Random Acts of Medicine – by Dr. Anupam Jena & Dr. Christopher Worsham

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We talked recently of small things that can change how productive your doctor’s appointment is, and this book is a more scientific version of that, and on a grander scale.

The author use what they call “natural experiments”, essentially observational studies, to determine what factors beyond the obvious affect health outcomes. With this approach, they address such questions as why kids with summer birthdays are more likely to get the flu, and why heart attack outcomes improve when there’s a cardiologists’ convention elsewhere. And many more such things that can seem like non-causal correlation, until one examines the causative factors, and controls (in the statistical analysis; remember this is still entirely observational, so no interventions are made) for other potential confounding factors.

They also look at what factors influence doctors’ decisions in ways they certainly shouldn’t, but they do, because doctors are as prone to biases as everyone else. And, for that matter, what factors influence patients’ decisions in ways they certainly shouldn’t—for the same reason. The authors acknowledge that they themselves are not immune, and you, dear reader, are not immune either.

Nevertheless, the practical value in this book comes from trying to at least be more aware of such things, the better to either leverage them, or at least ensure you don’t fall foul of them.

The style is conversational pop-science, making for quite light reading, albeit with many footnotes and a respectable bibliography.

Bottom line: if you’d like to understand more about the machinations that decide who lives and who dies (especially when sometimes it will be you or a loved one who lives or dies), then this is a fascinating book that that delves deeply into that.

Click here to check out Random Acts Of Medicine, and be aware!

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    Dairy products have conflicting associations with cancer, heart disease, and osteoporosis. Yogurt is considered beneficial, while the jury is still out on other dairy products.

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  • The Brain’s Way of Healing – by Dr. Norman Doidge

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    First, what this book isn’t: any sort of wishy-washy “think yourself better” fluff, and nor is it a “tapping into your Universal Divine Essence” thing.

    In contrast, Dr. Norman Doidge sticks with science, and the only “vibrational frequencies” involved are the sort that come from an MRI machine or similar.

    The author makes bold claims of the potential for leveraging neuroplasticity to heal many chronic diseases. All of them are neurological in whole or in part, ranging from chronic pain to Parkinson’s.

    How well are these claims backed up, you ask?

    The book makes heavy use of case studies. In science, case studies rarely prove anything, so much as indicate a potential proof of principle. Clinical trials are what’s needed to become more certain, and for Dr. Doidge’s claims, these are so far sadly lacking, or as yet inconclusive.

    Where the book’s strengths lie is in describing exactly what is done, and how, to effect each recovery. Specific exercises to do, and explanations of the mechanism of action. To that end, it makes them very repeatable for any would-be “citizen scientist” who wishes to try (in the cases that they don’t require special equipment).

    Bottom line: this book would be more reassuring if its putative techniques had enjoyed more clinical studies… But in the meantime, it’s a fair collection of promising therapeutic approaches for a number of neurological disorders.

    Click here to check out The Brain’s Way of Healing, and learn more!

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  • Who Screens The Sunscreens?

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    We Screen The Sunscreens!

    Yesterday, we asked you what your sunscreen policy was, and got a spread of answers. Apparently this one was quite polarizing!

    One subscriber who voted for “Sunscreen is essential to protect us against skin aging and cancer” wrote:

    ❝My mom died of complications from melanoma, so we are vigilant about sun and sunscreen. We are a family of campers and hikers and gardeners—outdoors in all seasons—and we never burn❞

    Our condolences with regard to your mom! Life is so precious, and when something like that happens, it tends to stick with us. We’re glad you and your family are taking care of yourselves.

    Of the subscribers who voted for “I put some on if I think I might otherwise get sunburned”, about half wrote to express uncertainties:

    • uncertainty about how safe it is, and
    • uncertainty about how helpful it is

    …so we’re going to tackle those questions in a moment. But what of those who voted for “Sunscreen is full of harmful chemicals that can cause cancer”?

    Of those, only one wrote a message, which was to say one has to be very careful of what is in the formula.

    Let’s take a look, then…

    Sunscreen is full of harmful chemicals that can cause cancer: True or False?

    False—according to current best science. Research is ongoing!

    There are four main chemicals (found in most sunscreens) that people tend to worry about:

    • Abobenzone
    • Oxybenzone
    • Octocrylene
    • Ecamsule

    Now, these two sound like four brands of rocket fuel, but then, dihydrogen monoxide (DHMO), which is also found in most sunscreens, sounds like a deadly toxin too. That’s water, by the way.

    But what of these four chemicals? Well, as we say, research is ongoing, but we found a study that measured all four, to see how much got into the blood, and what adverse effects, if any, this caused.

    We’ll skip to their conclusion:

    ❝In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens. The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.❞

    Now, “exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens” sounds alarming, so why did they close with the words “These results do not indicate that individuals should refrain from the use of sunscreen”?

    Let’s skip back up to a line from the results:

    ❝The most common adverse event was rash, which developed in 1 participant with each sunscreen.❞

    This was most probably due to the oxybenzone, which can cause allergic skin reactions in some people.

    Let us take a moment to remember the most common adverse event that occurs from not wearing sunscreen: sunburn!

    You can read the full study here:

    Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active Ingredients—A Randomized Clinical Trial

    None of those ingredients have been found to be carcinogenic, even at the maximal blood plasma concentrations studied, from applications 4x/day to 75% of the body.

    UVA rays, on the other hand, are absolutely very much known to cause cancer, and the effect is cumulative.

    Sunscreen is essential to protect us against skin aging and cancer: True or False?

    True, unequivocally, unless we live indoors and/or otherwise never go about under sunlight.

    “But our ancestors—” lived under the same sun we do, and either used sunscreen or got advanced skin aging and cancer.

    Sunscreen of times past ranged from mud to mineral lotions, but it’s pretty much always existed. Even non-human animals that have skin and don’t have fur or feathers, tend to take mud-baths in sunny parts of the world.

    If you’d like to avoid oxybenzone and other chemicals, though, you might have your reasons. Maybe you’re allergic, or maybe you read that it’s a potential endocrine disruptor with estrogen-like and anti-androgenic properties that you don’t want.

    There are other options, to include physical blockers containing zinc and titanium dioxide, which are generally recognized as safe and effective ingredients.

    If you’re interested, you can even make your own sunscreen that blocks both UVA and UVB rays (UVA is what causes skin cancer; UVB is “milder” and is what causes sunburn):

    How to Make a Safe and Effective Sunscreen from Scratch – medically reviewed by Dr. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT

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  • What Curiosity Really Kills

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    Curiosity Kills The Neurodegeneration

    Of the seven things that Leonardo da Vinci considered most important for developing and maintaining the mind, number one on his list was curiosity, and we’re going to be focussing on that today.

    In case you are curious about what seven things made Leonardo’s* list, they were:

    1. Curiosità: an insatiably curious approach to life and an unrelenting quest for continuous learning
    2. Dimostrazione: a commitment to test knowledge through experience, persistence, and a willingness to learn from mistakes
    3. Sensazione: the continual refinement of the senses, especially sight, as a means to enliven experience
    4. Sfumato: (lit: “gone up in smoke”) a willingness to embrace ambiguity, paradox, and uncertainty
    5. Arte/Scienza: the curated balance of art and science, imagination and logic
    6. Corporalità: the cultivation of physical grace, ambidexterity, and fitness
    7. Connessione: a recognition of and appreciation for the interconnectedness of phenomena (systems-based thinking)

    *In case you are curious why we wrote “Leonardo” and not “da Vinci” as per our usual convention of shortening names to last names, da Vinci is not technically a name, in much the same way as “of Nazareth” was not a name.

    You can read more about all 7 of these in a book that we’ve reviewed previously:

    How to Think Like Leonardo da Vinci: Seven Steps to Genius Every Day – by Michael J. Gelb

    But for now, let’s take on “curiosity”!

    If you need an extra reason to focus on growing and nurturing your curiosity, it was also #1 of Dr. Daniel Levitin’s list of…

    The Five Keys Of Aging Healthily

    …and that’s from a modern-day neuroscientist whose research focuses on aging, the brain, health, productivity, and creativity.

    But how do we foster curiosity in the age of Google?

    Curiosity is like a muscle: use it or lose it

    While it’s true that many things can be Googled to satisfy one’s curiosity in an instant…

    • do you? It’s only useful if you do use it
    • is the top result on Google reliable?
    • there are many things that aren’t available there

    In short: douse “fast food information” sources, but don’t rely on them! Not just for the sake of having correct information, but also: for the actual brain benefits which is what we are aiming for here with today’s article.

    If you want the best brain benefits, dive in, and go deep

    Here at 10almonds we often present superficial information, with links to deeper information (often: scholarly articles). We do this because a) there’s only so much we can fit in our articles and b) we know you only have so much time available, and/but may choose to dive deeper.

    Think of it in layers, e.g:

    • Collagen is good for joints and bones
    • Collagen is a protein made of these amino acids that also requires these vitamins and minerals to be present in order to formulate it
    • Those amino acids are needed in these quantities, of which this particular one is usually the weakest link that might need supplementing, and those vitamins and minerals need to be within this period of time, but not these ones at the exact same time, or else it will disrupt the process of collagen synthesis

    (in case you’re curious, we covered this here and here and offered a very good, very in-depth book about it here)

    Now, this doesn’t mean that to have a healthy brain you need to have the equivalent knowledge of an anatomy & physiology degree, but it is good to have that level of curiosity in at least some areas of your life—and the more, the better.

    Top tips for developing a habit of curiosity

    As you probably know, most of our endeavors as humans go best when they are habits:

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

    And as for specifically building a habit of curiosity:

    1. Make a deal with yourself that when someone is excited to tell you what they know about something (no matter whether it is your grandkid, or the socially awkward nerd at a party, or whoever), listen and learn, no matter the topic.
    2. Learn at least one language other than your native language (presumably English for most of our readers). Not only does learning a language convey a lot of brain benefits of its own, but also, it is almost impossible to separate language learning from cultural learning, and so you will learn a lot about another culture too, and have whole new worlds opened up to you. Again, more is better, but one second language is already a lot better than none.
    3. Make a regular habit of going to your local library, and picking out a non-fiction book to take home and read. This has an advantage over a bookshop, by the way (and not just that the library is free): since library books must be returned, you will keep going back, and build a habit of taking out books.
    4. Pick a skill that you’d like to make into a fully-fledged hobby, and commit to continually learning as much about it as you can. We already covered language-learning above, but others might include: gardening (perhaps a specific kind), cooking (perhaps a specific kind), needlecraft (perhaps a specific kind), dance (perhaps a specific kind). You could learn a musical instrument. Or it could be something very directly useful, like learning to be a first responder in case of emergencies, and committing to continually learning more about it (because there is always more to learn).

    And when it comes to the above choices… Pick things that excite you, regardless of how practical or not they are. Because that stimulation that keeps on driving you? That’s what keeps your brain active, healthy, and sharp.

    Enjoy!

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  • What’s the difference between a psychopath and a sociopath? Less than you might think

    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.

    Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as 7 signs your boss is a psychopath or How to avoid the sociopath next door.

    You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from The Silence of the Lambs.

    In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with something else entirely.

    So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts.

    Benoit Daoust/Shutterstock

    What’s a psychopath?

    Psychopathy has been mentioned in the psychiatric literature since the 1800s. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) doesn’t list it as a recognised clinical disorder.

    Since the 1950s, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with antisocial personality disorder, which is what we have today.

    The Silence of the Lambs movie poster
    Was Hannibal Lecter from The Silence of the Lambs a psychopath, a sociopath or something else entirely? Ralf Liebhold/Shutterstock

    Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions.

    To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves.

    US psychiatrist Hervey Cleckley provided the first formal description of psychopathy traits in his 1941 book The Mask of Sanity. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame.

    Canadian psychologist Professor Robert Hare refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM.

    When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others.

    Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions.

    So how about a sociopath?

    The term sociopath first appeared in the 1930s, and was attributed to US psychologist George Partridge. He emphasised the societal consequences of behaviour that habitually violates the rights of others.

    Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some preferred the term sociopath because they said the public sometimes confused the word psychopath with psychosis.

    “Sociopathic personality disturbance” was the term used in the first edition of the DSM in 1952. This aligned with the prevailing views at the time that antisocial behaviours were largely the product of the social environment, and that behaviours were only judged as deviant if they broke social, legal, and/or cultural rules.

    Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 definition of a psychopath.

    In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy.

    Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead.

    Born or made?

    Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes.

    For example, people with psychopathic traits have certain brain differences especially in regions associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their nervous system, including a reduced heart rate.

    However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to run in families. These behaviours has been associated with physical abuse and parental conflict.

    What are the consequences?

    Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series Killing Evenot all people with psychopathy or sociopathy traits are serial killers or are physically violent.

    But psychopathy predicts a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature.

    In the general population, psychopathy is associated with drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted failure to follow COVID restrictions.

    But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour.

    In a nutshell

    Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics.

    Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment.

    Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.

    Bruce Watt, Associate Professor in Psychology, Bond University and Katarina Fritzon, Associate Professor of Psychology, Bond University

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

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  • Lies I Taught in Medical School – by Dr. Robert Lufkin

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    There seems to be a pattern of doctors who practice medicine one way, get a serious disease personally, and then completely change their practice of medicine afterwards. This is one of those cases.

    Dr. Lufkin here presents, on a chapter-by-chapter basis, the titularly promised “lies” or, in more legally compliant speak (as he acknowledges in his preface), flawed hypotheses that are generally taught as truths. In many cases, the “lie” is some manner of “xyz is normal and nothing to worry about”, and/or “there is nothing to be done about xyz; suck it up”.

    The end result of the information is not complicated—enjoy a plants-forward whole foods low-carb diet to avoid metabolic diseases and all the other things to branch off from same (Dr. Lufkin makes a fair case for metabolic disease leading to a lot of secondary diseases that aren’t considered metabolic diseases per se). But, the journey there is actually important, as it answers a lot of questions that are much less commonly understood, and often not even especially talked-about, despite their great import and how they may affect health decisions beyond the dietary. Things like understanding the downsides of statins, or the statistical models that can be used to skew studies, per relative risk reduction and so forth.

    Bottom line: this book gives the ins and outs of what can go right or wrong with metabolic health and why, and how to make sure you don’t sabotage your health through missing information.

    Click here to check out Lies I Taught In Medical School, and arm yourself with knowledge!

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  • Avocado vs Olives – Which is Healthier?

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    Our Verdict

    When comparing avocado to olives, we picked the avocado.

    Why?

    Both are certainly great! And when it comes to their respective oils, olive oil wins out as it retains many micronutrients that avocado oil loses. But, in their whole form, avocado beats olive:

    In terms of macros, avocado has more protein, carbs, fiber, and (healthy) fats. Simply, it’s more nationally-dense than the already nutritionally-dense food that is olives.

    When it comes to vitamins, olives are great but avocados really shine; avocado has more of vitamins B1, B2, B3, B5, B6, B7 B9, C, E, K, and choline, while olives boast only more vitamin A.

    In the category of minerals, things are closer to even; avocado has more magnesium, manganese, phosphorus, potassium, and zinc, while olives have a lot more calcium, copper, iron, and selenium. Still, a marginal victory for avocado here.

    In short, this is another case of one very healthy food looking bad by standing next to an even better one, so by all means enjoy both—if you’re going to pick one though, avocado is the more nutritionally dense.

    Want to learn more?

    You might like to read:

    Avocado Oil vs Olive Oil – Which is Healthier? ← when made into oils, olive oil wins, but avocado oil is still a good option too

    Take care!

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