The Daily Stoic – by Ryan Holiday & Stephen Hanselman
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What’s this, a philosophy book in a health and productivity newsletter? Well, look at it this way: Aristotle basically wrote the “How To Win Friends And Influence People” of his day, and Plato before him wrote a book about management.
In this (chiefly modern!) book, we see what the later Stoic philosophers had to say about getting the most out of life—which is also what we’re about, here at 10almonds!
We tend to use the word “stoic” in modern English to refer to a person who is resolute in the face of hardship. The traditional meaning does encompass that, but also means a lot more: a whole, rounded, philosophy of life.
Philosophy in general is not an easy thing into which to “dip one’s toe”. No matter where we try to start, it seems, it turns out there were a thousand other things we needed to read first!
This book really gets around that. The format is:
- There’s a theme for each month
- Each month has one lesson per day
- Each daily lesson starts with some words from a renowned stoic philosopher, and then provides commentary on such
- The commentary provides a jumping-off point and serves as a prompt to actually, genuinely, reflect and apply the ideas.
Unlike a lot of “a year of…” day-by-day books, this is not light reading, by the way, and you are getting a weighty tome for your money.
But, the page-length daily lessons are indeed digestible—which, again, is what we like at 10almonds!
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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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We looked at over 166,000 psychiatric records. Over half showed people were admitted against their will
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Picture two people, both suffering from a serious mental illness requiring hospital admission. One was born in Australia, the other in Asia.
Hopefully, both could be treated on a voluntary basis, taking into account their individual needs, preferences and capacity to consent. If not, you might imagine they should be equally likely to receive treatment against their will (known colloquially as being “sectioned” or “scheduled”).
However, our research published in British Journal of Psychiatry Open suggests this is not the case.
In the largest study globally of its kind, we found Australians are more likely to be treated in hospital for their acute mental illness against their will if they are born overseas, speak a language other than English or are unemployed.
What we did and what we found
We examined more than 166,000 episodes of voluntary and involuntary psychiatric care in New South Wales public hospitals between 2016 and 2021. Most admissions (54%) included at least one day of involuntary care.
Being brought to hospital via legal means, such as by police or via a court order, was strongly linked to involuntary treatment.
While our study does not show why this is the case, it may be due to mental health laws. In NSW, which has similar laws to most jurisdictions in Australia, doctors may treat a person on an involuntary basis if they present with certain symptoms indicating serious mental illness (such as hallucinations and delusions) which cause them to require protection from serious harm, and there is no other less-restrictive care available. Someone who has been brought to hospital by police or the courts may be more likely to meet the legal requirement of requiring protection from serious harm.
The likelihood of involuntary care was also linked to someone’s diagnosis. A person with psychosis or organic brain diseases, such as dementia and delirium, were about four times as likely to be admitted involuntarily compared to someone with anxiety or adjustment disorders (conditions involving a severe reaction to stressors).
However, our data suggest non-clinical factors contribute to the decision to impose involuntary care.
Compared with people born in Australia, we found people born in Asia were 42% more likely to be treated involuntarily.
People born in Africa or the Middle East were 32% more likely to be treated this way.
Overall, people who spoke a language other than English were 11% more likely to receive involuntary treatment compared to those who spoke English as their first language.
Some international researchers have suggested higher rates of involuntary treatment seen in people born overseas might be due to higher rates of psychotic illness. But our research found a link between higher rates of involuntary care in people born overseas or who don’t speak English regardless of their diagnosis.
We don’t know why this is happening. It is likely to reflect a complex interplay of factors about both the people receiving treatment and the way services are provided to them.
People less likely to be treated involuntarily included those who hold private health insurance, and those referred through a community health centre or outpatients unit.
Our findings are in line with international studies. These show higher rates of involuntary treatment among people from Black and ethnic minority groups, and people living in areas of higher socioeconomic disadvantage.
A last resort? Or should we ban it?
Both the NSW and Australian mental health commissions have called involuntary psychiatric care an avoidable harm that should only be used as a last resort.
Despite this, one study found Australia’s rate of involuntary admissions has increased by 3.4% per year and it has one of the highest rates of involuntary admissions in the world.
Involuntary psychiatric treatment is also under increasing scrutiny globally.
When Australia signed up to the UN Convention on the Rights of Persons with Disabilities, it added a declaration noting it would allow for involuntary treatment of people with mental illness where such treatments are “necessary, as a last resort and subject to safeguards”.
However, the UN has rejected this, saying it is a fundamental human right “to be free from involuntary detention in a mental health facility and not to be forced to undergo mental health treatment”.
Others question if involuntary treatment could ever be removed entirely.
Where to from here?
Our research not only highlights concerns regarding how involuntary psychiatric treatment is implemented, it’s a first step towards decreasing its use. Without understanding how and when it is used it will be difficult to create effective interventions to reduce it.
But Australia is still a long way from significantly reducing involuntary treatment.
We need to provide more care options outside hospital, ones accessible to all Australians, including those born overseas, who don’t speak English, or who come from disadvantaged communities. This includes intervening early enough that people are supported to not become so unwell they end up being referred for treatment via police or the criminal justice system.
More broadly, we need to do more to reduce stigma surrounding mental illness and to ensure poverty and discrimination are tackled to help prevent more people becoming unwell in the first place.
Our study also shows we need to do more to respect the autonomy of someone with serious mental illness to choose if they are treated. That’s whether they are in NSW or other jurisdictions.
And legal reform is required to ensure more states and territories more fully reflect the principal that people who have the capacity to make such decisions should have the right to decline mental health treatment in the same way they would any other health care.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Amy Corderoy, Medical doctor and PhD candidate studying involuntary psychiatric treatment, School of Psychiatry, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Immunostimulant Superfood –
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First, what this book is not: a “detox cleanse” book of the kind that claims you can flush out the autism if you just eat enough celery.
What it rather is: an overview brain chemistry, gut microbiota, and the very many other bodily systems that interact with these “two brains”.
She also does some mythbusting of popular misconceptions (for example with regard to tryptophan), and explains with good science just what exactly such substances as gluten and casein can and can’t do.
The format is less of a textbook and more a multipart (i.e., chapter-by-chapter) lecture, in pop-science style though, making it very readable. There are a lot of practical advices too, and options to look up foods by effect, and what to eat for/against assorted mental states.
Bottom line: anyone who eats food is, effectively, drugging themselves in one fashion or another—so you might as well make a conscious choice about how to do so.
Click here to check out This Is Your Brain On Food, and choose what kind of day you have!
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Where to Get Turmeric?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
“I liked the info on Turmeric. The problem for me is that I do not like black pepper which should be ingested with the turmeric for best results. Is black pepper sold in capsule form?”
Better than just black pepper being sold in capsule form, it’s usually available in the same capsules as the turmeric. As in: if you buy turmeric capsules, there is often black pepper in them as well, for precisely that reason. Check labels, of course, but here’s an example on Amazon.
“I would like to read more on loneliness, meetup group’s for seniors. Thank you”
Well, 10almonds is an international newsletter, so it’s hard for us to advise about (necessarily: local) meetup groups!
But a very popular resource for connecting to your local community is Nextdoor, which operates throughout the US, Canada, Australia, and large parts of Europe including the UK.
In their own words:
Get the most out of your neighborhood with Nextdoor
It’s where communities come together to greet newcomers, exchange recommendations, and read the latest local news. Where neighbors support local businesses and get updates from public agencies. Where neighbors borrow tools and sell couches. It’s how to get the most out of everything nearby. Welcome, neighbor.
Curious? Click here to check it out and see if it’s of interest to you
“It was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!!”
We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:
! Don’t Forget…
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Carrots vs Parsnips – Which is Healthier?
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Our Verdict
When comparing carrots to parsnips, we picked the parsnips.
Why?
There are arguments for both! But we say parsnips win on overall nutritional density.
In terms of macros, parsnips vary quite a lot from region to another, but broadly speaking, parsnips have more carbs and fiber, and/but the ratios are such that carrots have the lower glycemic index. We’ll call this one a win for carrots.
When it comes to vitamins, carrots have more of vitamins A, B2, B3, B6, and choline, while parsnips have more of vitamins B1, B5, B9, C, E, and K. A small win for parsnips here.
In the category of minerals, carrots are not higher in any minerals, while parsnips are higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. An overwhelming win for parsnips.
While the overall vitamin and mineral content puts parsnips ahead, it’s still worth noting that carrots have highly bioavailable megadoses of vitamin A.
Another thing to note is that the glycemic index recorded for both is when peeled and boiled, whereas both of these root vegetables can be enjoyed raw if you wish, which has a much lower GI.
In short, enjoy either or both, but parsnips are the more nutritionally dense overall.
Want to learn more?
You might like to read:
Glycemic Index vs Glycemic Load vs Insulin Index
Take care!
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Glucomannan For Weight Loss, Gut Health, & More
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Glucomannan is a water-soluble dietary fiber found in the root of the konjac plant.
If you’ve had konjac noodles, also called shirataki, that’s what those are mostly made of, and it’s why they have next-to-no calories.
You may be wondering: if it’s water-soluble, how do the noodles not dissolve in water? And the answer is that the noodle-making process involves making a gel out of the fiber and water, which is then extruded into noodle shapes. In this gelatinous form, they’re fairly stable (it’s one of the most viscous dietary fibers), but yes, if you were to boil them for a long time, they would indeed turn the entire liquid contents of the saucepan into gel.
How it works for weight loss
Because of its viscosity, adding even a small amount of powdered* glucomannan to a glass of water will turn the whole thing into gel in seconds. This means that if you take glucomannan capsules with a glass of water, then so far as your stomach is concerned, you just ate a cup of gel, and the water is now processed as food, staying longer in the stomach than it otherwise would, and promoting feelings of fullness.
*i.e. dry powder, not in a gelatinous form like the noodles
As for its efficacy in weight loss, see for example:
❝Glucomannan was well-tolerated and resulted in significant weight loss in overweight and obese individuals❞
Read more: Glucomannan and obesity: a critical review
So, that covers the basic requirements, but may be wondering: does it have other benefits? And the answer is yes, it does:
❝Glucomannan appears to beneficially affect total cholesterol, LDL cholesterol, triglycerides, body weight, and fasting blood glucose❞
To further corroborate that and comment on safety…
❝Results showed a significant mean weight loss using glucomannan over an eight-week period. Serum cholesterol and low-density lipoprotein cholesterol were significantly reduced in the glucomannan treated group. No adverse reactions to glucomannan were reported.❞
Read more: Effect of glucomannan on obese patients: a clinical study
As to whether other gel-making agents work the same way, the answer is no, they don’t seem to:
❝Glucomannan induced body weight reduction in healthy overweight subjects, whereas the addition of guar gum and alginate did not seem to cause additional loss of weight❞
Read more: Experiences with three different fiber supplements in weight reduction
How it works for gut health
In the words of Dr. Yu Li et al.,
❝Konjaku flour can achieve positive effects on treating obesity, which manifest on reducing BMI, fat mass, blood glucose, and blood lipid, improving hepatic function, and also regulating intestinal microfloral structure.
Therefore, changes in gut microbiota may explain in part the effects of konjaku flour.❞
Read in full: Effects of Konjaku Flour on the Gut Microbiota of Obese Patients
This has extra positive knock-on effects too:
Want to try some?
We don’t sell it, but here for your convenience are example products on Amazon:
Konjac noodles | Glucomannan capsules
Enjoy!
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