Thirteen quick things to change your life today

19 08 2012

If our lives are the sum of things we do, then changing what we do can change our lives, one moment at a time. Here are thirteen things that can be easily achieved.

1. Exercise. If you are currently doing nothing, then ten minutes exercise will make a difference. If you are already exercising, make it an extra ten minutes.

2. Wear sunblock. Australians have the highest rate of skin cancer in the world, so as a red-head growing up in Australia, I know what I am talking about! Sun block is not only the one thing most guaranteed to keep you looking young, it may also save your life.

3. Eat some vegetables. Preferably green and leafy ones. A variety of fresh vegetables will keep you healthier and help with weight control.

4. Do the hard thing first. There is probably something you have been putting off, some emotionally challenging thing. Do it. Delaying doesn’t make it any better (in fact it usually makes it worse), and having it dragging around your neck doesn’t help your enjoyment of life now.

5. Act As If. A psychological principle whereby you can trick your brain into believing you are what you want to be. Smile, and your brain will think you are happy, and studies say you will start to feel happier. Michelangelo decided he was the world’s best artist years before he achieved it, but having this image meant he accepted the big projects (Sistine Chapel) that made his dream a reality.

6. Get organised. But don’t be overwhelmed. If your house is a mess, try scheduling fifteen minutes a day to do one room each day. Fifteen minutes is achievable and not overwhelming.

7. Stand up! Studies show that the more you sit down during the day, the earlier you die. It is now possible to get a desk to work at standing up.

8. Make time for a friend. Our lives can become very isolated a we get busier. Make time to enjoy others.

9. Have some downtime. Meditation is ideal, but even if you don’t know how to, have some quiet thinking time in a peaceful place. It doesn’t matter if you all asleep.

10. Get enough sleep. While we don’t really know he purpose of sleep, we o know it is necessary. Regular, sufficient sleep rejuvenated the body and mind, helps us think straight, manage our emotions, and have enough physical energy to exercise, dal with cravings and look after ourselves.

11. Give up one bad habit now. One less cigarette, one less biscuit, one less alcoholic drink – one less s a good thing. Then build on it.

12. Drink water. Water helps flush toxins from the body, helps control hunger, helps develop healthy skin and organs, and can help resolve headaches (some headaches are related to dehydration).

13. Live your life one moment at a time. (thanks to Maggie for this one). If losing weight, getting fit, finishing your study, tidying your house etc is too much, don’t think of he big goal. Just make he best decision for now. Faced with a range of lunch options, pick the healthy one now. How will you spend the next ten minutes?





Travel places to avoid

30 04 2012

Some people collect countries like scalps. And not every country has the same value. The more touristy, the less value. The more perceived danger, the more value. Even if you missed the “danger” period by a decade or more. And so I claim Egypt, Kenya, Zimbabwe, South Africa – more exotic and exciting than England, New Zealand, Singapore (but no less enjoyable). We did manage to time our visit to Egypt six months after the hand grenade attack on the tourist bus outside the Cairo Museum, and six months before the machine-gun attack on the tomb of Hat-sep-Chut (which I know I have misspelled). The most exciting thing that occurred while we were in Egypt was the 18-year-old armed youth on National Service as tourist police who tried to pick me up in the Cairo Museum (“Come with me and I’ll show you the Tomb of Ramses II” – an original line, if nothing else.) The fact that I was walking with my boyfriend seemed to be irrelevant. (NB: Tourist Police are supposed to guard the tourists – most of them seemed to be 18, carrying loaded weapons and on National Service. Their impressions of western women – and I generalise here – seemed to be somewhat jaundiced. While as Australians, we were somewhat nervous being watched and guarded by armed guards, the South Africans we were travelling with were relieved and said they would be much less comfortable of the guards had not been there.)

The following picture was sent to me at work. I can’t quite work out the “logic” or criteria for allocating each cause of death to each country, but I note that China does not feature as having a notable cause of death. Perhaps the source of their longevity? Not sure the same can be said for much of Central Africa, which also appears not to have any specific notable deaths. And in sheer numbers, shark attacks really do not feature that highly in Australia, despite what we might tell tourists. (Diabetes, cardio-vascular disease and cancer feature more highly, as in many western countries, including England, another notable left off the list.)

And seriously – death by lawnmower in the US? Is that not an episode of Six Feet Under?

Like some more Australian KULCHA (culture) abroad? Try Australians abroad.





Social media virus – recovery mode

26 02 2012

You may remember the particularly bizarre version of alleged mass hysteria allegedly being spread via social media in a New York High School. A group of about 12 teenage girls and one female adult had come down with a bizarre Tourette’s-like illness characterised by ticks, twitching and uncontrolled verbal outbursts. The girls had been posting videos of themselves on Youtube and authorities were concerned that this was a form of transmission for what they believed to be a conversion disorder. To be clear – this doesn’t mean that they are faking the symptoms, only that the symptoms are psychological in origin. We humans are suggestible beings.

Well, it appears that as mysteriously as it began, victims are recovering. But just as the cause was the subject of speculation and disagreement, so is the treatment. Nothing like a mysterious epidemic affecting teenage girls to bring out the feeding frenzy – medical and media.

Some girls are recovering after behavioural modification, psychological help and medication for anti-anxiety, depression and headaches by Dr. Laszlo Mechtler, medical director at DENT Neurologic Institute in western New York. Others have been treated with antibiotics after being diagnosed with PANDAS – Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections by Dr. Rosario Trifiletti, a child neurologist from New Jersey. And as with all good stories, it is not clear how many girls are being treated in each treatment group, or the recovery rates for each group. Both groups claim success.

Well-known environmental campaigner Erin Brokovich has also been on the case investigating whether cyanide and trichloroethylene (TCE) that was spilled a few miles from the school following a train wreck in December 1970. Parents invited Ms Brokovich to investigate environmental options after disputing psychological causes. The State Health Department had done soil testing and testing on the building, as well as considering illegal drugs and infectious diseases when the symptoms first emerged and announced negative results. I guess given her well-publicised background, Ms Brokovich probably doesn’t want to take that at face value. Her team will continue testing samples from around the school after being denied permission to take samples on school grounds.

(TCE exposure does have recognised psychological side-effects although they do not closely correlate with the reported symptoms of the girls. TCE affects the central nervous system and can cause drowsiness, difficulty moving and headaches. Psychological effects of cyanide include sluggishness, convulsions, coma. No information was found in my brief search regarding the combination of TCE and Cyanide on the nervous system.)

However, the question has to be asked – if it is due to environmental toxins from the train wreck, why now 41 years later, why only a few girls at the high school (not boys, not even all the girls, not the whole school, not teachers who may have taught there for many years and would presumably have had a much greater exposure to any environmental toxins). And if it is PANDAS – why is this surely quite rare side effect of strep throat suddenly showing up in a larger than usual number of cases?

If, as it seems from reading about this case and from my non-clinical standpoint, the diagnosis of mass hysteria turns out to be correct, despite the unpalatableness of a psychological cause to some students and parents, the up-side is that it is recoverable. So while it is important to ensure there is nothing more sinister going on and there are no toxins or other disease mechanisms causing this illness, a treatable psychological diagnosis would be the best outcome for those affected. And a level of anonymity that has perhaps not been happening so far with the posting of You-tube videos and the media attention.





Citizen juries

22 02 2012

photo credit: D-G-Seamon

Since my last post on the impact of social media on the jury system, I have been thinking about the concept of juries. Clearly from the examples given, there are some not-very-bright people being chosen for this very important task. These people, who hold the fate of another in their decision-making process, didn’t have enough common sense to not comment on cases on social media, not contact defendants and other participants in the trial via social media, or in one instance, to not brag about escaping jury duty on social media. And the woman who used a Facebook Poll to help her decide about a defendant’s guilt – words escape me. Quite frankly if I had been involved in any of these trials I would probably have been glad to see the back of these people.

So does the jury system stack up? Twelve people randomly selected from the eligible adult population, panelled to hear evidence which may be of a highly technical nature, in an adversary system. Shouldn’t there be an IQ test? Perhaps expert jurors who know and understand the law might be a better option? And why twelve? Presumably it is a small enough number that a decision might actually be reached, yet still large enough to allow for the….hmmm, shall we say “outliers”? A large enough number for any extremist views and crackpots to be ameliorated by the others. And then of course they do try to screen out the true crackpots and those with vested interests and strong prejudices.

Now I am not a lawyer, nor do I work in the legal system, but I have come across the concept of citizen juries in the health system. And this might restore all of our faith in the system.

Citizen Juries in health decision-making are provided with a variety of unbiased information such as costs of alternate treatments, population numbers and demographics, health statistics, epidemiology (how many people are affected by a particular illness or disease). This information should be unbiased and factual in nature, not opinion-based. In this way it does differ from the adversarial legal system where the two sides of the case are presented by the legal teams who are paid to present a particular point of view. Citizen juries are randomly selected, and are often paid a small stipend for their time.

WA Health Economist Professor Gavin Mooney has trialled the use of Citizen Juries as a way of increasing public participation in the health care system, and more importantly, in the prioritising of health care expenditure. With Australia’s ageing population increasingly calling on the health system for lifestyle and age-related diseases, increased expectations of the population in general that medical care can and will do everything to resolve their illnesses, and the technological and pharmaceutical boom which is creating more and more high-end expensive treatments and diagnostics, our health budget is unable to keep pace. Many years ago I saw a statistic that showed if the South Australian health budget continued to grow at its (then) current rate, it would absorb the entire state budget by 2032. Clearly that is not viable.

So somehow as a society we need to make decisions about what health services we do and do not want to provide on the public purse. So for instance, we make decisions between relatively cheap treatments that might improve the health of millions of people versus an extremely expensive treatment for a disease or condition that occurs for one in 20 million people. And between prevention strategies and emergency care (keeping in mind that the stats for health run at ~$1 prevention saves ~$9 cure later on). And between groups in the community already at considerable health disadvantage – for instance Aboriginal and Torres Strait Islander people – and other groups that already have a longer health expectancy and have access to resources to assist themselves in remaining healthy. And between those groups that we have compassion and sympathy for – for instance premature babies – and those that we feel less compassionate about – for instance those we consider to have caused their own illnesses.

Now of course, when you yourself are unwell, you want everything possible done, so these decisions need to be made in advance and in a theoretical framework. Prof. Mooney has facilitated seven such exercises in Australia: “two at a state-wide level in WA (one on health care in general and the other specifically on equity); one in an area health service; three in general practice and primary health care; and one in an Aboriginal health service”, and has published a free handbook on Citizen Juries, which is available here. In the handbook Prof Mooney is careful to point out that the juries are developing broad principles and priorities to inform the decision-making rather than specific decisions and allocations of dollars.

So do they work? From what I have read, and in my opinion yes, but it has to be noted that this is at least because (disclaimer here) the decisions the juries came to concur with my own opinions. The following excerpts are from the handbook:

in each of the citizens’ juries I have facilitated, greater equity has been identified as a priority. The citizens consistently want a better deal for the disadvantaged, especially Aboriginal people. They also have some concerns for other disadvantaged groups and want a shift to more prevention and away from cure.

and the handbook gives a specific example of a 2005 jury identifying as priorities:

the principles of greater transparency in decision-making, greater equity, more prevention and increased resources for mental health. To achieve this, they were willing to give up some small inefficient hospitals and Emergency Departments.

(And just to be clear, decision-making in health doesn’t mean cutting out all emergency services and redirecting all funding to prevention – it is a balance of the priorities across numerous very valid and deserving services.)

These are not the priorities you would come to if you based your judgement on the television news or the front page of the newspaper, but (IMHO) they are the priorities you would choose if you saw the statistics on effectiveness and took a long-term view of population health.

Bravo!

Want more information? Prof Mooney’s website has links and his contact details.





How to make your doctor VERY happy!

15 02 2012

picture credit Jacob T_98


(For those who need to be told – yes, that was sarcasm.)

When I used to work in the health sector, we had a phenomena called the “heart-sink patient”. I am sure they still exist. Everyone working front-line knew what this phrase meant.

The heart-sink patient was the patient who, when the doctor went to the waiting room to call the next patient, literally made the doctor’s heart sink.

Them. Again.

Now there were a few sub-categories of heart-sink patient. There were those who had a genuine condition that defeated all attempts at diagnosis or treatment – frustrating and reminding the doctor of their own fallibility and limitations. There were those who had unrealistic expectations – either for instantaneous cures, or who medicalised the ageing process and wanted it stopped. There were those who had self-inflicted illnesses and refused to address the underlying cause – leaving the doctor to do ongoing patch-up medicine, knowing that the illness was only getting worse (for example uncontrolled diabetes). And of course there were the drug-seeking patients, many of whom were highly manipulative, disruptive and unpleasant.

I suspect there is now an additional category. The Google patient. When I left the health sector this was already quite prevalent – the patient who came in having looked up their symptoms on the internet and done a self-diagnosis. Sometimes they come in quite panicked, having diagnosed terminal illness. Sometimes they would come in demanding irrelevant and expensive tests for some highly improbably diagnosis, or requesting a prescription for a drug without having any form of examination or investigation (not going to happen). Either way, it made consultations longer – although, I am told – sometimes more interesting. And of course sometimes Google had managed to give them a correct diagnosis.

Given a list of symptoms, we are quite capable of generating those symptoms in ourselves. Remember when someone at work had a raging flu and you started to feel an itchy throat and snuffly sinuses – and it went away the next day? Let’s be nice and call it empathy taken to the next level. Well, reading about symptoms and illnesses can have the same effect. Author Jon Ronsson looked at the DSM IV – the diagnostic manual for psychiatric illnesses – for his book The Psychopath Test: A Journey Through the Madness Industry and diagnosed himself with twelve of the conditions. Now I don’t know the man, so I can’t be sure he doesn’t actually have any of these conditions, but I suspect he is just identifying with the symptoms listed. We human beings are so suggestible!

However Google is now helpfully taking this to a new level. Using search algorithms, if you type in symptoms – say “stomach pain on right side”, they will suggest a series of possible options – appendicitis, ovarian cyst, etc. Google is very clear that these lists are not compiled by medical practitioners and they are also not offering these as diagnoses. Just linked searches. They would not want to be getting involved in the convoluted world of medical liability.

So will Google’s new search function aid access to reasonable diagnostic options? Will they screen out the quackery the way Google Scholar (for the most part) screens out the opinion and focuses on peer-reviewed journals? Will this aid doctors, or by using search algorithms are they potentially funneling people and their diagnosis down the most common options – after all, someone has to have the bizarre and very rare illness.

The danger is, I suspect, if the patient having done a quick self-diagnosis on the web (and no matter whether Google says it’s a diagnosis or not, that is how patients will consider the information), then subconsciously edits or reframes their symptoms to fit their self-pre-determined diagnosis when they visit the doctor (because we all like to be right), then the doctor may also be funnelled into making an incorrect diagnosis based on the biased infromation s/he is presented with.

As they say, medicine is as much art as science.

Google’s Chief Health Strategist Dr Roni Zeiger’s blog post on this issue is here.





How important is play?

13 02 2012

photo credit Jeremyiah

Parents and teachers will have been indoctrinated into the concept of play as a learning tool. It is important (we are told) for young children to have play-time in order to develop – gross motor skills, fine motor skills, social skills and an understanding of how to world works. Children who have been deprived of this opportunity (think of the terrible plight of Romanian orphans in the 1980s) have significant deficits in both their older childhood and their adulthood. Not to say that these things can’t be overcome, but the experiences of the child at an age when their brain connections are still forming can set the dominant and used connections for life. It’s pretty tough for an old brain to learn new tricks (connections).

For first-world parents, of course, this translates into guilt. Are you providing the right kind of play experiences? Are you providing the right kind of educational toys? Is your child hitting all of their milestones at the right time? Ka-ching, Ka-ching – the multinational toy companies know what you are thinking and they know how to press your buttons! (Click here for suggestions of the sorts of toys from which children really benefit. )

However a couple of recent articles have indicated how ingrained the concept of play is, and how it has played a survival function in evolution. Leading “play studies” scientist (there’s another job I want!) and author of Play: How it Shapes the Brain, Opens the Imagination, and Invigorates the Soul, Stuart Brown theorises that evolution favours those animals that are able to produce additional superfluous neural connections (eg through play) – connections that just might come in handy some time. Play keeps the brain flexible and helps it to think laterally and problem-solve. It helps you to develop courage and confidence to try new thinks

Author and former Professor of Ecology and Evolutionary Biology at the University of Colorado, Dr Marc Bekoff says animals have rules about when and how to play. The rules are as follows:

1.Everyone must want to play.
2.Everyone has to cooperate — they work together — to keep the game from becoming fighting. (NOte to my children: wild animals know the difference between playing and fighting…..)
3.Everyone needs to communicate and pay attention to each other’s movements, sounds and smells.

Put that way, it’s obvious what benefit a senseless and trivial activity like play must have for animals – and humans. Play behaviour has been observed in mammals, reptiles, insects and fish – and probably other categories of animals as well.

The second play article that crossed my desk in the last two days is about starving polar bears playing with a sled dog (as opposed to eating it). As well as featuring a video link of starving wild polar bears playing with sled dogs, this article also refers to evidence that animals that play tend to live longer and pass on their genes. (Of course it is also possible that animals that play are more attractive to the opposite sex….. but that’s just my take on things, not anything scientifically based!)

Play Scientist Stuart Brown’s book is available here: Play: How it Shapes the Brain, Opens the Imagination, and Invigorates the Soul

Interested in Neuroscience? Can I recommend the following book by UK neuroscientist Baroness Susan Greenfield: Tomorrow’s People: How 21st-Century Technology Is Changing the Way We Think and Feel





Fizzics and Chemistry: How to drink Champagne

10 02 2012

photo credit : Ross

First a disclaimer. I have borrowed that headline from the Daily Mail, because it I love a good pun!

Now, down to the important business at hand.

A study conducted at the University of Reims in France has found that champagne does actually taste better in a tall flute than in a saucer-shaped glass. Something to do with the flavour-enhancing bubbles (CO2) being better promoted in the flute. Apparently there are up to 30% more flavour-enhancing substances in the bubbles than in the rest of the drink. So Marilyn Monroe and Marie-Antoinette were wrong.

And decreasing the temperature of the champagne does not affect the amount of carbon dioxide in the champagne. However, colder champagne loses less CO2 when it is poured, hence being cold does make it taste better.

So now you know exactly how best to drink champagne. Cold, and in a flute.

I wonder if there any other such studies that I could get involved in? I feel a new career coming on!

Anyway, if this is your – I was going to say cup of tea, but obviously that is the wrong beverage – “thing”, here are the links to a couple of the important studies.

Champagne tastes better in flutes
Thermography shows how to pour champagne (Editor’s note: finally a genuine use for thermography!)

photo credit: Christmasstockimages.com