Saturday 29 February 2020

Coronavirus

Overview

Coronaviruses are a family of viruses that can cause illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). In 2019, a new virus called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a disease outbreak in China. The disease is called coronavirus disease 2019 (COVID-19).
There isn't much known about this new virus yet. Public health groups, such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), are monitoring the situation and posting updates on their websites. These groups have also issued recommendations for preventing and treating the illness.

Symptoms

Signs and symptoms of infection with the new coronavirus may appear two to 14 days after exposure and can include:
  • Fever
  • Cough
  • Shortness of breath or difficulty breathing
The severity of the new coronavirus symptoms can range from very mild to severe, even death. Although understanding of this disease continues to grow, most people with severe illness have been of an older age or had other significant existing medical conditions. This is similar to what is seen in people who have severe infections with other respiratory illnesses, such as influenza.

When to see a doctor

Contact your doctor right away if you have symptoms of infection with the new coronavirus and you've possibly been exposed to the virus. Tell your doctor if you've recently traveled internationally. Call your doctor ahead to tell him or her about your symptoms and recent travels and possible exposure before you go to your appointment.
Request an Appointment at Mayo Clinic

Causes

It's unclear exactly how contagious the new coronavirus is or how it spreads. It appears to be spreading from person to person among those in close contact. It may be spread by respiratory droplets released when someone with the virus coughs or sneezes.
It's not known if a person can catch the virus by touching a surface that an infected person has touched, and then putting his or her hand to the mouth.

Risk factors

Risk factors for infection with the new coronavirus appear to include:
  • Recent travel from or residence in China
  • Close contact with someone who has the new coronavirus — such as when a family member or health care worker takes care of an infected person
People who are older or who have other existing medical conditions, such as diabetes and heart disease, may be at higher risk of becoming seriously ill with the new coronavirus. But there is still much unknown about the virus, and the CDC and WHO continue to investigate.

Prevention

Although there is no vaccine available to prevent infection with the new coronavirus, you can take steps to reduce your risk of infection. WHO and CDC recommend following the standard precautions for avoiding respiratory viruses:
  • Wash your hands often with soap and water, or use an alcohol-based hand sanitizer.
  • Cover your mouth and nose with your elbow or tissue when you cough or sneeze.
  • Avoid touching your eyes, nose and mouth if your hands aren't clean.
  • Avoid close contact with anyone who is sick.
  • Avoid sharing dishes, glasses, bedding and other household items if you're sick.
  • Clean and disinfect surfaces you often touch.
  • Stay home from work, school and public areas if you're sick.
WHO also recommends that you:
  • Contact your doctor if you have a fever, cough and difficulty breathing, and tell him or her about any recent travels.
  • Avoid eating raw or undercooked meat or animal organs.
  • Avoid contact with live animals and surfaces they may have touched if you're visiting live markets in areas that have recently had new coronavirus cases.

Travel

If you're planning to travel internationally, first check travel advisories. You may also want to talk with your doctor if you have health conditions that make you more susceptible to respiratory infections and complications.
Source: Mayo Clinic

Friday 28 February 2020

Through my eyes: Living with shoulder arthritis

You won’t be able to weightlift anymore.” That’s what my orthopedic surgeon told me when we sat down to discuss getting a total shoulder replacement, something that seemed necessary to relieve my shoulder pain and arthritis.
Though I have had a long and successful career as a homebuilder, powerlifting has always been my passion.
I have been powerlifting for about 15 years, competing on the world stage with more than 30 world records to my name.
In 2014, at the peak of my competitive powerlifting career, Kabuki Strength, the gym I co-own in Portland, OR, opened its doors for amateur-to-elite-level lifters. This began the venture that has had the largest impact on my performance, health, and overall life.
However, around this time, I was also suffering from intense shoulder pain and needed it to subside. But by that point, what had started as a hobby had become my passion.
Plus, I was only in my 60s. There was no way that I wanted to step away from it all, retire, and put an end to my powerlifting career.
So, I took a deep breath and told my doctor, “No.” I didn’t want a traditional total shoulder replacement. I refused to accept that I could not continue to lead an active lifestyle. Instead, I decided to do what I had been doing for decades:
I continued to work through the pain.
It wasn’t easy. All that training, especially the squats and deadlifts, were taking a toll.
Over time, the cartilage in both my left and right shoulder joints was wearing out. It was getting to the point that whenever I moved in certain ways, bone hit bone. My range of motion was becoming increasingly limited, and I was often in pain.
Outside of the gym, even simple, everyday tasks were becoming more difficult. You don’t realize how much you use your shoulders until you’re in pain just from trying to put on a shirt.
The same goes for getting a dish from the top shelf of a kitchen cupboard or reaching to open the umbrella on a patio table; I found that ordinary tasks were starting to become challenges, and they usually left me grimacing in pain.
All of this wasn’t just annoying, it was also embarrassing. Here I was, a world-class powerlifter, and yet, whenever we were out in public, my wife had to help me put on my coat. With my limited range of motion, I couldn’t do anything like that by myself anymore.
Believe it or not, this went on for a few years. I continued to train as well as I could, but the deterioration of my shoulder cartilage only got worse. Finally, I decided that I had to take some kind of action, and I went back to my orthopedic surgeon to review my options.

Thursday 27 February 2020

Milk: Is it as healthful as we think?

Many people include milk in their diet, but few meet the daily recommended quantities. Experts now urge us to rethink these recommendations and explain why milk may not be as healthful as we think.
Dairy milk’s image has taken a bit of a beating, with the likes of oat, almond, and soy milk being hailed as environmentally friendly alternatives.
But for many people of all ages, cow’s milk remains a firm favorite —sloshed over cereal, as a frothy companion to coffee, or enjoyed as a bedtime drink. 
The United States 2015-2020 Dietary Guidelines recommend that individuals aged 9 years and over consume 3 cup-equivalents of fat-free and low-fat (1%) dairy products. According to the guideline, put together by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture, this includes milk, yogurt, cheese, and fortified soy milk. 
Yet the average amount of dairy that U.S. adults consume is around 1.6 cups each day, far short of the recommended levels. 
Does that mean we should all look to increase our dairy consumption? 
Experts writing in the New England Journal of Medicine do not think so. Instead, they call into question the quality of the evidence underpinning these recommendations and suggest alternative sources to provide us with the nutrients necessary for our health. 

Strength of evidence is ‘limited’

The debate about milk is, in fact, not a new one. 
Back in 2014, Connie M Weaver, emeritus professor and formerly the Head of the Department of Nutrition Science at Purdue University in West Lafayette, IN, wrote an article in The American Journal of Clinical Nutrition highlighting the lack of good quality evidence in support of dairy guidelines. 
In her article, which was, in part, funded by Danone Institute International, Weaver alludes to the historical reasons behind milk’s importance to our diet. 
“Dairy foods play a central role in most dietary guidance recommendations. They provide a package of essential nutrients and bioactive constituents for health that are difficult to obtain in diets with no or limited use of dairy products,” Weaver writes. 
Since the agricultural revolution, when energy sources shifted from plant foods relatively high in calcium in the diets of hunter-gatherers to cereal crops with low calcium content, the major source of dietary calcium has been milk,” she continues. 
Milk has featured in every iteration of the U.S. Dietary Guidelines since its first publication in 1917. Every 5 years, the Dietary Guidelines for Americans Advisory Committee updates the guide, reviewing the available evidence. 
Weaver references research that highlights how following a dairy-free diet in the context of a U.S.-style Western diet left adolescents aged 9 –18 years struggling to achieve the recommended intake of calcium. 
For the purpose of meeting daily nutrient intake, milk and cheese contribute “46.3% of calcium, 11.6% of potassium, and 7.9% of magnesium in the American diet.” 
Yet, when it comes to health overall, Weaver writes, “the strength of the evidence for dairy consumption and health is limited by the lack of appropriately powered randomized controlled trials.”

Human health and the environment

Fast forward to 2020, and a new review article in the New England Journal of Medicine picks up the argument. 
Dr. Walter C. Willett and Dr. David S. Ludwig, who both hold positions at Harvard T.H. Chain School of Public Health and Harvard Medical School in Boston, MA, discuss the merits of milk. They also pose questions about the possible risk that consuming it may carry.
Both Dr. Willett, a professor of epidemiology and nutrition, and Dr. Ludwig, an endocrinologist, declare no relevant conflicts of interest or industry sponsorship for their article. 
Medical News Today asked Dr. Willett why he is interested in studying the relationship between milk consumption and health. 
“This is an important topic because milk is one of few foods that are specifically part of dietary guidelines in the U.S. and many other countries, and the recommended amount in the U.S. (3 glasses per day or equivalent amounts of cheese or other dairy products) would make up a large part of an overall diet,” he explained. 
“However, studies over the last several decades have not clearly supported the need for such high intakes for prevention of fractures, which has been the main justification, and some concerns about harm have been raised,” he continued. “We thus thought an overview of evidence on risks and benefits would be useful.” 
But health is not Dr. Willett’s only concern. 
“Also, milk has a heavy environmental footprint, especially greenhouse gas production, and if everyone consumed 3 glasses per day, this would make avoiding extreme globally warming very difficult,” he elaborated. “This should be at least be considered when making decisions about production and consumption of milk.”

Wednesday 26 February 2020

How mitochondria respond to exercise, high fat die


Dubbed the powerhouses of the cell because they turn nutrients into energy, mitochondria are tiny organelles that live inside the cell and are key to metabolic health. New research offers fresh insights into how they work and what keeps them healthy.
Because of the role of the mitochondria in metabolic and overall health, previous research has suggested that dysfunction in these organelles may have implications in conditions such as obesity and diabetes.
Other conditions that mitochondrial dysfunction is involved in include age-related neurodegenerative conditions, such as Parkinson’s, Alzheimer’s, and Huntington’s disease.
In fact, mitochondrial dysfunction may be at the root of the aging process, in general. Although also disputed, the so-called mitochondrial-free radical theory of aging is a popular one, and more than one study has suggested that boosting mitochondria’s health can prevent cells from aging.
But what exactly keeps mitochondria in tip-top shape or makes them “unhealthy” remains unknown.
Previously, researchers thought that one molecular pathway that they called autophagy might offer precious clues to what keeps mitochondria healthy or makes them dysfunctional.
Autophagy — a word derived from ancient Greek to mean “self-eating” — is a “cellular survival pathway that recycles intracellular components to compensate for nutrient depletion and ensures the appropriate degradation of organelles.”
Therefore, it is key for the health of mitochondria, and previous studies have shown that exercise boosts autophagy, and the researchers believed that a high fat diet might impair the process.
The latest research looked at this pathway in mice and examined the ways in which exercise and a high fat diet affect it, as well as how these changes affect mitochondrial health.
Sarah Ehrlicher, a doctoral candidate in the College of Public Health and Human Sciences at Oregon State University in Corvallis, is the first author of the paper, which appears in the FASEB Journal.
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Bottom of Form
Ehrlicher and colleagues “stressed” the mitochondria of transgenic mice by making the animals exercise on a treadmill. Genetic alterations impaired their exercise-induced autophagy pathway.
The rodents were euthanized 36 hours after their last bout of exercise and 4 hours after their last meal, and the researchers examined the mitochondria in the rodents’ muscle cells.
What the team found was that despite the genetic modification and the added stress of exercise, the mitochondrial function of the mice’s muscles remained intact.
As a next step, Ehrlicher and colleagues fed the mice a high fat diet in addition to the exercise regimen to stress the mitochondria even more.
Again, the mice’s mitochondria showed signs of intact health and adaptation, even with the autophagy pathway blocked. This, explains the study’s lead author, suggests that the mitochondria have alternative ways to stimulate recycling and limit the damage.
Matt Robinson, a researcher in the same department as Ehrlicher and the last and corresponding author of the study, reports on the results.
He says, “[When] these animals were given a high fat diet, they got better at burning off those fats. If they were given just the exercise, they were able to make more mitochondria, which is good from an exercise perspective. And those adaptations seem to be very specific.”
The authors add that the findings elucidate more about how mitochondria work and what keeps them healthy.
The study “helps lay some future groundwork for how we can optimize (muscle and mitochondrial) health to promote their health with diseases like obesity, diabetes, even some implications with aging — conditions that we know have compromised mitochondria,” says Robinson.
Exercise may be one such way of optimizing mitochondrial and metabolic health. “Even without changes in weight, exercise has this amazing ability to improve metabolic health,” Ehrlicher says.
Obese mice do not seem to have an obvious pathway dysfunction in their mitochondria, and the muscles just seem to respond and adapt well to new stress, whether that is exercise or a high fat diet.

Tuesday 25 February 2020

Coronavirus: 81% of cases are 'mild,' study says


A new paper by the Chinese Centers for Disease Control and Prevention (CCDC) finds that the majority of coronavirus cases are mild, with older adults and people who have other conditions being most at risk.
CCDC’s Novel Coronavirus Pneumonia Emergency Response Epidemiology Team has conducted a study wherein they analyze all the confirmed coronavirus cases, as of February 11, 2020.
Experts have recently named the novel coronavirus SARS-CoV-2. The disease that infection with the virus causes is called COVID-19.
In the new study, the CCDC team extracted all the COVID-19 cases that China’s Infectious Disease Information System had recorded.
In their analysis, the scientists included the following:
  • a “summary of patient characteristics”
  • an analysis of viral spread by age and sex
  • a calculation of deaths and the “case fatality rate”
  • an analysis of viral spread over time and geographical space
  • an epidemiological curve, or visual display of the outbreak
  • a subgroup analysis of cases outside of China’s Hubei Province and “all cases among health workers nationwide”
The findings appear in the journal CCDC Weekly.
80.9% of the cases are ‘mild’
The researchers analyzed a total of 72,314 patient records, which included: “44,672 (61.8%) confirmed cases, 16,186 (22.4%) suspected cases, 10,567 (14.6%) clinically diagnosed cases,” and “889 asymptomatic cases (1.2%).”
Of the total number of individuals with confirmed cases, 80.9% were said to be “mild.” Most of the adults affected were between 30 and 79 years old.
Of the total number of confirmed cases, there were 1,023 fatalities, the equivalent of a death rate of 2.3%. The virus proved more fatal for men — 2.8% — than women — 1.7%.
Less deadly than SARS
Importantly, the study found that the case fatality rate rises with age. Specifically, up to the age of 39 years old, the fatality rate is 0.2%, at the age of 40, it is 0.4%, 1.3% for those in their 50s, 3.6% for people in their 60s, and finally, 8% for those in their 70s.
By comparison, the Severe Acute Respiratory Syndrome (SARS) that health experts have likened coronavirus to affected fewer people in 2002–2003, but the death rate was 14–15%, according to the World Health Organization (WHO).
In terms of the geotemporal spread of the virus, the study confirms that “COVID-19 spread outward from Hubei Province sometime after December 2019, and by February 11, 2020, 1,386 counties across all 31 provinces were affected.”
The study also found that people with cardiovascular disease were at the highest risk of death from coronavirus, followed by those with diabetes, chronic respiratory disease, hypertension, and cancer.
Furthermore, the authors note a “downward trend in the overall epidemic curve.”
The epidemic curve showed that the onset of symptoms “peaked around January 23–26, then began to decline, leading up to February 11,” they write.
They add that this suggests “that perhaps isolation of whole cities, broadcast of critical information (e.g., promoting handwashing, mask wearing, and care seeking) with high frequency through multiple channels, and mobilization of [a] multi-sector rapid response teams is helping to curb the epidemic.”


Monday 24 February 2020

Novel coronavirus: Your questions, answered

The current outbreak of infections with a novel type of coronavirus has sparked global anxiety and concern that the virus might spread too far and too fast and cause dramatic harm before health officials find a way to stop it. But what are the realities of the new coronavirus outbreak? We investigate.
What are the realities of the new coronavirus outbreak?
In December last year, reports started to emerge that a coronavirus that specialists had never before seen in humans had begun to spread among the population of Wuhan, a large city in the Chinese province of Hubei.
Since then, the virus has spread to other countries, both in and outside Asia, leading authorities to describe this as an outbreak. At the end of last month, the World Health Organization (WHO) declared the situation to be a public health emergency.
To date, the novel coronavirus — currently dubbed 2019-nCoV for short — has been responsible for 31,211 infections in China and 270 across 24 other world countries. In China, the virus has so far caused 637 deaths. It also led to one fatality in the Philippines.
But what do we really know about this virus? And how is it likely to affect the global population?
Medical News Today have contacted the WHO, used the information that public health organizations have offered, and looked at the newest studies that have featured in peer-reviewed journals to answer these and other questions from our readers.
1. What is the new virus?
2019-nCoV is a coronavirus. Coronaviruses are a family of viruses that target and affect mammals’ respiratory systems. According to their specific characteristics, there are four main “ranks” (genera) of coronaviruses, which are called alpha, beta, delta, and gamma.
Most of these only affect animals, but a few can also pass to humans. Those that are transmissible to humans belong to only two of these genera: alpha and beta.
Only two coronaviruses have previously caused global outbreaks. The first of these was the SARS coronavirus — responsible for severe acute respiratory syndrome (SARS) — which first started spreading back in 2002, also in China. The SARS virus epidemic primarily affected the populations of mainland China and Hong Kong, and it died off in 2003.
The other one was the MERS coronavirus — or Middle East respiratory syndrome coronavirus — which emerged in Saudi Arabia in 2012. This virus has affected at least 2,494 people since then.
2. Where did the virus originate?
When humans do become infected with a coronavirus, this typically happens via contact with an infected animal.
Some of the most common carriers are bats, although they do not typically transmit coronaviruses directly to humans. Instead, the transmission might occur via an “intermediary” animal, which will usually — though not always — be a domestic one.
The SARS coronavirus spread to humans via civet cats, while the MERS virus spread via dromedaries. However, it can be difficult to determine the animal from which a coronavirus infection first starts spreading.
In the case of the new coronavirus, initial reports from China tied the outbreak to a seafood market in central Wuhan. As a result, local authorities closed down the market on January 1.
However, later assessments have since suggested that this market was unlikely to be the single source of the coronavirus outbreak, as some of the people infected with the virus had not been frequenting the market.
Specialists have not yet been able to determine the true source of the virus or even confirm whether there was a single original reservoir.


Sunday 23 February 2020

What makes a healthy relationship?


W
hatever our take on Valentine’s Day, for those of us who are at all interested in pursuing romantic relationships, a key question remains: What makes a healthy relationship? In this feature, we give you an overview of what specialist studies have found.
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How can you build and maintain a happy relationship? We give you our top five tips.
“I’ve been making a list of the things they don’t teach you at school. They don’t teach you how to love somebody.”
So writes Neil Gaiman in the ninth volume of the comic book series The Sandman, “The Kindly Ones.”
Indeed, there is no single tried and true recipe for love and successful relationships that anyone can teach us. Different approaches work for different partnerships, and there is no point in trying to come up with strict guidelines for love.
Nevertheless, the reasons why relationship quality can deteriorate over time — or why relationships fail altogether — tend to be consistent.
Many researchers have studied what makes people leave a relationship, and what motivates them to stay together.
In this feature, we give you our top research-backed tips on what to look out for in building a meaningful, healthy, happy relationship.

1. Start your relationship with purpose

First of all, research suggests that there may be some truth to the phrase “start as you mean to go on” when it comes to relationships.
Recent studies suggest that, in many cases, people who are dating end up “falling” into a committed relationship out of a sense of inertia, and couples may end up living together even when they are unsure if they belong together.
“[M]any, if not most, couples slide from noncohabitation to cohabitation before fully realizing what is happening; it is often a nondeliberative and incremental process,” report researchers from the University of Denver in Colorado.
For instance, someone may end up deciding to move in, and, maybe, eventually, marry their partner simply because they have already spent a significant amount of time together and established a bond.
This can happen — argue dating and relationships researchers Samantha Joel, Ph.D., and Prof. Paul Eastwick — even when one or both partners are convinced, at the start of their relationship, that they are not necessarily well suited to each other.
Medical News Today spoke to Alex Psaila, clinical supervisor at Relate North and South West Sussex, a United Kingdom-based registered charity that provide relationship support and mediation. We asked him about early “red flags” that people may want to remember when starting a new relationship.
Blind love, he told us, can prevent individuals from acknowledging possible issues and personality clashes. It can also make them think that — no matter how bothersome some of their new partner’s behaviors might be — these will likely change with time. Not so, said Psaila:
“Does anyone go into a relationship with the idea that this relationship is flawed? If we are aware of something [being not quite right], we might tell ourselves that ‘we’ll fix it’ […] For the most part ‘being in love’ is like Cupid — blind — and we gloss over potential difficulties, wanting to believe it will go away and love will conquer all.
Joel and Prof. Eastwick argue that if people took more time to do some — potentially difficult — soul searching before committing to a relationship, they might be able to avoid entering a situation that will prove unsatisfactory for both partners in the long run.
We should, that is, start new relationships with a sense of purpose, really thinking about what we want and need, and if the person we are dating is truly likely to align with those wants and needs — and we with theirs.
“People may be able to boost their own relational, health, and well-being trajectories by more selectively choosing and investing in new relationships that are right for them and rejecting those that are not right for them,” write Joel and Prof. Eastwick.
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2. Communicate to solve conflict

As with anything, open communication is necessary when it comes to building and maintaining a healthy relationship.
And in a long-term relationship, calm, open, and constructive communication is essential when it comes to solving conflict since no interpersonal bond ever comes truly free from conflict.
“Stress can arise in relationships when partners experience conflicting goals, motives and preferences,” write Profs Nickola Overall and James McNulty in a recent study about communication during conflict.
The possible reasons for conflict in a romantic relationship can vary widely, and Profs Overall and McNulty cite unmet expectations, financial difficulties, the distribution of responsibilities, parenting styles, and jealousy, among others.
“Unresolved conflicts and the stress associated with conflict put even the most satisfying relationship at risk. Moreover, managing and resolving conflict is difficult, and can itself be a significant source of stress,” they note.
So what is the best way to communicate when it comes to solving conflicts in an intimate relationship?
According to the researchers, it depends. However, burying one’s feelings and misgivings, and brushing disagreements quickly under the carpet is unlikely to help, they say.
Profs Overall and McNulty suggest that it is crucial for couples first to evaluate the context in which the conflict has arisen in order to decide how best to address it.
When a serious issue is at stake, the researchers explain, it is important for both partners to express their opposing views and negotiate the direction of change.
However, if the couple is having disagreements about minor issues, or issues outside their control, it may be more helpful for them to acknowledge the problem but express mutual validation, affection, and forgiveness.
Psaila expressed a similar perspective to MNT. People who maintain healthy, happy relationships, he says, “say sorry and make reparation [when they acknowledge that they have done something hurtful].”
However, Psaila adds, they “do not hang on to secretive, hidden shame,” following a discordant situation.
“They learn from mistakes and know that awareness of their vulnerability is a strength. They can and will seek help and advice from trusted relatives, friends, mentors (even [trained] counselors).
– Alex Psaila
Psaila also notes that people who want their relationship to thrive also show openness to receiving support from a professional therapist, not just when things go wrong, but to make sure they stay the course.

3. Make time for couple activities

Life can sometimes get in the way of our spending time with the people we love, even when we share a living space. The demands of work, for instance, can leave us little time — and sometimes little energy — to do something enjoyable with our partners.
Yet research shows that couples who participate in fun activities together may also find it easier to stay together.
For instance, one study covered on MNT last year suggested that couples who make time to play board games together also had a good quality love life.
The study found a simple reason for this correlation: Partners who took part in these fun activities together saw an increase in oxytocin, the “love hormone,” so-called because it plays a key role in bonding behaviors.
Karen Melton, Ph.D., and her colleagues — who conducted the board games study — note that, for a couple’s activity to lead to the spike in oxytocin, it likely should involve interaction between the partners.
Simply attending an event together but not interacting, for instance, may not have the same bonding effect.
The researchers also found that the novelty factor influenced how much oxytocin they released: Couples who organized their fun activity in a new place outside their home saw a greater “love hormone” boost than those who played at home.
The takeaway? Doing fun things, ideally in new, unfamiliar surroundings, might help maintain relationship quality.

4. Carve your own space

Although spending quality time with your loved ones is essential, it is at least as important to spend quality time on our own — and allow partners to do the same.
“A healthy relationship is a bit like breathing in and then breathing out,” Psaila explained for MNT.
“There is a cycle of closeness and distance, of coming together, even merging and separation, individuation, [creating a] sense of self […] Both are important. If the relationship is too distant — little closeness — then the idea of seeking this elsewhere will arise (perhaps disguised as feeling abandoned and being unloved),” he noted.
Yet too much closeness can make a relationship feel like a trap and, taken to an extreme — if a partner gradually isolates their “significant other” from friends, family, and activities that they enjoy — could even be a mark of emotional abuse.
“If the relationship is too close, suffocating even, then the couple [becomes] merged and there is little scope for exploration and growth, of other interactions, of missing your loved one and wanting to return, bringing new ideas and energy into the relationship.
– Alex Psaila

5. Show attention and appreciation

While couples are at the beginning of their relationship, in the “honeymoon” phase, the partners will shower each other with affection and words of appreciation.
But often, as time goes on, partners may start taking each other for granted and forget to show the same kind of admiration they once did.
According to a study from 2017, one of the main reasons for long-term couples splitting up was that one of the partners was no longer showing enough affection and attention to the other.
And a study from 2018 found that young adults — aged 18–29 — who perceived that their partner put a similar effort into initiating text conversations also reported greater relationship satisfaction.
Other research has shown that women who reported being satisfied in their romantic relationships also reported that their partners were appreciative of their bodies. And, they reported increased satisfaction with their sex lives.
Finally, although material gifts are not a measure of love in any relationship, some studies have shown that when a partner can and does offer gifts, this can contribute to relationship satisfaction if done correctly.
Research from last year suggests that for a gift to increase relationship satisfaction, it has to be well thought out. The gifts we offer to others, the researchers explain, can reflect the image they have of themselves or the image we have of them.
If the two do not coincide, then it is likely that the gift we pick will be disappointing to the receiver. But, the researchers say, if we know our partners well, we will manage to pick a gift that truly fits in with their personality and hobbies — and will reflect positively on our relationship.
No matter how you choose to show your affection, though, expressing your appreciation of your significant other — and not just on Valentine’s Day — is a safe bet when it comes to maintaining relationship quality.
However, even if you put in all the effort you can muster into a romantic relationship, sometimes, it will not work out, and that should necessarily be a cause for regret.
If a relationship does not make you feel happy, secure, and valued, it may be time to turn your attention to yourself and invest more in some self-love before you decide how or whether to start afresh with someone new.

Source: MedicalNewsToday