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‘Girl math’ may not be smart financial advice, but it could help women feel more empowered with money

<div class="theconversation-article-body"><a href="https://theconversation.com/profiles/ylva-baeckstrom-1463175">Ylva Baeckstrom</a>, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</a> If you’ve ever calculated cost per wear to justify the price of an expensive dress, or felt like you’ve made a profit after returning an ill-fitting pair of jeans, you might be an expert in <a href="https://www.standard.co.uk/news/world/girl-maths-tiktok-trend-its-basically-free-b1100504.html">“girl math”</a>. With videos about the topic going viral on social media, girl math might seem like a silly (<a href="https://www.glamourmagazine.co.uk/article/girl-math-womens-spending-taken-seriously">or even sexist</a>) trend, but it actually tells us a lot about the relationship between gender, money and emotions. Girl math introduces a spend classification system: purchases below a certain value, or made in cash, don’t “count”. Psychologically, this makes low-value spending feel safe and emphasises the importance of the long-term value derived from more expensive items. For example, girl math tells us that buying an expensive dress is only “worth it” if you can wear it to multiple events. This approach has similarities to <a href="https://www.investopedia.com/terms/m/modernportfoliotheory.asp">portfolio theory</a> – a method of choosing investments to maximise expected returns and minimise risk. By evaluating how each purchase contributes to the shopping portfolio, girl math shoppers essentially become shopping portfolio managers. <h2>Money and emotions</h2> People of all genders, rich or poor, feel anxious when dealing with their personal finances. Many people in the UK do not understand pensions or saving enough to <a href="https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/workplacepensions/articles/pensionparticipationatrecordhighbutcontributionsclusteratminimumlevels/2018-05-04">afford their retirement</a>. Without motivation to learn, people avoid dealing with money altogether. One way to find this motivation, as girl math shows, is by having an emotional and tangible connection to our finances. On the surface, it may seem that women are being ridiculed and encouraged to overspend by using girl math. From a different perspective, it hints at something critical: for a person to really care about something as seemingly abstract as personal finance, they need to feel that they can relate to it. Thinking about money in terms of the value of purchases can help create an <a href="https://www.thetimes.co.uk/article/every-time-i-use-my-card-my-phone-buzzes-and-that-stops-me-shopping-ps0fjx6nj">emotional relationship</a> to finance, making it something people want to look after. <figure><iframe src="https://www.youtube.com/embed/GPzA7B6dcxc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <h2>The girl math we need</h2> Women are a consumer force to be reckoned with, controlling <a href="https://www.forbes.com/sites/bridgetbrennan/2015/01/21/top-10-things-everyone-should-know-about-women-consumers/#7679f9d6a8b4">up to 80%</a> of consumer spending globally. The girl math trend is a demonstration of women’s mastery at applying portfolio theory to their shopping, making them investment powerhouses whose potential is overlooked by the financial services industry. <a href="https://www.theguardian.com/world/2019/oct/28/women-paid-less-than-men-over-careers-gender-pay-gap-report">Women are disadvantaged</a> when it comes to money and finance. Women in the UK earn on average £260,000 less than men during their careers and the retirement income of men is twice as high as women’s. As I’ve found in <a href="https://www.routledge.com/Gender-and-Finance-Addressing-Inequality-in-the-Financial-Services-Industry/Baeckstrom/p/book/9781032055572">my research</a> on gender and finance, women have lower financial self-efficacy (belief in their own abilities) compared to men. This is not helped by women feeling patronised when seeking financial advice. Because the world of finance was created by men for men, its language and culture are <a href="https://www.routledge.com/Gender-and-Finance-Addressing-Inequality-in-the-Financial-Services-Industry/Baeckstrom/p/book/9781032055572">intrinsically male</a>. Only in the mid-1970s did women in the UK gain the legal right to open a bank account without a male signature and it was not until 1980 that they could apply for credit independently. With the law now more (<a href="https://www.worldbank.org/en/news/press-release/2023/03/02/pace-of-reform-toward-equal-rights-for-women-falls-to-20-year-low">but not fully</a>) gender equal, the financial services industry has failed to connect with women. Studies show that 49% of women are <a href="https://www.ellevest.com/magazine/disrupt-money/ellevest-financial-wellness-survey">anxious about their finances</a>. However they have not bought into patronising offers and <a href="https://www.fa-mag.com/news/gender-roles-block-female-financial-experience--ubs-says-73531.html">mansplaining by financial advisers</a>. This outdated approach suggests that it is women, rather than the malfunctioning financial system, <a href="https://www.theguardian.com/commentisfree/2020/sep/16/women-are-not-financially-illiterate-they-need-more-than-condescending-advice">who need fixing</a>. Women continue to feel that they do not belong to or are able to trust the world of finance. And why would women trust an industry with a <a href="https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/earningsandworkinghours/bulletins/genderpaygapintheuk/2019">gender pay gap</a> of up to 59% and a severe lack of women in senior positions? Girl math on its own isn’t necessarily good financial advice, but if it helps even a handful of women feel more empowered to manage and understand their finances, it should not be dismissed.  <a href="https://theconversation.com/profiles/ylva-baeckstrom-1463175">Ylva Baeckstrom</a>, Senior Lecturer in Finance, <a href="https://theconversation.com/institutions/kings-college-london-1196">King's College London</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/girl-math-may-not-be-smart-financial-advice-but-it-could-help-women-feel-more-empowered-with-money-211780">original article</a>. </div>

Money & Banking

The unique travel hack that is guaranteed to help beat jet lag

Experts have revealed how to beat jet lag on your next overseas holiday, and it all comes down to your modes of transport. Sleep researchers said it's good news for cruise lovers, as exposure to sea air and bright natural light improves sleep to cure the annoying condition quickly. Some experts say to avoid travelling by plane all together, and always opt for cruising holidays instead. However, if you have to travel to your cruise by plane, being on board is a great way to tackle the dreadful feeling, compared with holidaying on land, Panache Cruises said. Dr Lindsay Browning, expert at Trouble Sleeping said exposing yourself to bright lights at the right time after a long-haul flight is one of the most powerful things we can do to boost and help shift circadian rhythm, and being on a ship is the perfect place for that. "As a general rule, you want to get lots of bright light exposure during the daytime and avoid light at night," Browning said. "When travelling on a cruise ship, you will naturally get a lot of bright light exposure during the day, helping your circadian rhythm.” "Further, when travelling by ship you will have a cabin with a proper bed and curtain, enabling you to sleep at night when you want to." The company claimed research showed how prolonged exposure to sea air can improve blood oxygen levels, boost vitamin D, and improve breathing leading to higher-quality sleep, helping to rid travellers of pesky jet lag so they can enjoy their holidays. Image credits: Getty Images

Travel Tips

Bruce Springsteen helps a fan skip school for his concert

Bruce Springsteen has helped a fan skip school to attend his concert. While performing in San Francisco on his world tour, The Boss paused his performance to sign an absentee note for a fan who had missed class to attend the show. The fan, who was at the front of the barricade, held up a sign that read: "Skipping school. Sign my note?" Another concertgoer then captured the moment the 74-year-old rocker signed the note to a round of applause and cheers from his band and the crowd. <iframe style="border: none; overflow: hidden;" src="https://www.facebook.com/plugins/video.php?height=476&href=https%3A%2F%2Fwww.facebook.com%2Freel%2F794567008756785%2F&show_text=false&width=267&t=0" width="267" height="476" frameborder="0" scrolling="no" allowfullscreen="allowfullscreen"></iframe> "That is so awesome. Put tears in my eyes. A true hero," someone wrote in the comments on the Facebook video. "This is the best excuse note a teacher is ever going to see!!" another added. "So cool, Bruce is one of the true talent and a great man of many excuses," a third wrote. The adorable fan interaction comes just weeks after Springsteen returned to the stage for the first time in months after undergoing a lengthy health battle. Springsteen was forced to postpone his 2023 tour with the E Street Band after taking time off to recover from a peptic ulcer disease. Taking to the stage in Phoenix, Arizona, in the first show of the tour, he told the crowd mid-show, "Phoenix, first I want to apologise if there was any discomfort because we had to move the show last time...I hope we didn't inconvenience you too much." Image credits: Facebook

Music

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

Why do airlines charge so much for checked bags? This obscure rule helps explain why

<a href="https://theconversation.com/profiles/jay-l-zagorsky-152952">Jay L. Zagorsky</a>, <a href="https://theconversation.com/institutions/boston-university-898">Boston University</a> Five out of the six <a href="https://www.oag.com/blog/biggest-airlines-in-the-us">biggest U.S. airlines</a> have <a href="https://www.cnbc.com/2024/03/05/delta-is-the-latest-airline-to-raise-its-checked-bag-fee.html">raised their checked bag fees</a> since January 2024. Take American Airlines. In 2023, it cost US$30 to check a standard bag in with the airline; <a href="https://www.usatoday.com/story/travel/airline-news/2024/02/20/american-airlines-bag-fees-mileage-earning/72669245007/">today, as of March 2024, it costs $40</a> at a U.S. airport – a whopping 33% increase. As a <a href="https://www.bu.edu/questrom/">business school</a> <a href="https://www.bu.edu/questrom/profile/jay-zagorsky/">professor who studies travel</a>, I’m often asked why airlines alienate their customers with baggage fees instead of bundling all charges together. <a href="https://www.vox.com/2015/4/16/8431465/airlines-carry-on-bags">There are</a> <a href="https://www.usatoday.com/story/travel/columnist/2023/06/21/bag-fees-will-stay-a-while-cruising-altitude/70338849007/">many reasons</a>, but an important, often overlooked cause is buried in the U.S. tax code. <h2>A tax-law loophole</h2> Airlines pay the federal government <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D">7.5% of the ticket price</a> when <a href="https://www.pwc.com/us/en/services/tax/library/aircraft-club-nov-2023-air-transport-excise-tax-rates-for-2024.html">flying people domestically, alongside other fees</a>. The airlines dislike these charges, with their <a href="https://www.airlines.org/dataset/government-imposed-taxes-on-air-transportation/">trade association arguing</a> that they boost the cost to the consumer of a typical air ticket by around one-fifth. However, the U.S. Code of Federal Regulations <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D/section-49.4261-8">specifically excludes baggage</a> from the 7.5% transportation tax as long as “the charge is separable from the payment for the transportation of a person and is shown in the exact amount.” This means if an airline charges a combined $300 to fly you and a bag round-trip within the U.S., it owes $22.50 in tax. If the airline charges $220 to fly you plus separately charges $40 each way for the bag, then your total cost is the same — but the airline only owes the government $16.50 in taxes. Splitting out baggage charges saves the airline $6. Now $6 might not seem like much, but it can add up. Last year, passengers took <a href="https://www.transtats.bts.gov/Data_Elements.aspx?Data=1">more than 800 million trips on major airlines</a>. Even if only a fraction of them check their bags, that means large savings for the industry. How large? The government has <a href="https://www.bts.dot.gov/topics/airlines-and-airports/baggage-fees-airline-2023">tracked revenue from bag fees</a> for decades. In 2002, airlines charged passengers a total of $180 million to check bags, which worked out to around 33 cents per passenger. Today, as any flyer can attest, bag fees are a lot higher. Airlines collected over 40 times more money in bag fees last year than they did in 2002. When the full data is in for 2023, <a href="https://www.bts.dot.gov/baggage-fees">total bag fees</a> will likely top $7 billion, which is about $9 for the average domestic passenger. <a href="https://viewfromthewing.com/the-real-reason-airlines-charge-checked-bag-fees-and-its-not-what-you-think">By splitting out the cost of bags</a>, airlines avoided paying about half a billion dollars in taxes just last year. In the two decades since 2002, flyers paid a total of about $70 billion in bag fees. This means separately charging for bags saved airlines about $5 billion in taxes. <iframe id="88MYD" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/88MYD/2/" width="100%" height="400px" frameborder="0"></iframe> It seems clear to me that tax savings are one driver of the unbundling of baggage fees because of a quirk in the law. The U.S. government doesn’t apply the 7.5% tax to <a href="https://www.ecfr.gov/current/title-26/chapter-I/subchapter-D/part-49/subpart-D/section-49.4261-3">international flights that go more than 225 miles</a> beyond the nation’s borders. Instead, there are fixed <a href="https://www.airlines.org/dataset/government-imposed-taxes-on-air-transportation">international departure and arrival taxes</a>. This is why major airlines charge $35 to $40 <a href="https://www.aa.com/i18n/travel-info/baggage/checked-baggage-policy.jsp">for bags if you’re flying domestically</a>, but don’t charge a bag fee when you’re flying to Europe or Asia. <h2>Do travelers get anything for that money?</h2> This system raises an interesting question: Do baggage fees force airlines to be more careful with bags, since customers who pay more expect better service? To find out, I checked with the Bureau of Transportation Statistics, which has been <a href="https://www.bts.gov/content/mishandled-baggage-reports-filed-passengers-largest-us-air-carriersa">tracking lost luggage for decades</a>. For many years, it calculated the number of mishandled-baggage reports per thousand airline passengers. The government’s data showed mishandled bags peaked in 2007 with about seven reports of lost or damaged luggage for every thousand passengers. That means you could expect your luggage to go on a different trip than the one you are taking about once every 140 or so flights. By 2018, that estimate had fallen to once every 350 flights. In 2019, the government <a href="https://www.bts.gov/topics/airlines-and-airports/number-30a-technical-directive-mishandled-baggage-amended-effective-jan">changed how it tracks</a> mishandled bags, calculating figures based on the total number of bags checked, rather than the total number of passengers. The new data show about six bags per thousand checked get lost or damaged, which is less than 1% of checked bags. Unfortunately, the data doesn’t show improvement since 2019. Is there anything that you can do about higher bag fees? Complaining to politicians probably won’t help. In 2010, two senators <a href="https://www.nj.com/business/2010/04/us_senators_present_bill_to_ba.html">tried to ban bag fees</a>, and their bill went nowhere. Given that congressional action failed, there’s a simple way to avoid higher bag fees: <a href="https://www.cnn.com/travel/article/packing-expert-travel-world-handbag/index.html">travel light</a> and <a href="https://www.nytimes.com/2023/07/08/opinion/carry-on-packing-airlines-lost-luggage.html">don’t check any luggage</a>. It may sound tough not to have all your belongings when traveling, but it might be the best option as bag fees take off.<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/225857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jay-l-zagorsky-152952">Jay L. Zagorsky</a>, Associate Professor of Markets, Public Policy and Law, <a href="https://theconversation.com/institutions/boston-university-898">Boston University</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-do-airlines-charge-so-much-for-checked-bags-this-obscure-rule-helps-explain-why-225857">original article</a>.

Travel Trouble

Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like

<a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> At least <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.665019/full">one in ten people</a> have depression at some point in their lives, with some estimates <a href="https://www.sciencedirect.com/science/article/pii/S0749379720301793">closer to one in four</a>. It’s one of the worst things for someone’s wellbeing – worse than <a href="https://www.happinessresearchinstitute.com/_files/ugd/928487_4a99b6e23f014f85b38495b7ab1ac24b.pdf">debt, divorce or diabetes</a>. <a href="https://theconversation.com/why-are-so-many-australians-taking-antidepressants-221857">One in seven</a> Australians take antidepressants. Psychologists are in <a href="https://theconversation.com/we-cant-solve-australias-mental-health-emergency-if-we-dont-train-enough-psychologists-here-are-5-fixes-190135">high demand</a>. Still, only <a href="http://dx.doi.org/10.1371/journal.pmed.1003901">half</a> of people with depression in high-income countries get treatment. Our <a href="https://www.bmj.com/content/384/bmj-2023-075847">new research</a> shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it. <h2>Walk, run, lift, or dance away depression</h2> We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together. We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">cognitive behaviour therapy</a> – one of the <a href="https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2018.00004/full">gold-standard treatments</a> for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them. Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants. But of these exercises, people were most likely to stick with strength training and yoga. <iframe id="cZaWb" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/cZaWb/2/" width="100%" height="400px" frameborder="0"></iframe> Antidepressants certainly help <a href="https://www.thelancet.com/article/S0140-6736(17)32802-7/fulltext">some people</a>. And of course, anyone getting treatment for depression should talk to their doctor <a href="https://australia.cochrane.org/news/new-cochrane-review-explores-latest-evidence-approaches-stopping-long-term-antidepressants">before changing</a> what they are doing. Still, our evidence shows that if you have depression, you should get a psychologist and an exercise plan, whether or not you’re taking antidepressants. <h2>Join a program and go hard (with support)</h2> Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, <a href="https://www.who.int/initiatives/behealthy/physical-activity">such as</a> “some physical activity is better than doing none.” But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression. We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results. <h2>Yes, it’s hard to keep motivated</h2> We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results. Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free. We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression. Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result. Other reviews found it’s important to have a <a href="https://pubmed.ncbi.nlm.nih.gov/31923898/">clear action plan</a> (for example, putting exercise in your calendar) and to <a href="https://pubmed.ncbi.nlm.nih.gov/19916637/">track your progress</a> (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult. A <a href="https://www.nature.com/articles/s41586-021-04128-4">2021 mega-study</a> of more than 60,000 gym-goers <a href="https://www.nature.com/articles/s41586-021-04128-4/figures/1">found</a> experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted. Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it. So, when starting out, it seems wise to avoid going it alone. Instead: <ul> <li> join a fitness group or yoga studio </li> <li> get a trainer or an exercise physiologist </li> <li> ask a friend or family member to go for a walk with you. </li> </ul> Taking a few steps towards getting that support makes it more likely you’ll keep exercising. <h2>Let’s make this official</h2> Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only <a href="https://www.apa.org/depression-guideline/">conditionally recommends</a> exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”. Based on our research, this recommendation is withholding a potent treatment from many people who need it. In contrast, The Royal Australian and New Zealand College of Psychiatrists <a href="https://www.ranzcp.org/getmedia/a4678cf4-91f5-4746-99d4-03dc7379ae51/mood-disorders-clinical-practice-guideline-2020.pdf">recommends</a> vigorous aerobic activity at least two to three times a week for all people with depression. Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression. I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based. If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<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/223441/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/michael-noetel-147460">Michael Noetel</a>, Senior Lecturer in Psychology, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/running-or-yoga-can-help-beat-depression-research-shows-even-if-exercise-is-the-last-thing-you-feel-like-223441">original article</a>.

Body

Thinking of using an activity tracker to achieve your exercise goals? Here’s where it can help – and where it probably won’t

<a href="https://theconversation.com/profiles/corneel-vandelanotte-209636">Corneel Vandelanotte</a>, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</a> It’s that time of year when many people are getting started on their resolutions for the year ahead. Doing more physical activity is a popular and <a href="https://link.springer.com/article/10.1007/s13668-016-0175-5">worthwhile</a> goal. If you’re hoping to be more active in 2024, perhaps you’ve invested in an activity tracker, or you’re considering buying one. But what are the benefits of activity trackers? And will a basic tracker do the trick, or do you need a fancy one with lots of features? Let’s take a look. <h2>Why use an activity tracker?</h2> One of the <a href="https://doi.org/10.1186/s12966-020-01001-x">most powerful predictors</a> for being active is whether or not <a href="https://www.sciencedirect.com/science/article/abs/pii/S0140673621026301">you are monitoring</a> how active you are. Most people have a vague idea of how active they are, but this is inaccurate a lot of the time. Once people consciously start to keep track of how much activity they do, they often realise it’s less than what they thought, and this motivates them to be more active. You can self-monitor without an activity tracker (just by writing down what you do), but this method is hard to keep up in the long run and it’s also a lot less accurate compared to devices that track your every move 24/7. By tracking steps or “activity minutes” you can ascertain whether or not you are meeting the <a href="https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years">physical activity guidelines</a> (150 minutes of moderate to vigorous physical activity per week). It also allows you to track how you’re progressing with any personal activity goals, and view your progress over time. All this would be difficult without an activity tracker. Research has shown the most popular brands of activity trackers are generally reliable when it comes to tracking basic measures such as <a href="https://doi.org/10.2196/18694">steps</a> and <a href="https://doi.org/10.1123/jmpb.2019-0072">activity minutes</a>. <h2>But wait, there’s more</h2> Many activity trackers on the market nowadays track a range of other measures which their manufacturers promote as important in monitoring health and fitness. But is this really the case? Let’s look at some of these. Resting heart rate This is your heart rate at rest, which is normally somewhere <a href="https://www.healthdirect.gov.au/resting-heart-rate">between 60 and 100 beats per minute</a>. Your resting heart rate will gradually go down as you become fitter, especially if you’re doing a lot of high-intensity exercise. Your risk of dying of any cause (all-cause mortality) is much lower when you have a <a href="https://pubmed.ncbi.nlm.nih.gov/28552551/">low resting heart rate</a>. So, it is useful to keep an eye on your resting heart rate. Activity trackers are pretty good at tracking it, but you can also easily measure your heart rate by monitoring your pulse and using a stopwatch. Heart rate during exercise Activity trackers will also measure your heart rate when you’re active. To improve fitness efficiently, professional athletes focus on having their heart rate in certain “<a href="https://chhs.source.colostate.edu/how-to-target-heart-rate-training-zones-effectively/">zones</a>” when they’re exercising – so knowing their heart rate during exercise is important. But if you just want to be more active and healthier, without a specific training goal in mind, you can exercise at a level that feels good to you and not worry about your heart rate during activity. The <a href="https://doi.org/10.1097/HCO.0000000000000437">most important thing</a> is that you’re being active. Also, a dedicated heart rate monitor with a strap around your chest will do a much better job at measuring your actual heart rate <a href="https://doi.org/10.1038/s41746-020-0226-6">compared</a> to an activity tracker worn around your wrist. Maximal heart rate This is the hardest your heart could beat when you’re active, not something you could sustain very long. Your maximal heart rate is not influenced by how much exercise you do, or your fitness level. Most activity trackers <a href="https://jamanetwork.com/journals/jamacardiology/article-abstract/2566167">don’t measure it accurately</a> anyway, so you might as well forget about this one. VO₂max Your muscles need oxygen to work. The more oxygen your body can process, the harder you can work, and therefore the fitter you are. VO₂max is the volume (V) of oxygen (O₂) we could breathe maximally (max) over a one minute interval, expressed as millilitres of oxygen per kilogram of body weight per minute (ml/kg/min). Inactive women and men would have a VO₂max lower than 30 and 40 ml/kg/min, respectively. A reasonably good VO₂max would be mid thirties and higher for women and mid forties and higher for men. VO₂max is another measure of fitness that <a href="https://doi.org/10.1001/jamanetworkopen.2018.3605">correlates well</a> with all-cause mortality: the higher it is, the lower your risk of dying. For athletes, VO₂max is usually measured in a lab on a treadmill while wearing a mask that measures oxygen consumption. Activity trackers instead look at your running speed (using a GPS chip) and your heart rate and compare these measures to values from other people. If you can run fast with a low heart rate your tracker will assume you are relatively fit, resulting in a higher VO₂max. These estimates are <a href="https://doi.org/10.1007/s40279-021-01639-y">not very accurate</a> as they are based on lots of assumptions. However, the error of the measurement is reasonably consistent. This means if your VO₂max is gradually increasing, you are likely to be getting fitter. So what’s the take-home message? Focus on how many steps you take every day or the number of activity minutes you achieve. Even a basic activity tracker will measure these factors relatively accurately. There is no real need to track other measures and pay more for an activity tracker that records them, unless you are getting really serious about exercise.<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/219235/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/corneel-vandelanotte-209636">Corneel Vandelanotte</a>, Professorial Research Fellow: Physical Activity and Health, <a href="https://theconversation.com/institutions/cquniversity-australia-2140">CQUniversity Australia</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/thinking-of-using-an-activity-tracker-to-achieve-your-exercise-goals-heres-where-it-can-help-and-where-it-probably-wont-219235">original article</a>.

Body

You can’t reverse the ageing process but these 5 things can help you live longer

<a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a <a href="https://digiday.com/marketing/health-food-brands-ramp-up-marketing-efforts-around-consumers-new-years-resolutions/">roaring trade</a> of products purporting to guarantee you live longer, be healthier and look more youthful. While an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822264/">estimated</a> 25% of longevity is determined by our genes, the rest is determined by what we do, day to day. There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health. <h2>1. Eat a predominantly plant-based diet</h2> What you eat has a huge impact on your health. The evidence overwhelmingly <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8210981/#:%7E:text=According%20to%20an%20expansive%20review,13%20Given%20that%20so%20many">shows</a> eating a diet high in plant-based foods is associated with health and longevity. If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer. Plant-based foods <a href="https://www.nature.com/articles/s41398-019-0552-0">are rich</a> in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease. No particular diet is right for everyone but one of the most studied and <a href="https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/mediterranean-diet/#:%7E:text=%5B6%5D%20Those%20who%20had%20the,who%20had%20the%20lowest%20adherence.">healthiest</a> is the <a href="https://www.eatingwell.com/article/291120/mediterranean-diet-for-beginners-everything-you-need-to-get-started/">Mediterranean diet</a>. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil. <h2>2. Aim for a healthy weight</h2> Another important way you can be healthier is to try and achieve a healthy weight, as obesity <a href="https://www.healthline.com/health/obesity/how-obesity-affects-body">increases the risk</a> of a number of health problems that shorten our lives. Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These <a href="https://www.ncbi.nlm.nih.gov/books/NBK572076/">increase your chances</a> of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers. In addition to affecting us physically, obesity is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052856/">associated with</a> poorer psychological health. It’s linked to depression, low self-esteem and stress. One of the biggest challenges we face in the developed world is that we live in an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817492/">environment</a> that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories. <h2>3. Exercise regularly</h2> We all know that exercise is good for us – the <a href="https://www.insurancebusinessmag.com/au/news/breaking-news/hcf-reveals-australias-most-popular-new-years-resolutions-for-2023-431665.aspx">most common resolution</a> we make this time of year is to do more exercise and to get fitter. Regular exercise <a href="https://www.who.int/news-room/fact-sheets/detail/physical-activity">protects</a> against chronic illness, lowers your stress and improves your mental health. While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402378/#:%7E:text=For%20instance%2C%20routine%20physical%20activity,HDL%5D%20cholesterol%20levels%20and%20decreased">effects</a> are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function. While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence <a href="https://www.medicalnewstoday.com/articles/320760">suggests</a> that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy. <h2>4. Don’t smoke</h2> If you want to be healthier and live longer then don’t smoke or vape. Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your <a href="https://theconthatkills.org.au/?utm_source=googlesearch&utm_medium=search&utm_campaign=theconthatkills23&utm_content=RSA&gclid=Cj0KCQjwqP2pBhDMARIsAJQ0Czrlep6EQHC-8_9xUhpz0h9v2ZglMF-6-k7_65awq8FxVaIL5HRoivwaAqJwEALw_wcB&gclsrc=aw.ds">chances of developing</a> a range of cancers, heart disease and diabetes. Even if you have been smoking for years, by giving up smoking at any age you can experience <a href="https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm">health benefits</a> almost immediately, and you can reverse many of the harmful effects of smoking. If you’re thinking of switching to vapes as a healthy long term option, <a href="https://theconversation.com/can-vaping-help-people-quit-smoking-its-unlikely-204812">think again</a>. The long term health effects of vaping are not fully understood and they come with their own <a href="https://theconversation.com/no-vapes-arent-95-less-harmful-than-cigarettes-heres-how-this-decade-old-myth-took-off-203039">health risks</a>. <h2>5. Prioritise social connection</h2> When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health. People who are lonely and socially isolated have a much higher risk of dying early and are <a href="https://healthnews.com/longevity/healthspan/social-connection-and-longevity/#:%7E:text=One%20of%20the%20biggest%20benefits,the%20following%20factors%20and%20influences.">more likely</a> to suffer from heart disease, stroke, dementia as well as anxiety and depression. Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/">more likely</a> to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body. So if you want to be healthier and live longer, build and maintain your connections to others.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214580/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/hassan-vally-202904">Hassan Vally</a>, Associate Professor, Epidemiology, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin 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/you-cant-reverse-the-ageing-process-but-these-5-things-can-help-you-live-longer-214580">original article</a>.

Caring

Do you really need antibiotics? Curbing our use helps fight drug-resistant bacteria

<a href="https://theconversation.com/profiles/minyon-avent-1486987">Minyon Avent</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/fiona-doukas-1157050">Fiona Doukas</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kristin-xenos-1491653">Kristin Xenos</a>, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Antibiotic resistance occurs when a microorganism changes and no longer responds to an antibiotic that was previously effective. It’s <a href="https://thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00502-2/fulltext">associated with</a> poorer outcomes, a greater chance of death and higher health-care costs. In Australia, antibiotic resistance means some patients are admitted to hospital because oral antibiotics are <a href="https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance">no longer effective</a> and they need to receive intravenous therapy via a drip. Antibiotic resistance is rising to high levels in certain parts of the world. Some hospitals <a href="https://www.reactgroup.org/news-and-views/news-and-opinions/year-2022/the-impact-of-antibiotic-resistance-on-cancer-treatment-especially-in-low-and-middle-income-countries-and-the-way-forward/">have to consider</a> whether it’s even viable to treat cancers or perform surgery due to the risk of antibiotic-resistant infections. Australia is <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-aura/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one of the highest users</a> of antibiotics in the developed world. We need to use this precious resource wisely, or we risk a future where a simple infection could kill you because there isn’t an effective antibiotic. <h2>When should antibiotics not be used?</h2> Antibiotics only work for some infections. They work against bacteria but <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/do-i-really-need-antibiotics">don’t treat</a> infections caused by viruses. Most community acquired infections, even those caused by bacteria, are likely to get better without antibiotics. Taking an antibiotic when you don’t need it won’t make you feel better or recover sooner. But it can increase your chance of side effects like nausea and diarrhoea. Some people think green mucus (or snot) is a sign of bacterial infection, requiring antibiotics. But it’s actually <a href="https://www.safetyandquality.gov.au/sites/default/files/2023-11/aura_2023_do_i_really_need_antibiotics.pdf">a sign</a> your immune system is working to fight your infection. <h2>If you wait, you’ll often get better</h2> <a href="https://www.tg.org.au/">Clinical practice guidelines</a> for antibiotic use aim to ensure patients receive antibiotics when appropriate. Yet 40% of GPs say they prescribe antibiotics <a href="https://doi.org/10.1071/HI13019">to meet patient expectations</a>. And <a href="https://pubmed.ncbi.nlm.nih.gov/35973750/">one in five</a> patients expect antibiotics for respiratory infections. It can be difficult for doctors to decide if a patient has a viral respiratory infection or are at an early stage of serious bacterial infection, particularly in children. One option is to “watch and wait” and ask patients to return if there is clinical deterioration. An alternative is to prescribe an antibiotic but advise the patient to not have it dispensed unless specific symptoms occur. This can <a href="https://doi.org/10.1002/14651858.CD004417.pub5">reduce antibiotic use by 50%</a> with no decrease in patient satisfaction, and no increase in complication rates. <h2>Sometimes antibiotics are life-savers</h2> For some people – particularly those with a weakened immune system – a simple infection can become more serious. Patients with life-threatening suspected infections should receive an appropriate antibiotic <a href="https://www.safetyandquality.gov.au/our-work/clinical-care-standards/antimicrobial-stewardship-clinical-care-standard">immediately</a>. This includes serious infections such as <a href="https://www.hopkinsmedicine.org/health/conditions-and-diseases/bacterial-meningitis#:%7E:text=What%20is%20bacterial%20meningitis%3F,can%20cause%20life%2Dthreatening%20problems.">bacterial meningitis</a> (infection of the membranes surrounding the brain) and <a href="https://clinicalexcellence.qld.gov.au/priority-areas/safety-and-quality/sepsis/adult-sepsis#:%7E:text=Adult%20patients%20with%20sepsis%20also,adult%20emergency%20department%20sepsis%20pathway.">sepsis</a> (which can lead to organ failure and even death). <h2>When else might antibiotics be used?</h2> Antibiotics are sometimes used to prevent infections in patients who are undergoing surgery and are at significant risk of infection, such as those undergoing bowel resection. These patients will <a href="https://www.tg.org.au">generally receive</a> a single dose before the procedure. Antibiotics may also <a href="https://www.tg.org.au">be given</a> to patients undergoing chemotherapy for solid organ cancers (of the breast or prostate, for example), if they are at high risk of infection. While most sore throats are caused by a virus and usually resolve on their own, some high risk patients with a bacterial strep A infection which can cause “scarlet fever” are given antibiotics to prevent a more serious infection like <a href="https://www.rhdaustralia.org.au/">acute rheumatic fever</a>. <h2>How long is a course of antibiotics?</h2> The recommended duration of a course of antibiotics depends on the type of infection, the likely cause, where it is in your body and how effective the antibiotics are at killing the bacteria. In the past, courses were largely arbitrary and based on assumptions that antibiotics should be taken for long enough to eliminate the infecting bacteria. More recent research does not support this and shorter courses are <a href="https://www.acpjournals.org/doi/full/10.7326/M19-1509">nearly always as effective as longer ones</a>, particularly for community acquired respiratory infections. For <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736742/">community acquired pneumonia</a>, for example, research shows a three- to five-day course of antibiotics is at least as effective as a seven- to 14-day course. The “take until all finished” approach is no longer recommended, as the longer the antibiotic exposure, the greater the chance the bacteria will develop resistance. However, for infections where it is more difficult to eradicate the bacteria, such as tuberculosis and bone infections, a combination of antibiotics for many months is usually required. <h2>What if your infection is drug-resistant?</h2> You may have an antibiotic-resistant infection if you don’t get better after treatment with standard antibiotics. Your clinician will collect samples for lab testing if they suspect you have antibiotic-resistant infection, based on your travel history (especially if you’ve been hospitalised in a country with high rates of antibiotic resistance) and if you’ve had a recent course of antibiotics that hasn’t cleared your infection. Antibiotic-resistant infections are managed by prescribing broad-spectrum antibiotics. These are like a sledgehammer, wiping out many different species of bacteria. (Narrow-spectrum antibiotics conversely can be thought of as a scalpel, more targeted and only affecting one or two kinds of bacteria.) Broad-spectrum antibiotics are usually more expensive and come with more severe side effects. <h2>What can patients do?</h2> Decisions about antibiotic prescriptions should be made using <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">shared decision aids</a>, where patients and prescribers discuss the risks and benefits of antibiotics for conditions like a sore throat, middle ear infection or acute bronchitis. Consider asking your doctor questions such as: <ul> <li>do we need to test the cause of my infection?</li> <li>how long should my recovery take?</li> <li>what are the risks and benefits of me taking antibiotics?</li> <li>will the antibiotic affect my regular medicines?</li> <li>how should I take the antibiotic (how often, for how long)?</li> </ul> Other ways to fight antibiotic resistance include: <ul> <li>returning leftover antibiotics to a pharmacy for safe disposal</li> <li>never consuming leftover antibiotics or giving them to anyone else</li> <li>not keeping prescription repeats for antibiotics “in case” you become sick again</li> <li>asking your doctor or pharmacist what you can do to feel better and ease your symptoms rather than asking for antibiotics.</li> </ul> <a href="https://theconversation.com/profiles/minyon-avent-1486987">Minyon Avent</a>, Antimicrobial Stewardship Pharmacist, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/fiona-doukas-1157050">Fiona Doukas</a>, PhD candidate, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/kristin-xenos-1491653">Kristin Xenos</a>, Research Assistant, College of Health, Medicine and Wellbeing, School of Biomedical Science and Pharmacy, <a href="https://theconversation.com/institutions/university-of-newcastle-1060">University of Newcastle</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-you-really-need-antibiotics-curbing-our-use-helps-fight-drug-resistant-bacteria-217920">original article</a>.

Body

4 tips to help your loved one with dementia enjoy the festive season

<a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> The festive season is fast approaching, and if you’re organising celebrations with family or friends, you might be grappling with a seemingly endless to-do list. But as you make these plans, it’s important to consider how you can best include any friends or loved ones living with dementia. While no two people experience dementia in the exact same way, <a href="https://www.dementia.org.au/about-dementia/what-is-dementia">dementia</a> often affects the way people process and respond to their environment. Too much stimulation – like a lot of noise and activity at a Christmas party – can be overwhelming and may cause confusion or agitation. Finding ways to create a <a href="https://www.healthdirect.gov.au/creating-a-calming-home-for-people-with-dementia#:%7E:text=The%20physical%20environment%20is%20important,in%20and%20enjoy%20everyday%20activities.">safe environment</a> at home for your loved one with dementia will help maximise the chances everyone has a good time. <h2>1. Plan ahead, but be flexible</h2> Planning celebrations can be overwhelming for everyone involved, and having excessive expectations can raise stress levels. Try to keep <a href="https://www.dementia.org.au/information/about-you/i-am-a-carer-family-member-or-friend">expectations realistic</a> and in line with the current needs of your friend or loved one living with dementia. For example, people with dementia may experience <a href="https://www.dementia.org.au/information/about-you/i-am-a-carer-family-member-or-friend/personal-care/eating">changes in their appetite</a> or food preferences, or difficulties chewing and swallowing. These changes might make some of the things on your festive menu unappetising or difficult to eat. Be guided by the needs and preferences of the person with dementia and keep options limited to one or two special foods if larger banquets are likely to be overwhelming. Things can change quickly for people living with dementia and their abilities will likely <a href="https://www.dementia.org.au/about-dementia/what-is-dementia/progression-of-dementia#:%7E:text=A%20person%20with%20dementia's%20abilities,over%20a%20number%20of%20years.">vary from day to day</a>. Try to be flexible and have a backup plan in place. For special events, plan to record speeches or ceremonies to share when things are quieter. If you’re planning a large event, consider having a smaller gathering with your loved one with dementia and just a few special people. <h2>2. Stick to the familiar</h2> The sudden appearance of lots of decorations <a href="https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-TipsToAssistSocialEngagement03-TipsForHolidayCheer_english.pdf">may be overwhelming</a> for a person with dementia and trigger a negative sensory reaction or distress. Ensure decorations are safe and familiar and put them up slowly over a period of a few days. Try to also stick to familiar traditions and routines. <a href="https://www.alz.org/help-support/caregiving/daily-care/daily-care-plan">Daily routines</a> are an important way of supporting people with dementia and sudden changes <a href="https://memory.ucsf.edu/caregiving-support/behavior-personality-changes#I-Investigate-Possible-Causes">may result in agitation and distress</a>. Stick to routine eating, bathing, and rest times where possible throughout the holiday period. For many people with dementia, long-term memories are less affected than <a href="https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/memory-loss">more recent memories</a>. Familiar family traditions can therefore be a good way to <a href="https://www.dementia.org.au/national/support-and-services/carers/therapies-and-communication-approaches">reminisce</a>. Family keepsakes or <a href="https://www.dementia.org.au/sites/default/files/20110303-NSW-LifeHistoryBook.pdf">memory books</a> can also help connect with stories from past celebrations. <h2>3. Have a quiet space</h2> Try to have <a href="https://www.scie.org.uk/dementia/supporting-people-with-dementia/dementia-friendly-environments/noise.asp">a quiet place</a> where the person living with dementia can go if things become overwhelming. Designating a support person who can stay with them throughout the day and take them to a separate room or area away from the action can help to keep things calm. Having some familiar objects or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432607/#:%7E:text=Passive%20music%20listening%20is%20reported,et%20al.%2C%202013">quiet music</a> in the space can be a good way to block out the noise of activities and reduce agitation. <h2>4. Make sure everyone has a part</h2> Everyone wants to feel a part of the activities on a special day, including people living with dementia. Ensuring everyone has a role to play may mean modifying tasks to suit the abilities of the person with dementia. For example, if you’re hosting an event at home, try to get your friend or relative with dementia involved in the kitchen by tossing the salad or helping to set the table. People with dementia are still the same person, even if their abilities have changed or they can no longer communicate their needs and feelings like they used to. It’s important to treat everyone with dignity and try to include your friends and loved ones with dementia in celebrations whenever possible. <h2>Sometimes, you can’t be together</h2> Despite the best laid plans, sometimes it won’t be possible to share in festive celebrations with your loved one living with dementia. More advanced dementia, <a href="https://www.health.nsw.gov.au/Infectious/covid-19/Pages/racf-latest-advice.aspx">aged care visitor restrictions</a> or even just distance can keep many of us apart from our loved ones. Be prepared for this separation to bring up your own feelings of <a href="https://www.alz.org/help-support/caregiving/caregiver-health/grief-loss-as-alzheimers-progresses">grief or sadness</a>. Look after your mental health as well as the person with dementia. Caring responsibilities still largely <a href="https://www.pmc.gov.au/sites/default/files/resource/download/national-strategy-gender-equality-discussion-paper_0.pdf">fall to women</a> and it’s important to share the load. Where possible, the holidays can be a good time to think about giving primary carers a break to help them recharge for the year ahead. If you’re caring for someone with dementia and need support, <a href="https://www.dementia.org.au/support">Dementia Australia</a> or <a href="https://www.carergateway.gov.au/about?utm_source=google&utm_medium=paid-search&utm_campaign=10841470526&utm_adgroup=146956908840&utm_term=&gclid=CjwKCAjw9-6oBhBaEiwAHv1QvI1uJVJRppcDJtdgYNTDeObUk1tyrNUtLGBqpp3ytjb_khYkGExICBoC_5EQAvD_BwE">Carer Gateway</a> offer useful resources.<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/214944/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nikki-anne-wilson-342631">Nikki-Anne Wilson</a>, Postdoctoral Research Fellow, Neuroscience Research Australia (NeuRA), <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a> Image credits: 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/4-tips-to-help-your-loved-one-with-dementia-enjoy-the-festive-season-214944">original article</a>.

Caring

Squats and lunges might help you avoid knee surgery

Whether it’s another round of squats and lunges, or a longer wall sit, researchers say working those quads could help lower your risk of a knee replacement. <div> In Australia, <a href="https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis" target="_blank" rel="noopener">about 9% of the population</a> has osteoarthritis, a condition known to lead to hip and knee surgery in severe cases. About 14 million Americans suffer from knee osteoarthritis, about half are expected to face knee replacement surgery. But new research offers hope, finding stronger quadricep muscles could play a role in avoiding knee replacement surgery. A study presented to <a href="https://press.rsna.org/timssnet/media/rsna/newsroom2023.cfm" target="_blank" rel="noopener">annual meeting</a> of the Radiological Society of North America, offers hope to people with arthritis, finding stronger quadriceps could help in avoiding a knee replacement. The two most important muscles in the knee are the extensors or quadriceps, and the hamstrings. Quads are the strong muscles located at the front of the thigh, which play a key role in gait. Hammies at the back of the thigh, are essential for hip and knee flexibility. The two muscles act as opposing forces, allowing physical activity while also protecting the knee. An imbalance can change the body’s biomechanics, and may progress to osteoarthritis. Using MRI scans – from the time of surgery as well as 2 and 4 years prior – researchers analysed thigh muscle volume in 134 participants from a national study called the Osteoarthritis Initiative. Using artificial intelligence to compute muscle volume from the MRI scans, the researchers compared 67 of the cohort who had a total, single knee replacement with 67 control participants who had not undergone knee replacement surgery. They found patients who had a higher ratio of quadricep to hamstring volume had significantly lower odds of a total knee replacement. Higher volume hamstrings were also associated with lower odds of surgery. The results suggest strength training – focusing on the quadriceps – may be beneficial, both in people with arthritis as well as the general population.  <img id="cosmos-post-tracker" src="https://syndication.cosmosmagazine.com/?id=289325&title=Squats+and+lunges+might+help+you+avoid+knee+surgery" width="1" height="1" loading="lazy" aria-label="Syndication Tracker" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" />Image credits: Getty Images</div> <div> </div> <div><a href="https://cosmosmagazine.com/health/body-and-mind/squats-and-lunges-might-help-you-avoid-knee-surgery/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/petra-stock/">Petra Stock</a>. </div>

Body

Sustainable tourism needs to be built with the help of locals

<a href="https://theconversation.com/profiles/alfonso-vargas-sanchez-1205745">Alfonso Vargas Sánchez</a>, <a href="https://theconversation.com/institutions/universidad-de-huelva-3977">Universidad de Huelva</a> In the wake of the pandemic, tourism is experiencing a period of transition in which <a href="https://theconversation.com/el-futuro-del-turismo-inteligente-digital-y-sostenible-153965">two trends</a> which were already prevalent pre Covid-19 have gained momentum: <ul> <li> Sustainability, together with climate change, the circular economy and the Sustainable Development Goals of the UN’s 2030 Agenda. </li> <li> Digitalization, together with the new technological revolution. </li> </ul> If we focus on sustainability – whilst still emphasizing that technological ecosystems are essential for the development of tourism – we have to be aware that making sustainable that which has not been designed as such (a destination, a resort, a mode of transport, etc.) is not easy, fast or affordable. This is especially true since, rather than conforming to standards, labels or certifications, we must change our relationship with the environment in order to be sustainable, rather than just appearing to be so. <h2>Sustainability must be economical, environmental and social</h2> When a term is used so frequently, its meaning tends to become diluted. In fact, in this case, the term sustainable tourism is increasingly being replaced by regenerative tourism. <a href="https://doughnuteconomics.org/">Not all aspects of sustainability</a> are addressed with equal emphasis. Economic sustainability is taken for granted and environmental sustainability is taken into immediate consideration, while social sustainability is put on the back burner (see, among many others, <a href="https://www.thetimes.co.uk/article/is-the-party-over-in-the-balearics-b9qw9j7qp">the case of Ibiza and the cost of housing</a>). If there is to be true social sustainability, which in turn drives economic and environmental sustainability, the governance of tourism has to evolve. Before the pandemic, and in the post-pandemic period, news related to the sustainability of tourism appeared in the media. Negative attitudes towards tourism are once again prevalent, although in reality these are not directed against tourism itself but against certain models of tourism development, the product of a certain governance where it is important to take a look at who makes decisions and how. More than a one-off phenomenon, the problem of mass tourism is being tackled with various types of measures, such as the following: <ul> <li> The use of fiscal measures(e.g. <a href="https://en.wikipedia.org/wiki/Environmental_tax">ecotaxes</a>). </li> <li> Limiting the capacity of certain spaces (or even temporarily closing them). </li> <li> The use of the variable prices to regulate demand. </li> <li> The use of technological tools that assist in redirecting tourist flows, in an attempt to disperse the masses to other attractions that are not overcrowded (assuming that those affected wish to do so). </li> <li> The sanctioning of certain behaviour. </li> <li> Limiting accommodation options. </li> </ul> The case of <a href="https://www.euronews.com/travel/2023/06/22/sardinia-popular-beaches-protected-with-towel-bans-pre-booked-tickets-and-entry-fees">the island of Sardinia and its beaches</a> is perhaps less well known than others, but very telling in this context. <h2>Appreciating tourism</h2> The positive attitude of the population towards the impact of tourism development in their area may change significantly if <a href="https://theconversation.com/saturacion-turistica-un-problema-global-creciente-100778">the negative impact is perceived as outweighing the positive effects of it</a>. This happens when the tolerance level of the local community is exceeded and tourism no longer contributes positively to their quality of life. The problem arises when those who live there permanently begin to feel that friction with tourists disturbs and damages their lives to excess. When no one asks them, listens to them, takes them into account and decisions are made that severely affect their lives, it is not surprising that citizens turn against tourism when, in reality, the problem is not tourism, but the management of it. It is only by involving these communities in decision-making that we will find the missing link in tourism governance. Today, we usually speak of co-governance rather than governance. In other words, public-private partnership: a two-way governance which, although necessary, is not sufficient because they alone are not the only stakeholders involved. <a href="https://theconversation.com/como-superar-el-efecto-guggenheim-196421">A partnership with citizens</a>, in a broad sense, is essential to ensure their welfare and to avoid or reverse the trend of disconnection with tourism activities. The point is that tourism is required as an economic activity that affects the entire community, and the latter is something that seems to be missing or unwilling to be addressed. Tourism should not be created by political and business representatives without the local people, but with them. That’s the big difference. There is an added complexity, particularly in terms of legitimacy, in identifying the representatives of stakeholders in the territory and establishing effective participation mechanisms – not only with a voice, but also with a vote in certain decisions. However, this is the best way to support the tourism industry and to overcome mistrust and detachment. We must move towards inclusive and integrative governance, with <a href="https://www.e-unwto.org/doi/pdf/10.18111/9789284420841">a three-pronged approach</a>: public, private and community, whose study and application are virtually unknown fields. The question is not so much of what to do, but how to do it: a new model of shared leadership must include a redistribution of power within the system, which will require an extra effort to break down barriers and overcome resistance. <h2>Co-governance and well-being</h2> To avoid negative attitudes towards tourism, and promote harmonious relationships between locals and visitors as a path to sustainability, tourism must be able to forge a broad alliance with society. It is not about managing a destination, but a community with permanent residents and tourists, the latter being understood as temporary residents. The well-being of both must be at the core of the governance architecture. Although there is usually short-sightedness in political decisions – marked by electoral horizons – and in business decision-making – especially if they are geared towards speculation and immediate returns – the lack of support from the local population will end up generating a boomerang effect. Do we know the type of tourism development desired (or tolerated) by host communities? Are the voices of the local population heard and taken into account in the decision making processes, with a view to their well-being? Local communities have a much more decisive role to play in consolidating democracies. A tourism-oriented society must be geared towards tourism and committed to its development and co-creation.<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/211296/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/alfonso-vargas-sanchez-1205745">Alfonso Vargas Sánchez</a>, Catedrático de Universidad, área de Organización de Empresas, Dirección Estratégica, Turismo (empresas y destinos) - Jubilado, <a href="https://theconversation.com/institutions/universidad-de-huelva-3977">Universidad de Huelva</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/sustainable-tourism-needs-to-be-built-with-the-help-of-locals-211296">original article</a>.

International Travel

Why do people with hoarding disorder hoard, and how can we help?

<a href="https://theconversation.com/profiles/jessica-grisham-37825">Jessica Grisham</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/keong-yap-1468967">Keong Yap</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>, and <a href="https://theconversation.com/profiles/melissa-norberg-493004">Melissa Norberg</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a> Hoarding disorder is an under-recognised serious mental illness that <a href="https://pubmed.ncbi.nlm.nih.gov/25909628/">worsens with age</a>. It affects <a href="https://pubmed.ncbi.nlm.nih.gov/31200169/">2.5% of the working-age population</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/27939851/">7% of older adults</a>. That’s about 715,000 Australians. People who hoard and their families often feel ashamed and don’t get the support they need. Clutter can make it hard to do things most of us take for granted, such as eating at the table or sleeping in bed. In the gravest cases, homes are completely unsanitary, either because it has become impossible to clean or because the person <a href="https://pubmed.ncbi.nlm.nih.gov/23482436/">saves garbage</a>. The <a href="https://pubmed.ncbi.nlm.nih.gov/18275935/">strain on the family</a> can be extreme – couples get divorced, and children grow up feeling unloved. So why do people with hoarding disorder hoard? And how can we help? <h2>What causes hoarding disorder?</h2> Saving millions of objects, many worthless by objective standards, often makes little sense to those unfamiliar with the condition. However, most of us<a href="https://www.sciencedirect.com/science/article/pii/S2352250X21000282?via%3Dihub"> become attached to at least a few possessions</a>. Perhaps we love the way they look, or they trigger fond memories. Hoarding involves this same type of object attachment, as well over-reliance on possessions and <a href="https://pubmed.ncbi.nlm.nih.gov/32402421/">difficulty being away from them</a>. Research has shown genetic factors play a role but there is no one <a href="https://pubmed.ncbi.nlm.nih.gov/27445875/">single gene that causes hoarding disorder</a>. Instead, a range of psychological, neurobiological, and social factors can be at play. Although some who hoard report being deprived of material things in childhood, emotional deprivation may play a <a href="https://pubmed.ncbi.nlm.nih.gov/20934847/">stronger role</a>. People with hoarding problems often report excessively cold parenting, difficulty connecting with others, and more <a href="https://pubmed.ncbi.nlm.nih.gov/34717158/">traumatic experiences</a>. They may end up believing people are unreliable and untrustworthy, and that it’s better to rely on objects for comfort and safety. People with hoarding disorder are often as attached or perhaps <a href="https://akjournals.com/view/journals/2006/11/3/article-p941.xml">more attached to possessions</a> than to the people in their life. Their experiences have taught them their self-identity is tangled up in what they own; that if they part with their possessions, they will lose themselves. Research shows <a href="https://www.sciencedirect.com/science/article/pii/S0005789421000253?via%3Dihub">interpersonal problems</a>, such as loneliness, are linked to greater <a href="https://pubmed.ncbi.nlm.nih.gov/32853881/">attachment to objects</a>. Hoarding disorder is also associated with high rates of <a href="https://pubmed.ncbi.nlm.nih.gov/34923357/">attention deficit and hyperactivity disorder</a>. Difficulties with <a href="https://pubmed.ncbi.nlm.nih.gov/30907337/">decision-making</a>, planning, <a href="https://akjournals.com/view/journals/2006/12/3/article-p827.xml">attention</a> and categorising can make it hard to organise and <a href="https://pubmed.ncbi.nlm.nih.gov/20542489/">discard possessions</a>. The person ends up avoiding these tasks, which leads to unmanageable levels of clutter. <h2>Not everyone takes the same path to hoarding</h2> Most people with hoarding disorder also have strong beliefs about their possessions. For example, they are more likely to see beauty or usefulness in things and believe objects possess <a href="https://link.springer.com/article/10.1023/A:1025428631552">human-like qualities</a> such as intentions, emotions, or free will. Many also feel responsible for objects and for the environment. While others may not think twice about discarding broken or disposable things, people with hoarding disorder can <a href="https://pubmed.ncbi.nlm.nih.gov/30041077/">anguish over their fate</a>. This need to control, rescue, and protect objects is often at odds with the beliefs of friends and family, which can lead to conflict and <a href="https://pubmed.ncbi.nlm.nih.gov/32853881/">social isolation</a>. Not everyone with hoarding disorder describes the same pathway to overwhelming clutter. Some report more cognitive difficulties while others may have experienced more emotional deprivation. So it’s important to take an individualised approach to treatment. <h2>How can we treat hoarding disorder?</h2> There is specialised cognitive-behavioural therapy (CBT) tailored for hoarding disorder. <a href="https://academic.oup.com/edited-volume/46862/chapter-abstract/413932715?redirectedFrom=fulltext">Different strategies</a> are used to address the different factors contributing to a person’s hoarding. Cognitive-behavioural therapy can also help people understand and gradually challenge their beliefs about possessions. They may begin to consider how to remember, connect, feel safe, or express their identity in ways other via inanimate objects. Treatment can also help people learn the skills needed to organise, plan, and discard. Regardless of their path to hoarding, most people with hoarding disorder will benefit from a degree of exposure therapy. This helps people gradually learn to let go of possessions and resist acquiring more. Exposure to triggering situations (such as visiting shopping centres, op-shops or mounds of clutter without collecting new items) can help people learn to tolerate their urges and distress. Treatment can happen in an individual or group setting, and/or via <a href="https://pubmed.ncbi.nlm.nih.gov/35640322/">telehealth</a>. Research is underway on ways to <a href="https://pubmed.ncbi.nlm.nih.gov/34409679/">improve</a> the <a href="https://www.sciencedirect.com/science/article/pii/S2666915322001421">treatment</a> options further through, for example, learning different emotional regulation strategies. <h2>Sometimes, a harm-avoidance approach is best</h2> Addressing the emotional and behavioural drivers of hoarding through cognitive behavioural therapy is crucial. But hoarding is different to most other psychological disorders. Complex cases may require lots of different agencies to work together. For example, health-care workers may work with fire and housing officers to ensure the person can <a href="https://pubmed.ncbi.nlm.nih.gov/31984612/">live safely at home</a>. When people have severe hoarding problems but are reluctant to engage in treatment, a <a href="https://pubmed.ncbi.nlm.nih.gov/21360706/">harm-avoidance approach</a> may be best. This means working with the person with hoarding disorder to identify the most pressing safety hazards and come up with a practical plan to address them. We must continue to improve our understanding and treatment of this complex disorder and address barriers to accessing help. This will ultimately help reduce the devastating impact of hoarding disorder on individuals, their families, and the community.<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/208102/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jessica-grisham-37825">Jessica Grisham</a>, Professor in Psychology, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a>; <a href="https://theconversation.com/profiles/keong-yap-1468967">Keong Yap</a>, Associate Professor of Psychology, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>, and <a href="https://theconversation.com/profiles/melissa-norberg-493004">Melissa Norberg</a>, Professor in Psychology, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie 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/why-do-people-with-hoarding-disorder-hoard-and-how-can-we-help-208102">original article</a>.

Mind

Can coffee help you avoid weight gain? Here’s what the science says

<a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> Coffee is well recognised as having a positive impact on long-term health. Drinking the equivalent of three to four cups of instant coffee a day <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696634/">reduces the risk</a> of many health conditions including heart disease, type 2 diabetes and some cancers. Most people gain <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984841/">small amounts of weight</a> each year as they age. But can coffee help prevent this gradual weight gain? A group of researchers examined whether drinking an extra cup of coffee a day – or adding sugar, cream or a non-dairy alternative – resulted in more or less weight gain than those who didn’t adjust their intake. Their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0002916523661702">research</a> (currently a pre-proof, which means it has been peer reviewed but is yet to undergo the final formatting and copyediting) found a modest link between coffee and gaining less weight than expected. People who drank an extra cup of coffee a day gained 0.12 kg less weight than expected over four years. Adding sugar resulted in a fraction more (0.09 kg) weight gain than expected over four years. <h2>How was the study conducted? What did it find?</h2> Researchers combined data from three large studies from the United States: two <a href="https://nurseshealthstudy.org">Nurses’ Health Studies</a> from 1986 to 2010, and from 1991 to 2015, and a <a href="https://www.hsph.harvard.edu/hpfs/about-the-study/">Health Professional Follow-up study</a> from 1991 to 2014. The Nurses’ Health Studies are two of the largest cohort studies, with more 230,000 participants, and investigates chronic disease risks for women. The Health Professional Follow-up study involves more than 50,000 male health professionals and investigates the relationship between diet and health outcomes. Participants in all three studies completed a baseline questionnaire, and another questionnaire every four years to assess their food and drink intake. Using the combined datasets, researchers analysed changes in coffee intake and changes in the participants’ self-reported weight at four-year intervals. The average four year weight-gains for the nurses’ studies were 1.2kg and 1.7kg, while participants in the health professionals study gained an average of 0.8kg. The researchers found that increasing unsweetened caffeinated or decaffeinated coffee intake by one cup a day was associated with a weight gain that was 0.12 kg less than expected over four years. Adding creamer (milk) or a non-dairy alternative did not significantly affect this weight change. However, adding sugar (one teaspoon) to coffee was associated with a weight gain that was 0.09 kg more than expected over four years. These associations were stronger in participants who were younger and had a higher body mass index at the beginning of the studies. <h2>What are the pros and cons of the study?</h2> This study is unique in two ways. It had a very large sample size and followed participants for many years. This adds confidence that the associations were real and can likely be applied to other populations. However, there are three reasons to be cautious. First, the findings represent an association, not causation. This means the study does not prove that coffee intake is the true reason for the weight change. Rather, it shows the two changes were observed together over time. Second, the findings around weight were very modest. The average four-year weight gain averted, based on one cup of coffee, was 0.12 kilograms, which is about 30 grams per year. This amount may not be a meaningful change for most people looking to manage weight. Finally, this analysis did not consider the variability in the amount of caffeine in coffee (which we <a href="https://pubmed.ncbi.nlm.nih.gov/17412475/">know can be high</a>), it just assumed a standard amount of caffeine per cup. <h2>How could coffee help with weight management?</h2> Caffeine is a natural stimulant which has been <a href="https://www.sciencedirect.com/science/article/pii/S0149763416300690">shown to</a> temporarily reduce appetite and increase alertness. This may help to feel less hungry for a short period, potentially leading to reduced energy intake. Some people consume coffee before exercise as a stimulant to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777221/">improve their workout performance</a> – if a workout is more effective, more energy may be expended. However, the benefit is largely thought to be short-lived, rather than long-term. Caffeine has also been <a href="https://www.sciencedirect.com/science/article/pii/S0271531720304449">shown to</a> speed up our metabolism, causing more energy to be burned while resting. However, this effect is relatively small and is not a suitable substitute for regular physical activity and a healthy diet. Finally, coffee has a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725310/">mild diuretic effect</a>, which can lead to temporary water weight loss. This is water loss, not fat loss, and the weight is quickly regained when you re-hydrate. <h2>Is it worth trying coffee for weight loss?</h2> Losing weight can be influenced by various factors, so don’t get too enthusiastic about the coffee-weight link highlighted in this new study, or increase your coffee intake to unreasonable levels. Most adults can safely consume around <a href="https://www.healthdirect.gov.au/caffeine">400mg</a> of caffeine a day. That’s the equivalent of two espressos or four cups of instant coffee or eight cups of tea. If you are pregnant or breastfeeding, it is important to talk to your doctor before increasing your caffeine intake, because caffeine can be passed through to your growing baby. If you need individualised weight guidance, talk to your GP or visit an <a href="https://member.dietitiansaustralia.org.au/Portal/Portal/Search-Directories/Find-a-Dietitian.aspx">accredited practising dietitian</a>. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/214954/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Dietitian, Researcher & Lecturer, <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/can-coffee-help-you-avoid-weight-gain-heres-what-the-science-says-214954">original article</a>.

Body

These 10 smart grocery swaps can help reverse diabetes

Diagnosis diabetes It can feel daunting to be faced with the need to make a major lifestyle change. You enjoy food, and you should. At Reader’s Digest, we like to think nature designed nutrition to taste delicious so it can be a source of pleasure in your day that’s fun to look forward to. If you’ve been diagnosed with diabetes or pre-diabetes, this diagnosis doesn’t have to take over your whole identity and all the things that bring you joy. There are ways to adapt some of your favourite foods so you can still have them! Registered dietitian Jackie Newgent lists interesting meal swaps you can make so that classic dishes can be healthier, while still plenty pleasurable. With some wisdom and dedication, it can be possible to turn your condition around and feel great for good. Pair starchy with non-starchy veggies Instead of: one kilo potatoes Buy: 500g kilo potatoes plus 500g cauliflower This mashed potato hack keeps your total carbs in check without forgoing flavour. Whip equal parts boiled potatoes together with roasted or boiled cauliflower. The results of this dynamic duo may help you better manage your blood glucose, since they’re carb-friendlier than a huge bowl of mashed potatoes alone: 100 grams of cooked potatoes without skin provides 22 grams of total carbohydrates, versus 13 grams total carbohydrate in the 100 gram combination of cooked potatoes and cauliflower. Pick fruit you can chew <div> Instead of: one litre apple juice Buy: one bag of apples Enjoy whole fruit rather than just the juice whenever possible to get all the fibre of the naturally sweet fruit with its edible peel…plus chewing satisfaction. One medium apple contains 4.4 grams of fibre while a 200ml glass or juice box of 100-percent apple juice has 0.4 grams of fibre. The soluble fibre in apples can help slow down absorption of sugars. Polyphenols in apples may have powerful antioxidant properties. Grill a better burger Instead of: 500g 85% lean ground beef patties Buy: 500g ground chicken breast Gram for gram, chicken breast has significantly less saturated fat than the marbly beef of classic burgers. Specifically, an 85g cooked 85% lean ground beef patty has five grams of saturated fat compared to 0.6 grams of saturated fat for a cooked patty made from 85g of chicken breast meat. Keeping saturated fat intake low is especially important when you have diabetes to help keep your heart healthy. Pro-tip: make chicken burgers juicier and tastier by combining ground chicken breast with a little plain yogurt, rolled oats, and herbs and spices before cooking. Look for live cultures in the dairy section Instead of: one container regular cottage cheese Buy: one container plain low-fat Greek yogurt or cultured cottage cheese Probiotics are “good” bacteria that help keep your gut healthy. For people with type 2 diabetes, research published in Advances in Nutrition suggested that probiotics may also have glucose-lowering potential. So, pop products with live active cultures (probiotics) into your cart while strolling by the dairy aisle. Choose plain low-fat Greek yogurt or cultured cottage cheese. Be sure to read the nutrition labels, since probiotics aren’t in all dairy foods. And, for the lower-sodium pick, stick with yogurt. Choose healthier-sized grain portions Instead of: 1/2 dozen bakery-style plain bagels Buy: one package of wholegrain English muffins Swapping wholegrain in place of refined grain products helps kick up fibre and other plant nutrients. Studies suggests this is linked to lower risk of type 2 diabetes. Also, opting for healthier-sized varieties, such as wholegrain English muffins rather than big bakery-style plain bagels helps cut kilojoules (and carbs) – not enjoyment – while promoting a healthier weight. In fact, you’ll slash over 1000 kilojoules by enjoying a whole-wheat English muffin instead of that oversized 140g bagel. Get your munchies with benefits Instead of: one bag of potato chips Buy: one jar or bulk-bin container of roasted peanuts It’s a no-brainer: a small handful of nuts is a better bet than potato chips. Peanuts, for instance, offer a triple whammy of dietary fibre, plant protein and healthy fat, which can boost satiety. Greater satisfaction means a greater chance you’ll keep mealtime portions right-sized. When peanuts or other nuts are eaten along with carb-rich foods, they can help slow down the blood sugar response. Plus, a Mediterranean study found that higher nut consumption may be associated with better metabolic status. Dress a salad smartly Instead of: one bottle of fat-free salad dressing Buy: one small bottle olive oil plus one small bottle balsamic or red wine vinegar Some bottled salad dressings can trick you. For instance, “fat-free” salad dressing may be loaded with added sugars. (For reference: four grams of sugar is equal to one teaspoon.) So, read salad dressing labels carefully for sneaky ingredients, especially excess salt (over 250 milligrams of sodium per two-tablespoon serving) or added sugars (more than five grams added sugars per two-tablespoon serving). Better yet, keep it simple and make your own vinaigrette using 2-3 parts oil to 1 part vinegar. Select less salty soup Instead of: one can/carton of vegetable- or bean-based soup Buy: one can/carton of low-sodium vegetable- or bean-based soup When compared to people without diabetes, sodium levels were higher in patients with type 2 diabetes, based on a meta-analysis published in European Journal of Nutrition. Curbing sodium intake is beneficial for people with diabetes since too much may increase your risk for high blood pressure. So, slurp up soup that’s low in sodium. And kick up flavour with a splash of cider vinegar, grated citrus zest, herbs, spices, or a dash of hot sauce. Go for "naked" fish Instead of: Breaded fish sticks Buy: Frozen salmon fillets Cut salmon into large cubes, season, and grill on skewers. Or make fish sticks by simply cutting into skinny fillets, season and roast. Why? Research published in Diabetes Care finds that eating oily fish may be associated with a lower risk of type 2 diabetes. Non-oily fish, like the whitefish in fish sticks, didn’t show this link. Salmon is an oily fish and a major source of omega-3 fatty acids, a heart-friendly fat. Plus: when you make your own salmon skewers or sticks, you won’t have extra carbs from breading. Do dip with a punch of protein Instead of: one container of sour cream & onion dip Buy: one container of pulse-based dip, like hummus Wise snacking can be helpful for managing blood glucose. It can also be delicious. Dunk veggies or wholegrain pita wedges into pulse-based dip, like hummus, black bean dip, or lentil dip. Check this out: one-quarter cup (that’s 60 grams) of onion dip has 870 kiljoules, five grams of saturated fat, 1.2 grams of protein, and 0.1 grams of fibre, while one-quarter cup hummus has 590 kilojoules, 1.5 grams of saturated fat, 4.7 grams of protein, and 3.3 grams of fibre. Hummus clearly wins! Image credits: Getty Images This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/diabetes/reverse-diabetes-10-smart-grocery-swaps?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </div>

Food & Wine

Do blue-light glasses really work? Can they reduce eye strain or help me sleep?

<a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Blue-light glasses are said to <a href="https://www.baxterblue.com.au/collections/blue-light-glasses">reduce eye strain</a> when using <a href="https://www.blockbluelight.com.au/collections/computer-glasses">computers</a>, improve your <a href="https://www.ocushield.com/products/anti-blue-light-glasses">sleep</a> and protect your eye health. You can buy them yourself or your optometrist can prescribe them. But <a href="https://mivision.com.au/2019/03/debate-continues-over-blue-blocking-lenses/">do they work</a>? Or could they do you harm? We <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">reviewed</a> the evidence. Here’s what we found. <h2>What are they?</h2> Blue-light glasses, blue light-filtering lenses or blue-blocking lenses are different terms used to describe lenses that reduce the amount of short-wavelength visible (blue) light reaching the eyes. Most of these lenses prescribed by an optometrist decrease blue light transmission by <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">10-25%</a>. Standard (clear) lenses do not filter blue light. A wide variety of lens products are available. A filter can be added to prescription or non-prescription lenses. They are widely marketed and are becoming <a href="https://onlinelibrary.wiley.com/doi/10.1111/opo.12615">increasingly popular</a>. There’s often an added cost, which depends on the specific product. So, is the extra expense worth it? <h2>Blue light is all around us</h2> Outdoors, sunlight is the main source of blue light. Indoors, light sources – such as light-emitting diodes (LEDs) and the screens of digital devices – emit varying degrees of blue light. The amount of blue light emitted from artificial light sources is much lower than from the Sun. Nevertheless, artificial light sources are all around us, at home and at work, and we can spend a lot of our time inside. <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.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/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/549210/original/file-20230920-16-tsb23b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" alt="Blue light-filtering lenses block some blue light from screens from reaching the eye" /></a><figcaption>Screens emit blue light. The lenses are designed to reduce the amount of blue light that reaches the eye. <a class="source" href="https://www.shutterstock.com/image-vector/blue-light-blocking-ray-filter-lens-2286229107">Shutterstock</a></figcaption></figure> Our research team at the University of Melbourne, along with collaborators from Monash University and City, University London, sought to see if the best available evidence supports using blue light-filtering glasses, or if they could do you any harm. So we conducted a <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013244.pub2/full">systematic review</a> to bring together and evaluate all the relevant studies. We included all randomised controlled trials (clinical studies designed to test the effects of interventions) that evaluated blue light-filtering lenses in adults. We identified 17 eligible trials from six countries, involving a total of 619 adults. <h2>Do they reduce eye strain?</h2> We found no benefit of using blue light-filtering lenses, over standard (clear) lenses, to reduce eye strain with computer use. This conclusion was based on consistent findings from three studies that evaluated effects on eye strain over time periods ranging from two hours to five days. <h2>Do they help you sleep?</h2> Possible effects on sleep were uncertain. Six studies evaluated whether wearing blue-light filtering lenses before bedtime could improve sleep quality, and the findings were mixed. These studies involved people with a diverse range of medical conditions, including insomnia and bipolar disorder. Healthy adults were not included in the studies. So we do not yet know whether these lenses affect sleep quality in the general population. <h2>Do they boost your eye health?</h2> We did not find any clinical evidence to support using blue-light filtering lenses to protect the macula (the region of the retina that controls high-detailed, central vision). None of the studies evaluated this. <h2>Could they do harm? How about causing headaches?</h2> We could not draw clear conclusions on whether there might be harms from wearing blue light-filtering lenses, compared with standard (non blue-light filtering) lenses. Some studies described how study participants had headaches, lowered mood and discomfort from wearing the glasses. However, people using glasses with standard lenses reported similar effects. <h2>What about other benefits or harms?</h2> There are some important general considerations when interpreting our findings. First, most of the studies were for a relatively short period of time, which limited our ability to consider longer-term effects on vision, sleep quality and eye health. Second, the review evaluated effects in adults. We don’t yet know if the effects are different for children. Finally, we could not draw conclusions about the possible effects of blue light-filtering lenses on many vision and eye health measures, including colour vision, as the studies did not evaluate these. <h2>In a nutshell</h2> Overall, based on relatively limited published clinical data, our review does not support using blue-light filtering lenses to reduce eye strain with digital device use. It is unclear whether these lenses affect vision quality or sleep, and no conclusions can be drawn about any potential effects on the health of the retina. High-quality research is needed to answer these questions, as well as whether the effectiveness and safety of these lenses varies in people of different ages and health status. If you have eye strain, or other eye or vision concerns, discuss this with your optometrist. They can perform a thorough examination of your eye health and vision, and discuss any relevant treatment options.<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/213145/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/laura-downie-1469379">Laura Downie</a>, Associate Professor in Optometry and Vision Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</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/do-blue-light-glasses-really-work-can-they-reduce-eye-strain-or-help-me-sleep-213145">original article</a>.

Body

What is ‘budget Ozempic’ that’s all over social media? Can it help me lose weight?

<a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> Social media is lighting up over what influencers are calling “<a href="https://www.forbes.com/sites/brucelee/2023/09/09/budget-ozempic-tiktok-trend-how-its-contributing-to-the-laxative-shortage/?sh=1f54511b1569">budget Ozempic</a>”. These are drugs normally used as laxatives and stool softeners, but people are taking them to lose weight. The demand is so high in the United States, there are reports this is contributing to <a href="https://www.wsj.com/health/wellness/laxative-shortage-diet-weight-loss-5a15bf02">shortages</a> in pharmacies. These laxatives are just the latest alternatives influencers are touting for the <a href="https://www.abc.net.au/news/2023-09-09/ozempic-maker-novo-nordisk-becomes-biggest-company-in-europe/102812584">blockbuster drug</a> Ozempic. So, does “budget Ozempic” help you lose weight? Any weight loss is likely to be temporary and using these laxatives long term may be dangerous. <h2>Ozempic is in short supply</h2> Ozempic contains the active ingredient semaglutide. It is a prescription-only drug used to treat type 2 diabetes. One side effect of taking it is significant weight loss. This has led to so many people trying to obtain the drug there have been <a href="https://www.tga.gov.au/safety/shortages/information-about-major-medicine-shortages/about-ozempic-semaglutide-shortage-2022-and-2023">shortages</a>. Instead, some people have turned to more easily accessible over-the-counter alternatives to try to lose weight. That includes <a href="https://theconversation.com/natures-own-ozempic-or-berberine-is-all-over-social-media-but-does-it-really-help-you-lose-weight-206855">berberine</a>, which has been dubbed “nature’s own Ozempic”. <h2>What is ‘budget Ozempic’?</h2> “Budget Ozempic” is different to “nature’s own Ozempic”. It is the polymer polyethylene glycol 3350, or PEG 3350 for short. Chemically, it’s similar to other polymers used as ingredients in cosmetics, drug delivery, <a href="https://www.chemistryworld.com/features/raiders-of-the-lost-pigments/3007237.article">archaeological preservative paints</a>, soaps and even <a href="https://navyrecognition.com/index.php/naval-news/naval-news-archive/2023/june/13261-northrop-grumman-hits-production-milestone-with-trident-ii-d5-s-2000th-rocket-motor.html">missile fuel</a>. It’s not to be confused with ethylene glycol, which is used in antifreeze. Medically, PEG 3350 is mainly sold in Australia through pharmacies in <a href="https://australianprescriber.tg.org.au/articles/managing-constipation-in-adults.html">laxative and stool softening</a> products. It is also used to clean out your bowels before a colonoscopy. The products are referred to as <a href="https://www.healthdirect.gov.au/medicines/medicinal-product/aht,22630/macrogol-3350">macrogols</a>. Brands include DulcoSoft, Movicol, OsmoLax, ClearLax and ColonLYTELY. <h2>How can it cause weight loss?</h2> PEG 3350 is known as an <a href="https://www.nhs.uk/conditions/laxatives/#:%7E:text=Osmotic%20laxatives%20draw%20water%20from,brand%20names%20Duphalac%20and%20Lactugal">osmotic laxative</a>. It uses osmosis – how your body manages the balance of electrolytes in your blood serum – to soften your stools and treat constipation. When you swallow a drink with PEG 3350 the polymer isn’t absorbed by the body. Instead, as it passes through your intestines it draws water to it, making your faeces much more watery. Because it draws more water out of your body than you put into it from the drink, your weight goes down. That is, it just makes you dehydrated. This means any weight loss is likely to be short-lived; when you next drink, your body will retain more of the water to replace what was lost. To have any significant and sustained weight loss you’d need to take a lot of PEG 3350 every day. And at most, you would only lose a few kilograms. This is different to how <a href="https://www.nps.org.au/assets/medicines/42ccacc2-2326-42ad-ad14-abd6010499a4.pdf">Ozempic</a> works. Ozempic is similar to a family of hormones in your body called <a href="https://pubmed.ncbi.nlm.nih.gov/29364588/">incretins</a>. These have a number of actions that control both blood sugar levels and weight. For example, they slow how quickly food is absorbed from the stomach and decrease appetite, both of which help with sustained weight loss. <h2>Dangers and side effects</h2> PEG 3350 can make you <a href="https://www.healthdirect.gov.au/dehydration">dehydrated</a>. You may feel dizzy or light-headed, have a headache and have a dry mouth, lips or eyes. The concentration of electrolytes in your blood, such as salt, may also be too high (known as hypertonic blood serum). Hypertonic blood serum can affect the shape of your red blood cells, making it harder for them to carry oxygen around your body. This results in symptoms that include fatigue and tiredness, and those other symptoms of being dehydrated. In extreme cases it can result in <a href="https://psmf.org/story/emily-jerry/">death</a>. Incorrect levels of electrolytes can lead to other serious problems, affecting your heart and muscles. It can also lead to seizures, confusion, and coma. It can be dangerous to take PEG 3350 if you have heart disease, if your doctor has put you on a sodium-restricted diet, or if you already have an electrolyte disorder, such as <a href="https://www.healthdirect.gov.au/potassium">hyperkalaemia</a> (high potassium levels). These products are also dangerous for elderly people, those with kidney problems, and in very young children. Common side effects include anal irritation, vomiting, diarrhoea, nausea, cramps, pain, and swelling of your abdomen. Some people can have allergic reactions. If you use laxatives, including PEG 3350-based products, for a long period of time (over a period of weeks or months) then you may experience <a href="https://www.eatingdisorders.org.au/wp-content/uploads/2019/10/Eating-disorders-and-laxatives.pdf">withdrawal symptoms</a> if you stop taking them suddenly. These include constipation, bloating, weight gain and fluid retention. <h2>In a nutshell</h2> Overall, if you’ve been struggling with weight loss, then PEG 3350-based products are not a safe and effective solution. Any weight loss you experience will be temporary and may put your health at risk. Safer and more effective solutions are available. Eating healthily and exercising regularly are important first steps for anyone who wishes to lose weight. Otherwise, your GP or local pharmacist can help you with both lifestyle changes and medication options to help with weight loss.<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/213457/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/nial-wheate-96839">Nial Wheate</a>, Associate Professor of the Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a> and <a href="https://theconversation.com/profiles/jessica-pace-1401278">Jessica Pace</a>, Associate Lecturer, Sydney Pharmacy School, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</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/what-is-budget-ozempic-thats-all-over-social-media-can-it-help-me-lose-weight-213457">original article</a>.

Body

7 tips to help turn your cat into a friendly member of the family

How to make your cat love you Getting a cat to be more affectionate is the yearning of many a pet owner. Some cats are antisocial when it comes to being picked up, cuddled or petted (much less sitting in a person’s lap). Other kitties are born loving this sort of attention. If you’re not lucky enough to have a cat who automatically seeks out your affection, trying to entice that reclusive furball to become your snuggle buddy may take some motivation and determination on your part. Your pet may never convert to a drooly lap cat, even after weeks of effort on your part, but at the very least you’ll probably strengthen your relationship with your cat. Get the basics down The initial stage of coaxing a cat into being more lovable is to let her recognise your positive intentions by dependably offering her good food, clean water, fun toys to play with and a litterbox that is cleaned regularly. When she’s happier, you’ll be happier, and these mutual good feelings will carry over into your relationship together. Spend extra time with your cat, letting her see you not as her owner but as her friend, meal provider and guardian. If she’s not coming up to you to say hi, be proactive: Walk over to her (as long as she’s not super-shy) and lavish affection on her. Once she gets used to all this attention, she might very well start seeking it out from you. Be affectionate while feeding While preparing her food (or making a production of opening that can of food), talk to your kitty. When she begins eating, gently stroke her a few times. This will help her associate being petted with a positive experience. Be playful Instead of trying to force a hug from your reluctant cat, play with her a little, maybe getting her to paw at a piece of string or chase after a laser pointer. Try a little catnip Bringing out a tin of catnip often brings timid felines out of their shells, and aloof cats sometimes become far friendlier under the influence of catnip. Use the "slow blink" Remember that using the “slow blink” as a non-verbal statement saying “I love you” will go a much longer way with your cat, versus a direct stare, which she may take as a threat. Don't chase Don’t try to push affection on your cat – for example, running after her. This might work with a dog, but chasing usually causes a scaredy cat to jolt off in another direction feeling victimised. And I should hope it goes without saying, but don’t punish or yell at your shy cat. Give them a treat Each time you share a session of tenderness with your cat, give her a treat. Let her see that this affectionate behaviour has its rewards. Image credits: Shutterstock This article originally appeared on <a href="https://www.readersdigest.co.nz/food-home-garden/pets/7-tips-to-make-your-cat-more-friendly" target="_blank" rel="noopener">Reader's Digest</a>.

Family & Pets

Feeling lonely? Too many of us are. Here’s what our supermarkets can do to help

<a href="https://theconversation.com/profiles/louise-grimmer-212082">Louise Grimmer</a>, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</a> Even <a href="https://endingloneliness.com.au/wp-content/uploads/2020/11/Ending-Loneliness-Together-in-Australia_Nov20.pdf">before COVID-19</a>, <a href="https://aifs.gov.au/resources/resource-sheets/understanding-and-defining-loneliness-and-social-isolation">social isolation and loneliness</a> were all too common across the community. Living among millions of other people is no comfort for people in cities, where the pace of life is often hectic, and technology and digitisation often limit, rather than help with, social interaction. The pandemic <a href="https://www.apa.org/pubs/journals/releases/amp-amp0001005.pdf">amplified these problems</a>. In its wake, more of us report we’re lonely. For some, a weekly shopping trip may be the only chance to interact with others. A supermarket chain in the Netherlands is helping to combat loneliness with so-called “slow” checkouts where chatting is encouraged. Could a similar approach work here? <h2>We’re getting lonelier</h2> Around a third of Australians report feeling lonely. <a href="https://lonelinessawarenessweek.com.au/download/512/">One in six</a> experience severe loneliness. According to the annual Household, Income and Labour Dynamics in Australia (<a href="https://melbourneinstitute.unimelb.edu.au/hilda/publications/hilda-statistical-reports">HILDA</a>) Survey, people <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">aged 15 to 24</a> report the greatest increase in social isolation over the past 20 years and the highest rates of loneliness. Another <a href="https://www.abc.net.au/news/2023-07-14/middle-aged-men-experiencing-high-level-loneliness/102563492">Australian survey</a> found men aged 35 to 49 had the highest levels of loneliness. Loneliness and social isolation are <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">not the same</a>. Social isolation is a matter of how often we have contact with friends, family and others, which can be measured. Loneliness is more subjective. It describes how we feel about the “quality” of our interactions with others. Technology is <a href="https://www.psychologytoday.com/au/blog/live-long-and-prosper/202210/technology-use-loneliness-and-isolation#:%7E:text=Technology%20compulsion%20might%20lead%20to,disconnection%20and%20reduce%20well%2Dbeing.">contributing</a> to <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">high rates of loneliness</a>. Instead of meaningful face-to-face interactions, many of us now rely on social media, phone apps and video calls to socialise. We’re also working longer hours, often at home. And due to the cost of living, many of us are choosing to stay home and save money, rather than eat out or go to “the local”. It isn’t only in Australia where this is happening. In the UK, around <a href="https://www.lonelinessawarenessweek.org/statistics">3.9 million older people</a> say television is their main company. Half a million may go five or six days a week without seeing anyone. The World Health Organisation <a href="https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness">recognises</a> loneliness and social isolation as public health issues and priorities for policymakers. These issues seriously affect people’s mental and physical health as well as longevity. The impacts are comparable with other <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15967-3">risk factors</a> such as smoking, alcohol consumption, obesity and not being physically active. <h2>Could slow, ‘chatty’ checkouts be part of the solution?</h2> For many, a visit to the supermarket may be the only time they interact with others. Sadly, increased use of technology, including self-serve checkouts, and cashiers tasked with speedily processing customers can make it challenging to have a conversation. <iframe title="The FASTEST checkout cashier ever😮 TikTok: rogerlopez7511" src="https://www.youtube.com/embed/TpALSOvw4LU" width="100%" height="750" frameborder="0" allowfullscreen="allowfullscreen"></iframe> Four years ago, the Netherlands’ second-largest supermarket chain, <a href="https://jumbo.com">Jumbo</a>, introduced Kletskassa or “chat checkout”. It’s for shoppers who want to chat and aren’t in a hurry. Recognising loneliness was an issue for many, the idea was to increase social interaction between customers and staff by slowing things down and encouraging conversation. Jumbo’s chief commercial officer, Colette Cloosterman-van Eerd, <a href="https://www.dutchnews.nl/2021/09/jumbo-opens-chat-checkouts-to-combat-loneliness-among-the-elderly/">explained</a>: <blockquote> Many people, especially the elderly, sometimes feel lonely. As a family business and supermarket chain, we are at the heart of society. Our shops are an important meeting place for many people, and we want to play a role in identifying and reducing loneliness. </blockquote> The first Kletskassa, in Vlijmen in Brabant, was so successful the family-owned company started rolling out slow checkouts in <a href="https://www.dutchnews.nl/2021/09/jumbo-opens-chat-checkouts-to-combat-loneliness-among-the-elderly/">200 of its stores</a>. Not only were customers responding positively, the concept also appealed to Jumbo’s employees. They are trained to recognise signs of loneliness and come up with local initiatives to combat social isolation. Cloosterman-Van Eerd said: <blockquote> We are proud our staff want to work the chat checkout. They really want to help people and make contact with them. It’s a small gesture but it’s a valuable one, particularly in a world that is becoming more digital and faster. </blockquote> The original focus of Jumbo’s initiative was older shoppers. However, the trial showed people of all ages were keen to use the Kletskassa. The desire for human interaction didn’t change across age groups. So, these “chatty” checkouts are open to anyone who will benefit from social connection. Some Jumbo stores also have an <a href="https://www.brightvibes.com/dutch-supermarket-introduces-a-unique-chat-checkout-to-help-fight-loneliness/">All Together Coffee Corner</a>, where locals can enjoy a coffee and chat with neighbours and volunteers who also <a href="https://scoop.upworthy.com/dutch-supermarket-introduces-a-unique-slow-checkout-lane-to-help-fight-loneliness-595693-595693">help out</a> with shopping and gardening. The Netherlands’ government is partnering a range of organisations, local government and companies to come up with solutions to combat loneliness across the country. Some 50% of the 1.3 million people over 75 report they regularly feel lonely. Jumbo’s initiatives are part of the Health Ministry’s <a href="https://www.globalwellnesssummit.com/blog/governments-ramp-up-the-war-on-loneliness/">One Against Loneliness</a> campaign. <figure><iframe src="https://www.youtube.com/embed/11SY0wG6Zc8?wmode=transparent&start=10" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe><figcaption>Jumbo supermarket’s innovation of slow chat checkouts has been extended to 200 of its stores.</figcaption></figure> <h2>Supermarkets as ‘third places’ to combat loneliness</h2> In the 1980s, sociologist Ray Oldenberg coined the term <a href="https://link.springer.com/article/10.1007/BF00986754">“third place”</a> – a place that’s not home (the “first place”) and not work (the “second place”). Third places are familiar public spaces where people can connect over a shared interest or activity. Libraries, coffee shops, book stores, community gardens, churches, gyms and clubs are examples of third places. They all provide the opportunity for close proximity, interaction and often serendipitous conversations with other people we might not usually meet. Kletkassa have helped thousands of people, of all ages and backgrounds, by providing a few minutes of kindness and conversation. Imagine what could be achieved if our supermarkets offered their own version of the “slow checkout” for anyone who’s in need of a chat to brighten their day. The first chain to introduce this sort of initiative in Australia would have a solid advantage over competitors through differentiation and prioritising customers. At the same time, it would make a small but meaningful contribution to improving social wellbeing. Challenge extended!<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/211126/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/louise-grimmer-212082">Louise Grimmer</a>, Senior Lecturer in Retail Marketing, <a href="https://theconversation.com/institutions/university-of-tasmania-888">University of Tasmania</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/feeling-lonely-too-many-of-us-are-heres-what-our-supermarkets-can-do-to-help-211126">original article</a>.

Caring

Not all mental health apps are helpful. Experts explain the risks, and how to choose one wisely

<a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> There are thousands of mental health apps available on the app market, offering services including meditation, mood tracking and counselling, among others. You would think such “health” and “wellbeing” apps – which often present as solutions for conditions such as <a href="https://www.headspace.com/">anxiety</a> and <a href="https://www.calm.com">sleeplessness</a> – would have been rigorously tested and verified. But this isn’t necessarily the case. In fact, many may be taking your money and data in return for a service that does nothing for your mental health – at least, not in a way that’s backed by scientific evidence. <h2>Bringing AI to mental health apps</h2> Although some mental health apps connect users with a <a href="https://www.betterhelp.com/get-started/?go=true&utm_source=AdWords&utm_medium=Search_PPC_c&utm_term=betterhelp+australia_e&utm_content=133525856790&network=g&placement=&target=&matchtype=e&utm_campaign=15228709182&ad_type=text&adposition=&kwd_id=kwd-401317619253&gclid=Cj0KCQjwoeemBhCfARIsADR2QCtfZHNw8mqpBe7cLfLtZBD-JZ5xvAmDCfol8npbAAH3ALJGYvpngtoaAtFlEALw_wcB¬_found=1&gor=start">registered therapist</a>, most provide a fully automated service that bypasses the human element. This means they’re not subject to the same standards of care and confidentiality as a registered mental health professional. Some aren’t even designed by mental health professionals. These apps also increasingly claim to be incorporating artificial intelligence into their design to make personalised recommendations (such as for meditation or mindfulness) to users. However, they give little detail about this process. It’s possible the recommendations are based on a user’s previous activities, similar to Netflix’s <a href="https://help.netflix.com/en/node/100639">recommendation algorithm</a>. Some apps such as <a href="https://legal.wysa.io/privacy-policy#aiChatbot">Wysa</a>, <a href="https://www.youper.ai/">Youper</a> and <a href="https://woebothealth.com/">Woebot</a> use AI-driven chatbots to deliver support, or even established therapeutic interventions such as cognitive behavioural therapy. But these apps usually don’t reveal what kinds of algorithms they use. It’s likely most of these AI chatbots use <a href="https://www.techtarget.com/searchenterpriseai/feature/How-to-choose-between-a-rules-based-vs-machine-learning-system">rules-based systems</a> that respond to users in accordance with predetermined rules (rather than learning on the go as adaptive models do). These rules would ideally prevent the unexpected (and often <a href="https://www.vice.com/en/article/pkadgm/man-dies-by-suicide-after-talking-with-ai-chatbot-widow-says">harmful and inappropriate</a>) outputs AI chatbots have become known for – but there’s no guarantee. The use of AI in this context comes with risks of biased, discriminatory or completely inapplicable information being provided to users. And these risks haven’t been adequately investigated. <h2>Misleading marketing and a lack of supporting evidence</h2> Mental health apps might be able to provide certain benefits to users if they are well designed and properly vetted and deployed. But even then they can’t be considered a substitute for professional therapy targeted towards conditions such as anxiety or depression. The <a href="https://theconversation.com/pixels-are-not-people-mental-health-apps-are-increasingly-popular-but-human-connection-is-still-key-192247">clinical value</a> of automated mental health and mindfulness apps is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1077722918300233?casa_token=lwm1E6FhcG0AAAAA:saV7szbZl4DqbvmZiomLG9yMWi_4-zbmy3QCtQzVEQr957QX1E7Aiqkm5BcEntR0mVFgfDVo">still being assessed</a>. Evidence of their efficacy is generally <a href="https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000002">lacking</a>. Some apps make ambitious claims regarding their effectiveness and refer to studies that supposedly support their benefits. In many cases these claims are based on less-than-robust findings. For instance, they may be based on: <ul> <li><a href="https://sensa.health/">user testimonials</a></li> <li>short-term studies with narrow <a href="https://www.wired.co.uk/article/mental-health-chatbots">or homogeneous cohorts</a></li> <li><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9533203/">studies involving</a> researchers or funding from the very group <a href="https://www.theguardian.com/us-news/2022/apr/13/chatbots-robot-therapists-youth-mental-health-crisis">promoting the app</a></li> <li>or evidence of the benefits of a <a href="https://www.headspace.com/meditation/anxiety">practice delivered face to face</a> (rather than via an app).</li> </ul> Moreover, any claims about reducing symptoms of poor mental health aren’t carried through in contract terms. The fine print will typically state the app does not claim to provide any physical, therapeutic or medical benefit (along with a host of other disclaimers). In other words, it isn’t obliged to successfully provide the service it promotes. For some users, mental health apps may even cause harm, and lead to increases in the very <a href="https://pubmed.ncbi.nlm.nih.gov/34074221/">symptoms</a> people so often use them to address. The may happen, in part, as a result of creating more awareness of problems, without providing the tools needed to address them. In the case of most mental health apps, research on their effectiveness won’t have considered <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505389/">individual differences</a> such as socioeconomic status, age and other factors that can influence engagement. Most apps also will not indicate whether they’re an inclusive space for marginalised people, such as those from culturally and linguistically diverse, LGBTQ+ or neurodiverse communities. <h2>Inadequate privacy protections</h2> Mental health apps are subject to standard consumer protection and privacy laws. While data protection and <a href="https://cybersecuritycrc.org.au/sites/default/files/2021-07/2915_cscrc_casestudies_mentalhealthapps_1.pdf">cybersecurity</a> practices vary between apps, an investigation by research foundation Mozilla <a href="https://foundation.mozilla.org/en/privacynotincluded/articles/are-mental-health-apps-better-or-worse-at-privacy-in-2023">concluded that</a> most rank poorly. For example, the mindfulness app <a href="https://www.headspace.com/privacy-policy">Headspace</a> collects data about users from a <a href="https://foundation.mozilla.org/en/privacynotincluded/headspace/">range of sources</a>, and uses those data to advertise to users. Chatbot-based apps also commonly repurpose conversations to predict <a href="https://legal.wysa.io/privacy-policy">users’ moods</a>, and use anonymised user data to train the language models <a href="https://www.youper.ai/policy/privacy-policy">underpinning the bots</a>. Many apps share so-called <a href="https://theconversation.com/popular-fertility-apps-are-engaging-in-widespread-misuse-of-data-including-on-sex-periods-and-pregnancy-202127">anonymised</a> data with <a href="https://www.wysa.com/">third parties</a>, such as <a href="https://www.headspace.com/privacy-policy">employers</a>, that sponsor their use. Re-identification of <a href="https://www.unimelb.edu.au/newsroom/news/2017/december/research-reveals-de-identified-patient-data-can-be-re-identified">these data</a> can be relatively easy in some cases. Australia’s Therapeutic Goods Administration (TGA) doesn’t require most mental health and wellbeing apps to go through the same testing and monitoring as other medical products. In most cases, they are lightly regulated as <a href="https://www.tga.gov.au/how-we-regulate/manufacturing/medical-devices/manufacturer-guidance-specific-types-medical-devices/regulation-software-based-medical-devices">health and lifestyle</a> products or tools for <a href="https://www.tga.gov.au/sites/default/files/digital-mental-health-software-based-medical-devices.pdf">managing mental health</a> that are excluded from TGA regulations (provided they meet certain criteria). <h2>How can you choose an app?</h2> Although consumers can access third-party rankings for various mental health apps, these often focus on just a few elements, such as <a href="https://onemindpsyberguide.org/apps/">usability</a> or <a href="https://foundation.mozilla.org/en/privacynotincluded/categories/mental-health-apps/">privacy</a>. Different guides may also be inconsistent with each other. Nonetheless, there are some steps you can take to figure out whether a particular mental health or mindfulness app might be useful for you. <ol> <li> consult your doctor, as they may have a better understanding of the efficacy of particular apps and/or how they might benefit you as an individual </li> <li> check whether a mental health professional or trusted institution was involved in developing the app </li> <li> check if the app has been rated by a third party, and compare different ratings </li> <li> make use of free trials, but be careful of them shifting to paid subscriptions, and be wary about trials that require payment information upfront </li> <li> stop using the app if you experience any adverse effects. </li> </ol> Overall, and most importantly, remember that an app is never a substitute for real help from a human professional.<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/211513/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/nicholas-t-van-dam-389879">Nicholas T. Van Dam</a>, Associate Professor, School of Psychological Sciences, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>, and <a href="https://theconversation.com/profiles/piers-gooding-207492">Piers Gooding</a>, Postdoctoral Research Fellow, Disability Research Initiative, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/not-all-mental-health-apps-are-helpful-experts-explain-the-risks-and-how-to-choose-one-wisely-211513">original article</a>.

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