When You Know What You “Should” Do (But Knowing Isn’t The Problem)

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When knowing what to do isn’t the problem

Often, we know what we need to do. Sometimes, knowing isn’t the problem!

The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.

While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.

What is Motivational Interviewing?

❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞

Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice

It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.

However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.

Three Phases

Motivational Interviewing traditionally has three phases:

  1. Exploring and understanding the issue at hand
  2. Guiding and deciding importance and goals
  3. Choosing and setting an action plan

In self-practice, maybe you can already know and understand what it is that you want/need to change.

If not, consider asking yourself such questions as:

  • What does a good day look like? What does a bad day look like?
  • If things are not good now, when were they good? What changed?
  • If everything were perfect now, what would that look like? How would you know?

Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?

This is a critical process:

  • Give your answers numerically on a scale from 0 to 10
  • Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
  • In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
  • After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.

Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.

Some things to ask yourself at this stage of the motivational self-interviewing:

  • What’s a good SMART goal to get you started?
  • What could stop you from achieving your goal?
    • How could you overcome that challenge?
    • What is your backup plan, if you have to scale back your goal for some reason?

A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.

The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.

Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”

Secret fourth stage

The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.

For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.

When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.

Want to learn more?

We only have so much room here, but there are lots of resources out there.

Here’s a high-quality page that:

  • explains motivational interviewing in more depth than we have room for here
  • offers a lot of free downloadable resource packs and the like

Check it out: Motivational Interviewing Theory & Resources

Enjoy!

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  • Scarcity Brain – by Michael Easter

    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.

    After a brief overview of theevolutionary psychology underpinnings of the scarcity brain, the author grounds the rest of this book firmly in the present. He explains how the scarcity loop hooks us and why we crave more, and what factors can increase or lessen its hold over us.

    As for what things we are wired to consider “potentially scarce any time now” no matter how saturated we are in them, he looks at an array of categories, each with their nuances. From the obvious such as “food” and “stuff“, to understandable “information” and “happiness“, to abstractions like “influence“, he goes to many sources—experts of various kinds from around the world—to explore how we can know “how much is enough”, and—which can be harder—act accordingly.

    The key, he argues, is not in simply wanting less, but in understanding why we crave more in the first place, get rid of our worst habits, and use what we already have, better.

    Bottom line: if you feel a gnawing sense of needing more “to be on the safe side”, this book can help you to be a little more strategic (and at the same time, less stressed!) about that.

    Click here to check out Scarcity Brain, and manage yours more mindfully!

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  • Coenzyme Q10 From Foods & Supplements

    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.

    Coenzyme Q10 and the difference it makes

    Coenzyme Q10, often abbreviated to CoQ10, is a popular supplement, and is often one of the more expensive supplements that’s commonly found on supermarket shelves as opposed to having to go to more specialist stores or looking online.

    What is it?

    It’s a compound naturally made in the human body and stored in mitochondria. Now, everyone remembers the main job of mitochondria (producing energy), but they also protect cells from oxidative stress, among other things. In other words, aging.

    Like many things, CoQ10 production slows as we age. So after a certain age, often around 45 but lifestyle factors can push it either way, it can start to make sense to supplement.

    Does it work?

    The short answer is “yes”, though we’ll do a quick breakdown of some main benefits, and studies for such, before moving on.

    First, do bear in mind that CoQ10 comes in two main forms, ubiquinol and ubiquinone.

    Ubiquinol is much more easily-used by the body, so that’s the one you want. Here be science:

    Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone

    What is it good for?

    Benefits include:

    Can we get it from foods?

    Yes, and it’s equally well-absorbed through foods or supplementation, so feel free to go with whichever is more convenient for you.

    Read: Intestinal absorption of coenzyme Q10 administered in a meal or as capsules to healthy subjects

    If you do want to get it from food, you can get it from many places:

    • Organ meats: the top source, though many don’t want to eat them, either because they don’t like them or some of us just don’t eat meat. If you do, though, top choices include the heart, liver, and kidneys.
    • Fatty fish: sardines are up top, along with mackerel, herring, and trout
    • Vegetables: leafy greens, and cruciferous vegetables e.g. cauliflower, broccoli, sprouts
    • Legumes: for example soy, lentils, peanuts
    • Nuts and seeds: pistachios come up top; sesame seeds are great too
    • Fruit: strawberries come up top; oranges are great too

    If supplementing, how much is good?

    Most studies have used doses in the 100mg–200mg (per day) range.

    However, it’s also been found to be safe at 1200mg (per day), for example in this high-quality study that found that higher doses resulted in greater benefit, in patients with early Parkinson’s Disease:

    Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline

    Wondering where you can get it?

    We don’t sell it (or anything else for that matter), and you can probably find it in your local supermarket or health food store. However, if you’d like to buy it online, here’s an example product on Amazon

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  • When Carbs, Proteins, & Fats Switch Metabolic Roles

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    Strange Things Happening In The Islets Of Langerhans

    It is generally known and widely accepted that carbs have the biggest effect on blood sugar levels (and thus insulin response), fats less so, and protein least of all.

    And yet, there was a groundbreaking study published yesterday which found:

    Glucose is the well-known driver of insulin, but we were surprised to see such high variability, with some individuals showing a strong response to proteins, and others to fats, which had never been characterized before.

    Insulin plays a major role in human health, in everything from diabetes, where it is too low*, to obesity, weight gain and even some forms of cancer, where it is too high.

    These findings lay the groundwork for personalized nutrition that could transform how we treat and manage a range of conditions.❞

    ~ Dr. James Johnson

    *saying ”too low” here is potentially misleading without clarification; yes, Type 1 Diabetics will have too little [endogenous] insulin (because the pancreas is at war with itself and thus isn’t producing useful quantities of insulin, if any). Type 2, however, is more a case of acquired insulin insensitivity, because of having too much at once too often, thus the body stops listening to it, “boy who cried wolf”-style, and the pancreas also starts to get fatigued from producing so much insulin that’s often getting ignored, and does eventually produce less and less while needing more and more insulin to get the same response, so it can be legitimately said “there’s not enough”, but that’s more of a subjective outcome than an objective cause.

    Back to the study itself, though…

    What they found, and how they found it

    Researchers took pancreatic islets from 140 heterogenous donors (varied in age and sex; ostensibly mostly non-diabetic donors, but they acknowledge type 2 diabetes could potentially have gone undiagnosed in some donors*) and tested cell cultures from each with various carbs, proteins, and fats.

    They found the expected results in most of the cases, but around 9% responded more strongly to the fats than the carbs (even more strongly than to glucose specifically), and even more surprisingly 8% responded more strongly to the proteins.

    *there were also some known type 2 diabetics amongst the donors; as expected, those had a poor insulin response to glucose, but their insulin response to proteins and fats were largely unaffected.

    What this means

    While this is, in essence, a pilot study (the researchers called for larger and more varied studies, as well as in vivo human studies), the implications so far are important:

    It appears that, for a minority of people, a lot of (generally considered very good) antidiabetic advice may not be working in the way previously understood. They’re going to (for example) put fat on their carbs to reduce the blood sugar spike, which will technically still work, but the insulin response is going to be briefly spiked anyway, because of the fats, which very insulin response is what will lower the blood sugars.

    In practical terms, there’s not a lot we can do about this at home just yet—even continuous glucose monitors won’t tell us precisely, because they’re monitoring glucose, not the insulin response. We could probably measure everything and do some math and work out what our insulin response has been like based on the pace of change in blood sugar levels (which won’t decrease without insulin to allow such), but even that is at best grounds for a hypothesis for now.

    Hopefully, more publicly-available tests will be developed soon, enabling us all to know our “insulin response type” per the proteome predictors discovered in this study, rather than having to just blindly bet on it being “normal”.

    Ironically, this very response may have hidden itself for a while—if taking fats raised insulin response without raising blood sugar levels, then if blood sugar levels are the only thing being measured, all we’ll see is “took fats at dinner; blood sugars returned to normal more quickly than when taking carbs without fats”.

    You can read the study in full here:

    Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease

    Want to know more about blood sugar management?

    You might like to catch up on:

    Take care!

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  • We created a VR tool to test brain function. It could one day help diagnose dementia

    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.

    If you or a loved one have noticed changes in your memory or thinking as you’ve grown older, this could reflect typical changes that occur with ageing. In some cases though, it might suggest something more, such as the onset of dementia.

    The best thing to do if you have concerns is to make an appointment with your GP, who will probably run some tests. Assessment is important because if there is something more going on, early diagnosis can enable prompt access to the right interventions, supports and care.

    But current methods of dementia screening have limitations, and testing can be daunting for patients.

    Our research suggests virtual reality (VR) could be a useful cognitive screening tool, and mitigate some of the challenges associated with current testing methods, opening up the possibility it may one day play a role in dementia diagnosis.

    Where current testing is falling short

    If someone is worried about their memory and thinking, their GP might ask them to complete a series of quick tasks that check things like the ability to follow simple instructions, basic arithmetic, memory and orientation.

    These sorts of screening tools are really good at confirming cognitive problems that may already be very apparent. But commonly used screening tests are not always so good at detecting early and more subtle difficulties with memory and thinking, meaning such changes could be missed until they get worse.

    A clinical neuropsychological assessment is better equipped to detect early changes. This involves a comprehensive review of a patient’s personal and medical history, and detailed assessment of cognitive functions, including attention, language, memory, executive functioning, mood factors and more. However, this can be costly and the testing can take several hours.

    Testing is also somewhat removed from everyday experience, not directly tapping into activities of daily living.

    Enter virtual reality

    VR technology uses computer-generated environments to create immersive experiences that feel like real life. While VR is often used for entertainment, it has increasingly found applications in health care, including in rehabilitation and falls prevention.

    Using VR for cognitive screening is still a new area. VR-based cognitive tests generally create a scenario such as shopping at a supermarket or driving around a city to ascertain how a person would perform in these situations.

    Notably, they engage various senses and cognitive processes such as sight, sound and spatial awareness in immersive ways. All this may reveal subtle impairments which can be missed by standard methods.

    VR assessments are also often more engaging and enjoyable, potentially reducing anxiety for those who may feel uneasy in traditional testing environments, and improving compliance compared to standard assessments.

    A senior woman sitting on a bed with her hand to her face.
    Millions of people around the world have dementia.
    pikselstock/Shutterstock

    Most studies of VR-based cognitive tests have explored their capacity to pick up impairments in spatial memory (the ability to remember where something is located and how to get there), and the results have been promising.

    Given VR’s potential for assisting with diagnosis of cognitive impairment and dementia remains largely untapped, our team developed an online computerised game (referred to as semi-immersive VR) to see how well a person can remember, recall and complete everyday tasks. In our VR game, which lasts about 20 minutes, the user role plays a waiter in a cafe and receives a score on their performance.

    To assess its potential, we enlisted more than 140 people to play the game and provide feedback. The results of this research are published across three recent papers.

    Testing our VR tool

    In our most recently published study, we wanted to verify the accuracy and sensitivity of our VR game to assess cognitive abilities.

    We compared our test to an existing screening tool (called the TICS-M) in more than 130 adults. We found our VR task was able to capture meaningful aspects of cognitive function, including recalling food items and spatial memory.

    We also found younger adults performed better in the game than older adults, which echoes the pattern commonly seen in regular memory tests.

    A senior man sitting outdoors using a laptop.
    Adults of a range of ages tried our computerised game.
    pikselstock/Shutterstock

    In a separate study, we followed ten adults aged over 65 while they completed the game, and interviewed them afterwards. We wanted to understand how this group – who the tool would target – perceived the task.

    These seniors told us they found the game user-friendly and believed it was a promising tool for screening memory. They described the game as engaging and immersive, expressing enthusiasm to continue playing. They didn’t find the task created anxiety.

    For a third study, we spoke to seven health-care professionals about the tool. Overall they gave positive feedback, and noted its dynamic approach to age-old diagnostic challenges.

    However, they did flag some concerns and potential barriers to implementing this sort of tool. These included resource constraints in clinical practice (such as time and space to carry out the assessment) and whether it would be accessible for people with limited technological skills. There was also some scepticism about whether the tool would be an accurate method to assist with dementia diagnosis.

    While our initial research suggests this tool could be a promising way to assess cognitive performance, this is not the same as diagnosing dementia. To improve the test’s ability to accurately detect those who likely have dementia, we’ll need to make it more specific for that purpose, and carry out further research to validate its effectiveness.

    We’ll be conducting more testing of the game soon. Anyone interested in giving it a go to help with our research can register on our team’s website.The Conversation

    Joyce Siette, Research Theme Fellow in Health and Wellbeing, Western Sydney University and Paul Strutt, Senior Lecturer in Psychology, Western Sydney University

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

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  • Long COVID is real—here’s how patients can get treatment and support

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    What you need to know

    • There is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms.
    • Long COVID patients may be eligible for government benefits that can ease financial burdens.
    • Getting reinfected with COVID-19 can worsen existing long COVID symptoms, but patients can take steps to stay protected.

    On March 15—Long COVID Awareness Day—patients shared their stories and demanded more funding for long COVID research. Nearly one in five U.S. adults who contract COVID-19 suffer from long COVID, and up to 5.8 million children have the disease.

    Anyone who contracts COVID-19 is at risk of developing long-term illness. Long COVID has been deemed by some a “mass-disabling event,” as its symptoms can significantly disrupt patients’ lives.

    Fortunately, there’s hope. New treatment options are in development, and there are resources available that may ease the physical, mental, and financial burdens that long COVID patients face.

    Read on to learn more about resources for long COVID patients and how you can support the long COVID patients in your life.


    What is long COVID, and who is at risk?

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    Anyone who gets infected with COVID-19 is at risk of developing long COVID, but some groups are at greater risk, including unvaccinated people, women, people over 40, and people who face health inequities.

    What types of support are available for long COVID patients?

    Currently, there is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms. Some options for long COVID treatment include therapies to improve lung function and retrain your sense of smell, as well as medications for pain and blood pressure regulation. Staying up to date on COVID-19 vaccines may also improve symptoms and reduce inflammation.

    Long COVID patients are eligible for disability benefits under the Americans with Disabilities Act. The Pandemic Legal Assistance Network provides pro bono support for long COVID patients applying for these benefits.

    Long COVID patients may also be eligible for other forms of government assistance, such as Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, and rental and utility assistance programs.

    How can friends and family of long COVID patients provide support?

    Getting reinfected with COVID-19 can worsen existing long COVID symptoms. Wearing a high-quality, well-fitting mask will reduce your risk of contracting COVID-19 and spreading it to long COVID patients and others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of the COVID-19 virus.

    Long COVID patients may also benefit from emotional and financial support as they manage symptoms, navigate barriers to treatment, and go through the months-long process of applying for and receiving disability benefits.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Avocado Oil vs Olive Oil – Which is Healthier?

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    Our Verdict

    When comparing avocado oil to olive oil, we picked the olive oil.

    Why?

    Avocados and olives are both very healthy foods. However, when they are made into oils, there’s an important distinguishing factor:

    Olive oil usually retains a lot of the micronutrients from the olives (including vitamins E and K), whereas no measurable micronutrients usually remain in avocado oil.

    So while both olive oil and avocado oil have a similar (excellent; very heart-healthy!) lipids profile, the olive oil has some bonuses that the avocado oil doesn’t.

    We haven’t written about the nutritional profiles of either avocados or olives yet, but here’s what we had to say on the different kinds of olive oil available:

    Is “Extra Virgin” Worth It?

    And here’s an example of a good one on Amazon, for your convenience 😎

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