
13 Things Mentally Strong Couples Don’t Do – by Dr. Amy Morin
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The saying “happy wife; happy life” indeed goes regardless of gender. One can have every other happiness, but if there’s relational trouble, it brings everything else down.
This book is not intended, however, only for people whose relationships are one couple’s therapy session away from divorce. Rather, it’s intended as a preventative. Because, in this as in every other aspect of health, prevention is better than cure!
It is the sign of a strong couple to be proactive about the health of the relationship, and work together to build and reinforce things along the way.
The style of this book is very accessible pop-science, but the author speaks from a strong professional background in social work, psychology, and psychotherapy, and it shows.
Bottom line: if you’d like to strengthen your relationship skills, this book gives 13 great ways to do that.
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Treat Your Own Back – by Robin McKenzie
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A quick note about the author first: he’s a physiotherapist and not a doctor, but with over 40 years of practice to his name and 33 letters after his name (CNZM OBE FCSP (Hon) FNZSP (Hon) Dip MDT Dip MT), he seems to know his stuff. And certainly, if you visit any physiotherapist, they will probably have some of his books on their own shelves.
This book is intended for the layperson, and as such, explains everything that you need to know, in order to diagnose and treat your back. To this end, he includes assorted tests to perform, a lot of details about various possible back conditions, and then exercises to fix it, i.e. fix whatever you have now learned that the problem is, in your case (if indeed you didn’t know for sure already).
Of course, not everything can be treated by exercises, and he does point to what other things may be necessary in those cases, but for the majority, a significant improvement (if not outright symptom-free status) can be enjoyed by applying the techniques described in this book.
Bottom line: for most people, this book gives you the tools required to do exactly what the title says.
Click here to check out Treat Your Own Back, and treat your own back!
PS: if your issue is not with your back, we recommend you check out his other books in the series (neck, shoulder, hip, knee, ankle) 😎
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How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise
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A growing number of complaints against older doctors has prompted the Medical Board of Australia to announce today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table.
The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine.
The second would require only general health checks for doctors over 70.
A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their professional code of conduct, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo.
PeopleImages.com – Yuri A/Shutterstock Haven’t we moved on from set retirement ages?
It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “still valid in a modern society”.
However, unlike judges, doctors are already required to renew their registration annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct performance assessments if and when they are needed.
What has prompted these proposals?
This latest proposal identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years.
Studies of medical competence in ageing doctors show variable results. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour.
The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors.
In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.
In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015.
While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate.
It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients.
So what distinguishes the two new proposed options?
The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80.
Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions.
Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia.
The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia.
In practice, both of these proposals appear to allow doctors to manage their own general health confidentially.
Older surgeons could be independently assessed for dexterity, sight and the ability to give clinical instructions. worradirek/Shutterstock The law tends to prioritise patient safety
All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. That provision basically says patient safety is paramount and trumps all other considerations.
As with legal regimes regulating childcare, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional.
Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “punished” for errors in practice.
All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care.
Could these proposals amount to age discrimination?
It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws.
For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals who are “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”.
In broader terms, a licence to practise medicine is often compared to a licence to drive or pilot an aircraft. Despite claims of discrimination, New South Wales law requires older drivers to undergo a medical assessment every year; and similar requirements affect older pilots and air traffic controllers.
Where to from here?
When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different.
How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, others have suggested this would only exacerbate shortages in the health-care workforce.
The proposals are open for public comment until October 4.
Christopher Rudge, Law lecturer, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Most Annoying Nutrition Tips (7 Things That Actually Work)
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You can’t out-exercise a bad diet, and getting a good diet can be a challenge depending on your starting point. Here’s Cori Lefkowith’s unglamorous seven-point plan:
Step by step
Seven things to do:
- Start tracking first: track your food intake (as it is, without changing anything) without judgment to identify realistic areas for improvement.
- Add protein: add 10g of protein to three meals daily to improve satiety, aid fat loss, and retain muscle.
- Fiber swaps: swap foods for higher-fiber options where possible to improve gut health, improve heart health, support fat loss, and promote satiety.
- Hydration: take your body weight in kilograms (or half your body weight in pounds), then get that many ounces of water daily to support metabolism and reduce cravings.
- Calorie swaps: replace or reduce calorie-dense foods to create a small, modestly sustainable calorie deficit. Your body will still adjust to this after a while; that’s fine; it’s about a gradual reduction.
- Tweak and adjust: regularly reassess and adjust your diet and habits to fit your lifestyle and progress.
- Guard against complacency: track consistently, and stay on course.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
The Smartest Way To Get To 20% Body Fat (Or 10% For Men)
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The BAT-pause!
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When Cold Weather & The Menopause Battle It Out
You may know that (moderate, safe) exposure to the cold allows our body to convert our white and yellow fat into the much healthier brown fat—also called brown adipose tissue, or “BAT” to its friends.
If you didn’t already know that, then well, neither did scientists until about 15 years ago:
The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
You can read more about it here:
Cool Temperature Alters Human Fat and Metabolism
This is important, especially because the white fat that gets converted is the kind that makes up most visceral fat—the kind most associated with all-cause mortality:
Visceral Belly Fat & How To Lose It ← this is not the same as your subcutaneous fat, the kind that sits directly under your skin and keeps you warm; this is the fat that goes between your organs and of which we should only have a small amount!
The BAT-pause
It’s been known (since before the above discovery) that BAT production slows considerably as we get older. Not too shocking—after all, many metabolic functions slow as we get older, so why should fat regulation be any different?
But! Rodent studies found that this was tied less to age, but to ovarian function: rats who underwent ovariectomies suffered reduced BAT production, regardless of their age.
Naturally, it’s been difficult to recreate such studies in humans, because it’s difficult to find a large sample of young adults willing to have their ovaries whipped out (or even suppressed chemically) to see how badly their metabolism suffers as a result.
Nor can an observational study (for example, of people who incidentally have ovaries removed due to ovarian cancer) usefully be undertaken, because then the cancer itself and any additional cancer treatments would be confounding factors.
Perimenopausal study to the rescue!
A recent (published last month, at time of writing!) study looked at women around the age of menopause, but specifically in cohorts before and after, measuring BAT metabolism.
By dividing the participants into groups based on age and menopausal status, and dividing the post-menopausal group into “takes HRT” and “no HRT” groups, and dividing the pre-menopausal group into “normal ovarian function” and “ovarian production of estrogen suppressed to mimic slightly early menopause” groups (there’s a drug for that), and then having groups exposed to warm and cold temperatures, and measuring BAT metabolism in all cases, they were able to find…
It is about estrogen, not age!
You can read more about the study here:
“Good” fat metabolism changes tied to estrogen loss, not necessarily to aging, shows study
…and the study itself, here:
Brown adipose tissue metabolism in women is dependent on ovarian status
What does this mean for men?
This means nothing directly for (cis) men, sorry.
But to satisfy your likely curiosity: yes, testosterone does at least moderately suppress BAT metabolism—based on rodent studies, anyway, because again it’s difficult to find enough human volunteers willing to have their testicles removed for science (without there being other confounding variables in play, anyway):
Testosterone reduces metabolic brown fat activity in male mice
So, that’s bad per se, but there isn’t much to be done about it, since the rest of your (addressing our male readers here) metabolism runs on testosterone, as do many of your bodily functions, and you would suffer many unwanted effects without it.
However, as men do typically have notably less body fat in general than women (this is regulated by hormones), the effects of changes in BAT metabolism are rather less pronounced in men (per testosterone level changes) than in women (per estrogen level changes), because there’s less overall fat to convert.
In summary…
While menopausal HRT is not necessarily a silver bullet to all metabolic problems, its BAT-maintaining ability is certainly one more thing in its favor.
See also:
Dr. Jen Gunter | What You Should Have Been Told About The Menopause Beforehand
Take care!
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Wouldn’t It Be Nice To Have Regenerative Superpowers?
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The Best-Laid Schemes of Mice and Medical Researchers…
This is Dr. Ellen Heber-Katz. She’s an internationally-renowned immunologist and regeneration biologist, but her perhaps greatest discovery was accidental.
Unlike in Robert Burns’ famous poem, this one has a happy ending!
But it did involve the best-laid schemes of mice and medical researchers, and how they did indeed “gang gagly“ (or in the English translation, “go awry”).
How it started…
Back in 1995, she was conducting autoimmune research, and doing a mouse study. Her post-doc assistant was assigned to punch holes in the ears of mice that had received an experimental treatment, to distinguish them from the control group.
However, when the mice were later checked, none of them had holes (nor even any indication there ever had been holes punched)—the experiment was ruined, though the post-doc swore she did her job correctly.
So, they had to start from scratch in the new year, but again, a second batch of mice repeated the trick. No holes, no wounds, no scarring, not disruption to their fur, no damage to the cartilage that had been punched through.
In a turn of events worthy of a superhero origin story, they discovered that their laboratory-made autoimmune disease had accidentally given the mice super-healing powers of regeneration.
In the animal kingdom, this is akin to a salamander growing a new tail, but it’s not something usually found in mammals.
Read: A New Murine Model for Mammalian Wound Repair and Regeneration
How it’s going…
Dr. Heber-Katz and colleagues took another 20 years of work to isolate hypoxia-inducible factor-1a (HIF-1a) as a critical molecule that, if blocked, would eliminate the regenerative response.
Further, a drug (which they went on to patent), 1,4-dihydrophenonthrolin-4-one-3-carboxylic acid (1,4-DPCA), chemically induced this regenerative power:
See: Drug-induced regeneration in adult mice
Another 5 years later, they found that this same drug can be used to stimulate the regrowth of bones, too:
And now…
The research is continuing. Here’s the latest, a little over a month ago:
Epithelial–mesenchymal transition: an organizing principle of mammalian regeneration
Regrowing nerves has also been added into the list of things the drug can do.
What about humans?
Superpowered mice are all very well and good, but when can we expect this in humans?
The next step is testing the drug in larger animals, which she hopes to do next year, followed eventually by studies in humans.
Read the latest:
Regrowing nerves and healing without scars? A scientist’s career-long quest comes closer to fruition
Very promising!
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Infections, Heart Failure, & More
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Some health news to round off the week:
The Infection That Leads To Heart Failure
It’s long been held that, for example, flossing reduces heart disease risk, with the hypothesis being that if plaque bacteria enter the blood stream, well, that’s an even worse place for plaque bacteria to be. Now, with much more data, attention has turned to
- actual infections, and
- actual heart failure
Way to up the ante! And, it holds true regardless of what kind of infection. So, you might think that a UTI, for example, is surely “downstream” and should not affect the heart, but it does. Because of this, researchers currently believe that it is not the infection itself, so much as the body’s inflammation response to infection, that leads to the heart failure. Which is reasonable, because, for example, atherosclerosis is made mostly not of cholesterol itself, but rather mostly of dead immune cells that got stuck in the cholesterol.
Moreover, it’s not so much about the acute inflammatory response (which is almost always a good thing, circumstantially), but rather that after cases where an infection managed to take hold, the immune system can then often stay on high alert for many years alter. Long COVID is an obvious recent example of this, but it’s hardly a new phenomenon; see for example post-polio syndrome, and consider how many more such post-infection maladies are likely to exist that never got a name because they flew under the radar or got diagnosed as fibromyalgia or something (fibromyalgia is a common diagnosis doctors give when they acknowledge something’s wrong, and it causes pain and exhaustion, but they don’t know what, and it appears to be stable—so while it can be helpful to put a name to the collection of symptoms, it’s a non-diagnosis diagnosis on the doctors’ part. It’s saying “I diagnose you with hurty tiredness”).
The take-away from all this? Avoid infections, for your heart’s sake, and if you do get an infection, take it seriously even if it’s minor. The safe amount of infection is “no infection”.
Read in full: Study uncovers new link between infections and heart failure
Cold Water Immersion: Hot Or Not?
The evidence is clear for some benefits; for others, not so much:
- It’s great (if you’re already in fair health, and definitely not if you have a heart condition) to improve circulation and stress response
- There may be some benefits to immune function, but however reasonable the hypothesis, actual evidence is thin on the ground
- The oft-hyped mood benefits are a) marginal b) short-lived, with benefits fading after 3 months of regular cold baths/showers/etc
Read in full: The big chill: Is cold-water immersion good for our health?
Related: Ice Baths: To Dip Or Not To Dip?
The Unspoken Trials Of Going To The Gym (While Being A Woman)
Public health decision-makers often think that getting people to go to the gym more is a matter of public information, or perhaps branding. Some who have their thinking heads on might even realize that there may be economic factors for many. But for women, there’s an additional factor—or rather, an additionally prominent factor. The study we’ll link started with this observation (please read it in the voice of your favorite nature documentary narrator):
❝Despite an increase in gym memberships, women are less active than men and little is known about the barriers women face when navigating gym spaces.❞
What then, of these shy, elusive creatures that make up a mere 51% of the world’s population?
A medium-sized (n=279) study of women, of whom 84% being current gym-goers, reported often feeling “judged for their appearance or performance, as well as having to fight for space in the gym and to be taken seriously, while navigating harassment and unsolicited comments from men”
Even gym attire becomes an issue:
❝Aligning with previous literature, women often chose attire based on comfort and functionality. However, their choices were also influenced by comparisons with others or fear of judgement for wearing non-branded attire or looking too put together. Many women also chose gym attire to hide perceived problem areas or avoid appearance concerns, including visible sweat stains.❞
…which main seem silly; you’re at the gym, of course you’re going to sweat, but if you’re the only one with visible sweat stains, then there can be social consequences (bad ones).
Similarly, there’s a “damned if you do; damned if you don’t” when it comes to working out while fat—on the one hand, society conflates fatness with laziness; on the other, it can be extra intimidating to be the only fat person in a gym full of people who look like they’re going to audition for a superhero movie.
❝In the gym, just like in other areas of life, women often feel stuck between being seen as ‘too much’ and ‘not enough’, dealing with judgement about how they look, how they perform, and even how much space they take up. Even though the pressure to be super thin is decreasing, the growing focus on being muscular and athletic is creating new challenges. It is pushing unrealistic standards that can negatively affect women’s body image and overall well-being.❞
Writer’s note: I live a few minutes walk from my nearest gym, and I work out at home instead. This way, if I want to do yoga in my pajamas, I can. If I want to use my treadmill naked and watch my T+A bounce in the mirror, I can. If I want to lift weights in the dress I happened to be wearing, I can. Alas that I can’t swim at home!
Read in full: Women face multiple barriers while exercising in gyms
Related: Body Image Dissatisfaction/Appreciation Across The Ages
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