Stop The World…

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Some news highlights from this week:

“US vs Them”?

With the US now set to lose its WHO membership, what does that mean for Americans? For most, the consequences will be indirect:

  • the nation’s scientists and institutions will be somewhat “left out in the cold” when it comes to international scientific collaboration in the field of health
  • the US will no longer enjoy a position of influence and power within the WHO, which organization’s reports and position statements have a lot of sway over the world’s health practices

Are there any benefits (of leaving the WHO) for Americans? Yes, there is one: the US will no longer be paying into the WHO’s budget, which means:

  • the US will save the 0.006% of the Federal budget that it was paying into the WHO annually
  • for the average American’s monthly budget, that means (if the saving is passed on) you’ll have an extra dime

However, since US scientific institutions will still need access to international data, likely that access will need to be paid separately, at a higher rate than US membership in WHO cost.

In short: it seems likely to go the way that Brexit did: “saving” on membership fees and then paying more for access to less.

Why is the US leaving again? The stated reasons were mainly twofold:

  1. the cost of US membership (the US’s contribution constituted 15% of the the overall WHO budget)
  2. holding the US’s disproportionately high COVID death rate (especially compared to countries such as China) to be a case of WHO mismanagement

Read in full: What losing WHO membership means for the U.S.

Related: What Would a Second Trump Presidency Look Like for Health Care? ← this was a speculative post by KFF Health News, last year

Halt, You’re Under A Breast

More seriously, this is about halting the metastasis of cancerous tumors in the breast. It is reasonable to expect the same principle and thus treatment may apply to other cancers too, but this is where the research is at for now (breast cancer research gets a lot of funding).

And, what principle and treatment is this, you ask? It’s about the foxglove-derived drug digoxin, and how it stops cancerous cells from forming clusters, and even actively dissolves clusters that have already formed. No clusters means no new tumors, which means no metastasis. No metastasis, in turn, means the cancer becomes much more treatable because it’s no longer a game of whack-a-mole; instead of spreading to other places, it’s a much more manageable case of “here’s the tumor, now let’s kill it with something”.

Note: yes, that does mean the tumor still needs killing by some other means—digoxin won’t do that, it “just” stops it from spreading while treatment is undertaken.

Read in full: Proof-of-concept study dissolves clusters of breast cancer cells to prevent metastases

Related: The Hormone Therapy That Reduces Breast Cancer Risk & More

Force Of Habit

“It takes 21 days to make a habit”, says popular lore. Popular is not, however, evidence-based:

❝This systematic review of 20 studies involving 2601 participants challenges the prevailing notion of rapid habit formation, revealing that health-related habits typically require 2–5 months to develop, with substantial individual variability ranging from 4 to 335 days. The meta-analysis demonstrated significant improvements in habit scores across various health behaviours, with key determinants including morning practices, personal choice, and behavioural characteristics

So, this is not a lottery, “maybe it will take until Tuesday, maybe it will take nearly a year”, so much as “there are important factors that seriously change how long a habit takes to become engrained, and here is what those factors are”.

Read in full: Study reveals healthy habits take longer than 21 days to set in

Related: How To Really Pick Up (And Keep!) Those Habits

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  • The Aesthetic Brain – by Dr. Anjan Chatterjee

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Anjan Chatterjee (not to be mistaken for Dr. Rangan Chatterjee, whose books we have also sometimes reviewed before) is a neurologist.

    A lot about aesthetics is easy enough to understand. We like physical features in humans that suggest a healthy mate, and we like lush and/or colorful plants that reassure us that we will have plenty to eat.

    But what about a beautiful building, or a charcoal drawing of some captivatingly eldritch horror? And what, neurologically speaking, is the difference between a bowl of fruit and a painting of a bowl of fruit? And what, if anything, does appreciation of such do for us?

    In this very readable pop-science book, we learn about these things and many more, from the perspective of an experienced neurologist who explains things simply but with plenty of science.

    Bottom line: if you’d like to understand how and why your brain does more things than just process tasks necessary for survival, this book will give you plenty of insight.

    Click here to check out The Aesthetic Brain, and learn more about yours!

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  • Walking can prevent low back pain, a new study shows

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly 70% of people who recover from an episode of low back pain will experience a new episode in the following year.

    The recurrent nature of low back pain is a major contributor to the enormous burden low back pain places on individuals and the health-care system.

    In our new study, published today in The Lancet, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.

    PeopleImages.com – Yuri A/Shutterstock

    The WalkBack trial

    We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).

    Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.

    The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.

    A health-care professional examines a woman's back.
    Low back pain can be debilitating. Karolina Kaboompics/Pexels

    The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.

    Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.

    People in the control group received no preventative treatment or education. This reflects what typically occurs after people recover from an episode of low back pain and are discharged from care.

    What the results showed

    We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.

    The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.

    Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.

    Two men walking and talking in a park.
    In our study, regular walking appeared to help with low back pain. PeopleImages.com – Yuri A/Shutterstock

    Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.

    This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.

    Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.

    Walking has multiple benefits

    We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost all previous studies have focused on treating episodes of pain, not preventing future back pain.

    A limited number of small studies have shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.

    On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.

    Two feet and lower legs in athletic gear walking alongside the water.
    Walking has a variety of advantages. Cast Of Thousands/Shutterstock

    Walking also delivers many other health benefits, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.

    While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participants reported that the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.

    Why is walking helpful for low back pain?

    We don’t know exactly why walking is effective for preventing back pain, but possible reasons could include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, which block pain signals between your body and brain – essentially turning down the dial on pain.

    It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly, no studies have investigated this.

    Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.

    Tash Pocovi, Postdoctoral research fellow, Department of Health Sciences, Macquarie University; Christine Lin, Professor, Institute for Musculoskeletal Health, University of Sydney; Mark Hancock, Professor of Physiotherapy, Macquarie University; Petra Graham, Associate Professor, School of Mathematical and Physical Sciences, Macquarie University, and Simon French, Professor of Musculoskeletal Disorders, Macquarie University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • 4 Critical Things Female Runners Should Know

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When it comes to keeping up performance in the face of menopause, Shona Hendricks has advice:

    Don’t let menopause run you down

    1. Prioritize recovery! Overtraining without adequate recovery just leads to decreased performance in the long term, and remember, you may not recover as quickly as you used to. If you’re still achey from your previous run, give it another day, or at least make it a lighter run.
    2. Slow down in easy and long runs! This isn’t “taking the easy way out”; it will improve your overall performance, reducing muscle damage, allowing for quicker recovery and ultimately better fitness gains.
    3. Focus on nutrition! And that means carbs too. A lot of people fighting menopausal weight gain reduce their intake of food, but without sufficient energy availability, you will not be able to run well. In particular, carbohydrates are vital for energy. Consume them sensibly and with fiber and proteins and fats rather than alone, but do consume them.
    4. Incorporate strength training! Your run is not “leg day” by itself. Furthermore, do whole-body strength training, to prevent injuries and improve overall performance. A strong core is particularly important.

    For more on each of these (and some bonus comments about mobility training for runners), enjoy:

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  • One Critical Mistake That Costs Seniors Their Mobility

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Will Harlow, the over-50s specialist physio, advises what to do instead:

    Nose over toes

    Often considered the most important test of mobility in later life (or in general, but later life is when it tends to decline) is the ability to get up off the floor without using your arms.

    Many seniors, meanwhile, struggle to get out of a chair without using their arms.

    Now, sitting in chairs in the first place is not good for the health, but that’s another matter and beyond the scope of today’s article.

    If, perchance, you struggle to get up from a chair (especially if it’s low/deep, like many armchairs are) without using your hands, then here’s the way to do it:

    1. While practicing, cross your arms in front of you, so that you cannot use them.
    2. Shuffle yourself towards the front of the chair. No, don’t use your arms for this either, do a little butt-walk instead, to get you to the front edge of the chair.
    3. Lean forwards to position your nose over your toes (hence the mnemonic: “nose over toes”; memorize that!), as this will put your center of gravity where it needs to be.
    4. Now, push with your feet to rise up and forwards; slowly is better than quickly (quickly may be easier, but slowly will improve your strength and balance).

    For more on all of this plus a visual demonstration, enjoy:

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    The Most Anti Aging Exercise

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  • Alpha, beta, theta: what are brain states and brain waves? And can we control them?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    There’s no shortage of apps and technology that claim to shift the brain into a “theta” state – said to help with relaxation, inward focus and sleep.

    But what exactly does it mean to change one’s “mental state”? And is that even possible? For now, the evidence remains murky. But our understanding of the brain is growing exponentially as our methods of investigation improve.

    Brain-measuring tech is evolving

    Currently, no single approach to imaging or measuring brain activity gives us the whole picture. What we “see” in the brain depends on which tool we use to “look”. There are myriad ways to do this, but each one comes with trade-offs.

    We learnt a lot about brain activity in the 1980s thanks to the advent of magnetic resonance imaging (MRI).

    Eventually we invented “functional MRI”, which allows us to link brain activity with certain functions or behaviours in real time by measuring the brain’s use of oxygenated blood during a task.

    We can also measure electrical activity using EEG (electroencephalography). This can accurately measure the timing of brain waves as they occur, but isn’t very accurate at identifying which specific areas of the brain they occur in.

    Alternatively, we can measure the brain’s response to magnetic stimulation. This is very accurate in terms of area and timing, but only as long as it’s close to the surface.

    What are brain states?

    All of our simple and complex behaviours, as well as our cognition (thoughts) have a foundation in brain activity, or “neural activity”. Neurons – the brain’s nerve cells – communicate by a sequence of electrical impulses and chemical signals called “neurotransmitters”.

    Neurons are very greedy for fuel from the blood and require a lot of support from companion cells. Hence, a lot of measurement of the site, amount and timing of brain activity is done via measuring electrical activity, neurotransmitter levels or blood flow.

    We can consider this activity at three levels. The first is a single-cell level, wherein individual neurons communicate. But measurement at this level is difficult (laboratory-based) and provides a limited picture.

    As such, we rely more on measurements done on a network level, where a series of neurons or networks are activated. Or, we measure whole-of-brain activity patterns which can incorporate one or more so-called “brain states”.

    According to a recent definition, brain states are “recurring activity patterns distributed across the brain that emerge from physiological or cognitive processes”. These states are functionally relevant, which means they are related to behaviour.

    Brain states involve the synchronisation of different brain regions, something that’s been most readily observed in animal models, usually rodents. Only now are we starting to see some evidence in human studies.

    Various kinds of states

    The most commonly-studied brain states in both rodents and humans are states of “arousal” and “resting”. You can picture these as various levels of alertness.

    Studies show environmental factors and activity influence our brain states. Activities or environments with high cognitive demands drive “attentional” brain states (so-called task-induced brain states) with increased connectivity. Examples of task-induced brain states include complex behaviours such as reward anticipation, mood, hunger and so on.

    In contrast, a brain state such as “mind-wandering” seems to be divorced from one’s environment and tasks. Dropping into daydreaming is, by definition, without connection to the real world.

    We can’t currently disentangle multiple “states” that exist in the brain at any given time and place. As mentioned earlier, this is because of the trade-offs that come with recording spatial (brain region) versus temporal (timing) brain activity.

    Brain states vs brain waves

    Brain state work can be couched in terms such as alpha, delta and so forth. However, this is actually referring to brain waves which specifically come from measuring brain activity using EEG.

    EEG picks up on changing electrical activity in the brain, which can be sorted into different frequencies (based on wavelength). Classically, these frequencies have had specific associations:

    • gamma is linked with states or tasks that require more focused concentration
    • beta is linked with higher anxiety and more active states, with attention often directed externally
    • alpha is linked with being very relaxed, and passive attention (such as listening quietly but not engaging)
    • theta is linked with deep relaxation and inward focus
    • and delta is linked with deep sleep.

    Brain wave patterns are used a lot to monitor sleep stages. When we fall asleep we go from drowsy, light attention that’s easily roused (alpha), to being relaxed and no longer alert (theta), to being deeply asleep (delta).

    Can we control our brain states?

    The question on many people’s minds is: can we judiciously and intentionally influence our brain states?

    For now, it’s likely too simplistic to suggest we can do this, as the actual mechanisms that influence brain states remain hard to detangle. Nonetheless, researchers are investigating everything from the use of drugs, to environmental cues, to practising mindfulness, meditation and sensory manipulation.

    Controversially, brain wave patterns are used in something called “neurofeedback” therapy. In these treatments, people are given feedback (such as visual or auditory) based on their brain wave activity and are then tasked with trying to maintain or change it. To stay in a required state they may be encouraged to control their thoughts, relax, or breathe in certain ways.

    The applications of this work are predominantly around mental health, including for individuals who have experienced trauma, or who have difficulty self-regulating – which may manifest as poor attention or emotional turbulence.

    However, although these techniques have intuitive appeal, they don’t account for the issue of multiple brain states being present at any given time. Overall, clinical studies have been largely inconclusive, and proponents of neurofeedback therapy remain frustrated by a lack of orthodox support.

    Other forms of neurofeedback are delivered by MRI-generated data. Participants engaging in mental tasks are given signals based on their neural activity, which they use to try and “up-regulate” (activate) regions of the brain involved in positive emotions. This could, for instance, be useful for helping people with depression.

    Another potential method claimed to purportedly change brain states involves different sensory inputs. Binaural beats are perhaps the most popular example, wherein two different wavelengths of sound are played in each ear. But the evidence for such techniques is similarly mixed.

    Treatments such as neurofeedback therapy are often very costly, and their success likely relies as much on the therapeutic relationship than the actual therapy.

    On the bright side, there’s no evidence these treatment do any harm – other than potentially delaying treatments which have been proven to be beneficial.The Conversation

    Susan Hillier, Professor: Neuroscience and Rehabilitation, University of South Australia

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Treat Your Own Hip – by Robin McKenzie

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We previously reviewed another book by this author in this series, “Treat Your Own Knee”, and today it’s the same deal, but for the hip.

    A quick note about the author first: 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.

    He takes the reader through first diagnosing the nature of the pain (and how to rule out, for example, a back problem manifesting as hip pain, rather than a hip problem per se—and points to his own “Treat Your Own Back” manual if it turns out that that’s your problem instead), and then treating it. A bold claim, the kind that many people’s lawyers don’t let them make, but once again, this guy is pretty much the expert when it comes to this. Ask any other physiotherapist, and they probably have several of his books on their shelf.

    The treatments recommend are tailored to the results of various diagnostic flowcharts; essentially troubleshooting your hip. However, they mainly consist of exercises (perhaps the greatest value of the book), and lifestyle adjustments (these ones, 10almonds readers probably know already, but a reminder never hurts).

    The explanations are thorough while still being comprehensible, and there is zero sensationalization or fluff. It is straight to the point, and clearly illustrated too with diagrams and photographs.

    Bottom line: if you’re looking for a “one-stop shop” for diagnosing and treating your bad hip, then this is it.

    Click here to check out Treat Your Own Hip, and indeed Treat Your Own Hip!

    PS: if you have musculoskeletal problems elsewhere in your body, you might want to check out the rest of his body parts series (neck, back, shoulder, wrist, knee, ankle) for the one that’s tailored to your specific problem.

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