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What’s the difference between ADD and ADHD?

<a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Around <a href="https://www.healthdirect.gov.au/attention-deficit-disorder-add-or-adhd#:%7E:text=Around%201%20in%20every%2020,have%20symptoms%20as%20an%20adult.">one in 20 people</a> has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood. ADHD is <a href="https://www.psychiatry.org/psychiatrists/practice/dsm">diagnosed</a> when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home. Some people call the condition attention-deficit disorder, or ADD. So what’s the difference? In short, what was previously called ADD is now known as ADHD. So how did we get here? <h2>Let’s start with some history</h2> The <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">first clinical description</a> of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still <a href="https://pubmed.ncbi.nlm.nih.gov/26740929/">presented</a> a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate. Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions. The first DSM, published in 1952, did not include a specific related child or adolescent category. But the <a href="https://dsm.psychiatryonline.org/doi/abs/10.1176/appi.books.9780890420355.dsm-ii">second edition</a>, published in 1968, <a href="https://www.tandfonline.com/doi/full/10.1080/00207411.2015.1009310">included a section</a> on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder. In the early 1980s, the <a href="https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm">third DSM</a> added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity. However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today: <ul> <li>predominantly inattentive</li> <li>predominantly hyperactive-impulsive</li> <li>combined.</li> </ul> <h2>Why change ADD to ADHD?</h2> ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons. First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was <a href="https://www.guilford.com/books/Attention-Deficit-Hyperactivity-Disorder/Russell-Barkley/9781462538874">initially named</a>, little research had been done to determine the similarities and differences between the two sub-types. The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions? Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours <a href="https://academic.oup.com/shm/article/30/4/767/2919401">may not necessarily be</a> disruptive and challenging but are more likely to be forgetful and daydreamers. <h2>Why do some people use the term ADD?</h2> There was a <a href="https://academic.oup.com/shm/article/30/4/767/2919401">surge of diagnoses</a> in the 1980s. So it’s understandable that some people still hold onto the term ADD. Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits. Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed. <h2>How is ADHD currently diagnosed?</h2> The three sub-types of ADHD, outlined in the DSM-5 are: <ul> <li> predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions </li> <li> predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control </li> <li> combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive. </li> </ul> ADHD diagnoses <a href="https://www.aihw.gov.au/reports/children-youth/australias-children/contents/health/children-mental-illness">continue to rise</a> among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses. However, some international experts <a href="https://academic.oup.com/shm/article/30/4/767/2919401">contest</a> the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors. Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.<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/225162/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/kathy-gibbs-1392051">Kathy Gibbs</a>, Program Director for the Bachelor of Education, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-add-and-adhd-225162">original article</a>.

Mind

How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

<a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati </a> COVID-19 taught most people that the line between tolerable and toxic stress – defined as persistent demands that lead to disease – varies widely. But some people will age faster and die younger from toxic stressors than others. So how much stress is too much, and what can you do about it? I’m a <a href="https://researchdirectory.uc.edu/p/wulsinlr">psychiatrist specializing in psychosomatic medicine</a>, which is the study and treatment of people who have physical and mental illnesses. My research is focused on people who have psychological conditions and medical illnesses as well as those whose stress exacerbates their health issues. I’ve spent my career studying mind-body questions and training physicians to treat mental illness in primary care settings. My <a href="https://www.cambridge.org/core/books/toxic-stress/677FA62B741540DBDB53E2F0A52A74B1">forthcoming book</a> is titled “Toxic Stress: How Stress is Killing Us and What We Can Do About It.” A 2023 study of stress and aging over the life span – one of the first studies to confirm this piece of common wisdom – found that four measures of stress all speed up the pace of biological aging in midlife. It also found that persistent high stress ages people in a comparable way to the <a href="https://doi.org/10.1097/PSY.0000000000001197">effects of smoking and low socioeconomic status</a>, two well-established risk factors for accelerated aging. <figure><iframe src="https://www.youtube.com/embed/yiglpsqv5ik?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Children with alcoholic or drug-addicted parents have a greater risk of developing toxic stress.</figcaption></figure> <h2>The difference between good stress and the toxic kind</h2> Good stress – a demand or challenge you readily cope with – is good for your health. In fact, the rhythm of these daily challenges, including feeding yourself, cleaning up messes, communicating with one another and carrying out your job, helps to regulate your stress response system and keep you fit. Toxic stress, on the other hand, wears down your stress response system in ways that have lasting effects, as psychiatrist and trauma expert Bessel van der Kolk explains in his bestselling book “<a href="https://www.penguinrandomhouse.com/books/313183/the-body-%20keeps-the-score-by-bessel-van-der-kolk-md/">The Body Keeps the Score</a>.” The earliest effects of toxic stress are often persistent symptoms such as headache, fatigue or abdominal pain that interfere with overall functioning. After months of initial symptoms, a full-blown illness with a life of its own – such as migraine headaches, asthma, diabetes or ulcerative colitis – may surface. When we are healthy, our stress response systems are like an orchestra of organs that miraculously tune themselves and play in unison without our conscious effort – a process called self-regulation. But when we are sick, some parts of this orchestra struggle to regulate themselves, which causes a cascade of stress-related dysregulation that contributes to other conditions. For instance, in the case of diabetes, the hormonal system struggles to regulate sugar. With obesity, the metabolic system has a difficult time regulating energy intake and consumption. With depression, the central nervous system develops an imbalance in its circuits and neurotransmitters that makes it difficult to regulate mood, thoughts and behaviors. <h2>‘Treating’ stress</h2> Though stress neuroscience in recent years has given researchers like me <a href="https://doi.org/10.1097/PSY.0000000000001051">new ways to measure and understand stress</a>, you may have noticed that in your doctor’s office, the management of stress isn’t typically part of your treatment plan. Most doctors don’t assess the contribution of stress to a patient’s common chronic diseases such as diabetes, heart disease and obesity, partly because stress is complicated to measure and partly because it is difficult to treat. In general, doctors don’t treat what they can’t measure. Stress neuroscience and epidemiology have also taught researchers recently that the chances of developing serious mental and physical illnesses in midlife rise dramatically when people are exposed to trauma or adverse events, especially during <a href="https://www.cdc.gov/violenceprevention/aces/ace-brfss.html">vulnerable periods such as childhood</a>. Over the past 40 years in the U.S., the alarming rise in <a href="https://www.cdc.gov/diabetes/health-equity/diabetes-by-the-numbers.html">rates of diabetes</a>, <a href="https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf">obesity</a>, depression, PTSD, <a href="https://www.cdc.gov/nchs/products/databriefs/db433.htm">suicide</a> and addictions points to one contributing factor that these different illnesses share: toxic stress. Toxic stress increases the risk for the onset, progression, complications or early death from these illnesses. <h2>Suffering from toxic stress</h2> Because the definition of toxic stress varies from one person to another, it’s hard to know how many people struggle with it. One starting point is the fact that about 16% of adults report having been exposed to <a href="https://www.cdc.gov/violenceprevention/aces/fastfact.html">four or more adverse events in childhood</a>. This is the threshold for higher risk for illnesses in adulthood. Research dating back to before the COVID-19 pandemic also shows that about 19% of adults in the U.S. have <a href="https://doi.org/10.7249/TL221">four or more chronic illnesses</a>. If you have even one chronic illness, you can imagine how stressful four must be. And about 12% of the U.S. population <a href="https://blogs.worldbank.org/opendata/introducing-second-edition-world-banks-global-subnational-atlas-poverty">lives in poverty</a>, the epitome of a life in which demands exceed resources every day. For instance, if a person doesn’t know how they will get to work each day, or doesn’t have a way to fix a leaking water pipe or resolve a conflict with their partner, their stress response system can never rest. One or any combination of threats may keep them on high alert or shut them down in a way that prevents them from trying to cope at all. Add to these overlapping groups all those who struggle with harassing relationships, homelessness, captivity, severe loneliness, living in high-crime neighborhoods or working in or around noise or air pollution. It seems conservative to estimate that about 20% of people in the U.S. live with the effects of toxic stress. <figure><iframe src="https://www.youtube.com/embed/WuyPuH9ojCE?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Exercise, meditation and a healthy diet help fight toxic stress.</figcaption></figure> <h2>Recognizing and managing stress and its associated conditions</h2> The first step to managing stress is to recognize it and talk to your primary care clinician about it. The clinician may do an assessment involving a <a href="https://doi.org/10.1097/PSY.0000000000001051">self-reported measure of stress</a>. The next step is treatment. Research shows that it is possible to retrain a dysregulated stress response system. This approach, <a href="https://lifestylemedicine.org/">called “lifestyle medicine</a>,” focuses on improving health outcomes through changing high-risk health behaviors and adopting daily habits that help the stress response system self-regulate. Adopting these lifestyle changes is not quick or easy, but it works. The <a href="https://www.cdc.gov/diabetes/prevention/index.html">National Diabetes Prevention Program</a>, the <a href="https://www.ornish.com/">Ornish “UnDo” heart disease program</a> and the <a href="https://www.ptsd.va.gov/understand_tx/tx_basics.asp">U.S. Department of Veterans Affairs PTSD program</a>, for example, all achieve a slowing or reversal of stress-related chronic conditions through weekly support groups and guided daily practice over six to nine months. These programs help teach people how to practice personal regimens of stress management, diet and exercise in ways that build and sustain their new habits. There is now strong evidence that it is possible to treat toxic stress in ways that improve health outcomes for people with stress-related conditions. The next steps include finding ways to expand the recognition of toxic stress and, for those affected, to expand access to these new and effective approaches to treatment.<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/222245/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lawson-r-wulsin-1493655">Lawson R. Wulsin</a>, Professor of Psychiatry and Family Medicine, <a href="https://theconversation.com/institutions/university-of-cincinnati-1717">University of Cincinnati</a> Image credits: Getty Images 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-much-stress-is-too-much-a-psychiatrist-explains-the-links-between-toxic-stress-and-poor-health-and-how-to-get-help-222245">original article</a>.

Mind

What’s the difference between autism and Asperger’s disorder?

<a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Swedish climate activist Greta Thunberg describes herself as having <a href="https://www.theguardian.com/environment/2019/sep/02/greta-thunberg-responds-to-aspergers-critics-its-a-superpower">Asperger’s</a> while others on the autism spectrum, such as Australian comedian Hannah Gatsby, <a href="https://www.theguardian.com/stage/2022/mar/19/hannah-gadsby-autism-diagnosis-little-out-of-whack">describe</a> themselves as “autistic”. But what’s the difference? Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD. Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges. When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of <a href="https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder">autism spectrum disorder</a> is made. <h2>Where do the definitions come from?</h2> The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders. Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4. In 2013, the DSM-5 collapsed both diagnoses into one <a href="https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596">autism spectrum disorder</a>. <h2>How did we used to think about autism?</h2> The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder. Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress. Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism. The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech. Today, as a legacy of the recognition of the autism itself, the <a href="https://www.aihw.gov.au/reports/disability/autism-in-australia/contents/autism">majority of people</a> diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability. <h2>What changed with ‘autism spectrum disorder’?</h2> The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term. It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things. The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”. The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in. <h2>Why do some people prefer the old terminology?</h2> Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism. The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, <a href="https://xminds.org/resources/Documents/Web%20files/Aspie%20Criteria%20by%20Attwood.pdf">Tony Attwood and Carol Gray</a>, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges. <h2>What about identity-based language?</h2> A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”. The neurodiversity rights movement describes its aim to <a href="https://researchonline.jcu.edu.au/71531/1/JCU_71531_AAM.pdf">push back</a> against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism. The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments. However the social model contrasts itself against a very outdated medical or clinical model. Current clinical thinking and practice focuses on <a href="https://www.collegianjournal.com/article/S1322-7696(22)00122-6/fulltext">targeted</a> supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism. A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.<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/223643/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/andrew-cashin-458270">Andrew Cashin</a>, Professor of Nursing, School of Health and Human Sciences, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/whats-the-difference-between-autism-and-aspergers-disorder-223643">original article</a>.

Mind

What’s the difference between memory loss and dementia?

When it comes to memory loss, it's normal to become a little more forgetful as we age. However, it’s important to know the difference between a standard level of memory loss, and the early signs of dementia. Researchers at the University of New South Wales (UNSW) say it is crucially important to distinguish between the physical decline of ageing, and the more sinister reality of cognitive decline. Associate Professor Simone Reppermund from the Centre for Healthy Brain Ageing says, “As we age, we get more frail, and it may be difficult to walk longer distances or to have the range of motion to drive a car.” “But that's unrelated to cognitive decline, and this is where dementia or cognitive impairment comes in. A person with dementia at some point will not be able to do the things they once could do without thinking, such as drive a car, because they get confused and are no longer able to process the sensory information required to do this.” Prof. Brodaty went on to say that some cognitive decline is part of normal ageing. “As we age, we become slower in our processing speed. We’re not as good at remembering things, particularly when they’re not able to be logically sorted and connected.” But it’s not all bad for older folks, as some things are known to improve with age. “As we age our vocabulary improves, our judgement improves, our ability to organise things improves. In everyday tests where we can sort, say, 10 grocery items into different categories, we do just as well as the younger person because we can use those strategies to compensate. There is also evidence that we become wiser as we get older.” According to <a href="https://www.dementia.org.au" target="_blank" rel="noopener">Dementia Australia</a>, it’s when people encounter difficulties with the following on a regular basis that there could be some underlying cognitive cause worth investigating. These difficulties include: <ul> <li dir="ltr" aria-level="1"> Trouble remembering recent events </li> <li dir="ltr" aria-level="1"> Trouble finding the right word </li> <li dir="ltr" aria-level="1"> Trouble remembering the day and date </li> <li dir="ltr" aria-level="1"> Forgetting where things are usually kept </li> <li dir="ltr" aria-level="1"> Difficulty adjusting to changes in routine </li> <li dir="ltr" aria-level="1"> Trouble understanding written content or a story on television </li> <li dir="ltr" aria-level="1"> Difficulty following conversations in groups </li> <li dir="ltr" aria-level="1"> Problems handling finances </li> <li dir="ltr" aria-level="1"> Difficulty with everyday activities </li> <li dir="ltr" aria-level="1"> Losing interest in activities that were previously enjoyable </li> </ul> Researchers and medical experts say that even if encountering these difficulties has not become a huge hurdle, it is important to be assessed by a doctor. Some conditions can cause symptoms similar to illnesses of cognitive decline, and can be reversed and prevented if caught early enough. While Professor Brodaty says there is no cure for most types of dementia and no known way to prevent it, we can certainly delay the onset of it. “There are certain risk factors that make it more or less likely to develop cognitive decline and dementia, including physical and social inactivity. Being inactive, not engaging in social activities, a poor diet and too much alcohol are all risk factors.” Even then, Professor Brodaty says, “it’s never too late to start, and never too early to start” making changes that maintain and protect your brain health into old age. Image credits: Getty Images

Mind

Heated argument between economy passengers reignites plane etiquette debate

A 12-second clip of two passengers arguing on a plane has reignited the age-old debate of whether it is acceptable to recline your seat on a plane. The viral video which was originally posted on TikTok and then re-shared on X, has racked up over 8 million views since Thursday. In the video, a frustrated woman was calling out another female passenger for pushing her seat the entire flight, right after they landed. “The whole trip she pushed my seat,” the woman said to a male passenger seated next to the female passenger accused of kicking her seat. “You seen it. You know she did.” “I’m allowed to put my seat back," she yelled repeatedly. Ian Miles Cheong, the user who posted the video on X, defended the woman saying: “She’s allowed to put her seat back. You don’t get to kick it repeatedly just because you want more space.” A few were on the woman's side and praised her for standing up for herself. “You are allowed! Period! You want space in front of you instead of pushing the seat, buy a seat with extra space or get your a** to business class. Reclining was put there for a reason,” one person wrote. “She was patient enough to wait till flight landed," they added. “If the seat is reclinable, recline it,” another commented. "What she’s saying is right. The woman has a right to put her seat back without someone kicking it," a third agreed. <blockquote class="twitter-tweet"> She’s allowed to put her seat back. You don’t get to kick it repeatedly just because you want more space. <a href="https://t.co/WELD7Qh4Re">pic.twitter.com/WELD7Qh4Re</a> — Ian Miles Cheong (@stillgray) <a href="https://twitter.com/stillgray/status/1719881310351863952?ref_src=twsrc%5Etfw">November 2, 2023</a></blockquote> However, others claimed that there was an unwritten rule that you shouldn't recline your seat, especially on a short-haul flight, adding that the recline feature should be scrapped from airplanes. “Putting your seat back in coach is an unspoken thing most people don’t do. It’s really the airline’s fault because they’ve made coach so cramped and tight that putting the seat back shouldn’t even be an option,” one commented. “Airline seats simply shouldn’t be able to recline. It intrudes on the already very little space a person has on the plane for the person behind them,” another added. “Really it’s the airline’s fault for cramming so many people in such a small space. They don’t call it cattle class for nothing,” a third wrote. One user understood both sides of the argument, and blamed the airlines for making the seats so cramped. "It can be annoying sometimes to be behind someone with their seat all the way, but if the airlines didn't want to allow that, it wouldn't happen," they wrote. "You don't kick the seat like a baby. Blame the airline, not the person doing what the airline says is fine." Images: Twitter

Travel Trouble

How biological differences between men and women alter immune responses – and affect women’s health

<a href="https://theconversation.com/profiles/helen-mcgettrick-1451122">Helen McGettrick</a>, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> and <a href="https://theconversation.com/profiles/asif-iqbal-1451123">Asif Iqbal</a>, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> Most people will have heard the term “man flu”, which refers to men’s perceived tendency to exaggerate the severity of a cold or a similar minor ailment. What most people may not know is that, generally speaking, women mount stronger <a href="https://pubmed.ncbi.nlm.nih.gov/36121220/">immune responses</a> to infections than men. Men are <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005374">more susceptible</a> to infections from, for example, HIV, hepatitis B, and Plasmodium falciparum (the parasite responsible for malaria). They can also have more severe symptoms, with evidence showing they’re more likely to be <a href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1005374">admitted to hospital</a> when infected with hepatitis B, tuberculosis, and Campylobacter jejuni (a bacteria that causes gastroenteritis), among others. While this may be positive for women in some respects, it also means women are at <a href="https://www.nature.com/articles/nri2815">greater risk</a> of developing chronic diseases driven by the immune system, known as immune-mediated inflammatory diseases. Here we will explore how biological factors influence immune differences between the sexes and how this affects women’s health. While we acknowledge that both sex and gender may affect immune responses, this article will focus on biological sex rather than gender. <h2>Battle of the sexes</h2> There are differences <a href="https://www.nature.com/articles/nri.2016.90">between the sexes</a> at every stage of the immune response, from the number of immune cells, to their degree of activation (how ready they are to respond to a challenge), and beyond. However, the story is more complicated than that. Our immune system evolves throughout our lives, learning from past experiences, but also responding to the physiological challenges of getting older. As a result, <a href="https://www.nature.com/articles/nri.2016.90">sex differences</a> in the immune system can be seen from birth through puberty into adulthood and <a href="https://academic.oup.com/jleukbio/advance-article/doi/10.1093/jleuko/qiad053/7190870">old age</a>. Why do these differences occur? The first part of answering this question involves the X chromosome. Females have two X chromosomes, while males have one X and one Y chromosome. The <a href="https://pubmed.ncbi.nlm.nih.gov/20651746/">X chromosome</a> contains the largest number of immune-related genes. The X chromosome also has <a href="https://link.springer.com/article/10.1007/s00018-020-03526-7">around 118 genes</a> from a gene family that are able to stop the expression of other genes, or change how proteins are made, including those required for immunity. These gene-protein regulators are known as microRNA, and there are only <a href="https://pubmed.ncbi.nlm.nih.gov/24808907/">two microRNA genes</a> on the Y chromosome. The X chromosome has <a href="https://www.genome.gov/about-genomics/fact-sheets/X-Chromosome-facts">more genes overall</a> (around 900) than the Y chromosome (around 55), so female cells have evolved to switch off one of their X chromosomes. This is not like turning off a light switch, but more like using a dimmer. Around <a href="https://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-019-5507-6">15-25% of genes</a> on the silenced X chromosome are expressed at any given moment in any given cell. This means female cells can often express more immune-related genes and gene-protein regulators than males. This generally means a faster clearance of pathogens in females than males. Second, men and women have <a href="https://www.frontiersin.org/articles/10.3389/fimmu.2020.604000/full">varying levels</a> of different sex hormones. Progesterone and testosterone are broadly considered to limit immune responses. While both hormones are produced by males and females, progesterone is found at higher concentrations in non-menopausal women than men, and testosterone is much higher in men than women. The role of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533072/">oestrogen</a>, one of the main female sex hormones, is more complicated. Although generally oestrogen <a href="https://www.sciencedirect.com/science/article/abs/pii/S000887491500026X?via%3Dihub">enhances immune responses</a>, its levels vary during the menstrual cycle, are high in pregnancy and low after menopause. Due in part to these genetic and hormonal factors, pregnancy and the years following are associated with heightened immune responses to external challenges such as infection. This has been regarded as an <a href="https://www.nature.com/articles/nri.2016.90">evolutionary feature</a>, protecting women and their unborn children during pregnancy and enhancing the mother’s survival throughout the child-rearing years, ultimately ensuring the survival of the population. We also see this pattern in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628977/">other species</a> including insects, lizards, birds and mammals. <h2>What does this all mean?</h2> With women’s heightened immune responses to infections comes an increased risk of certain diseases and prolonged immune responses after infections. An <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328995/">estimated 75-80%</a> of all immune-mediated inflammatory diseases <a href="https://pubmed.ncbi.nlm.nih.gov/32542149/">occur in females</a>. Diseases more common in women include multiple sclerosis, <a href="https://www.nature.com/articles/nri2815">rheumatoid arthritis</a>, lupus, Sjogren’s syndrome, and <a href="https://www.nature.com/articles/nri.2016.90">thyroid disorders</a> such as Graves disease. In these diseases, the immune system is continuously fighting against what it sees as a foreign agent. However, often this perceived threat is not a foreign agent, but cells or tissues from the host. This leads to tissue damage, pain and immobility. Women are also prone to chronic inflammation following infection. For example, after infections with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818468/">Epstein Barr virus</a> or <a href="https://www.liebertpub.com/doi/10.1089/jwh.2008.1193">Lyme disease</a>, they may go on to develop <a href="https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/">chronic fatigue syndrome</a>, another condition that affects more women than men. This is one possible explanation for the heightened risk among <a href="https://www.frontiersin.org/articles/10.3389/fresc.2023.1122673/full">pre-menopausal women</a> of developing long COVID following infection with SARS-CoV-2, the virus that causes COVID. Research has also revealed the presence of auto-antibodies (antibodies that attack the host) in patients with long COVID, suggesting it might be an <a href="https://www.sciencedirect.com/science/article/pii/S1568997221000550">autoimmune disease</a>. As women are more susceptible to autoimmune conditions, this could potentially explain the sex bias seen. However, the exact causes of long COVID, and the reason women may be at greater risk, are yet to be defined. This paints a bleak picture, but it’s not all bad news. Women typically mount <a href="https://pubmed.ncbi.nlm.nih.gov/24966191/">better vaccine responses</a> to several common infections (for example, influenza, measles, mumps, rubella, hepatitis A and B), producing higher antibody levels than men. One study showed that women vaccinated with half a dose of flu vaccine produced the same amount of antibodies compared to men vaccinated with <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/773453">a full dose</a>. However, these responses <a href="https://www.nature.com/articles/nri.2016.90">decline as women age</a>, and particularly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954964/">after menopause</a>. All of this shows it’s vital to consider sex when designing studies examining the immune system and treating patients with immune-related diseases.<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/208802/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/helen-mcgettrick-1451122">Helen McGettrick</a>, Reader in Inflammation and Vascular Biology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> and <a href="https://theconversation.com/profiles/asif-iqbal-1451123">Asif Iqbal</a>, Associate Professor in Inflammation Biology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a> Image credits: Getty Images 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-biological-differences-between-men-and-women-alter-immune-responses-and-affect-womens-health-208802">original article</a>.

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Bees have appeared on coins for millennia, hinting at an age-old link between sweetness and value

<a href="https://theconversation.com/profiles/adrian-dyer-387798">Adrian Dyer</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> In 2022, the Royal Australian Mint issued a $2 coin decorated with honeybees. Around 2,400 years earlier, a mint in the kingdom of Macedon had the same idea, creating a silver obol coin with a bee stamped on one side. Over the centuries between these two events, currency demonstrating a symbolic link between honey and money is surprisingly common. In a recent study in <a href="https://s3.ap-southeast-2.amazonaws.com/assets.mmxgroup.com.au/ACR/Bee+Article.pdf">Australian Coin Review</a>, I trace the bee through numismatic history – and suggest a scientific reason why our brains might naturally draw a connection between the melliferous insects and the abstract idea of value. <figure class="align-center "><img src="https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&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/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536400/original/file-20230709-15-2u5ywn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" alt="" /><figcaption>A Royal Australian Mint 2022 two-dollar coin representing 200 years since the introduction of the honeybee to Australia.</figcaption></figure> <h2>What is currency and why is it important?</h2> Money is a store of value, and can act as a medium of exchange for goods or services. Currency is a physical manifestation of money, so coins are a durable representation of value. Coins have had central role in many communities to enable efficient trade since ancient times. Their durability makes them important time capsules. Ancient Malta was famous for its honey. The modern 3 Mils coin (<a href="https://en.numista.com/catalogue/pieces1775.html">1972-81</a>) celebrates this history with images of a bee and honeycomb. According to the information card issued with the coin set, <blockquote> A bee and honeycomb are shown on the 3 Mils coin, symbolising the fact that honey was used as currency in Ancient Malta. </blockquote> <figure class="align-center "><img src="https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&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/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=582&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=582&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=582&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=732&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=732&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536403/original/file-20230709-23-drk2lj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=732&fit=crop&dpr=3 2262w" alt="" /><figcaption>A circulating 3 Mils coin from Malta showing a honeybee on honeycomb.</figcaption></figure> In ancient Greece, bees were used on some of the earliest coins made in Europe. A silver Greek obol coin minted in Macedon between 412 BCE and 350 BCE, now housed in the British Museum, shows a bee on one side of the coin. <figure class="align-center "><img src="https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&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/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=293&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=293&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=293&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=368&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=368&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536411/original/file-20230709-182252-v4evxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=368&fit=crop&dpr=3 2262w" alt="" /><figcaption>An ancient obol from Macedon, dated between 412 BCE and 350 BCE, shows a bee one side.</figcaption></figure> Bees also feature on coins minted elsewhere in the ancient Greek world, such as a bronze coin minted in Ephesus dated between 202 BCE and 133 BCE. <figure class="align-center "><img src="https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&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/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=546&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=546&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=546&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=686&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=686&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536407/original/file-20230709-27-a2jvo3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=686&fit=crop&dpr=3 2262w" alt="" /><figcaption>A bronze coin minted in Ephesus, dated between 202BCE and 133BCE, featuring a honeybee.</figcaption></figure> The use of bees on ancient coins extended for many centuries including widely circulated bronze coins, and new varieties <a href="https://coinweek.com/bee-all-that-you-can-bee-honeybees-on-ancient-coins/">continue to be discovered</a>. <h2>Why we might like bees on coins</h2> Why have bees appeared so often on coins? One approach to this question comes from the field of neuro-aesthetics, which seeks to understand our tastes by understanding the basic brain processes that underpin aesthetic appreciation. From this perspective, it seems likely the sweet taste of honey – which indicates the large amount of sugar it delivers – promotes positive neural activity <a href="https://brill.com/view/journals/artp/10/1/article-p1_2.xml">associated with bees and honey</a>. Indeed, primatologist Jane Goodall once proposed that obtaining high-calorie nutrition from bee honey may have been <a href="https://www.sciencedirect.com/science/article/abs/pii/S0066185668800032">an important step</a> in the cognitive development of primates. Our brain may thus be pre-adapted to liking bees due to their association with the sweet taste of honey. Early usage of bees on coins may have been a functional illustration of the link between a known value (honey) and a new form of currency: coins as money. <h2>The bee on modern coins</h2> <figure class="align-center "><img src="https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&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/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=588&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=588&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=588&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=738&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=738&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536393/original/file-20230709-17-jywq3f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=738&fit=crop&dpr=3 2262w" alt="" /><figcaption>A 1920 Italian bronze ten-centesimi coin featuring featuring an Italian honeybee on a flower.</figcaption></figure> The use of bees as a design feature has persisted from ancient to modern times. A honeybee visiting a flower is shown on a series of ten-centesimi bronze coins issued in Italy from <a href="https://en.numista.com/catalogue/pieces1960.html">1919 to 1937</a>. (As an aside, the world’s last stock of pure Italian honeybees is found in Australia, on Kangaroo Island, which was declared a sanctuary for Ligurian bees by an <a href="https://www.legislation.sa.gov.au/home/historical-numbered-as-made-acts/1885/0342-Lingurian-Bees-Act-No-342-of-48-and-49-Vic,-1885.pdf">act of parliament</a> in 1885.) <figure class="align-center "><img src="https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&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/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=586&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=586&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=586&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=737&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=737&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536416/original/file-20230709-15-60yst8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=737&fit=crop&dpr=3 2262w" alt="" /><figcaption>A coin from Tonga showing 20 honeybees emerging from a hive.</figcaption></figure> More recently, a 20-seniti coin from the Pacific nation of Tonga shows 20 honeybees flying out of a hive. This coin was part of a series initiated by the Food and Agriculture Organization of the United Nations to promote sustainable agricultural and cultural development around the world. Bees are relevant here because their pollinating efforts contribute to about one-third of the food required to feed the world, with a value in excess of <a href="https://zenodo.org/record/2616458">US$200 billion per year</a>, and they are threatened by climate change and other environmental factors. <h2>Bees on coins, today and tomorrow</h2> Public awareness of bees and environmental sustainability may well be factors in the current interest in bee coins. The diversity of countries using bees as a design feature over the entire history of coins suggests people have valued the relationship with bees as essential to our own prosperity for a long time. In Australia, the 2022 honeybee $2 coin is part of a series developed by the <a href="https://www.ramint.gov.au/about-mint">Royal Australian Mint</a>. In 2019, the Perth Mint in Western Australia also released coins and stamps celebrating native bees. <figure class="align-center "><img src="https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&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/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=373&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=373&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=373&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=469&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=469&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536405/original/file-20230709-15-iditcb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=469&fit=crop&dpr=3 2262w" alt="" /><figcaption>Australian native bee coin and stamps released in 2019 by the Perth Mint.</figcaption></figure> Despite the decline of cash, bee coins still appear to be going strong. The buzzing companions of human society are likely to be an important subject for coin design for as long as coins continue to be used.<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/208912/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/adrian-dyer-387798">Adrian Dyer</a>, Associate Professor, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Australian Royal Mint / NZ Post Collectables 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/bees-have-appeared-on-coins-for-millennia-hinting-at-an-age-old-link-between-sweetness-and-value-208912">original article</a>.

Money & Banking

Eerie link between OceanGate pilot and Titanic disaster

A chilling link has been discovered between pilot Stockton Rush, who was onboard the OceanGate submersible, and the Titanic disaster in 1912. Mr Rush, who was at the helm of the vehicle bound for the Titanic wreckage, has a personal connection to two of the victims who were onboard the Titanic when it sank over 100 years ago. His wife, Wendy Rush, is the great-great-granddaughter of Isador Straus, who co-founded Macy’s department store, and Ida Straus, who were among the wealthiest people aboard the Titanic’s ill-fated transatlantic voyage, according to archived records obtained by the New York Times. The Strauses have long been remembered for their display of love and affection when the ocean liner hit the iceberg before infamously sinking in the North Atlantic, claiming the lives of more than 1500 people. Survivors of the disaster reported seeing Ida refuse a place on the lifeboats, which were reserved largely for women and children, and decided to stay onboard the sinking vessel with her husband of more than 40 years. Their tragic love story was depicted in James Cameron’s fictionalised version of the tragedy, his 1997 blockbuster Titanic, which features a scene showing an elderly couple holding on to each other in bed as waters rise around them. Wendy Rush is descended from one of the couple’s daughters, Minnie Strauss, who married Dr. Richard Weil in 1905, and their son, Richard Weil Jr., served as president of Macy’s New York, His son, Dr. Richard Weil III, is Wendy Rush’s father, Joan Adler, the executive director of the Straus Historical Society. Isador’s body was found at sea weeks after the Titanic sank, but his wife’s body was never recovered. Wendy also worked for OceanGate as their communications director, with her LinkedIn indicating she had been on several trips to the wreckage of the Titanic herself. The OceanGate submersible <a href="https://oversixty.co.nz/news/news/surprising-cause-of-death-revealed-for-missing-titan-sub-crew" target="_blank" rel="noopener">reportedly imploded</a> hours after it went missing, with all five people on board believed to be dead. Image credits: OceanGate / Wikimedia

Family & Pets

Why does my back get so sore when I’m sick? The connection between immunity and pain

<a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Have you ever wondered why your back aches when you’re down with the flu or a cold? Or COVID? This discomfort, common during many illnesses, is not just a random symptom. It’s a result of complex interactions between your immune system and your brain called the “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314453/">neuroimmune synapse</a>”. A fascinating and yet-to-be-understood consequence of this conversation between the immune and brain systems during sickness is that it is particularly noticeable in the <a href="https://academic.oup.com/brain/article/145/3/1098/6370954">lower back</a>. This is thought to be one of the body’s most sensitive regions to neuroimmune threats. <h2>Immunology basics</h2> Our immune system is a double-edged sword. Yes, it fights off infections for us – but it also makes us acutely aware of the job it is doing. When our body detects an infection, our immune system releases molecules including signalling proteins called <a href="https://www.researchgate.net/publication/227831648_The_functions_of_cytokines_and_their_uses_in_toxicology">cytokines</a>. These proteins coordinate our immune system to fight off the infection and talk to our brain and spinal cord to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740752/#:%7E:text=Production%20of%20proinflammatory%20cytokines%20induces,to%20depression%20in%20vulnerable%20individuals.">change our behaviour</a> and physiology. This can result in symptoms like fatigue, loss of appetite, fever and increased sensitivity to pain. Classically, we think of this as a beneficial behavioural change to help us conserve energy to fight off the infection. It’s why we often feel the need to rest and withdraw from our usual activities when we’re sick – and also why we are grumpier than usual. <h2>Invisibly small changes</h2> Part of this self-protective response is a change in how we perceive threats, including sensory stimuli. When we are sick, touch can become painful and muscles can ache. Many changes in behaviour and sensory systems are <a href="https://doi.org/10.1159/000521476">believed</a> to have origins at the nanoscale. When molecular changes occur in part of the brain linked to cognition or mood, we think and feel differently. If these neuroimmune synapse changes happen in the sensory processing regions of the brain and spinal cord, we feel more pain. Such sensory changes, known as <a href="https://www.iasp-pain.org/resources/fact-sheets/allodynia-and-hyperalgesia-in-neuropathic-pain/#:%7E:text=Allodynia%20is%20pain%20due%20to,stimulus%20that%20normally%20provokes%20pain.">allodynia and hyperalgesia</a>, can lead to heightened pain sensitivity, even in areas not directly affected by the infection – <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889159114001731?via%3Dihub">such as the lower back</a>. <h2>Immune memories</h2> This immune response happens with a range of bacterial infections and viruses like COVID or the flu. In fact, the sick feeling we sometimes get after a vaccination is the good work our immune system is doing to contribute to <a href="https://theconversation.com/you-cant-get-influenza-from-a-flu-shot-heres-how-it-works-118916">a protective immune memory</a>. Some of that immune-cellular conversation also alerts our brains that we are sick, or makes us think we are. After some viral infections, the sick feeling persists longer than the virus. We are seeing a long-term response to COVID in some people, termed <a href="https://theconversation.com/when-does-covid-become-long-covid-and-whats-happening-in-the-body-when-symptoms-persist-heres-what-weve-learnt-so-far-188976">long COVID</a>. Women, who generally have a <a href="https://www.nature.com/articles/nri.2016.90">stronger immune response</a> than men, may be more likely to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7937378/">experience pain symptoms</a>. Their heightened immune response (while beneficial in resisting infections) also predisposes women to a higher risk of inflammatory conditions like <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980266/">autoimmune diseases</a>. <h2>When to worry and what to do</h2> If the pain is severe, persistent, or accompanied by other concerning symptoms, seek medical attention. Mild to moderate pain is a common symptom during illness and we often notice this in the lower back. The good news is it usually subsides as the infection clears and the sickness resolves. While treating the underlying infection is crucial, there are also ways to dial down sickness-induced neuroimmune pain. Maintaining a diverse microbiome (the collection of microorganisms living in and on your body) by <a href="https://pubmed.ncbi.nlm.nih.gov/31704402/">eating well and getting outside</a> can help. Getting quality sleep, staying hydrated and minimising inflammation <a href="https://karger.com/bbe/article/97/3-4/197/821576/Sickness-and-the-Social-Brain-How-the-Immune">helps too</a>. Amazingly, there is <a href="https://pubmed.ncbi.nlm.nih.gov/34404209/">research</a> suggesting your grandmother’s traditional chicken broth recipe decreases the immune signals at the neuroimmune synapse. Scientists are also <a href="https://pubmed.ncbi.nlm.nih.gov/24799686/">showing</a> mindfulness meditation, cold water therapy and controlled breathing can drive profound cellular and molecular changes to help activate bodily systems like the autonomic nervous system and alter the immune response. These practices might not only help manage pain but also add an anti-inflammatory component to the immune response, reducing the severity and duration of sickness. Heat treatment (with a pack or hot water bottle) might <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401625/">provide some relief</a> due to increased circulation. Over-the-counter pain relief maybe also be helpful but seek advice if you are taking other medications. <h2>All in the mind?</h2> Is this all mind over matter? A little of yes and a lot of no. The little of yes comes from <a href="https://pubmed.ncbi.nlm.nih.gov/26194270/">research</a> supporting the idea that if you expect your breathing, meditation and cold bath therapy to work, it may well make a difference at the cellular and molecular level. But by understanding the mechanisms of back pain during illness and by using some simple strategies, there is hope to manage this pain effectively. Always remember to seek medical help if your symptoms are severe or persist longer than expected. Your health and comfort are paramount.<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/207222/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/joshua-pate-1399299">Joshua Pate</a>, Senior Lecturer in Physiotherapy, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/mark-hutchinson-105409">Mark Hutchinson</a>, Professor, <a href="https://theconversation.com/institutions/university-of-adelaide-1119">University of Adelaide</a> Image credits: Getty Images 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-does-my-back-get-so-sore-when-im-sick-the-connection-between-immunity-and-pain-207222">original article</a>.

Caring

There’s a growing gap between countries advancing LGBTQ+ rights, and those going backwards

Prime Minister Anthony Albanese and Foreign Minister Penny Wong joined 50,000 people to march in support of queer rights across the Sydney Harbour Bridge for World Pride in early March. A week earlier, Albanese became the first sitting prime minister to march in Sydney’s Mardi Gras, something he’s done over several decades. And yet at the same time, in another part of the world, Uganda’s parliament passed <a href="https://theconversation.com/ugandas-new-anti-lgbtq-law-could-lead-to-death-penalty-for-same-sex-offences-202376">a string of draconian measures</a> against homosexuality, including possible death sentences for “aggravated homosexuality”. Any “promotion” of homosexuality is also outlawed. Seven years ago, I co-wrote a book with Jonathan Symons called Queer Wars. Back then, we suggested there was <a href="https://researchers.mq.edu.au/en/publications/queer-wars-the-new-global-polarization-over-gay-rights">a growing gap</a>between countries in which sexual and gender diversity was becoming more acceptable, and those where repression was increasing. Sadly, that analysis seems even more relevant today. <h2>A growing gap</h2> Some countries have been unwinding criminal sanctions around homosexuality, which are often the legacy of colonialism. This includes, in recent years, former British colonies <a href="https://www.hrw.org/news/2022/08/22/singapore-decriminalize-gay-sex">Singapore</a> and <a href="https://www.theguardian.com/world/2018/sep/06/indian-supreme-court-decriminalises-homosexuality">India</a>. But others have been imposing new and more vicious penalties for any deviation from stereotypical assumptions of heterosexual masculine superiority (what Australian sociologist Raewyn Connell <a href="https://journals.sagepub.com/doi/abs/10.1177/0891243205278639">terms</a> “hegemonic masculinity”). Anti-gay legislation is currently pending in Ghana, which led US Vice President Kamala Harris to <a href="https://www.bbc.com/news/world-43822234">express concerns</a> on a recent visit. These moves echo the deep homophobia of Russian President Vladimir Putin, who has <a href="https://www.bostonreview.net/articles/putins-anti-gay-war-on-ukraine/">bizarrely linked</a> intervention in Ukraine to protecting traditional values against LGBTQ+ infiltration. Meanwhile, reports from Afghanistan suggest that anyone identified as “LGBT” is <a href="https://www.hrw.org/news/2022/01/26/afghanistan-taliban-target-lgbt-afghans">in danger of being killed</a>. Indonesia recently passed legislation <a href="https://www.theguardian.com/world/2022/dec/06/indonesia-passes-legislation-banning-sex-outside-marriage">penalising all sex outside marriage</a>. This follows <a href="https://www.tandfonline.com/doi/full/10.1080/13639811.2022.2038871">years of anti-queer rhetoric</a> from Indonesian leaders and crackdowns in regional areas. And while the Biden administration is supportive of queer rights globally, the extraordinary hysteria <a href="https://www.theguardian.com/us-news/2023/mar/07/cpac-anti-trans-rhetoric">around trans issues in the Republican Party</a> reminds us the West has no inherent claim to moral superiority. <h2>Where to next?</h2> Speaking at the World Pride Human Rights Conference, both Wong and Attorney General Mark Dreyfus made it clear Australia would press for recognition of sexuality and gender identity as deserving protection, as part of <a href="https://www.foreignminister.gov.au/minister/penny-wong/speech/sydney-worldpride-human-rights-conference-opening-statement">our commitment to human rights</a>. Wong also announced a <a href="https://www.themandarin.com.au/213443-wong-announces-international-fund-for-lgbt-rights/">new Inclusion and Equality Fund</a> to support queer community organisations within our region. Australian governments have usually been wary of loud assertions of support for queer rights. This is partly due to a reasonable fear this merely reinforces the perception that such language reflects <a href="https://www.cambridge.org/core/journals/african-studies-review/article/abs/locating-neocolonialism-tradition-and-human-rights-in-ugandas-gay-death-penalty/33A06F4F33CF586E20E208BE790E71E0">a sense of Western superiority</a>, unwilling to acknowledge other societies may have very different attitudes towards gender and sexuality. Australia is part of the Equal Rights Coalition, an intergovernmental body of 42 countries dedicated to the protection of the rights of LGBTQ+ people, and has supported sexual and gender rights in the <a href="https://humanrights.gov.au/our-work/rights-and-freedoms/australias-second-universal-periodic-review-human-rights">country reviews</a> undertaken by the United Nations Human Rights Commission. Australia has a minimal presence in Uganda, and direct representations are unlikely to have much effect. Uganda is a member of the Commonwealth, as are Ghana, Kenya and Zambia, where official homophobia appears to be increasing. But there’s little evidence the Australian government sees this as a significant foreign policy forum, or is prepared to push for sexual rights through its institutions. As persecution on the basis of sexuality and gender identity increases, more people will seek to flee their countries. Queer refugees face double jeopardy: they’re not safe at home, but they’re often equally unsafe in their diasporic communities, which have inherited the <a href="https://www.weforum.org/agenda/2018/01/lgbt-refugees-untold-story/">deep prejudices of their homelands</a>. The UN’s refugee agency <a href="https://www.unhcr.org/lgbtiq-persons.html">reports</a> that most people seeking asylum because of their sexuality are unwilling to disclose this, because of discrimination within their own ethnic communities. This makes it impossible to have accurate numbers. But a clear signal from Australia would be a powerful statement of support – that it understands the situation and welcomes people who need flee because of their sexuality or gender expression. An official Canadian government document <a href="https://www.canada.ca/en/immigration-refugees-citizenship/services/refugees/canada-role/2slgbtqi-plus.html">states</a>: "Canada has a proud history of providing protection to and helping to resettle the world’s most vulnerable groups. That includes those in the Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, and additional sexually and gender diverse community." Theirs is a model worth following. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/theres-a-growing-gap-between-countries-advancing-lgbtq-rights-and-those-going-backwards-203329" target="_blank" rel="noopener">The Conversation</a>.

Caring

Global review shows link between social media use, body image and eating disorders

Body image has remains a <a href="https://www.missionaustralia.com.au/what-we-do/research-impact-policy-advocacy/youth-survey" target="_blank" rel="noopener">top personal concern</a> for young people in Australia, with 76% concerned about the issue. Social media use by teens is rising at the same time – with <a href="https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Social-Media-and-Teens-100.aspx" target="_blank" rel="noopener">more than 90% on platforms</a> like Facebook, YouTube, Instagram, Snapchat, WeChat and TikTok. While there have long been concerns about the association between social media, body image and eating disorders the connection remains relatively unexplored as a public health issue. Now, researchers from University College London in the UK have undertaken a systematic review of 50 scientific studies across 17 countries showing clear links between social media use and body image concerns. The paper, <a href="https://doi.org/10.1371/journal.pgph.0001091" target="_blank" rel="noopener">published</a> in PLOS Global Public Health, analyses the relationship between body image or eating disorders in young people and social media use. The researchers identify specific aspects of social media – platforms with an emphasis on photos, and engaging with “fitspiration” and “thinspiration” trends – as the factors most closely linked to body image concerns, disordered eating and poor mental health. Other key risk factors included female gender, high body-mass-index and pre-existing body image concerns. The researchers note further studies are needed into the direction of causality. “For example, do body image dissatisfaction and disordered eating occur because of social media usage, or do these pre-exist, encourage engagement in certain online activities, and result in unfavourable clinically significant outcomes?” they ask. Eating disorders involve disturbed attitudes to body image, pre-occupation with weight and body shape and are associated with significant negative outcomes such as cardiovascular disease, reduced bone density, and psychiatric conditions. In Australia, the <a href="https://butterfly.org.au/" target="_blank" rel="noopener">Butterfly Foundation</a> reports eating disorders affect around one million people, with the conditions causing more people die each year than the road toll. Image credits: Getty Images This article was originally published on <a href="https://cosmosmagazine.com/health/social-media-use-body-image/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Petra Stock.

Technology

Music and mental health: the parallels between Victorian asylum treatments and modern social prescribing

Music has a powerful effect on the listener. It is linked to <a href="https://www.nature.com/articles/s41398-021-01483-8">better mental health</a>, and it has been shown to <a href="https://journals.sagepub.com/doi/abs/10.1177/0305735617703811?journalCode=poma">alleviate loneliness, pain, anxiety and depression</a>. For this reason, it is increasingly being prescribed by doctors as a form of medicine. This practice – where patients are referred to various activities such as running groups, art classes and choirs – is known as <a href="https://www.england.nhs.uk/personalisedcare/social-prescribing/">social prescribing</a>. Music-based activities may be prescribed to <a href="https://link.springer.com/article/10.1186/s13612-016-0048-0">help support</a> patients’ <a href="https://www.tandfonline.com/doi/abs/10.1080/08098131.2018.1432676">mental health</a>, <a href="https://link.springer.com/chapter/10.1007/978-3-319-76240-1_9">combat isolation</a>, encourage <a href="https://www.tandfonline.com/doi/full/10.1080/17482631.2020.1732526">physical activity</a>, and <a href="https://www.frontiersin.org/articles/10.3389/fnagi.2021.693791/full">keep an active brain</a>. While social prescribing is a relatively new practice, the use of music as a therapeutic tool is not. The first widespread use of music as a therapeutic tool can be traced back to the 19th century, where it was used in Victorian asylums to support patients’ treatment. <h2>Music in asylums</h2> Victorian asylums are usually associated with poor sanitation, overcrowding, <a href="https://www.tandfonline.com/doi/abs/10.1179/0308018813Z.00000000063">danger</a> and patients held against their will. Indeed, the Victorians had little understanding of mental illness and the brain, which meant <a href="https://journals.sagepub.com/doi/10.1177/030802269005301009">many treatments </a>considered barbaric today were used on patients – including bleeding, leeching, shaving the head and bathing in ice. From the end of the 18th century, however, practitioners moved away from the worst types of physical restraint. A new practice emerged, known as “<a href="https://www.sciencemuseum.org.uk/objects-and-stories/medicine/victorian-mental-asylum#:%7E:text=The%20Victorian%20mental%20asylum%20has,humane%20attitude%20towards%20mental%20healthcare.">moral management</a>”, which placed a focus on using employment, diet, surroundings and recreational activities as <a href="https://historicengland.org.uk/research/inclusive-heritage/disability-history/1832-1914/daily-life-in-the-asylum/">forms of therapy</a>. When state-run asylums were first introduced in Britain in the <a href="https://www.bloomsbury.com/uk/cure-comfort-and-safe-custody-9780718500948/">early 19th century</a>, music soon became included as a <a href="https://link.springer.com/book/10.1007/978-3-030-78525-3">form of moral management</a> to distract patients outside of working hours and keep them occupied. Both music and dance were efficient ways of entertaining large numbers of patients. By the middle of the 19th century, almost all the larger asylums in the UK had their own band and would often organise dances, attended by over a hundred patients. Asylums also hosted concerts by travelling performers, from comic sketches to solo singers and amateur choirs. Dances and concerts were usually the only opportunities for patients to meet in a large group, providing important social interaction. Among the <a href="https://www.cambridge.org/core/journals/royal-musical-association-research-chronicle/article/music-as-therapy-for-the-exceptionally-wealthy-at-the-nineteenthcentury-ticehurst-asylum/CBB82DA05DAB7A9D47636BCE2DF9DBB7">smaller asylums</a>, chiefly catering for wealthier patients, patients had more options to create music as part of their treatment. They would often bring instruments with them. And small concerts put on by patients and staff were common. <h2>The benefits of music</h2> Much of the therapeutic value of music was attached to its social function. Accounts suggest that patients benefited from the anticipation of these social engagements and that events were used to reward good behaviour. Music was also used to break up the monotony of asylum life. For example, <a href="https://link.springer.com/chapter/10.1007/978-3-030-78525-3_11">at one private asylum</a>, Dr Alfred Wood, wrote, "These entertainments involved a great amount of trouble in their preparation and arrangement and, I may add, considerable expense; but they are invaluable as a relief to the monotony of life in an Asylum. The pleasure they afford as well in anticipation as in reality, is ample to compensate for the efforts made to present them …" Dances, in particular, offered exercise and enjoyment, and even patients who were unable to dance enjoyed the music and watching fellow patients. Musical events also carried strict expectations of behaviour. Patients needed a good deal of self-control to participate and behave appropriately. It was this process of conforming to expectations that formed an important part of rehabilitation. William A.F. Browne, one of the most noteworthy asylum doctors of the era, wrote in 1841 about the <a href="https://wellcomecollection.org/works/dkxnvx35/items?canvas=91">self-control</a> needed before, during and after amusements. Others suggested that music would help <a href="https://wellcomecollection.org/works/vmmq4wv8/items?canvas=216">remind patients of happier days</a> and give them hope and pleasure during their treatment. Browne also cited the “powers of music to soothe, enliven, rouse, or melt”. He suggested that even difficult patients may benefit from music, <a href="https://wellcomecollection.org/works/far6jdph/items?canvas=26">writing</a>: “There is or may be a hidden life within him which may be reached by harmony.” The writer James Webster <a href="https://www.bmj.com/content/s1-5/114/197.2">recorded in 1842</a> that: “In many, the effect produced by the music upon their countenances and behaviour was often quite apparent.” Records include many stories of patients seemingly cured by music. Webster cites the example of a young girl, previously “morose” and “stupefied”, who under the influence of music, seemed “pleased” and “cheerful” – appearing “altogether a changed creature”. Browne also wrote in one of his books of the <a href="https://wellcomecollection.org/works/far6jdph/items?canvas=26">miraculous effect</a> music had on one patient who awoke, cured, the morning after listening to a performance of Scottish traditional melodies. <h2>Music as treatment</h2> In the 1890s, many doctors carried out experiments on the relationship between music and mental illness. Herbert Hayes Newington, medical superintendent of one of the era’s most prestigious asylums, used music to diagnose patients and <a href="https://www.cambridge.org/core/journals/journal-of-mental-science/article/abs/some-mental-aspects-of-music/A87C190163A86070D4445A830E656557">help develop theories</a> on how the brain works. Reverend Frederick Kill Harford, who campaigned to provide music in public hospitals during the early 1890s, believed music could <a href="https://www.bmj.com/content/2/1603/667">treat depression</a>, alleviate physical pain and help with sleep. Although music remained in asylums as a form of <a href="https://theconversation.com/what-life-was-like-in-mental-hospitals-in-the-early-20th-century-119949">therapy</a>, interest in it as a large-scale treatment waned as innovations such as <a href="https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2020.160103">electroconvulsive therapy</a> emerged in the 20th century. For patients in Victorian asylums, therefore, music was an important part of mental health treatment – not only providing an opportunity for creative engagement but also fulfilling a range of social, emotional and intellectual needs. Given what we know now about the <a href="https://www.nature.com/articles/s41398-021-01483-8">benefit of music on mental health</a>, it’s no wonder doctors are making use of it again. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/music-and-mental-health-the-parallels-between-victorian-asylum-treatments-and-modern-social-prescribing-200576" target="_blank" rel="noopener">The Conversation</a>.

Music

This is the difference between dementia and Alzheimer’s

There are around 50 million people living with dementia worldwide, according to the World Health Organization. While dementia and Alzheimer's disease are often used interchangeably, there are important differences between them. Here’s what you need to know. Dementia vs. Alzheimer’s Here’s the first thing you need to know: how to tell the difference between dementia and Alzheimer’s disease. Dementia is an umbrella term for symptoms like impaired memory and thinking that interferes with daily living; Alzheimer’s disease is a specific type of dementia. Other types of dementia include vascular dementia, dementia with Lewy bodies, frontotemporal dementia, Parkinson’s disease, and Huntington’s disease. “Alzheimer’s is the most common form of dementia – about 60 to 70 per cent of the time, a patient with dementia has Alzheimer’s,” says Dr Richard Isaacson, Director of the Alzheimer’s Prevention Clinic at NewYork-Presbyterian/Weill Cornell Medical Center. The reason you hear about Alzheimer’s most often is not only because it is the most common type of dementia, but also because the science behind Alzheimer’s is the most advanced across all dementias,” explains Dr Isaacson. Causes of dementia are vastly different A medical illness, metabolic issue (like a nutritional or thyroid problem), vascular disease (like a stroke), or, rarely, infectious diseases can affect brain cells, causing dementia. Even mad cow disease, which is very rare, can contribute to dementia, says Dr Isaacson. A condition called depressive “pseudo” dementia is another possible source. As he explains, when levels of the neurotransmitter serotonin run low, you may have trouble paying attention. And when you’re distracted, you have trouble remembering things, which can manifest as dementia. On the other hand, Alzheimer’s has its own origins. It’s a brain disease marked by deposits of beta-amyloid plaques and proteins called tau that damage cells in brain regions that control functions like thinking, memory, and reasoning. Multiple factors can be at play There’s also what’s called mixed dementia, meaning there are multiple conditions that can come together to cause dementia. “Thirty percent of the time, patients who have Alzheimer’s also have a vascular disease that makes cognitive symptoms worse,” says Dr Isaacson. Alzheimer’s and dementia with Lewy bodies (in this disease, clumps of alpha-synuclein proteins develop in the brain) have also been found to occur together. Symptoms can look very similar Losing your keys – again – and forgetting where you parked are basic memory problems, so how do you know when it crosses the line to dementia or Alzheimer’s? According to the Alzheimer’s Association, in order for a person to be diagnosed with dementia, two of the following must be “significantly impaired”: memory, communication and language, the ability to focus and pay attention, reasoning and judgment, and visual perception. When it comes to Alzheimer’s, you may forget new information or find that you have to ask family members to remember important facts you should be able to keep track of yourself. (It’s not those little brain blips where you can’t remember the name of your second cousin and then it comes to you later – that’s normal). Research published in the Journal of Alzheimer’s Disease in 2016 also indicates that difficulty using a map may be one of the earliest warning signs of Alzheimer’s. You may be able to prevent Alzheimer’s “We have the Alzheimer’s Prevention Clinic, and the fact that you can talk about those words together is advanced,” says Dr Isaacson. The clinic investigates how lifestyle choices – a healthy diet, exercise, social and mentally stimulating activities, as well as everyday habits, and ample sleep can markedly reduce your risk of Alzheimer’s. In fact, in a study in 2014 published in the Lancet Neurology, reducing certain risk factors can decrease the risk of Alzheimer’s by 33 per cent. The most important ways to prevent Alzheimer’s: Control diabetes and high blood pressure, reduce weight if obese, stay active, treat depression, don’t smoke, and stay in school. The Lancet, in a 2017 article, also notes that staying social (spending time with friends and family members) and managing hearing loss have been shown to be among the controllable factors that may help prevent dementia. Treatment options depend on the type of dementia There are virtually no FDA-approved therapies for dementia (only one approved drug for Parkinson’s dementia), but there are four medications that target Alzheimer’s, according to Dr Isaacson. And while these drugs don’t stall disease progression (or cure the disease), they can help control symptoms. Patients of Dr Isaacson’s say these drugs may help for six to nine months, but many stay on them for the long haul because they help with behavioural symptoms such as agitation and aggression. “When you stop the medications, the psychological symptoms get worse,” he says. As for other types of dementia, lifestyle changes may be the best option. Treatment for vascular dementia relies on doing things that are healthy for your arteries and heart: reducing blood pressure and cholesterol, and controlling diabetes. “Managing other chronic conditions is important,” says Dr Isaacson. “Those are a great way to press the fast-forward button on dementia.” You can find out if you’re at an increased risk of Alzheimer’s now If you get evaluated for Alzheimer’s, your doctor can make a diagnosis based on symptoms, a clinical history, and medical tests (to rule out causes like thyroid issues or nutritional deficiencies). Brain imaging tests like a cat scan or MRI can look for beta amylase plaques gunking up brain regions. You don’t have to be scared Forgetting how to work the remote in your home, being afraid to leave your neighbourhood out of fear you might not get home, or misplacing your belongings so often that it hurts your ability to get out the door can all be particularly worrisome – especially if a loved one expresses concern. If you’re worried, see your doctor, says Dr Issacson. “Get educated, get informed, get evaluated,” he says. “The earlier the diagnosis, the earlier you can be treated. And the earlier you’re treated, the better you’ll do.” Written by Jessica Migala. This article first appeared in <a href="https://www.readersdigest.co.nz/healthsmart/this-is-the-difference-between-dementia-and-alzheimers" target="_blank" rel="noopener">Reader’s Digest</a>. For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.innovations.co.nz/c/readersdigestemailsubscribe?utm_source=over60&utm_medium=articles&utm_campaign=RDSUB&keycode=WRA87V" target="_blank" rel="noopener">here’s our best subscription offer.</a> Image: Getty Images

Mind

What’s the connection between cosmetic procedures and mental health?

Although we cannot be sure of the exact numbers of Australians undergoing cosmetic procedures, as there is no requirement for health professionals to report their statistics, there is a consensus demand is on the rise. In 2015, the <a href="https://cpca.net.au/wp-content/uploads/2016/05/31-05-2016_AUSTRALIAS_SPEND_ON_COSMETIC_TREATMENTS_TOPS_1_BILLION.pdf">Cosmetic Physicians College of Australasia</a> found Australians were spending more than $1 billion a year on non-invasive cosmetic procedures like Botox and fillers. This is more than 40% higher, per capita, than in the United States. In the US, where procedure <a href="https://cdn.theaestheticsociety.org/media/statistics/2021-TheAestheticSocietyStatistics.pdf">statistics are reported</a>, there was a 42% increase in the number of filler procedures and a 40% increase in Botox procedures performed in the last year alone. Rates of mental health issues in this group may be higher than the general population, but seemingly not enough is being done to ensure the psychological safety of people requesting cosmetic procedures. <h2>Body dysmorphic disorder</h2> Body image concerns are generally the main motivator for seeking cosmetic procedures of all kinds. These concerns are <a href="https://www.sciencedirect.com/science/article/pii/S1740144518305552">usually focused on the body part</a> where the cosmetic intervention is sought, such as the nose for a rhinoplasty. Severe body image concerns are a key feature of several mental health conditions. The most prevalent in people seeking cosmetic procedures is body dysmorphic disorder. In the general community, around 1-3% of people will experience body dysmorphic disorder, but in populations seeking cosmetic surgery, this <a href="https://pubmed.ncbi.nlm.nih.gov/35715310/">rises to 16-23%</a>. <a href="https://bdd.iocdf.org/professionals/diagnosis/">Body dysmorphic disorder</a> involves a preoccupation or obsession with one or more perceived flaws in physical appearance which are not visible or seem minor to other people. In response to the distress regarding the flaw, the person with body dysmorphic disorder will perform repetitive behaviours (such as excessively checking body parts in the mirror) and mental acts (such as comparing their appearance with other people). These concerns can have a significant negative impact on the person’s daily life, with some people too distressed to leave their home or even eat dinner with family members out of fear of being seen by others. With the distress associated with body dysmorphic disorder seemingly stemming from physical appearance issues, it makes sense someone with body dysmorphic disorder is far more likely to turn up at a cosmetic clinic for treatment than a mental health clinic. The problem is, cosmetic intervention usually makes the person with body dysmorphic disorder feel the <a href="https://link.springer.com/article/10.1007/s00266-017-0819-x">same or worse</a> after the procedure. They may become even more preoccupied with the perceived flaw and seek further cosmetic procedures. Patients with body dysmorphic disorder are also <a href="https://academic.oup.com/asj/article/22/6/531/204131">more likely</a> to take legal action against their treating cosmetic practitioner after believing they have not received the result they wanted. For these reasons, body dysmorphic disorder is generally considered by health professionals to be a “red flag” or contraindication (a reason not to undergo a medical procedure) for cosmetic procedures. However, this is not entirely clear-cut. <a href="https://academic.oup.com/asj/advance-article/doi/10.1093/asj/sjac243/6678852?searchresult=1">Some studies</a> have shown people with body dysmorphic disorder can improve their symptoms after cosmetic intervention, but the obsession may just move to another body part and the body dysmorphic disorder diagnosis remain. <h2>What about other mental health conditions?</h2> Body dysmorphic disorder is by far the most well-studied disorder in this area, but is not the only mental health condition that may be associated with poorer outcomes from cosmetic procedures. According to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034989/">recent systematic review</a>, the rates of depression (5-26%), anxiety (11-22%) and personality disorders (0-53%) in people seeking cosmetic surgery may be higher than the general population (which are estimated to be 10%, 16% and 12% respectively). However, these rates should be interpreted with some caution as they depend greatly on how the mental health diagnosis was made – clinician-led interview (higher rates) versus mental health questionnaire (lower rates). Some interview approaches can suggest higher rates of mental health issues as they may be quite unstructured and thus have questionable validity compared with highly structured questionnaires. Besides body dysmorphic disorder, the research investigating other mental health conditions is limited. This may just be due to the fact body image focus is at the core of body dysmorphic disorder, which makes it a logical focus for cosmetic surgery research compared with other types of psychiatric disorders. <h2>So what should happen?</h2> Ideally, all cosmetic surgeons and practitioners should receive sufficient training to enable them to conduct a brief routine assessment of all prospective patients. Those with signs indicating they are unlikely to derive psychological benefit from the procedure should undergo a further assessment by a mental health professional before undergoing the procedure. This could include an in-depth clinical interview about motivations for the procedure, and completing a range of standard mental health questionnaires. If a person was found to have a mental health issue in the assessment process, it does not necessarily mean the mental health professional would recommend against pursuing the procedure. They may suggest a course of psychological therapy to address the issue of concern and then undergo the cosmetic procedure. At the moment, assessments are only recommended rather than mandated for cosmetic surgery (and not at all for injectables like Botox and fillers). The <a href="https://plasticsurgery.org.au/wp-content/uploads/2020/08/2.5-AHPRA-MBA-Guidelines-for-Registered-Medical-Practitioners-Who-Perform-Cosmetic-Medical-and-Surgical-Procedures-2016.pdf">guidelines</a> say evaluation should be undertaken if there are signs the patient has “significant underlying psychological problems”. This means we are relying on the cosmetic medical practitioner being capable of detecting such issues when they may have received only basic psychological training at medical school, and when their business may possibly benefit from not attending to such diagnoses. An August 2022 <a href="https://www.ahpra.gov.au/Resources/Cosmetic-surgery-hub/Cosmetic-surgery-review.aspx">independent review</a> by the Australian Health Practitioner Regulation Agency and the Medical Board of Australia recommended the guidelines around mental health assessment should be “strengthened” and emphasised the importance of medical practitioners receiving more training in the detection of psychiatric disorders. Ultimately, as cosmetic practitioners are treating patients who are seeking treatment for psychological rather than medical reasons, they must have the wellbeing of the patient front-of-mind, both out of professional integrity and to protect themselves from legal action. Mandatory evaluation of all patients seeking any kind of cosmetic procedure would likely improve patient satisfaction overall. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/whats-the-connection-between-cosmetic-procedures-and-mental-health-190841" target="_blank" rel="noopener">The Conversation</a>.

Beauty & Style

Long COVID: How lost connections between nerve cells in the brain may explain cognitive symptoms

For a portion of people who get COVID, symptoms continue for <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk/6october2022" target="_blank" rel="noopener">months or even years</a> after the initial infection. This is commonly referred to as “long COVID”. Some people with long COVID complain of “<a href="https://theconversation.com/what-is-and-what-isnt-brain-fog-190537" target="_blank" rel="noopener">brain fog</a>”, which includes a wide variety of cognitive symptoms affecting memory, concentration, sleep and speech. There’s also growing concern about findings that people who have had COVID are at <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(22)00260-7/fulltext" target="_blank" rel="noopener">increased risk</a> of developing brain disorders, such as dementia. Scientists are working to understand how exactly a COVID infection affects the human brain. But this is difficult to study, because we can’t experiment on living people’s brains. One way around this is to create <a href="https://www.nature.com/articles/s41578-021-00279-y" target="_blank" rel="noopener">organoids</a>, which are miniature organs grown from stem cells. In a <a href="https://www.nature.com/articles/s41380-022-01786-2.pdf" target="_blank" rel="noopener">recent study</a>, we created brain organoids a little bigger than a pinhead and infected them with SARS-CoV-2, the virus that causes COVID-19. In these organoids, we found that an excessive number of synapses (the connections between brain cells) were eliminated – more than you would expect to see in a normal brain. Synapses are important because they allow neurons to communicate with each other. Still, the elimination of a certain amount of inactive synapses is part of normal brain function. The brain essentially gets rid of old connections when they’re no longer needed, and makes way for new connections, allowing for more efficient functioning. One of the crucial functions of the brain’s immune cells, or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768411/" target="_blank" rel="noopener">microglia</a>, is to prune these inactive synapses. The exaggerated elimination of synapses we saw in the COVID-infected models could explain why some people have cognitive symptoms as part of long COVID. Parallels with neurodegenerative disorders Interestingly, this pruning process is believed to go awry in several disorders affecting the brain. In particular, excessive elimination of synapses has recently been linked to <a href="https://www.nature.com/articles/s41593-018-0334-7" target="_blank" rel="noopener">neurodevelopmental disorders</a> such as <a href="https://www.nature.com/articles/s41593-018-0334-7" target="_blank" rel="noopener">schizophrenia</a>, as well as <a href="https://www.frontiersin.org/articles/10.3389/fncel.2019.00063/full" target="_blank" rel="noopener">neurodegenerative disorders</a> such as Alzheimer’s and Parkinson’s disease. By sequencing the RNA of single cells, we could study how different cell types in the organoid responded to the virus. We found that the pattern of genes turned on and off by the microglia in our COVID-infected organoids mimicked changes seen in neurodegenerative disorders. This may go some way in explaining the link between COVID and the risk of developing certain neurological disorders. <figure class="align-center "><img src="https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&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/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=425&fit=crop&dpr=1 754w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=425&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/491380/original/file-20221024-17-9wi5pg.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=425&fit=crop&dpr=3 2262w" alt="" /><figcaption>A brain organoid used in our study. You can see the microglial cells in red. Sellgren lab, Author provided</figcaption></figure> A possible target for treatment One limitation of our research is that our organoid models closely resemble the foetal or early brain, rather than the adult brain. So we can’t say for sure whether the changes we noted in our study will necessarily be reflected in the adult brain. However, some <a href="https://pubmed.ncbi.nlm.nih.gov/33248159/" target="_blank" rel="noopener">post-mortem</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/35255491/" target="_blank" rel="noopener">imaging studies</a> report neuronal death and reduction in grey matter thickness in COVID patients, which hints at similar instances of synapse loss caused by an infection in adults. If this proves to be a fruitful line of enquiry, we believe our findings could point to a mechanism contributing to persisting cognitive symptoms after COVID and other viral infections that affect the brain. SARS-CoV-2 is an RNA virus and similar <a href="https://pubmed.ncbi.nlm.nih.gov/27337340/" target="_blank" rel="noopener">processes</a> have been seen in mice infected with other RNA viruses that can also cause residual cognitive symptoms, such as the <a href="https://pubmed.ncbi.nlm.nih.gov/31235930/" target="_blank" rel="noopener">West Nile virus</a>. From here we want to study how different drugs could inhibit the changes we saw in the infected models, hopefully paving the way towards effective treatments. In <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410571/">other research</a>, we’ve observed that an antibiotic called minocycline can reduce the degree to which microglia prune synapses in a dish. So we want to see if this drug can help in our brain organoid models following SARS-CoV-2 infection.<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/192702/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Writen by Samudyata and Carl Sellgren. Republished with permission from <a href="https://theconversation.com/long-covid-how-lost-connections-between-nerve-cells-in-the-brain-may-explain-cognitive-symptoms-192702" target="_blank" rel="noopener">The Conversation</a>. Image: Getty Images

Mind

New research uncovers correlation between smoking and Covid

According to new research from UC San Diego, smoking increases the likelihood for a person to develop severe Covid-19 symptoms that require hospitalisation and could potentially be fatal. The study done under UCSD’s Rady school of Management and two Danish universities have seen cigarette sales among regular smokers decline between 20-30%. The number of those quitting smoking increased by 10% from March 2020-January 2021 in Denmark. “The pandemic led to reductions in physical activity, increases in stress and declines in mental well-being, all factors commonly associated with triggering higher tobacco use - however, we find evidence of sustained decreases in smoking, which could be a bright spot in the pandemic,” corresponding study author of the study and Rady School associate professor of economics and strategy Sally Sadoff said. “The health risks associated with COVID-19 and smoking may help some smokers overcome a key barrier to quitting - that the enjoyment of smoking is felt in the present and health costs are usually felt in the future.” The paper, published in the journal Communications Medicine, has also found that dips in smoking were sustained for at least the first year of the pandemic and quitting rates lasted at least six months. These findings suggest COVID-19 may lead to a persistent decline in smoking. According to the Australian Bureau of Statistics National Health Survey, the prevalence of daily smoking for Australians aged 18 and older in 2020-21 was 10.7%. Image: Getty

Body

Lip reader reveals insight into THOSE scenes between Kate and Louis

Prince Louis’ adorable antics certainly stole the show at the Platinum Jubilee, however, it seems not everyone was fond of his behaviour. A lip reader captured a serious parenting moment between the Duchess of Cambridge and young Louis, as the family were sitting in the royal box on the final day of celebrations. The Cambridges were enjoying the colourful floats at the pageant and Louis was seen pulling faces and getting tired and restless. According to lip reading expert Jeremy Freeman, Kate had some stern words for her youngest during his grumpy moment. Jeremy says when Kate spotted Louis picking his nose and put his hand down, she said to her son: "You have to." "I don't want to," Louis reportedly answered, before cheekily covering his mum's mouth. Kate then replied: "I said no hands!" and gave him another serious look. The lip reader says Kate once again told Louis to stop with his antics after he stuck his tongue out. "Stop doing that," she said. A sweet moment between Prince Louis and his older cousin Mike Tindall was also caught on camera. While Louis was misbehaving, Mike was seen jokingly warning the young Royal that he was watching him from the seats above, gesturing to his eyes. There were other moments when Louis sat in the lap of dad Prince William and granddad Prince Charles. The Prince of Wales was seen bopping his grandson with his legs and also pointed out parts of the display to him. Prince Louis was also spotted having a great time dancing along to the music as the floats went by. Kate's relatable parenting moment captured the hearts of millions as they watched the Cambridges enjoy the Jubilee carnival. The Duke and Duchess of Cambridge made light of Louis' cheeky behaviour in an Instagram, <a href="https://www.oversixty.com.au/lifestyle/family-pets/kate-and-will-respond-to-haters-with-unseen-snap-of-louis" target="_blank" rel="noopener">sharing ten unseen photos from the Jubilee celebrations</a>. Freeman also caught a precious exchange between the Queen, and her great-grandson during their balcony appearance at Trooping the Colour. Reportedly, Prince Louis looked up to his great-grandmother and asked: "Are the Red Arrows coming?" The Queen replied, "I hope so." At one point, the Queen told Louis to "look at the smoke". The young royal also expressed amazement at the Armed Forces jets, turning to his mother and saying: "Woah." At the end of the display, the monarch told her great-grandson: "Let's go, it's finished now." Body language expert Judi James told the publication that the monarch and Prince Louis shared "childlike excitement" on the balcony. She explained: "Louis stepped in front of the Queen before tilting his head back to engage her in some animated conversation as they waited for the Red Arrows. "Louis made this conversation look like the most natural thing in the world and his lack of anything bordering on fear suggested these two might share a rather close friendship based on shared fun behind the scenes, too." Image: Getty

Family & Pets

No link found between caesarean birth and food allergies

While babies born through caesareans may lack some gut bacteria that would otherwise be gained through vaginal births, recent research has consistently shown that there is little evidence for caesarean births being responsible for asthma and allergies. A recent study by the Murdoch Children’s Research Institute (MCRI) in Melbourne, confirmed no link between caesarean births and food allergies during the first year of life. This research, published in the Journal of Allergy and Clinical Immunology: In Practice, looked at 2,045 infants who underwent skin prick testing and an oral food challenge to test for allergy status. In this group, of the 30% that were born by caesarean, 12.7 % had a food allergy, compared to 13.2% born vaginally, meaning there was no statistically significant difference between birthing methods. “We found no meaningful differences in food allergy for infants born by caesarean delivery compared to those born by vaginal delivery,” says Rachel Peters, who led the study. “Additionally, there was no difference in likelihood of food allergy if the caesarean was performed before or after the onset of labour, or whether it was an emergency or elective caesarean.” A potential link between caesarean births and allergies had long been suspected because of the difference in early microbial exposure compared to vaginal delivery. “The infant immune system undergoes rapid development during the neonatal period,” says Peters. “The mode of delivery may interfere with the normal development of the immune system. Babies born by caesarean have less exposure to the bacteria from the mother’s gut and vagina, which influences the composition of the baby’s microbiome and immune system development. However, this doesn’t appear to play a major role in the development of food allergy.” These findings will assist caregivers to better evaluate risks and benefits of caesarean birth, and provide reassurance to parents that such interventions do not lead to an increased risk of food allergy in their babies. One in 10 infants, and one in 20 children over the age of five years in Australia, have a food allergy, one of the highest rates in the world. This research provides further good news to parents and children: 30% of peanut allergies and 90% of egg allergies naturally resolved by six years of age. These infants should be targeted for early intervention trials, such as oral immunotherapy. “Prioritising research of these and future interventions for infants less likely to naturally outgrow their allergy would yield the most benefit for healthcare resources and research funding,” says Peters. This article originally appeared on <a href="https://cosmosmagazine.com/health/caesarean-no-food-allergy-link/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Qamariya Nasrullah. Image: Shutterstock

Caring

What adds value to your house? How to decide between renovating and selling

The government’s <a href="https://treasury.gov.au/coronavirus/homebuilder">HomeBuilder</a> scheme allows <a href="https://www.corelogic.com.au/news/homebuilder-renovations-where-are-most-owner-occupied-dwellings-below-15-million">certain</a> home owners to apply for a tax-free grant of A$25,000 if they are spending between $150,000 and $750,000 renovating a home or building a new home. Eligibility criteria are strict. The scheme has boosted renovation talk in some circles (although, as CoreLogic has <a href="https://www.corelogic.com.au/news/vacuum-effect-and-its-implications-homebuilder-scheme">pointed</a> out, it may merely bring forward works that were already planned). Here are some questions to ask yourself when trying to decide between renovating and moving – and how to add value to your existing home. <h2>What adds value to a house?</h2> Property market observers <a href="https://www.domain.com.au/advice/how-to-make-your-home-stand-out-when-selling-932031/">advise</a> updating or renewing bathrooms or kitchens – even small fixes such as replacing a cracked or dated splashback, replacing a bath or adding skylights can go a long way. Think about easy repairs that create an invaluable good first impression – a fixed-up fence, a new carpet or resurfaced flooring or even good old decluttering. But remember you’ll only qualify for HomeBuilder if you plan to spend at least $150,000 on an owner-occupied home worth no more than A$1.5 million (CoreLogic has <a href="https://www.corelogic.com.au/news/homebuilder-renovations-where-are-most-owner-occupied-dwellings-below-15-million">listed</a> which suburbs have the most owner-occupied properties under A$1.5 million). <h2>Factors to consider if you’re thinking of renovating</h2> How long till you retire? How secure is your employment? Thinking carefully about your earning potential between now and retirement will help you understand how what you can borrow and afford. If you are planning to stay, you will get the benefit and enjoyment of the renovations. Do you need to stay close to school or work? If that’s a consideration, renovating may be worth more to you than buying further out. Look closely at what your property is worth (there are plenty of online calculators) and keep track of how much similar local properties with one extra bedroom or bathroom sell for. That will give you a sense of the value-add to your home equity that a renovation might represent. Be honest with yourself about the total cost of renovation. There are myriad expenses not always initially apparent. These may include: <ul> <li>planning fees (the cost of getting a development assessed by council)</li> <li>the cost of architectural drawings</li> <li>consultants’ fees for environmental impact statements or arborists’ reports</li> <li>extra costs due to a heritage listing</li> <li>renting, if it’s not possible to live at home during renovation</li> <li>the cost of protecting underground public assets such as water or sewerage pipes</li> <li>extra costs caused by poor access or other limitations.</li> </ul> Consider the possible long-term savings of retrofitting your home to be more energy-efficient. Proper insulation, secondary glazing, draught excluders and solar PV energy are expensive upfront but will save on long term running costs. It’s likely, as energy costs increase, homes that are at least partially off grid will be more attractive and valuable over time. And remember that for some, even with help from HomeBuilder, renovation won’t stack up economically. Some older people may eschew home renovation to put money aside to help children get a foot on the property ladder. Others may decide potentially expensive renovation is worth it to hold onto a family home to which children return as they get older. It might sound sentimental but the idea of Christmas in the family homestead is worth it, for some. <h2>Tax considerations</h2> Find out what tax breaks, if any, you might be eligible for if you renovate to divide the family home into a smaller space (if you’re keen to downsize, or enhance the accessibility of your home, for example) and adding a self-contained granny flat. However, if the granny flat is leased out, this section of the home would be considered income-producing. Your “main residence” is generally <a href="https://www.ato.gov.au/General/Capital-gains-tax/Your-home-and-other-real-estate/Your-main-residence/">exempt</a> from capital gains tax when it comes time to sell, but you may not qualify entirely for this exemption if a section of the property is income-producing. You may also consider remodelling the family home into a duplex and, depending on council planning laws, convert the title into dual occupancy. However, these suggestions may complicate eligibility for the HomeBuilder grant (which seems to exclude property investors, although there’s no mention of partly converting the main place into a dual occupancy). The best option here is to seek advice from a tax specialist. <h2>Factors to consider if you’re thinking of selling up and buying elsewhere</h2> Use a <a href="https://www.realestate.com.au/home-loans/stamp-duty-calculator">stamp-duty calculator</a> and <a href="https://www.localagentfinder.com.au/selling-costs-calculator">cost-of-selling calculator</a> to get a rough idea of those costs. How important is proximity to work? Particularly if the coronavirus pandemic has opened your (or your employer’s) eyes to working remotely, would you consider a move to a more remote area where you can afford a bigger house? Chat with a range of real estate agents and get into the habit of reading market media coverage. Have a sense of what houses sell for that featured your desired attributes (such as more bedrooms or off-street parking). As a chartered building surveyor, I’d advise would-be downsizers to be cautious when buying a brand new high-rise apartment, due to risks of potentially costly defects that might become apparent over time. And remember, even if you do sell and buy a new place, very few are able to find the perfect home. You may decide to make renovations anyway. There are no easy answers. It comes down to your individual circumstances, your attitude to risk and ensuring you have a good grasp of the relative costs of each option. Talk to a financial adviser, tax accountant, real estate agents, builders, architects and others who have been through each process about what they’d do differently next time. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/what-adds-value-to-your-house-how-to-decide-between-renovating-and-selling-140627" target="_blank" rel="noopener">The Conversation</a>.

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Heartbreaking texts between Russian soldier and his mother before death

A Russian soldier’s final text messages sent to his mother before his death have been revealed during a UN General Assembly meeting. Ukraine’s ambassador to the United Nations Sergiy Kyslytsya, read the alleged text exchange to the 139 members on Monday. “Mama, I’m no longer in Crimea – I’m not in training sessions,” the soldier allegedly replied when his mother texted asking why he hadn’t updated her. “Mama, I’m in Ukraine. There is a real war raging here. I’m afraid. “We are bombing all of the cities together, even targeting civilians. We were told that they would welcome us. “They are falling under our armoured vehicles, throwing themselves under the wheels and not allowing us to pass. They call us fascists. “Mama, this is so hard.” Russia invaded Ukraine on February 24, which saw close to 500,000 people flee the war-torn country. Thousands of Russians also participated in anti-war demonstrations, with many holding placards with peace signs and anti-war slogans in both Russian and Ukrainian. Image: Twitter

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Heartbreaking texts between Russian soldier and his mother before death

News

Shop

Catalogues

Travel

Health

Lifestyle

Finance

Entertainment

Property

Information

Keep up to date

Search

What’s the difference between ADD and ADHD?

How much stress is too much? A psychiatrist explains the links between toxic stress and poor health − and how to get help

What’s the difference between autism and Asperger’s disorder?

What’s the difference between memory loss and dementia?

Heated argument between economy passengers reignites plane etiquette debate

How biological differences between men and women alter immune responses – and affect women’s health

Bees have appeared on coins for millennia, hinting at an age-old link between sweetness and value

Eerie link between OceanGate pilot and Titanic disaster

Why does my back get so sore when I’m sick? The connection between immunity and pain

There’s a growing gap between countries advancing LGBTQ+ rights, and those going backwards

Global review shows link between social media use, body image and eating disorders

Music and mental health: the parallels between Victorian asylum treatments and modern social prescribing

This is the difference between dementia and Alzheimer’s

What’s the connection between cosmetic procedures and mental health?

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Lip reader reveals insight into THOSE scenes between Kate and Louis

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What adds value to your house? How to decide between renovating and selling

Heartbreaking texts between Russian soldier and his mother before death

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