The Age-Proof Brain – by Dr. Marc Milstein

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Biological aging is not truly just one thing, but rather the amalgam of many things intersecting—and most of them are modifiable. The cells of your body neither know nor care how many times you have flown around the sun; they just respond to the stimuli they’re given.

Which is what fuels this book. The idea is to have a brain that is less-assailed by the things that would make it age, and more rejuvenated by the things that can make it biologically younger.

Dr. Milstein doesn’t neglect the rest of the body, and indeed notes the brain’s connections with the immune system, the heart, the gut, and more. But everything in this book is done with the brain in mind and its good health as the top priority outcome of all the things he advises.

On which note, yes, there is plenty of practical, implementable advice here. For a book that is consistently full of study paper citations, he does take care to make everything useful to the reader, and makes everything as easy as possible for the layperson along the way.

Bottom line: if you would like your brain to age less, this is an excellent, very evidence-based, guidebook.

Click here to check out The Age-Proof Brain, and age-proof your brain!

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  • Reduce Your Glaucoma Risk

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

    We’ve talked before about eye health, including:

    Today we’ll be looking at a large (n=9,973) study into how various factors increase or decrease glaucoma risk, discussing some of the fascinating statistics involved, and boiling it down to some practical takeaways:

    The study

    The researchers chose to express the increased or decreased risk of glaucoma in the form of logistic regression beta coefficients, which is not how most such papers (or especially their abstracts) do it; the usual way is to express risk as an odds ratio (sometimes called a hazard ratio in the case of risks, but mathematically it’s the same thing). So, for clarity, we’ve taken the logistical regression beta coefficients provided in the paper, converted them to odds ratios (using the formula eβ=OR, since we don’t have the raw data to know the error rate to factor in), and then multiplied the results by 100 to get a percentage in each case.

    With that in mind, here’s the list of things you probably can’t change, first:

    • Older age slightly increases glaucoma risk: each standard deviation increase in age raises odds by about 5.1%.

    Yes, just age. That’s it for relevant (i.e., that were found to have an impact) non-modifiable risk factors.

    You may be wondering: personally, I age in years, not standard deviations, so what does this mean for me?

    And the answer is: we had to scour the paper for this, but buried in a table in the middle we found that the mean age of those with glaucoma was 62.9 (standard deviation 7.99) and the mean age of those without glaucoma was 60.81 (standard deviation 7.49). Taking this information and taking into account the relevant numbers (9,631 people without glaucoma, and 342 with), means that the global standard deviation was a little over 7½ years. So in practical terms, and rounding a little for simplicity: every 7½ years, your risk increases by about 5%, which means that for every year, your risk increases by about 0.6%.

    That might seem like a very small increase, but it has unfortunate implications if you plan to live to 120.

    Now, for modifiable risk factors that increased the likelihood of glaucoma:

    • High blood pressure increases glaucoma risk by about 72.4%.
    • Diabetes increases glaucoma risk by about 47.4%.
    • Smoking increases glaucoma risk by 29.5%.
    • Alcohol consumption increases glaucoma risk by 26.3%.

    Some notes:

    Finally, some things that reduced risk according to the abstract:

    • Not being obese decreases glaucoma risk by 16.8%.
    • Being illiterate decreases glaucoma risk by 5.5%.
    • Having a low health-related quality of life (HRQoL) score decreases glaucoma risk by 3.9% (per standard deviation drop in score).

    Those last two might be confusing, and here we see an issue with data collection, and at first glance this seemed almost certainly a case of reporting bias.

    In other words:

    • someone who is illiterate may be less likely to get their glaucoma diagnosed
    • someone with a low HRQoL might also have less access to healthcare services (and/or poor/negligible/no ability to advocate for themselves), and again, be less likely to get their glaucoma diagnosed.

    To learn more about reporting bias and other such problems, see: How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

    However! When actually looking at the tabulated data, and reading the discussion in the article, it looks suspiciously like that there was simply a typo in the abstract, as doing our own calculations reveals that those two characteristics (illiteracy and low HRQoL) were, when all was said and done and investigated thoroughly, associated with a higher glaucoma risk.

    In contrast, not being obese really was associated with a lower risk, as initially described.

    You can read the paper in full here: Incidence and risk factors for glaucoma and its clinical, mental health and economic impact in an elderly population: a longitudinal study

    What does this mean in practical terms?

    There are a few key takeaways:

    • Keep your blood pressure within healthy ranges (ideally under 120/80; the threshold for “high” is 130/80, but 120/80 is already “elevated”, and you don’t want that either; as for how, see: Hypertension: Factors Far More Relevant Than Salt)
    • Keep your glucose metabolism healthy (so, eat in a way to avoid diabetes, per How To Prevent And Reverse Type 2 Diabetes; if you are unlucky and have Type 1 Diabetes, this advice still stands, as even if you can’t reverse T1D with your diet, you have even more reason to absolutely want to avoid insulin resistance / keep your insulin sensitivity high)
    • Keep your weight within healthy ranges—albeit the association here is most probably heavily mediated by cardio/metabolic disorder (e.g. hypertension/diabetes), rather than the adiposity itself, as well as the considerations we discussed in Fat’s Real Barriers To Health, which in turn are typically correlated with low HRQoL. If you want to lose weight, then here’s what we recommend: How To Lose Weight (Healthily!)
    • Don’t smoke
    • Don’t drink

    For the latter two items, see: Which Addiction-Quitting Methods Work Best?

    Take care!

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  • Is Soybean Oil Safe?

    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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? We love to hear from you!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small 😎

    ❝Is soybean oil safe? What is best?❞

    A good question! Of course, it makes a difference what you do with it, e.g:

    • Using it on salad
    • Using it for cooking
    • Boiling yourself in it
    • Gargling with it
    • Putting it on your face

    …etc can all have quite different safety outcomes.

    Now, some may seem silly, such as “gargling with it”, but actually this is not too far removed from the practice of oil-pulling, which is not gargling, but rather “put in your mouth and swish it around vigorously to clean the teeth”.

    Which, for what it’s worth, isn’t particularly harmful, but it also isn’t very effective, so really it’s best as an adjunct to other methods if possible. See: Less Common Alternatives For Oral Hygiene!

    We imagine you’re talking about culinary uses, but before we move onto those, let’s quickly note the topical application. We wrote a bit before about vegetable oils of various kinds and the skin, here:

    Beyond Castor: Vegetable Oils That Regenerate Your Skin

    Now, soybean oil didn’t feature there, but it has been studied, and:

    ❝Topical application of soybean oil extracts has been shown to decrease the transepidermal water loss of forearm skin. This feature may be linked to the presence of soy phytosterols, which have shown a positive effect on skin barrier recovery.

    Moreover, topical soybean oil protects against UVB-induced cutaneous erythema.❞

    Read in full: Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils

    Soybean oil in the kitchen

    First, for contrast, note that we’ve previously written about seed oils in general here:

    Do Seed Oils Have A Place In A Healthy Lifestyle?

    Soybean oil is, generally, considered a seed oil. That said, it has some interesting metabolism-modulating properties of its own. Have a guess whether it modulates the metabolism in a good way.

    If you guessed “no”, then you guessed correctly!

    Researchers (Dr. Frances Sladek et al.) looked at this recently, and found that there’s a protein (HNF4α is its name) that changes how we metabolise the linoleic acid found in soybean oil. Basically, we humans produce two forms of that protein, and one form of it changes the expression of hundreds of fat-metabolism genes and promotes the conversion of linoleic acid into oxylipins—molecules linked to inflammation and fat accumulation. The other does the opposite.

    This explains why different people can have quite different metabolic responses to the oil—it depends on which protein we make more of, which can also be changed during times of metabolic stress that were induced for other reasons (e.g. chronic illness, fasting, etc).

    To quote Dr. Sladek herself:

    ❝We’ve known since our 2015 study that soybean oil is more obesogenic than coconut oil. But now we have the clearest evidence yet that it’s not the oil itself, or even linoleic acid. It’s what the fat turns into inside the body.

    It took 100 years from the first observed link between chewing tobacco and cancer to get warning labels on cigarettes. We hope it won’t take that long for society to recognize the link between excessive soybean oil consumption and negative health effects.

    Soybean oil isn’t inherently evil. But the quantities in which we consume it is triggering pathways our bodies didn’t evolve to handle.❞

    You can read the paper in full, here: P2-HNF4α Alters Linoleic Acid Metabolism and Mitigates Soybean Oil-Induced Obesity: Role for Oxylipins

    And for the 2015 study she mentioned: Soybean Oil Is More Obesogenic and Diabetogenic than Coconut Oil and Fructose

    As for what to use instead…

    Top-tier healthy options include olive oil and avocado oil. Both are great, though olive oil has quite a strong taste and so isn’t suitable for everything, and avocado oil has a milder but still-present taste, though it is more suitable than olive-oil for higher-temperature cooking.

    In any case, deep-frying anything in any oil is always going to be bad, so keeping it to light use is best.

    For olive oil, see: All About Olive Oil and Is “Extra Virgin” Worth It?

    For how it compares to avocado oil, check out: Avocado Oil vs Olive Oil – Which is Healthier?

    If you’re considering butter as an alternative, then literally any plant oil is healthier.

    It was a JAMA Internal Medicine cohort study, which followed 221,054 adults (average age 56 at the start of the study, with a standard deviation of 7 years from that age) for up to 33 years.

    Why “up to”? Because not everybody survived the study.

    Specifically, 50,932 deaths were recorded, including 12,241 from cancer and 11,240 from cardiovascular disease (CVD).

    Participants were categorized into quartiles based on butter or plant-based oil intake, and…

    • The highest quartile (i.e. the 25% of people who consumed the most) butter intake linked to a 15% higher total mortality.
    • The highest quartile (i.e. the 25% of people who consumed the most) plant-based oil intake linked to a 16% lower total mortality.

    You can read more about this, here: Butter vs Plant Oils: What The Latest Evidence Shows

    And for a full set of head-to-heads (or at least, the ones we’ve head-to-headed so far, at time of writing), see:

    Take care!

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  • They Were Injured at the Super Bowl Parade. A Month Later, They Feel Forgotten.

    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.

    KFF Health News and KCUR are following the stories of people injured during the Feb. 14 mass shooting at the Kansas City Chiefs Super Bowl celebration. Listen to how one Kansas family is coping with the trauma.

    Jason Barton didn’t want to attend the Super Bowl parade this year. He told a co-worker the night before that he worried about a mass shooting. But it was Valentine’s Day, his wife is a Kansas City Chiefs superfan, and he couldn’t afford to take her to games since ticket prices soared after the team won the championship in 2020.

    So Barton drove 50 miles from Osawatomie, Kansas, to downtown Kansas City, Missouri, with his wife, Bridget, her 13-year-old daughter, Gabriella, and Gabriella’s school friend. When they finally arrived home that night, they cleaned blood from Gabriella’s sneakers and found a bullet in Bridget’s backpack.

    Gabriella’s legs were burned by sparks from a ricocheted bullet, Bridget was trampled while shielding Gabriella in the chaos, and Jason gave chest compressions to a man injured by gunfire. He believes it was Lyndell Mays, one of two men charged with second-degree felony murder.

    “There’s never going to be a Valentine’s Day where I look back and I don’t think about it,” Gabriella said, “because that’s a day where we’re supposed to have fun and appreciate the people that we have.”

    One month after the parade in which the U.S. public health crisis that is gun violence played out on live television, the Bartons are reeling from their role at its epicenter. They were just feet from 43-year-old Lisa Lopez-Galvan, who was killed. Twenty-four other people were injured. Although the Bartons aren’t included in that official victim number, they were traumatized, physically and emotionally, and pain permeates their lives: Bridget and Jason keep canceling plans to go out, opting instead to stay home together; Gabriella plans to join a boxing club instead of the dance team.

    During this first month, Kansas City community leaders have weighed how to care for people caught in the bloody crossfire and how to divide more than $2 million donated to public funds for victims in the initial outpouring of grief.

    The questions are far-reaching: How does a city compensate people for medical bills, recovery treatments, counseling, and lost wages? And what about those who have PTSD-like symptoms that could last years? How does a community identify and care for victims often overlooked in the first flush of reporting on a mass shooting: the injured?

    The injured list could grow. Prosecutors and Kansas City police are mounting a legal case against four of the shooting suspects, and are encouraging additional victims to come forward.

    “Specifically, we’re looking for individuals who suffered wounds from their trying to escape. A stampede occurred while people were trying to flee,” said Jackson County Prosecutor Jean Peters Baker. Anyone who “in the fleeing of this event that maybe fell down, you were trampled, you sprained an ankle, you broke a bone.”

    Meanwhile, people who took charge of raising money and providing services to care for the injured are wrestling with who gets the money — and who doesn’t. Due to large donations from celebrities like Taylor Swift and Travis Kelce, some victims or their families will have access to hundreds of thousands of dollars for medical expenses. Other victims may simply have their counseling covered.

    The overall economic cost of U.S. firearm injuries is estimated by a recent Harvard Medical School study at $557 billion annually. Most of that — 88% — represented quality-of-life losses among those injured by firearms and their families. The JAMA-published study found that each nonfatal firearm injury leads to roughly $30,000 in direct health care spending per survivor in the first year alone.

    In the immediate aftermath of the shootings, as well-intentioned GoFundMe pages popped up to help victims, executives at United Way of Greater Kansas City gathered to devise a collective donation response. They came up with “three concentric circles of victims,” said Jessica Blubaugh, the United Way’s chief philanthropy officer, and launched the #KCStrong campaign.

    “There were folks that were obviously directly impacted by gunfire. Then the next circle out is folks that were impacted, not necessarily by gunshots, but by physical impact. So maybe they were trampled and maybe they tore a ligament or something because they were running away,” Blubaugh said. “Then third is folks that were just adjacent and/or bystanders that have a lot of trauma from all of this.”

    PTSD, Panic, and the Echo of Gunfire

    Bridget Barton returned to Kansas City the day after the shooting to turn in the bullet she found in her backpack and to give a statement at police headquarters. Unbeknownst to her, Mayor Quinton Lucas and the police and fire chiefs had just finished a press conference outside the building. She was mobbed by the media assembled there — interviews that are now a blur.

    “I don’t know how you guys do this every day,” she remembered telling a detective once she finally got inside.

    The Bartons have been overwhelmed by well wishes from close friends and family as they navigate the trauma, almost to the point of exhaustion. Bridget took to social media to explain she wasn’t ignoring the messages, she’s just responding as she feels able — some days she can hardly look at her phone, she said.

    A family friend bought new Barbie blankets for Gabriella and her friend after the ones they brought to the parade were lost or ruined. Bridget tried replacing the blankets herself at her local Walmart, but when she was bumped accidentally, it triggered a panic attack. She abandoned her cart and drove home.

    “I’m trying to get my anxiety under control,” Bridget said.

    That means therapy. Before the parade, she was already seeing a therapist and planning to begin eye movement desensitization and reprocessing, a form of therapy associated with treating post-traumatic stress disorder. Now the shooting is the first thing she wants to talk about in therapy.

    Since Gabriella, an eighth grader, has returned to middle school, she has dealt with the compounding immaturity of adolescence: peers telling her to get over it, pointing finger guns at her, or even saying it should have been her who was shot. But her friends are checking on her and asking how she’s doing. She wishes more people would do the same for her friend, who took off running when the shooting started and avoided injury. Gabriella feels guilty about bringing her to what turned into a horrifying experience.

    “We can tell her all day long, ‘It wasn’t your fault. She’s not your responsibility.’ Just like I can tell myself, ‘It wasn’t my fault or my responsibility,’” Bridget said. “But I still bawled on her mom’s shoulder telling her how sorry I was that I grabbed my kid first.”

    The two girls have spent a lot of time talking since the shooting, which Gabriella said helps with her own stress. So does spending time with her dog and her lizard, putting on makeup, and listening to music — Tech N9ne’s performance was a highlight of the Super Bowl celebration for her.

    In addition to the spark burns on Gabriella’s legs, when she fell to the concrete in the pandemonium she split open a burn wound on her stomach previously caused by a styling iron.

    “When I see that, I just picture my mom trying to protect me and seeing everyone run,” Gabriella said of the wound.

    It’s hard not to feel forgotten by the public, Bridget said. The shooting, especially its survivors, have largely faded from the headlines aside from court dates. Two additional high-profile shootings have occurred in the area since the parade. Doesn’t the community care, she wonders, that her family is still living with the fallout every day?

    “I’m going to put this as plainly as possible. I’m f—ing pissed because my family went through something traumatic,” Bridget vented in a recent social media post. “I don’t really want anything other [than], ‘Your story matters, too, and we want to know how you’re doing.’ Have we gotten that? Abso-f—lutely not.”

    ‘What Is the Landscape of Need?’

    Helped in part by celebrities like Swift and Kelce, donations for the family of Lopez-Galvan, the lone fatality, and other victims poured in immediately after the shootings. Swift and Kelce donated $100,000 each. With the help of an initial $200,000 donation from the Kansas City Chiefs, the United Way’s #KCStrong campaign took off, reaching $1 million in the first two weeks and sitting at $1.2 million now.

    Six verified GoFundMe funds were established. One solely for the Lopez-Galvan family has collected over $406,000. Smaller ones were started by a local college student and Swift fans. Churches have also stepped up, and one local coalition had raised $183,000, money set aside for Lopez-Galvan’s funeral, counseling services for five victims, and other medical bills from Children’s Mercy Kansas City hospital, said Ray Jarrett, executive director of Unite KC.

    Money for Victims Rolls In

    Donations poured in for those injured at the Super Bowl Parade in Kansas City after the Feb. 14 shootings. The largest, starting with a $200,000 donation from the Kansas City Chiefs, is at the United Way of Greater Kansas City. Six GoFundMe sites also popped up, due in part to $100,000 donations each from Taylor Swift and Travis Kelce. Here’s a look at the totals as of March 12.United Way#KCStrong: $1.2 million.Six Verified GoFundMe AccountsLisa Lopez-Galvan GoFundMe (Taylor Swift donated): $406,142Reyes Family GoFundMe (Travis Kelce donated): $207,035Samuel Arellano GoFundMe: $11,896Emily Tavis GoFundMe: $9,518Cristian Martinez’s GoFundMe for United Way: $2,967Swifties’ GoFundMe for Children’s Mercy hospital: $1,060ChurchesResurrection (Methodist) “Victims of Violence Fund”: $53,358‘The Church Loves Kansas City’: $183,000 

    Meanwhile, those leading the efforts found models in other cities. The United Way’s Blubaugh called counterparts who’d responded to their own mass shootings in Orlando, Florida; Buffalo, New York; and Newtown, Connecticut.

    “The unfortunate reality is we have a cadre of communities across the country who have already faced tragedies like this,” Blubaugh said. “So there is an unfortunate protocol that is, sort of, already in place.”

    #KCStrong monies could start being paid out by the end of March, Blubaugh said. Hundreds of people called the nonprofit’s 211 line, and the United Way is consulting with hospitals and law enforcement to verify victims and then offer services they may need, she said.

    The range of needs is staggering — several people are still recovering at home, some are seeking counseling, and many weren’t even counted in the beginning. For instance, a plainclothes police officer was injured in the melee but is doing fine now, said Police Chief Stacey Graves.

    Determining who is eligible for assistance was one of the first conversations United Way officials had when creating the fund. They prioritized three areas of focus: first were the wounded victims and their families, second was collaborating with organizations already helping victims in violence intervention and prevention and mental health services, and third were the first responders.

    Specifically, the funds will be steered to cover medical bills, or lost wages for those who haven’t been able to work since the shootings, Blubaugh said. The goal is to work quickly to help people, she said, but also to spend the money in a judicious, strategic way.

    “We don’t have a clear sightline of the entire landscape that we’re dealing with,” Blubaugh said. “Not only of how much money do we have to work with, but also, what is the landscape of need? And we need both of those things to be able to make those decisions.”

    Firsthand Experience of Daily Kansas City Violence

    Jason used his lone remaining sick day to stay home with Bridget and Gabriella. An overnight automation technician, he is the family’s primary breadwinner.

    “I can’t take off work, you know?” he said. “It happened. It sucked. But it’s time to move on.”

    “He’s a guy’s guy,” Bridget interjected.

    On Jason’s first night back at work, the sudden sound of falling dishes startled Bridget and Gabriella, sending them into each other’s arms crying.

    “It’s just those moments of flashbacks that are kicking our butts,” Bridget said.

    Tell Us About Your Experience

    We are continuing to report on the effects of the parade shooting on the people who were injured and the community as a whole. Do you have an experience you want to tell us about, or a question you think we should look into? Message KCUR’s text line at (816) 601-4777. Your information will not be used in an article without your permission.

    In a way, the shooting has brought the family closer. They’ve been through a lot recently. Jason survived a heart attack and cancer last year. Raising a teenager is never easy.

    Bridget can appreciate that the bullet lodged in her backpack, narrowly missing her, and that Gabriella’s legs were burned by sparks but she wasn’t shot.

    Jason is grateful for another reason: It wasn’t a terrorist attack, as he initially feared. Instead, it fits into the type of gun violence he’d become accustomed to growing up in Kansas City, which recorded its deadliest year last year, although he’d never been this close to it before.

    “This crap happens every single day,” he said. “The only difference is we were here for it.”

    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.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • 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!

    Don’t Forget…

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  • Cherries vs Raspberries – Which is Healthier?

    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.

    Our Verdict

    When comparing cherries to raspberries, we picked the raspberries.

    Why?

    Both are great! But…

    In terms of macros, raspberries have more than 4x the fiber, for similar carbs and similar (minimal) protein, winning this round easily.

    In the category of vitamins, cherries have more vitamin A, while raspberries have more of vitamins B1, B2, B3, B5, B6, B7, B9, C, E, and K, for another overwhelming win.

    Looking at minerals, cherries have (very slightly) more copper and potassium, while raspberries have rather more calcium, iron, magnesium, manganese, phosphorus, selenium, and zinc, winning a third round just as easily as the previous two.

    In other considerations, cherries have some special phytochemical benefits of their own (see the “learn more” below), while raspberries have a lot more polyphenols, so we’ll call this round a tie.

    Adding up the sections makes for a clear overall win for raspberries but by all means enjoy either or both, as diversity is good!

    Want to learn more?

    You might like:

    Cherries’ Very Healthy Wealth Of Benefits!

    Enjoy!

    Don’t Forget…

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  • Hantavirus quarantine has started. Two infection control experts explain what to expect

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    Six passengers from the hantavirus cruise ship have started their quarantine at Australia’s purpose-built facility in Western Australia.

    Over the next three weeks, the Australians and one New Zealander will be housed at the 500-bed Bullsbrook facility north-east of Perth, one of three purpose-built “centres for national resilience” around the country.

    There, staff from the National Critical Care and Trauma Response Centre will monitor the returned passengers’ health, before authorities decide what happens next.

    We are both infection prevention and control experts who advised the Victorian government on best-practice quarantine arrangements during COVID. This included the design of a dedicated quarantine facility.

    Here’s how the Perth facility – and similar purpose-built ones in Melbourne and Brisbane – have been designed to minimise the spread of infectious diseases.

    Multiplex

    What actually is quarantine?

    The word itself comes from the Italian phrase quaranta giorni, meaning “40 days”. Back during the Black Death, ships had to anchor off the coast for 40 days before they could land in European cities to make sure no one on board was sick.

    Today, quarantine is specifically for people who have been exposed to a virus – in this case the Andes strain of hantavirus – but aren’t showing any symptoms yet.

    Experience from managing other infectious diseases, including COVID, has taught us that people can spread a virus before they even feel sick. We use quarantine to protect the community and also to make sure the person who was exposed doesn’t catch anything else.

    During the early stages of the COVID pandemic, Australia was among countries that used hotels for quarantine purposes. But hotels are designed for comfort, not for stopping airborne pathogens. Shared spaces, inadequate ventilation systems, poor workflow (see points two and three below), and staff often with little or no expertise in infection control contributed to several breaches.

    Many of these hotels were in the middle of busy cities. This was risky because any breach could immediately expose a lot of people in a crowded area.

    So Australia built three centres for national resilience in Mickleham (near Melbourne), Perth and Brisbane. These were placed outside crowded city centres but still close to airports.

    So what are these facilities like?

    When architects and health experts design these facilities, they focus on four main things: fresh air, design, workflow and dignity.

    1. Fresh air inside and out

    These buildings need a constant supply of fresh air. The air is never recirculated (reused). Instead, old air is pushed outside so people aren’t breathing in “re-breathed” particles from someone else. So a lot of thought goes into air handling, that is, stopping germs from hanging around in the air and spreading to others.

    That includes designing facilities with verandahs (for residents) and open-air walkways (for staff).

    Verandahs, balconies, walkways of quarantine facilities
    Perth’s facility has verandahs and open-air walkways to minimise the spread of infectious diseases. Multiplex

    2. Designed with zones

    The safest way to run a facility is to split it into three “traffic light” zones:

    • the green zone (clean): where staff enter, have their offices, and take breaks
    • orange zone (transition): a buffer area, like a verandah or porch, where staff put on their protective gear or hand over meals and medical samples
    • red zone (contaminated): the actual room or area where the person stays. Anyone entering this area must wear full personal protective equipment. This often includes properly fitted long-sleeved gowns, gloves, N95 masks and face shields or goggles, combined with mandatory training in “donning and doffing” (putting on and taking off personal protective equipment).

    3. One-way workflow

    A crucial rule in infection control is that you never move “dirty” items back into “clean” areas. Everything must move in one direction: from clean to dirty.

    So staff and supplies follow a strict path to ensure nothing from the “red zone” accidentally moves back into the “green zone”. This could include infectious air, as well as people and objects or equipment.

    Sometimes, however, objects from the “red zone” have to move back into other zones, but need to be cleaned and disinfected first. This would be the case for the dirty laundry of people in quarantine. In this case, there are strict protocols to make sure any risk is minimised. Once cleaned and disinfected, these items can then be re-used.

    4. Ensuring dignity

    One of the hardest parts of quarantine is the mental toll. Staying in a room for weeks is hard. Those in quarantine often experience mental health stressors.

    This may include a fear of infection, constantly being on alert for symptoms, and having trouble sleeping.

    In the old hotel quarantine, some people couldn’t even go outside. By contrast, purpose-built facilities are designed to be more humane. This means:

    • accessing natural light, outdoor space and fresh air
    • good quality food and water
    • internet and entertainment so they can stay connected
    • emotional support to help with the stress of being isolated.

    What happens now?

    If anyone in the Perth facility does become sick, there is a medical clinic on-site so they can be treated or stabilised before transferring to hospital. People in quarantine also have access to telehealth.

    What happens after the three-week period is up has yet to be decided. The World Health Organization recommends active monitoring and home or facility quarantine of high-risk contacts for 42 days after their last potential exposure.

    As hantaviruses are rarely transmitted between people, the risk to the general public remains low and the virus is not a pandemic threat.

    But this outbreak is a reminder that we need to be prepared for future outbreaks of infectious diseases. So our quarantine facilities need to be ready to go should they be needed again.

    Philip Russo, Professor, Director of Research, Nursing and Midwifery, Monash University and Brett Mitchell, Professor of Nursing and Health Services Research, University of Newcastle

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

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