No-Frills, Evidence-Based Mindfulness
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What’s on your mind, really?
We hear a lot about “the evidence-based benefits of mindfulness”, but what actually are they? And what is the evidence? And, perhaps most importantly: how do we do it?
What are the benefits?
The benefits of mindfulness are many, and include:
- reducing stress
- reducing pain
- improving quality of life
- reducing fatigue
- providing relief from digestive disorders
- reducing symptoms of sleep disorders
- improving immune response
- providing support for caregivers
The evidence is also abundant, and includes:
- Effects of mindfulness exercises as stand-alone intervention on symptoms of anxiety and depression: Systematic review and meta-analysis
- Fusing character strengths and mindfulness interventions: Benefits for satisfaction and performance
- Evidence for the Role of Mindfulness in Cancer: Benefits and Techniques
- Effects of mindfulness-based stress reduction on anxiety symptoms: A systematic review and meta-analysis
- The benefits of meditation and mindfulness practices during times of crisis such as COVID-19
Sounds great… What actually is it, though?
Mindfulness is the state of being attentive to one’s mind. This is at its heart a meditative practice, but that doesn’t necessarily mean you have to be sitting in the lotus position with candles—mindfulness can be built into any daily activity, or even no activity at all.
An exercise you can try right now:
Take a moment to notice everything you can hear. For this writer, that includes:
- The noise of my keystrokes as I type
- The ticking of the clock on the wall
- The gentle humming of my computer’s processor
- The higher-pitched noise of my computer’s monitor
- Birdsong outside
- Traffic further away
- My own breathing
- The sound of my eyelids as I blink
Whatever it is for you, notice how much you can notice that you had previously taken for granted.
You can repeat this exercise with other senses, by the way! For example:
- Notice five things you can see in your immediate environment that you’ve never noticed before. If you’re at home reading this, you probably think you’re very familiar with everything around you, but now see that mark on the wall you’d never noticed before, or a quirk of some electrical wiring, or the stitching on some furnishing, for example.
- Notice the textures of your clothes, or your face, or perhaps an object you’ve never paid attention to touching before. Your fingertips, unless you have some special reason this doesn’t apply to you, are far more sensitive than you probably give them credit for, and can notice the tiniest differentiation in textures, so take a moment to do that now.
- Mindful eating can be an especially healthful practice because it requires that we pay every attention to what we’re putting in our mouth, tasting, chewing, swallowing. No more thoughtlessly downing a box of cookies; every bite is now an experience. On the one hand, you’ll probably eat less at a sitting. On the other hand, what a sensory experience! It really reminds one that life is for living, not just for zipping through at a speed-run pace!
What about mindfulness as a meditative practice?
Well, those are meditative practices! But yes, mindfulness goes for more formal meditation too. For example:
Sit comfortably, with good posture, whatever that means to you. No need to get too caught up in the physical mechanics here—it’d take a whole article. For now, if you’re sitting and comfortable, that’s enough.
Notice your breathing. No need to try to control it—that’s not what this is about today. Just notice it. The in, the out, whether you breathe to your chest or abdomen, through your nose or mouth, don’t worry about doing it “right”, just notice what you are doing. Observe without judgement.
Notice your thoughts—no need to try to stop them. Notice noticing your thoughts, and again, observe without judgement. Notice your feelings; are you angry, hopeful, stressed, serene? There are no wrong answers here, and there’s nothing you should try to “correct”. Just observe. No judgement, only observe. Watch your thoughts, and watch your thoughts go.
Did you forget about your breathing while watching your thoughts? Don’t worry about that either if so, just notice that it happened. If you have any feelings about that, notice them too, and carry on observing.
We go through so much of our lives in “autopilot”, that it can be an amazing experience to sometimes just “be”—and be aware of being.
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Delicious Quinoa Avocado Bread
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They’re gluten-free, full of protein and healthy fats, generous with the fiber, easy to make, and tasty too! What’s not to love? Keep this recipe (and its ingredients) handy for next time you want healthy burger buns or similar:
You will need
- 2½ cups quinoa flour
- 2 cups almond flour (if allergic, just substitute more quinoa flour)
- 1 avocado, peeled, pitted, and mashed
- zest and juice of 1 lime
- 2 tbsp ground flaxseed
- 1 tsp baking powder
- ½ tsp MSG or 1 tsp low-sodium salt
- Optional: seeds, oats, or similar for topping the buns
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 350℉/175℃.
2) Mix the flaxseed with ⅓ cup warm water and set aside.
3) Mix, in a large bowl, the quinoa flour and almond flour with the baking powder and the MSG or salt.
4) Mix, in a separate smaller bowl, the avocado and lime.
5) Add the wet ingredients to the dry, slowly, adding an extra ½ cup water as you do, and knead into a dough.
6) Divide the dough into 4 equal portions, each shaped into a ball and then slightly flattened, to create a burger bun shape. If you’re going to add any seeds or similar as a topping, add those now.
7) Bake them in the oven (on a baking sheet lined with baking paper) for 20–25 minutes. You can check whether they’re done the same way you would a cake, by piercing them to the center with a toothpick and seeing whether it comes out clean.
8) Serve when sufficiently cooled.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Gluten: What’s The Truth?
- Why You Should Diversify Your Nuts!
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
Take care!
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Loss, Trauma, and Resilience – by Dr. Pauline Boss
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Most books about bereavement are focused on grieving healthily and then moving on healthily. And, while it may be said “everyone’s grief is on their own timescale”… society’s expectation is often quite fixed:
“Time will heal”, they say.
But what if it doesn’t? What happens when that’s not possible?
Ambiguous loss occurs when someone is on the one hand “gone”, but on the other hand, not necessarily.
This can be:
- Someone was lost in a way that didn’t leave a body to 100% confirm it
- (e.g. disaster, terrorism, war, murder, missing persons)
- Someone remains physically present but in some ways already “gone”
- (e.g. Alzheimer’s disease or other dementia, brain injury, coma)
These things stop us continuing as normal, and/but also stop us from moving on as normal.
When either kind of moving forward is made impossible, everything gets frozen in place. How does one deal with that?
Dr. Boss wrote this book for therapists, but its content is equally useful for anyone struggling with ambiguous loss—or who has a loved one who is, in turn, struggling with that.
The book looks at the impact of ambiguous loss on continuing life, and how to navigate that:
- How to be resilient, in the sense of when life tries to break you, to have ways to bend instead.
- How to live with the cognitive dissonance of a loved one who is a sort of “Schrödinger’s person”.
- How, and this is sometimes the biggest one, to manage ambiguous loss in a society that often pushes toward: “it’s been x period of time, come on, get over it now, back to normal”
Will this book heal your heart and resolve your grief? No, it won’t. But what it can do is give a roadmap for nonetheless thriving in life, while gently holding onto whatever we need to along the way.
Click here to check out “Ambiguous loss, Trauma, and Resilience” on Amazon—it can really help
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- Someone was lost in a way that didn’t leave a body to 100% confirm it
Hospitals worldwide are short of saline. We can’t just switch to other IV fluids – here’s why
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Last week, the Australian Therapeutic Goods Administration added intravenous (IV) fluids to the growing list of medicines in short supply. The shortage is due to higher-than-expected demand and manufacturing issues.
Two particular IV fluids are affected: saline and compound sodium lactate (also called Hartmann’s solution). Both fluids are made with salts.
There are IV fluids that use other components, such as sugar, rather than salt. But instead of switching patients to those fluids, the government has chosen to approve salt-based solutions by other overseas brands.
So why do IV fluids contain different chemicals? And why can’t they just be interchanged when one runs low?
Pavel Kosolapov/Shutterstock We can’t just inject water into a vein
Drugs are always injected into veins in a water-based solution. But we can’t do this with pure water, we need to add other chemicals. That’s because of a scientific principle called osmosis.
Osmosis occurs when water moves rapidly in and out of the cells in the blood stream, in response to changes to the concentration of chemicals dissolved in the blood plasma. Think salts, sugars, nutrients, drugs and proteins.
Too high a concentration of chemicals and protein in your blood stream leads it to being in a “hypertonic” state, which causes your blood cells to shrink. Not enough chemicals and proteins in your blood stream causes your blood cells to expand. Just the right amount is called “isotonic”.
Mixing the drug with the right amount of chemicals, via an injection or infusion, ensures the concentration inside the syringe or IV bag remains close to isotonic.
Australia is currently short on two salt-based IV fluids. sirnength88/Shutterstock What are the different types of IV fluids?
There are a range of IV fluids available to administer drugs. The two most popular are:
- 0.9% saline, which is an isotonic solution of table salt. This is one of the IV fluids in short supply
- a 5% solution of the sugar glucose/dextrose. This fluid is not in short supply.
There are also IV fluids that combine both saline and glucose, and IV fluids that have other salts:
- Ringer’s solution is an IV fluid which has sodium, potassium and calcium salts
- Plasma-Lyte has different sodium salts, as well as magnesium
- Hartmann’s solution (compound sodium lactate) contains a range of different salts. It is generally used to treat a condition called metabolic acidosis, where patients have increased acid in their blood stream. This is in short supply.
What if you use the wrong solution?
Some drugs are only stable in specific IV fluids, for instance, only in salt-based IV fluids or only in glucose.
Putting a drug into the wrong IV fluid can potentially cause the drug to “crash out” of the solution, meaning patients won’t get the full dose.
Or it could cause the drug to decompose: not only will it not work, but it could also cause serious side effects.
An example of where a drug can be transformed into something toxic is the cancer chemotherapy drug cisplatin. When administered in saline it is safe, but administration in pure glucose can cause life-threatening damage to a patients’ kidneys.
What can hospitals use instead?
The IV fluids in short supply are saline and Hartmann’s solution. They are provided by three approved Australian suppliers: Baxter Healthcare, B.Braun and Fresenius Kabi.
The government’s solution to this is to approve multiple overseas-registered alternative saline brands, which they are allowed to do under current legislation without it going through the normal Australian quality checks and approval process. They will have received approval in their country of manufacture.
The government is taking this approach because it may not be effective or safe to formulate medicines that are meant to be in saline into different IV fluids. And we don’t have sufficient capacity to manufacture saline IV fluids here in Australia.
The Australian Society of Hospital Pharmacists provides guidance to other health staff about what drugs have to go with which IV fluids in their Australian Injectable Drugs Handbook. If there is a shortage of saline or Hartmann’s solution, and shipments of other overseas brands have not arrived, this guidance can be used to select another appropriate IV fluid.
Why don’t we make it locally?
The current shortage of IV fluids is just another example of the problems Australia faces when it is almost completely reliant on its critical medicines from overseas manufacturers.
Fortunately, we have workarounds to address the current shortage. But Australia is likely to face ongoing shortages, not only for IV fluids but for any medicines that we rely on overseas manufacturers to produce. Shortages like this put Australian lives at risk.
In the past both myself, and others, have called for the federal government to develop or back the development of medicines manufacturing in Australia. This could involve manufacturing off-patent medicines with an emphasis on those medicines most used in Australia.
Not only would this create stable, high technology jobs in Australia, it would also contribute to our economy and make us less susceptible to future global drug supply problems.
Nial Wheate, Professor and Director Academic Excellence, Macquarie University and Shoohb Alassadi, Casual academic, pharmaceutical sciences, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Say That Again: Using Hearing Aids Can Be Frustrating for Older Adults, but Necessary
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It was an every-other-day routine, full of frustration.
Every time my husband called his father, who was 94 when he died in 2022, he’d wait for his dad to find his hearing aids and put them in before they started talking.
Even then, my father-in-law could barely hear what my husband was saying. “What?” he’d ask over and over.
Then, there were the problems my father-in-law had replacing the devices’ batteries. And the times he’d end up in the hospital, unable to understand what people were saying because his hearing aids didn’t seem to be functioning. And the times he’d drop one of the devices and be unable to find it.
How many older adults have problems of this kind?
There’s no good data about this topic, according to Nicholas Reed, an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health who studies hearing loss. He did a literature search when I posed the question and came up empty.
Reed co-authored the most definitive study to date of hearing issues in older Americans, published in JAMA Open Network last year. Previous studies excluded people 80 and older. But data became available when a 2021 survey by the National Health and Aging Trends Study included hearing assessments conducted at people’s homes.
The results, based on a nationally representative sample of 2,803 people 71 and older, are eye-opening. Hearing problems become pervasive with advancing age, exceeding 90% in people 85 and older, compared with 53% of 71- to 74-year-olds. Also, hearing worsens over time, with more people experiencing moderate or severe deficits once they reach or exceed age 80, compared with people in their 70s.
However, only 29% of those with hearing loss used hearing aids. Multiple studies have documented barriers that inhibit use. Such devices, which Medicare doesn’t cover, are pricey, from nearly $1,000 for a good over-the-counter set (OTC hearing aids became available in 2022) to more than $6,000 for some prescription models. In some communities, hearing evaluation services are difficult to find. Also, people often associate hearing aids with being old and feel self-conscious about wearing them. And they tend to underestimate hearing problems that develop gradually.
Barbara Weinstein, a professor of audiology at the City University of New York Graduate Center and author of the textbook “Geriatric Audiology,” added another concern to this list when I reached out to her: usability.
“Hearing aids aren’t really designed for the population that most needs to use them,” she told me. “The move to make devices smaller and more sophisticated technologically isn’t right for many people who are older.”
That’s problematic because hearing loss raises the risk of cognitive decline, dementia, falls, depression, and social isolation.
What advice do specialists in hearing health have for older adults who have a hard time using their hearing aids? Here are some thoughts they shared.
Consider larger, customized devices. Many older people, especially those with arthritis, poor fine motor skills, compromised vision, and some degree of cognitive impairment, have a hard time manipulating small hearing aids and using them properly.
Lindsay Creed, associate director of audiology practices at the American Speech-Language-Hearing Association, said about half of her older clients have “some sort of dexterity issue, whether numbness or reduced movement or tremor or a lack of coordination.” Shekinah Mast, owner of Mast Audiology Services in Seaford, Delaware, estimates nearly half of her clients have vision issues.
For clients with dexterity challenges, Creed often recommends “behind-the-ear hearing aids,” with a loop over the ear, and customized molds that fit snugly in the ear. Customized earpieces are larger than standardized models.
“The more dexterity challenges you have, the better you’ll do with a larger device and with lots of practice picking it up, orienting it, and putting it in your ear,” said Marquitta Merkison, associate director of audiology practices at ASHA.
For older people with vision issues, Mast sometimes orders hearing aids in different colors for different ears. Also, she’ll help clients set up stands at home for storing devices, chargers, and accessories so they can readily find them each time they need them.
Opt for ease of use. Instead of buying devices that require replacing tiny batteries, select a device that can be charged overnight and operate for at least a day before being recharged, recommended Thomas Powers, a consultant to the Hearing Industries Association. These are now widely available.
People who are comfortable using a smartphone should consider using a phone app to change volume and other device settings. Dave Fabry, chief hearing health officer at Starkey, a major hearing aid manufacturer, said he has patients in their 80s and 90s “who’ve found that being able to hold a phone and use larger visible controls is easier than manipulating the hearing aid.”
If that’s too difficult, try a remote control. GN ReSound, another major manufacturer, has designed one with two large buttons that activate the volume control and programming for its hearing aids, said Megan Quilter, the company’s lead audiologist for research and development.
Check out accessories. Say you’re having trouble hearing other people in restaurants. You can ask the person across the table to clip a microphone to his shirt or put the mike in the center of the table. (The hearing aids will need to be programmed to allow the sound to be streamed to your ears.)
Another low-tech option: a hearing aid clip that connects to a piece of clothing to prevent a device from falling to the floor if it becomes dislodged from the ear.
Wear your hearing aids all day. “The No. 1 thing I hear from older adults is they think they don’t need to put on their hearing aids when they’re at home in a quiet environment,” said Erika Shakespeare, who owns Audiology and Hearing Aid Associates in La Grande, Oregon.
That’s based on a misunderstanding. Our brains need regular, not occasional, stimulation from our environments to optimize hearing, Shakespeare explained. This includes noises in seemingly quiet environments, such as the whoosh of a fan, the creak of a floor, or the wind’s wail outside a window.
“If the only time you wear hearing aids is when you think you need them, your brain doesn’t know how to process all those sounds,” she told me. Her rule of thumb: “Wear hearing aids all your waking hours.”
Consult a hearing professional. Everyone’s needs are different, so it’s a good idea to seek out an audiologist or hearing specialist who, for a fee, can provide guidance.
“Most older people are not going to know what they need” and what options exist without professional assistance, said Virginia Ramachandran, the head of audiology at Oticon, a major hearing aid manufacturer, and a past president of the American Academy of Audiology.
Her advice to older adults: Be “really open” about your challenges.
If you can’t afford hearing aids, ask a hearing professional for an appointment to go over features you should look for in over-the-counter devices. Make it clear you want the appointment to be about your needs, not a sales pitch, Reed said. Audiology practices don’t routinely offer this kind of service, but there’s good reason to ask since Medicare started covering once-a-year audiologist consultations last year.
We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care, and advice you need in dealing with the health care system. Visit http://kffhealthnews.org/columnists to submit your requests or tips.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Celery vs Cucumber – Which is Healthier?
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Our Verdict
When comparing celery to cucumber, we picked the celery.
Why?
They are both great, of course! But celery came out on top:
Their macros are very comparable; they’re both 95% water with just enough other things to hold them together, and those other things are in approximately the same proportions in both celery and cucumber.
In the category of vitamins, however, celery has a lot more of vitamins A, B2, B3, B6, B9, E, and K, as well as slightly more vitamin C. Cucumber, meanwhile, only boasts slightly higher vitamin B1.
An easy win for celery on the vitamin front!
Minerals are closer, but celery still comes out on top with its notably higher calcium and potassium content. Cucumber has more iron and zinc, but the margin is smaller.
As a point in cucumber’s favor, it has been noted for its anti-inflammatory effect in ways that celery hasn’t, but we don’t think this is enough to say it wins over celery sweeping the vitamins category and coming out top for minerals too.
However! They are both great, so enjoy them both, of course.
Want to learn more?
You might like to read:
- Cucumber Extract Beats Glucosamine & Chondroitin… At 1/135th Of The Dose?!
- Some Surprising Truths About Hunger And Satiety ← both celery and cucumber are great for this
Enjoy!
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‘I keep away from people’ – combined vision and hearing loss is isolating more and more older Australians
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Our ageing population brings a growing crisis: people over 65 are at greater risk of dual sensory impairment (also known as “deafblindness” or combined vision and hearing loss).
Some 66% of people over 60 have hearing loss and 33% of older Australians have low vision. Estimates suggest more than a quarter of Australians over 80 are living with dual sensory impairment.
Combined vision and hearing loss describes any degree of sight and hearing loss, so neither sense can compensate for the other. Dual sensory impairment can occur at any point in life but is increasingly common as people get older.
The experience can make older people feel isolated and unable to participate in important conversations, including about their health.
bricolage/Shutterstock Causes and conditions
Conditions related to hearing and vision impairment often increase as we age – but many of these changes are subtle.
Hearing loss can start as early as our 50s and often accompany other age-related visual changes, such as age-related macular degeneration.
Other age-related conditions are frequently prioritised by patients, doctors or carers, such as diabetes or heart disease. Vision and hearing changes can be easy to overlook or accept as a normal aspect of ageing. As an older person we interviewed for our research told us
I don’t see too good or hear too well. It’s just part of old age.
An invisible disability
Dual sensory impairment has a significant and negative impact in all aspects of a person’s life. It reduces access to information, mobility and orientation, impacts social activities and communication, making it difficult for older adults to manage.
It is underdiagnosed, underrecognised and sometimes misattributed (for example, to cognitive impairment or decline). However, there is also growing evidence of links between dementia and dual sensory loss. If left untreated or without appropriate support, dual sensory impairment diminishes the capacity of older people to live independently, feel happy and be safe.
A dearth of specific resources to educate and support older Australians with their dual sensory impairment means when older people do raise the issue, their GP or health professional may not understand its significance or where to refer them. One older person told us:
There’s another thing too about the GP, the sort of mentality ‘well what do you expect? You’re 95.’ Hearing and vision loss in old age is not seen as a disability, it’s seen as something else.
Isolated yet more dependent on others
Global trends show a worrying conundrum. Older people with dual sensory impairment become more socially isolated, which impacts their mental health and wellbeing. At the same time they can become increasingly dependent on other people to help them navigate and manage day-to-day activities with limited sight and hearing.
One aspect of this is how effectively they can comprehend and communicate in a health-care setting. Recent research shows doctors and nurses in hospitals aren’t making themselves understood to most of their patients with dual sensory impairment. Good communication in the health context is about more than just “knowing what is going on”, researchers note. It facilitates:
- shorter hospital stays
- fewer re-admissions
- reduced emergency room visits
- better treatment adherence and medical follow up
- less unnecessary diagnostic testing
- improved health-care outcomes.
‘Too hard’
Globally, there is a better understanding of how important it is to maintain active social lives as people age. But this is difficult for older adults with dual sensory loss. One person told us
I don’t particularly want to mix with people. Too hard, because they can’t understand. I can no longer now walk into that room, see nothing, find my seat and not recognise [or hear] people.
Again, these experiences increase reliance on family. But caring in this context is tough and largely hidden. Family members describe being the “eyes and ears” for their loved one. It’s a 24/7 role which can bring frustration, social isolation and depression for carers too. One spouse told us:
He doesn’t talk anymore much, because he doesn’t know whether [people are] talking to him, unless they use his name, he’s unaware they’re speaking to him, so he might ignore people and so on. And in the end, I noticed people weren’t even bothering him to talk, so now I refuse to go. Because I don’t think it’s fair.
Dual sensory loss can be isolating for older people and carers. Synthex/Shutterstock So, what can we do?
Dual sensory impairment is a growing problem with potentially devastating impacts.
It should be considered a unique and distinct disability in all relevant protections and policies. This includes the right to dedicated diagnosis and support, accessibility provisions and specialised skill development for health and social professionals and carers.
We need to develop resources to help people with dual sensory impairment and their families and carers understand the condition, what it means and how everyone can be supported. This could include communication adaptation, such as social haptics (communicating using touch) and specialised support for older adults to navigate health care.
Increasing awareness and understanding of dual sensory impairment will also help those impacted with everyday engagement with the world around them – rather than the isolation many feel now.
Moira Dunsmore, Senior Lecturer, Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, University of Sydney; Annmaree Watharow, Lived Experience Research Fellow, Centre for Disability Research and Policy, University of Sydney, and Emily Kecman, Postdoctoral research fellow, Department of Linguistics, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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