The Truth About Handwashing
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Washing Our Hands Of It
In Tuesdays’s newsletter, we asked you how often you wash your hands, and got the above-depicted, below-described, set of self-reported answers:
- About 54% said “More times per day than [the other options]”
- About 38% said “Whenever using the bathroom or kitchen
- About 5% said “Once or twice per day”
- Two (2) said “Only when visibly dirty”
- Two (2) said “I prefer to just use sanitizer gel”
What does the science have to say about this?
People lie about their handwashing habits: True or False?
True and False (since some people lie and some don’t), but there’s science to this too. Here’s a great study from 2021 that used various levels of confidentiality in questioning (i.e., there were ways of asking that made it either obvious or impossible to know who answered how), and found…
❝We analysed data of 1434 participants. In the direct questioning group 94.5% of the participants claimed to practice proper hand hygiene; in the indirect questioning group a significantly lower estimate of only 78.1% was observed.❞
Note: the abstract alone doesn’t make it clear how the anonymization worked (it is explained later in the paper), and it was noted as a limitation of the study that the participants may not have understood how it works well enough to have confidence in it, meaning that the 78.1% is probably also inflated, just not as much as the 94.5% in the direct questioning group.
Here’s a pop-science article that cites a collection of studies, finding such things as for example…
❝With the use of wireless devices to record how many people entered the restroom and used the pumps of the soap dispensers, researchers were able to collect data on almost 200,000 restroom trips over a three-month period.
The found that only 31% of men and 65% of women washed their hands with soap.❞
Source: Study: Men Wash Their Hands Much Less Often Than Women (And People Lie About Washing Their Hands)
Sanitizer gel does the job of washing one’s hands with soap: True or False?
False, though it’s still not a bad option for when soap and water aren’t available or practical. Here’s an educational article about the science of why this is so:
UCI Health | Soap vs. Hand Sanitizer
There’s also some consideration of lab results vs real-world results, because while in principle the alcohol gel is very good at killing most bacteria / inactivating most viruses, it can take up to 4 minutes of alcohol gel contact to do so, as in this study with flu viruses:
In contrast, 20 seconds of handwashing with soap will generally do the job.
Antibacterial soap is better than other soap: True or False?
False, because the main way that soap protects us is not in its antibacterial properties (although it does also destroy the surface membrane of some bacteria and for that matter viruses too, killing/inactivating them, respectively), but rather in how it causes pathogens to simply slide off during washing.
Here’s a study that found that handwashing with soap reduced disease incidence by 50–53%, and…
❝Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap.❞
Read more: Effect of handwashing on child health: a randomised controlled trial
Want to wash your hands more than you do?
There have been many studies into motivating people to wash their hands more (often with education and/or disgust-based shaming), but an effective method you can use for yourself at home is to simply buy more luxurious hand soap, and generally do what you can to make handwashing a more pleasant experience (taking a moment to let the water run warm is another good thing to do if that’s more comfortable for you).
Take care!
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Is It Dementia?
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Spot The Signs (Because None Of Us Are Immune)
Dementia affects increasingly many people, and unlike a lot of diseases, it disproportionately affects people in wealthy industrialized nations.
There are two main reasons for this:
- Longevity (in poorer countries, more people die of other things sooner; can’t get age-related cognitive decline if you don’t age)
- Lifestyle (in the age of convenience, it has never been easier to live an unhealthy lifestyle)
The former is obviously no bad thing for those of us lucky enough to be in wealthier countries (though even in such places, good healthcare access is of course sadly not a given for all).
The latter, however, is less systemic and more epidemic. But it does cut both ways:
- An unhealthy lifestyle is much easier here, yes
- A healthier lifestyle is much easier here, too!
This then comes down to two factors in turn:
- Information: knowing about dementia, what things lead to it, what to look out for, what to do
- Motivation: priorities, and how much attention we choose to give this matter
So, let’s get some information, and then give it our attention!
More than just memory
It’s easy to focus on memory loss, but the four key disabilities directly caused by dementia (each person may not get all four), can be remembered by the mnemonic: “AAAA!”
No, somebody didn’t just murder your writer. It’s:
- Amnesia: memory loss, in one or more of its many forms
- e.g. short term memory loss, and/or inability to make new memories
- Aphasia: loss of ability to express oneself, and/or understand what is expressed
- e.g. “More people have been to Berlin than I have”
- Or even less communication-friendly, Broca’s (Expressive) Aphasia and Wernicke’s (Receptive) Aphasia
- Apraxia: loss of ability to do things, through no obvious physical disability
- e.g. staring at the bathroom mirror wondering how to brush one’s teeth
- Agnosia: loss of ability to recognize things
- e.g. prosopagnosia, also called face-blindness.
If any of those seem worryingly familiar, be aware that while yes, it could be a red flag, what’s most important is patterns of these things.
Another difference between having a momentary brainlapse and having dementia might be, for example, the difference between forgetting your keys, and forgetting what keys do or how to use one.
That said, some are neurological deficits that may show up quite unrelated to dementia, including most of those given as examples above. So if you have just one, then that’s probably worthy of note, but probably not dementia.
Writer’s anecdote: I have had prosopagnosia all my life. To give an example of what that is like and how it’s rather more than just “bad with faces”…
Recently I saw my neighbor, and I could tell something was wrong with her face, but I couldn’t put my finger on what it was. Then some moments later, I realized I had mistaken her hat for her face. It was a large beanie with a panda design on it, and that was facelike enough for me to find myself looking at the wrong face.
Subjective memory matters as much as objective
Objective memory tests are great indicators of potential cognitive decline (or improvement!), but even a subjective idea of having memory problems, that one’s memory is “not as good as it used to be”, can be an important indicator too:
Subjective memory may be marker for cognitive decline
And more recently:
If your memory feels like it’s not what it once was, it could point to a future dementia risk
If you’d like an objective test of memory and other cognitive impairments, here’s the industry’s gold standard test (it’s free):
SAGE: A Test to Detect Signs of Alzheimer’s and Dementia
(The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments)
There are things that can look like dementia that aren’t
A person with dementia may be unable to recognize their partner, but hey, this writer knows that feeling very well too. So what sets things apart?
More than we have room for today, but here’s a good overview:
What are the early signs of dementia, and how does it differ from normal aging?
Want to read more?
You might like our previous article more specifically about reducing Alzheimer’s risk:
Reducing Alzheimer’s Risk Early!
Take care!
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AI: The Doctor That Never Tires?
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AI: The Doctor That Never Tires?
We asked you for your opinion on the use of Artificial Intelligence (AI) in healthcare, and got the above-depicted, below-described set of results:
- A little over half of respondents to the poll voted for “It speeds up research, and is more methodical about diagnosis, so it’s at least a good extra tool”
- A quarter of respondents voted for “I’m on the fence—it seems to make no more nor less mistakes than human doctors do”
- A little under a fifth of respondents voted for “AI is less prone to fatigue/bias than human doctors, making it an essential new tech”
- Three respondents voted for “AI is a step too far in medical technology, and we’re not ready for it”
Writer’s note: I’m a professional writer (you’d never have guessed, right?) and, apparently, I really did write “no more nor less mistakes”, despite the correct grammar being “no more nor fewer mistakes”. Now, I know this, and in fact, people getting less/fewer wrong is a pet hate of mine. Nevertheless, I erred.
Yet, now that I’m writing this out in my usual software, and not directly into the poll-generation software, my (AI!) grammar/style-checker is highlighting the error for me.
Now, an AI could not do my job. ChatGPT would try, and fail miserably. But can technology help me do mine better? Absolutely!
And still, I dismiss a lot of the AI’s suggestions, because I know my field and can make informed choices. I don’t follow it blindly, and I think that’s key.
AI is less prone to fatigue/bias than human doctors, making it an essential new tech: True or False?
True—with one caveat.
First, a quick anecdote from a subscriber who selected this option in the poll:
❝As long as it receives the same data inputs as my doctor (ie my entire medical history), I can see it providing a much more personalised service than my human doctor who is always forgetting what I have told him. I’m also concerned that my doctor may be depressed – not an ailment that ought to affect AI! I recently asked my newly qualified doctor goddaughter whether she would prefer to be treated by a human or AI doctor. No contest, she said – she’d go with AI. Her argument was that human doctors leap to conclusions, rather than properly weighing all the evidence – meaning AI, as long as it receives the same inputs, will be much more reliable❞
Now, an anecdote is not data, so what does the science say?
Well… It says the same:
❝Of 6695 responding physicians in active practice, 6586 provided information on the areas of interest: 3574 (54.3%) reported symptoms of burnout, 2163 (32.8%) reported excessive fatigue, and 427 (6.5%) reported recent suicidal ideation, with 255 of 6563 (3.9%) reporting a poor or failing patient safety grade in their primary work area and 691 of 6586 (10.5%) reporting a major medical error in the prior 3 months. Physicians reporting errors were more likely to have symptoms of burnout (77.6% vs 51.5%; P<.001), fatigue (46.6% vs 31.2%; P<.001), and recent suicidal ideation (12.7% vs 5.8%; P<.001).❞
See the damning report for yourself: Physician Burnout, Well-being, and Work Unit Safety Grades in Relationship to Reported Medical Errors
AI, of course, does not suffer from burnout, fatigue, or suicidal ideation.
So, what was the caveat?
The caveat is about bias. Humans are biased, and that goes for medical practitioners just the same. AI’s machine learning is based on source data, and the source data comes from humans, who are biased.
See: Bias and Discrimination in AI: A Cross-Disciplinary Perspective
So, AI can perpetuate human biases and doesn’t have a special extra strength in this regard.
The lack of burnout, fatigue, and suicidal ideation, however, make a big difference.
AI speeds up research, and is more methodical about diagnosis: True or False?
True! AI is getting more and more efficient at this, and as has been pointed out, doesn’t make errors due to fatigue, and often comes to accurate conclusions near-instantaneously. To give just one example:
❝Deep learning algorithms achieved better diagnostic performance than a panel of 11 pathologists participating in a simulation exercise designed to mimic routine pathology workflow; algorithm performance was comparable with an expert pathologist interpreting whole-slide images without time constraints. The area under the curve was 0.994 (best algorithm) vs 0.884 (best pathologist).❞
About that “getting more and more efficient at this”; it’s in the nature of machine learning that every new piece of data improves the neural net being used. So long as it is getting fed new data, which it can process at rate far exceeding humans’ abilities, it will always be constantly improving.
AI makes no more nor
lessfewer mistakes than humans do: True or False?False! AI makes fewer, now. This study is from 2021, and it’s only improved since then:
❝Professionals only came to the same conclusions [as each other] approximately 75 per cent of the time. More importantly, machine learning produced fewer decision-making errors than did all the professionals❞
See: AI can make better clinical decisions than humans: study
All that said, we’re not quite at Star Trek levels of “AI can do a human’s job entirely” just yet:
BMJ | Artificial intelligence versus clinicians: pros and cons
To summarize: medical AI is a powerful tool that:
- Makes healthcare more accessible
- Speeds up diagnosis
- Reduces human error
…and yet, for now at least, still requires human oversights, checks and balances.
Essentially: it’s not really about humans vs machines at all. It’s about humans and machines giving each other information, and catching any mistakes made by the other. That way, humans can make more informed decisions, and still keep a “hand on the wheel”.
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Pine Nuts vs Peanuts – Which is Healthier?
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Our Verdict
When comparing pine nuts to peanuts, we picked the pine nuts.
Why?
An argument could be made for either, honestly, as it depends on what we prioritize the most. These are both very high-calorie foods, and/but are far from empty calories, as they both contain main nutrients. Obviously, if you are allergic to nuts, this one is just not a comparison for you, sorry.
Looking at the macros first, peanuts are higher in protein, carbs, and fiber, while pine nuts are higher in fats—though the fats are healthy, being mostly polyunsaturated, with about a third of the total fats monounsaturated, and a low amount of saturated fat (peanuts have nearly 2x the saturated fat). On balance, we’ll call the macros category a moderate win for peanuts, though.
In terms of vitamins, peanuts have more of vitamins B1, B3, B5, B6, and B9, while pine nuts have more of vitamins A, B2, C, E, K, and choline. All in all, a marginal win for pine nuts.
In the category of minerals, peanuts have more calcium and selenium, while pine nuts have more copper, iron, magnesium, manganese, phosphorus, and zinc. An easy win for pine nuts, even before we take into account that peanuts have nearly 10x as much sodium. And yes, we are talking about the raw nuts, not nuts that have been roasted and salted.
Adding up the categories gives a win for pine nuts—but if you have certain particular priorities, you might still prefer peanuts for the areas in which peanuts are stronger.
Of course, the best solution is to enjoy both!
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts!
Take care!
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How stigma perpetuates substance use
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In 2022, 54.6 million people 12 and older in the United States needed substance use disorder (SUD) treatment. Of those, only 24 percent received treatment, according to the most recent National Survey on Drug Use and Health.
SUD is a treatable, chronic medical condition that causes people to have difficulty controlling their use of legal or illegal substances, such as alcohol, tobacco, prescription opioids, heroin, methamphetamine, or cocaine. Using these substances may impact people’s health and ability to function in their daily life.
While help is available for people with SUD, the stigma they face—negative attitudes, stereotypes, and discrimination—often leads to shame, worsens their condition, and keeps them from seeking help.
Read on to find out more about how stigma perpetuates substance use.
Stigma can keep people from seeking treatment
Suzan M. Walters, assistant professor at New York University’s Grossman School of Medicine, has seen this firsthand in her research on stigma and health disparities.
She explains that people with SUD may be treated differently at a hospital or another health care setting because of their drug use, appearance (including track marks on their arms), or housing situation, which may discourage them from seeking care.
“And this is not just one case; this is a trend that I’m seeing with people who use drugs,” Walters tells PGN. “Someone said, ‘If I overdose, I’m not even going to the [emergency room] to get help because of this, because of the way I’m treated. Because I know I’m going to be treated differently.’”
People experience stigma not only because of their addiction, but also because of other aspects of their identities, Walters says, including “immigration or race and ethnicity. Hispanic folks, brown folks, Black folks [are] being treated differently and experiencing different outcomes.”
And despite the effective harm reduction tools and treatment options available for SUD, research has shown that stigma creates barriers to access.
Syringe services programs, for example, provide infectious disease testing, Narcan, and fentanyl test strips. These programs have been proven to save lives and reduce the spread of HIV and hepatitis C. SSPs don’t increase crime, but they’re often mistakenly “viewed by communities as potential settings of drug-related crime;” this myth persists despite decades of research proving that SSPs make communities safer.
To improve this bias, Walters says it’s helpful for people to take a step back and recognize how we use substances, like alcohol, in our own lives, while also humanizing those with addiction. She says, “There’s a lack of understanding that these are human beings and people … [who] are living lives, and many times very functional lives.”
Misconceptions lead to stigma
SUD results from changes in the brain that make it difficult for a person to stop using a substance. But research has shown that a big misconception that leads to stigma is that addiction is a choice and reflects a person’s willpower.
Michelle Maloney, executive clinical director of mental health and addiction recovery services for Rogers Behavioral Health, tells PGN that statements such as “you should be able to stop” can keep a patient from seeking treatment. This belief goes back to the 1980s and the War on Drugs, she adds.
“We think about public service announcements that occurred during that time: ‘Just say no to drugs,’” Maloney says. “People who have struggled, whether that be with nicotine, alcohol, or opioids, [know] it’s not as easy as just saying no.”
Stigma can worsen addiction
Stigma can also lead people with SUD to feel guilt and shame and blame themselves for their medical condition. These feelings, according to the National Institute on Drug Abuse, may “reinforce drug-seeking behavior.”
In a 2020 article, Dr. Nora D. Volkow, the director of NIDA, said that “when internalized, stigma and the painful isolation it produces encourage further drug taking, directly exacerbating the disease.”
Overall, research agrees that stigma harms people experiencing addiction and can make the condition worse. Experts also agree that debunking myths about the condition and using non-stigmatizing language (like saying someone is a person with a substance use disorder, not an addict) can go a long way toward reducing stigma.
Resources to mitigate stigma:
- CDC: Stigma Reduction
- National Harm Reduction Coalition: Respect To Connect: Undoing Stigma
- NIDA:
- Shatterproof: Addiction language guide (Disclosure: The Public Good Projects, PGN’s parent company, is a Shatterproof partner)
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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7 Healthy Gut Habits For Women Over 40 – by Lara West
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With regard to the titular 7 healthy gut habits for women over 40, a chapter is devoted to each one of those habits, and she goes into quite some detail in each category, more than you might expect.
As for the 7 things, we’ll not keep them a mystery; they are:
- Intermittent fasting
- Prebiotics & probiotics
- Mindful eating
- Understanding ingredients
- Movement
- Sleep
- Stress management
Of course, all of these things are good regardless of one’s age or gender, but West is writing with women over 40 in mind, and as such, she will focus on things that are especially relevant to those of us who are indeed women over 40.
You may be wondering: what if I’m a long way over 40, and menopause is a distant memory? In that case, 90% of this will still be relevant to you; the only parts that won’t be, are those that pertain specifically to the menopausal transitional phase itself, rather than the post-menopause state.
You may also be wondering: what if I’m a man, and menopause is just not in the cards for me? In that case, maybe about 70% of this will still be relevant to you, because of the broad applicability of most of the advice. That said, if it’s just for yourself, you’d probably do better with a book of which 100% is relevant to you, rather than this one.
The style is conversational pop-science, with personal anecdotes mixed in with references to science. It’s definitely on the light/easy-reading end of books that we’ve reviewed on the topic.
Bottom line: if you’re a woman over 40 who would like to improve your gut health, this book was written for you.
Click here to check out 7 Healthy Gut Habits For Women Over 40, and rediscover vitality!
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Synergistic Brain-Training
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Let The Games Begin (But It Matters What Kind)
Exercise is good for brain health; we’ve written about this before, for example:
How To Reduce Your Alzheimer’s Risk ← there are many advices here, but exercise, especially cardiovascular exercise in this case, is an important item on the list!
Today it’s Psychology Sunday though, and we’re going to talk about looking after brain health by means of brain-training, via games.
“Brain-training” gets a lot of hype and flak:
- Hype: do sudoku every day and soon you will have an IQ of 200 and still have a sharp wit at the age of 120
- Flak: brain-training is usually training only one kind of cognitive function, with limited transferability to the rest of life
The reality is somewhere between the two. Brain training really does improve not just outwardly measurable cognitive function, but also internally measurable improvements visible on brain scans, for example:
- Cognitive training modified age-related brain changes in older adults with subjective memory decline
- Functional brain changes associated with cognitive training in healthy older adults: A preliminary ALE meta-analysis
But what about the transferability?
Let us play
This is where game-based brain-training comes in. And, the more complex the game, the better the benefits, because there is more chance of applicability to life, e.g:
- Sudoku: very limited applicability
- Crosswords: language faculties
- Chess: spatial reasoning, critical path analysis, planning, memory, focus (also unlike the previous two, chess tends to be social for most people, and also involve a lot of reading, if one is keen)
- Computer games: wildly varied depending on the game. While an arcade-style “shoot-em-up” may do little for the brain, there is a lot of potential for a lot of much more relevant brain-training in other kinds of games: it could be planning, problem-solving, social dynamics, economics, things that mirror the day-to-day challenges of running a household, even, or a business.
- It’s not that the skills are useful, by the way. Playing “Stardew Valley” will not qualify you to run a real farm, nor will playing “Civilization” qualify you to run a country. But the brain functions used and trained? Those are important.
It becomes easily explicable, then, why these two research reviews with very similar titles got very different results:
- A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults
- Game-based brain training for improving cognitive function in community-dwelling older adults: A systematic review and meta-regression
The first review found that game-based brain-training had negligible actual use. The “games” they looked at? BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. In other words, made-for-purpose brain-trainers, not actual computer games per se.
The second reviewfound that game-based training was very beneficial. The games they looked at? They didn’t name them, but based on the descriptions, they were actual multiplayer online turn-based computer games, not made-for-purpose brain-trainers.
To summarize the above in few words: multiplayer online turn-based computer games outperform made-for-purpose brain-trainers for cognitive improvement.
Bringing synergy
However, before you order that expensive gaming-chair for marathon gaming sessions (research suggests a tail-off in usefulness after about an hour of continuous gaming per session, by the way), be aware that cognitive training and (physical) exercise training combined, performed close in time to each other or simultaneously, perform better than the sum of either alone:
See also:
❝Simultaneous training was the most efficacious approach for cognition, followed by sequential combinations and cognitive training alone, and significantly better than physical exercise.
Our findings suggest that simultaneously and sequentially combined interventions are efficacious for promoting cognitive alongside physical health in older adults, and therefore should be preferred over implementation of single-domain training❞
~ Dr. Hanna Malmberg Gavelin et al.
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