our brain?

<a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Intermittent fasting has become a popular dietary approach to help people lose or manage their <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8683964/">weight</a>. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and <a href="https://pubmed.ncbi.nlm.nih.gov/27810402">improve overall health</a>. Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like <a href="https://link.springer.com/article/10.1007/s11011-023-01288-2">Alzheimer’s disease</a>. This is not a new idea – the ancient Greeks believed fasting <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8839325/">enhanced thinking</a>. But what does the modern-day evidence say? <h2>First, what is intermittent fasting?</h2> Our <a href="https://pubmed.ncbi.nlm.nih.gov/35487190/">diets</a> – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains. Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast. Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods. <h2>4 ways fasting works and how it might affect the brain</h2> The brain accounts for about <a href="https://theconversation.com/how-much-energy-do-we-expend-thinking-and-using-our-brain-197990">20% of the body’s energy consumption</a>. Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain. 1. Ketosis The goal of many intermittent fasting routines is to flip a “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">metabolic switch</a>” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. <a href="https://www.ncbi.nlm.nih.gov/books/NBK493179/">Ketones</a> – chemicals produced by this metabolic process – become the preferred energy source for the brain. Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10844723/">cause symptoms</a> of hunger, fatigue, nausea, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754590/">low mood</a>, irritability, constipation, headaches, and brain “fog”. At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to <a href="https://www.science.org/doi/10.1126/science.aau2095">preserve brain function</a> and prevent <a href="https://pubmed.ncbi.nlm.nih.gov/32709961/">age-related neurodegeneration disorders and cognitive decline</a>. Consistent with this, increasing ketones through <a href="https://pubmed.ncbi.nlm.nih.gov/31027873/">supplementation</a> or <a href="https://pubmed.ncbi.nlm.nih.gov/31757576/">diet</a> has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively. 2. Circadian syncing Eating at times that <a href="https://pubmed.ncbi.nlm.nih.gov/32480126/">don’t match our body’s natural daily rhythms</a> can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to <a href="https://pubmed.ncbi.nlm.nih.gov/22010477/">chronic disease</a>. Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in <a href="https://pubmed.ncbi.nlm.nih.gov/36599299/">expression of genes in tissue</a> and helps the body during rest and activity. A 2021 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827225/">study of 883 adults</a> in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions. 3. Mitochondria Intermittent fasting may provide <a href="https://pubmed.ncbi.nlm.nih.gov/35218914/">brain protection</a> through improving mitochondrial function, metabolism and reducing oxidants. Mitochondria’s <a href="https://www.genome.gov/genetics-glossary/Mitochondria">main role is to produce energy</a> and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to <a href="https://www.nature.com/articles/s41574-021-00626-7">mitochondrial dysfunction during ageing</a>. Rodent studies suggest alternate day fasting or reducing calories <a href="https://journals.sagepub.com/doi/10.1038/jcbfm.2014.114">by up to 40%</a> might protect or improve <a href="http://www.ncbi.nlm.nih.gov/pubmed/21861096">brain mitochondrial function</a>. But not all studies support this theory. 4. The gut-brain axis The <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/">gut and the brain communicate with each other</a> via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health. In mice, intermittent fasting has shown promise for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5913738/">improving brain health</a> by increasing survival and <a href="https://pubmed.ncbi.nlm.nih.gov/12354284/">formation of neurons</a> (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion. There’s <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470960/">no clear evidence</a> on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646955/">lower meal frequency</a> (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging. Some research has suggested calorie restriction may have a protective effect against <a href="https://academic.oup.com/nutritionreviews/article/81/9/1225/7116310">Alzheimer’s disease</a> by reducing oxidative stress and inflammation and promoting vascular health. When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed <a href="https://pubmed.ncbi.nlm.nih.gov/26713821/">cognitive improvement</a> when participants followed a calorie restricted diet for 12 months. Another study found a 25% calorie restriction was associated with <a href="https://pubmed.ncbi.nlm.nih.gov/30968820">slightly improved working memory</a> in healthy adults. But a <a href="https://www.sciencedirect.com/science/article/pii/S0022316623025221?via%3Dihub">recent study</a>, which looked at the impact of calorie restriction on spatial working memory, found no significant effect. <h2>Bottom line</h2> Studies in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9740746/">mice</a> support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed. Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749464/">older adults</a> whose nutritional needs may be higher. Further, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/">prolonged fasting</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9042193/">severe calorie restriction</a> may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions. If you’re considering <a href="https://www.nejm.org/doi/10.1056/NEJMra1905136?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">intermittent fasting</a>, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.<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/223181/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hayley-oneill-1458016">Hayley O'Neill</a>, Assistant Professor, Faculty of Health Sciences and Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-intermittent-fasting-have-benefits-for-our-brain-223181">original article</a>. Image: Getty

Body

Young boy beats rare brain cancer in world first

A 13-year-old boy from Belgium has become the first person in the world to be cured from a deadly brain cancer. Lucas Jemeljanova was only six-years-old when he was diagnosed with diffuse intrinsic pontine glioma (DIPG), a rare and aggressive brain cancer which kills 98 per cent of sufferers within five years. He was randomly assigned to receive everolimus, a type of chemotherapy drug during a clinical trial. The drug is commonly used to treat kidney, pancreas, breast and brain cancer, but up to this point has not been successfully used to treat DIPG. Seven years later, Lucas has responded well to the treatment and has no trace of cancer, and has officially been in remission for five years. His doctor, Jacques Grill said that Lucas "beat the odds" and his case "offers real hope". Lucas was one of the first few people enrolled in the BIOMEDE trial in France, which was testing potential new drugs for DIPG. The drug works by preventing the cancer cells from reproducing and decreasing blood supply to the cancer cells, and it is an FDA approved prescription drug for cancer. Doctors were initially hesitant to stop the treatment until a year ago and a half ago. "I didn’t know when to stop, or how, because there was no reference in the world," Dr Grill told the AFP. "Over a series of MRI scans, I watched as the tumour completely disappeared," he added. Seven other children who were also in the trial have been considered "long responders", as they haven't had any relapses for three years after their diagnosis, but only Lucas was cured. The reason behind his complete recovery is still unknown, but it could be because of "biological particularities" in his tumour. "Lucas' tumour had an extremely rare mutation which we believe made its cells far more sensitive to the drug," Dr Grill added. DIPG is typically found in children between ages five and nine. The cause of the tumour is unknown but some of the first symptoms include problems with eye movement and balance, facial weakness, difficulty walking and strange limb movements. Researchers are currently trying to reproduce the difference seen in Lucas' cells. "Lucas is believed to have had a particular form of the disease," Dr Grill said. "We must understand what and why to succeed in medically reproducing in other patients what happened naturally with him." However Dr Grill said that this process won't be quick. "On average, it takes 10-15 years from the first lead to become a drug – it's a long and drawn-out process." Images: Facebook

Caring

Michael Bolton shares shocking health update

Renowned singer Michael Bolton recently shared a shocking revelation with his fans – that he has been diagnosed with brain cancer. The 70-year-old artist famous for his pop-rock ballads underwent immediate surgery just before Christmas, marking the end of 2023 with unexpected challenges. In a heartfelt message on Facebook and Instagram, Bolton expressed gratitude for the success of the surgery and the unwavering support of his medical team, family and fans. In his statement, Bolton disclosed the discovery of a brain tumour just before the holidays, necessitating urgent surgery. Fortunately, the operation was successful, and the singer is currently recuperating at home. Despite the challenging times ahead, Bolton conveyed his determination to focus on recovery and temporarily step back from touring to devote time and energy to the healing process. Acknowledging the difficulty of disappointing fans and postponing shows, Bolton assured his followers that he is working hard to accelerate his recovery and return to the stage as soon as possible. The singer, known for his powerful love songs, expressed gratitude for the positive messages from fans, promising to keep them updated on his progress. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C1vGsEdv07S/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C1vGsEdv07S/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Michael Bolton (@michaelbolton)</a> </div> </blockquote> Prior to his revelation, fans had expressed concerns about Bolton's health following his performance during the Disney Parks Christmas Day Parade. Some viewers noted that he appeared to be in pain, sparking speculation about his well-being. Bolton gained fame in the late 1980s for his transition from heavy metal to power ballads, earning recognition for his emotive love songs. Throughout his illustrious career, he amassed six American Music Awards, two Grammy Awards, and achieved chart-topping success with two number-one singles on the Billboard charts. Beyond his musical achievements, Bolton showcased his versatility by participating in various entertainment ventures. Notably, his appearance in The Lonely Island's viral video "Jack Sparrow" garnered widespread attention, accumulating over 200 million views. He also co-hosted ABC's Celebrity Dating Game and delved into acting with roles in shows like Meet Wally Sparks, Two and a Half Men, and a stint on Dancing with the Stars US. Despite his success, Bolton faced financial setbacks in 1992 when he was sued by the Isley Brothers for alleged song theft. The legal battle concluded in 2001, with substantial payments made to the Isley Brothers. Bolton's personal life has seen its share of ups and downs, including a marriage to Maureen McGuire that ended in 1990, and a subsequent relationship with Nicollette Sheridan. Bolton's announcement of his battle with brain cancer has left fans shocked and concerned for the beloved singer. As he embarks on the path to recovery, the outpouring of support from fans and well-wishers reflects the impact he has had on the music industry and in the hearts of those who have followed his journey. Images: Instagram

Caring

"Betrayed": Shannen Doherty opens up on tough divorce amid cancer battle

Shannen Doherty revealed it all on the debut episode of her new podcast Let’s Be Clear with Shannen Doherty. The actress opened up on her tough split from her husband of 14 years, Kurt Iswarienko, after she found out he had been having an affair for two years, while she was battling brain cancer. She recalled the moment she found out, right before her surgery to remove the tumour in January. “I went into that surgery early in the morning and I went in after I found out that my marriage was essentially over, that my husband had been carrying on an affair for two years,” she said. “To not go in that surgery, even though, being very clear, he wanted to go, I couldn’t go into that surgery with him there. I felt so betrayed.” “At the end of the day, I just felt so incredibly unloved by someone I was with for 14 years, by someone I loved with all my heart,” Doherty continued, adding that she had her family and friends by her side. Though the Charmed actress is currently focusing on her health and the future, she did admit that the entire experience has been overwhelming. “Just to have to go through all of that while trying to figure out if you’re going to get a frickin’ divorce and trying to get to the truth of that,” she said. She added that she was "obsessed" with finding out the truth of the affair, “through conversations, expecting someone to be honest with me.” “If you share 14 years together and you cheated, doesn’t that person deserve the absolute truth regardless of how much that hurts them? If they’re the ones asking for it, if they’re the ones saying, ‘Listen, I get it, I may cry, I may get angry, and this may really suck to hear, but I need to hear it because I need closure and this is how I get my closure.’ So I had a lot of months of trying to figure out what I was going to do,” she explained. She added that the reason why she was trying so hard to make sense of the situation was because she herself does not condone cheating, “If you cheat on me, you’re out," she said. “Then when someone you really, really love, someone that you regard as your absolute best friend in the world, when you’re lied to and you discover they cheated on you, or they finally tell you they’re cheating on you because they’re riddled by guilt or whatever, I didn’t walk away. I couldn’t. I was so confused.” She added that the confusion was also a side effect from her surgery as she was undertaking a bunch of medication and steroids to prevent her brain from swelling. Doherty and Iswarienko tied the knot in 2011 and filed for divorce earlier this year in April. The actress revealed that she struggled with her decision to file for divorce, and did talk to “girlfriend of two years that he cheated on me with.” “And honestly, it’s still really hard. Yes, I made the decision to file for divorce, but I have a lot of memories with this person,” she said. She added that although she takes responsibility for some of the issues in their marriage, she does not take responsibility for the "demise" of it. “I take responsibility not only because of how I was but because of how cancer impacted my marriage and how it impacted him the second time around," she said. "I do not take responsibility for the demise of our marriage because I am not a quitter. If somebody is still showing me loyalty and respect and love, I’m going to hang in there. I’m going to try my hardest," she added. Despite three failed marriages, the actress said that she still believes in love. Images: Getty

Caring

"I'm home": Paramedics grant dying grandmother's final wish

Dedicated paramedics have made an emotional pit stop at the beach for a dying grandmother who wanted to see the ocean one last time. The ambos were transporting 94-year-old Shirl McHugh to the hospital when the grandmother asked to make a stop at Newcastle's Bar Beach: her favourite spot. Shirl told the paramedics she wanted to "feel the salt breeze one last time", as she had a feeling she wouldn't be leaving the hospital. When they stopped at the beach, the great-grandmother relaxed and told paramedic Brittaney Banks, "I'm home". Thankfully, Ms McHugh was able to bask in a beautifully fine day to take in the famous stretch of beach, which is busy with swimmers, surfers, lifesavers and families most days. Shirl, who was a respected member of her church as well as the wider community, died just 15 hours after her stop at the ocean. The NSW ambulance shared Shirl's story to their Instagram page, with paramedic Brittaney Banks recalling the emotional day. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/CyK0y_Ns8j5/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CyK0y_Ns8j5/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by NSW Ambulance (@nswambulance)</a> </div> </blockquote> "When I opened the doors of the ambulance, Shirley said 'I'm home', and breathed a sigh of relaxation… it's one of those jobs I will remember forever," Brittaney said. Her granddaughter expressed her gratitude on social media, thanking the ambulance crew for respecting the special request from the stylish great-grandmother known to many as 'Shirl the Pearl'. "Thank you ladies for fulfilling my Nan's final wish on her way home," Emma Brown wrote. "She had such a beautiful soul, it was really my pleasure," Ms Banks replied. "I am so glad we could bring her home." Image credits: Instagram

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"I'm home": Paramedics grant dying grandmother's final wish