Women are less likely to receive CPR than men. Training on manikins with breasts could help
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If someone’s heart suddenly stops beating, they may only have minutes to live. Doing CPR (cardiopulmonary resusciation) can increase their chances of survival. CPR makes sure blood keeps pumping, providing oxygen to the brain and vital organs until specialist treatment arrives.
But research shows bystanders are less likely to intervene to perform CPR when that person is a woman. A recent Australian study analysed 4,491 cardiac arrests between 2017–19 and found bystanders were more likely to give CPR to men (74%) than women (65%).
Could this partly be because CPR training dummies (known as manikins) don’t have breasts? Our new research looked at manikins available worldwide to train people in performing CPR and found 95% are flat-chested.
Anatomically, breasts don’t change CPR technique. But they may influence whether people attempt it – and hesitation in these crucial moments could mean the difference between life and death.
Heart health disparities
Cardiovascular diseases – including heart disease, stroke and cardiac arrest – are the leading cause of death for women across the world.
But if a woman has a cardiac arrest outside hospital (meaning her heart stops pumping properly), she is 10% less likely to receive CPR than a man. Women are also less likely to survive CPR and more likely to have brain damage following cardiac arrests.
These are just some of many unequal health outcomes women experience, along with transgender and non-binary people. Compared to men, their symptoms are more likely to be dismissed or misdiagnosed, or it may take longer for them to receive a diagnosis.
Bystander reluctance
There is also increasing evidence women are less likely to receive CPR compared to men.
This may be partly due to bystander concerns they’ll be accused of sexual harassment, worry they might cause damage (in some cases based on a perception women are more “frail”) and discomfort about touching a woman’s breast.
Bystanders may also have trouble recognising a woman is experiencing a cardiac arrest.
Even in simulations of scenarios, researchers have found those who intervened were less likely to remove a woman’s clothing to prepare for resuscitation, compared to men. And women were less likely to receive CPR or defibrillation (an electric charge to restart the heart) – even when the training was an online game that didn’t involve touching anyone.
There is evidence that how people act in resuscitation training scenarios mirrors what they do in real emergencies. This means it’s vital to train people to recognise a cardiac arrest and be prepared to intervene, across genders and body types.
Skewed to male bodies
Most CPR training resources feature male bodies, or don’t specify a sex. If the bodies don’t have breasts, it implies a male default.
For example, a 2022 study looking at CPR training across North, Central and South America, found most manikins available were white (88%), male (94%) and lean (99%).
These studies reflect what we see in our own work, training other health practitioners to do CPR. We have noticed all the manikins available to for training are flat-chested. One of us (Rebecca) found it difficult to find any training manikins with breasts.
A single manikin with breasts
Our new research investigated what CPR manikins are available and how diverse they are. We identified 20 CPR manikins on the global market in 2023. Manikins are usually a torso with a head and no arms.
Of the 20 available, five (25%) were sold as “female” – but only one of these had breasts. That means 95% of available CPR training manikins were flat-chested.
We also looked at other features of diversity, including skin tone and larger bodies. We found 65% had more than one skin tone available, but just one was a larger size body. More research is needed on how these aspects affect bystanders in giving CPR.
Breasts don’t change CPR technique
CPR technique doesn’t change when someone has breasts. The barriers are cultural. And while you might feel uncomfortable, starting CPR as soon as possible could save a life.
Signs someone might need CPR include not breathing properly or at all, or not responding to you.
To perform effective CPR, you should:
- put the heel of your hand on the middle of their chest
- put your other hand on the top of the first hand, and interlock fingers (keep your arms straight)
- press down hard, to a depth of about 5cm before releasing
- push the chest at a rate of 100-120 beats per minute (you can sing a song) in your head to help keep time!)
https://www.youtube.com/embed/Plse2FOkV4Q?wmode=transparent&start=94 An example of how to do CPR – with a flat-chested manikin.
What about a defibrillator?
You don’t need to remove someone’s bra to perform CPR. But you may need to if a defibrillator is required.
A defibrillator is a device that applies an electric charge to restore the heartbeat. A bra with an underwire could cause a slight burn to the skin when the debrillator’s pads apply the electric charge. But if you can’t remove the bra, don’t let it delay care.
What should change?
Our research highlights the need for a range of CPR training manikins with breasts, as well as different body sizes.
Training resources need to better prepare people to intervene and perform CPR on people with breasts. We also need greater education about women’s risk of getting and dying from heart-related diseases.
Jessica Stokes-Parish, Assistant Professor in Medicine, Bond University and Rebecca A. Szabo, Honorary Senior Lecturer in Critical Care and Obstetrics, Gynaecology and Newborn Health, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Oh She Glows Cookbook – by Angela Liddon
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Let’s get the criticism out of the way first: notwithstanding the subtitle promising over 100 recipes, there are about 80-odd here, if we discount recipes that are no-brainer things like smoothies, sides such as for example “roasted garlic”, or meta-ingredients such as oat flour (instructions: blend the oats and you get oat flour).
The other criticism is more subjective: if you are like this reviewer, you will want to add more seasonings than recommended to most of the recipes. But that’s easy enough to do.
As for the rest: this is a very healthy cookbook, and quite wide-ranging and versatile, with recipes that are homely, with a lot of emphasis on comfort foods (but still, healthy), though certainly some are perfectly worthy of entertaining too.
A nice bonus of this book is that it offers a lot of available substitutions (much like we do at 10almonds), and also ways of turning the recipe into something else entirely with just a small change. This trait more than makes up for the slight swindle in terms of number of recipes, since some of the recipes have bonus recipes snuck in.
Bottom line: if you’d like to broaden your plant-based cooking range, this book is a fine option for expanding your repertoire.
Click here to check out The Oh She Glows Cookbook, and indeed glow!
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True Age – by Dr. Morgan Levine
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Yesterday’s book review (Counterclockwise) was about psychological factors affecting physical aging (progression or reversal thereof); today we have a book about the physiological factors affecting physical aging (progression or reversal thereof).
Dr. Levine is first and foremost a gerontological epigeneticist, and a lot of this book touches on her research in that field and that of her colleagues.
She does also discuss direct environmental factors also though, and—as you might well expect—lifestyle factors.
Regular readers of 10almonds are unlikely to gain anything new in the category of lifestyle matters, but a lot of the other material will be enlightening, especially with regard to the things that might at first glance seem set in stone, but we can in fact modify, and thus “choose our own adventure” when it comes to how the rest of our life plays out, healthwise (so: choose wisely!).
The book is mostly an overview on the (at time of writing: 2022) current state of affairs in the world of longevity research, and although it’s not a “how to” manual, there is plenty in the category of practical takeaways to be gleaned too.
The style is is mostly light pop science, but with a lot of hard science woven in—she is a good explainer, and has clearly made a notable effort to explain complex concepts in simple ways, while still delivering the complex concepts too (i.e. not overly “dumbing down”).
Bottom line: if you’d like to know about what can be done to increase your healthspan and general longevity, this book has a lot of answers!
Click here to check out True Age, and shift yours in the direction you prefer!
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Anxiety Attack vs Panic Attack: Do You Know The Difference?
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The terms are sometimes used incorrectly, but have quite different meanings. Dr. Julie Smith, psychologist, explains in this short video:
Important distinctions
Anxiety attacks are not clinically recognized terms and lack a clear definition, often used to describe a build-up of anxiety before anticipated stressful events (e.g. social gatherings, medical appointments, etc, though of course what it is will vary from person to person—not everyone finds the same things stressful, or has the same kinds of anticipations around things).
Panic attacks, in contrast, are sudden surges of intense fear or discomfort that peak within minutes. They are characterized by symptoms including at least 4 of:
- palpitations
- sweating
- shortness of breath
- chest pain
- dizziness
- fear of losing control or dying
There’s a misconception that panic attacks never have identifiable triggers while anxiety attacks always do.
In reality, both can occur with or without a clear cause. Panic attacks can arise from various conditions, including trauma, OCD, or phobias, and don’t necessarily mean you have a panic disorder. They can also occur as a drug response, without any known underlying psychological condition.
You may also notice that that list of symptoms has quite a bit of overlap with the symptoms of a heart attack, which a) does not help people to calm down b) can, on the flipside, cause a heart attack to be misdiagnosed as a panic attack.
In terms of management:
- In the moment: breathing exercises, like extending your exhalation (a common example is the “7-11” method, inhaling for 7 seconds and exhaling for 11 seconds), can calm the body and reduce panic symptoms.
- More generally: to prevent panic attacks from becoming more frequent, avoid avoiding safe environments that triggered an attack, like supermarkets or social gatherings. Gradual exposure helps reduce anxiety over time, while avoidance can worsen it.
If panic attacks persist, Dr. Smith advises to seek help from a doctor or psychologist to understand their root causes and develop effective coping strategies.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Take care!
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Intuitive Eating Might Not Be What You Think
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In our recent Expert Insights main features, we’ve looked at two fairly opposing schools of thought when it comes to managing what we eat.
First we looked at:
What Flexible Dieting Really Means
…and the notion of doing things imperfectly for greater sustainability, and reducing the cognitive load of dieting by measuring only the things that are necessary.
And then in opposition to that,
What Are The “Bright Lines” Of Bright Line Eating?
…and the notion of doing things perfectly so as to not go astray, and reducing the cognitive load of dieting by having hard-and-fast rules that one does not second-guess or reconsider later when hungry.
Today we’re going to look at Intuitive Eating, and what it does and doesn’t mean.
Intuitive Eating does mean paying attention to hunger signals (each way)
Intuitive Eating means listening to one’s body, and responding to hunger signals, whether those signals are saying “time to eat” or “time to stop”.
A common recommendation is to “check in” with one’s body several times per meal, reflecting on such questions as:
- Do I have hunger pangs? Would I seek food now if I weren’t already at the table?
- If I hadn’t made more food than I’ve already eaten so far, would that have been enough, or would I have to look for something else to eat?
- Am I craving any of the foods that are still before me? Which one(s)?
- How much “room” do I feel I still have, really? Am I still in the comfort zone, and/or am I about to pass into having overeaten?
- Am I eating for pleasure only at this point? (This is not inherently bad, by the way—it’s ok to have a little more just for pleasure! But it is good to note that this is the reason we’re eating, and take it as a cue to slow down and remember to eat mindfully, and enjoy every bite)
- Have I, in fact, passed the point of pleasure, and I’m just eating because it’s in front of me, or so as to “not be wasteful”?
See also: Interoception: Improving Our Awareness Of Body Cues
And for that matter: Mindful Eating: How To Get More Out Of What’s On Your Plate
Intuitive Eating is not “80:20”
When it comes to food, the 80:20 rule is the idea of having 80% of one’s diet healthy, and the other 20% “free”, not necessarily unhealthy, but certainly not moderated either.
Do you know what else the 80:20 food rule is?
A food rule.
Intuitive Eating doesn’t do those.
The problem with food rules is that they can get us into the sorts of problems described in the studies showing how flexible dieting generally works better than rigid dieting.
Suddenly, what should have been our free-eating 20% becomes “wait, is this still 20%, or have I now eaten so much compared to the healthy food, that I’m at 110% for my overall food consumption today?”
Then one gets into “Well, I’ve already failed to do 80:20 today, so I’ll try again tomorrow [and binge meanwhile, since today is already written off]”
See also: Eating Disorders: More Varied (And Prevalent) Than People Think
It’s not “eat anything, anytime”, either
Intuitive Eating is about listening to your body, and your brain is also part of your body.
- If your body is saying “give me sugar”, your brain might add the information “fruit is healthier than candy”.
- If your body is saying “give me fat”, your brain might add the information “nuts are healthier than fried food”
- If your body is saying “give me salt”, your brain might add the information “kimchi is healthier than potato chips”
That doesn’t mean you have to swear off candy, fried food, or potato chips.
But it does mean that you might try satisfying your craving with the healthier option first, giving yourself permission to have the less healthy option afterwards if you still want it (you probably won’t).
See also:
I want to eat healthily. So why do I crave sugar, salt and carbs?
Want to know more about Intuitive Eating?
You might like this book that we reviewed previously:
Intuitive Eating – by Evelyn Tribole and Elyse Resch
Enjoy!
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Paracetamol pack sizes and availability are changing. Here’s what you need to know
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Changes are coming into effect from February 1 about how paracetamol is sold in Australia.
This mainly affects pack sizes of paracetamol sold outside pharmacies and how paracetamol is accessed in pharmacies.
The changes, announced by Australia’s drug regulator, are in line with moves internationally to reduce the harms of liver toxicity and the risk of overdose.
However, there are no new safety concerns when paracetamol is used as directed. And children’s products are not affected.
Bowonpat Sakaew/Shutterstock What is paracetamol?
Paracetamol is commonly sold under brand names such as Panadol, Dymadon and Panamax. It’s used to treat mild pain and fever for short periods or can be prescribed for chronic (long-term) pain.
Millions of packs of this cheap and accessible medicine are sold in Australia every year.
Small packs (up to 20 tablets) have been available from supermarkets and other retailers such as petrol stations. Larger packs (up to 100 tablets) are only available from pharmacies.
Paracetamol is relatively safe when used as directed. However, at higher-than-recommended doses, it can cause liver toxicity. In severe cases and when left untreated, this can be lethal.
Why are the rules changing?
In 2022, we wrote about how the Therapeutic Goods Administration (TGA) was considering changes to paracetamol access because of an increase in people going to hospital with paracetamol poisoning.
An expert review it commissioned found there were about 40–50 deaths every year from paracetamol poisoning between 2007 and 2020. Between 2009–10 and 2016–17, hospital admissions for this increased (from 8,617 to 11,697), before reducing in 2019–20 (8,723). Most admissions were due to intentional self-poisonings, and about half of these were among people aged ten to 24.
After the report, the TGA consulted with the public to work out how to prevent paracetamol poisonings.
Options included reducing pack sizes, limiting how many packs could be bought at once, moving larger packs behind the pharmacy counter and restricting access by age.
Responses were mixed. Although responses supported the need to prevent poisonings, there were concerns about how changes might affect:
- people with chronic pain, especially those in regional areas, where it may be harder to access pharmacies and, therefore, larger packs
- people on limited incomes, if certain products were made prescription-only.
Although deaths from paracetamol poisoning are tragic and preventable, they are rare considering how much paracetamol Australians use. There is less than one death due to poisoning for every million packs sold.
Because of this, it was important the TGA addressed concerns about poisonings while making sure Australians still had easy access to this essential medicine.
If you buy large packs of paracetamol for chronic pain, you’ll need to go to the pharmacy counter. StratfordProductions/Shutterstock So what’s changing?
The key changes being introduced relate to new rules about the pack sizes that can be sold outside pharmacies, and the location of products sold in pharmacies.
From February 1, packs sold in supermarkets and places other than pharmacies will reduce from a maximum 20 tablets to 16 tablets per pack. These changes bring Australia in line with other countries. These include the United Kingdom, which restricted supermarket packs to 16 tablets in 1998, and saw reductions in poisonings.
In all jurisdictions except Queensland and Western Australia, packs sold in pharmacies larger than 50 tablets will move behind the pharmacy counter and can only be sold under pharmacist supervision. In Queensland and WA, products containing more than 16 tablets will only be available from behind the pharmacy counter and sold under pharmacist supervision.
In all jurisdictions, any packs containing more than 50 tablets will need to be sold in blister packs, rather than bottles.
Several paracetamol products are not affected by these changes. These include children’s products, slow-release formulations (for example, “osteo” products), and products already behind the pharmacy counter or only available via prescription.
What else do I need to know?
These changes have been introduced to reduce the risk of poisonings from people exceeding recommended doses. The overall safety profile of paracetamol has not changed.
Paracetamol is still available from all current locations and there are no plans to make it prescription-only or remove it from supermarkets altogether. Many companies have already been updating their packaging to ensure there are no gaps in supply.
The reduction in pack sizes of paracetamol available in supermarkets means a pack of 16 tablets will now last two days instead of two-and-a-half days if taken at the maximum dose (two tablets, four times a day). Anyone in pain that does not improve after short-term use should speak to their pharmacist or GP.
For people who use paracetamol regularly for chronic pain, it is more cost-effective to continue buying larger packs from pharmacies. As larger packs (50+ tablets) need to be kept out of sight, you will need to ask at the pharmacy counter. Pharmacists know that for many people it’s appropriate to use paracetamol daily for chronic pain.
Natasa Gisev, Clinical pharmacist and Scientia Associate Professor at the National Drug and Alcohol Research Centre, UNSW Sydney and Ria Hopkins, Postdoctoral Research Fellow, National Drug and Alcohol Research Centre, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Keep Your Mind From Wandering
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Whether your mind keeps wandering more as you get older, or you’re a young student whose super-active brain is more suited to TikTok than your assigned reading, sustained singular focus can be a challenge for everyone—and yet (alas!) it remains a required skill for so much in life.
Today’s edition of 10Almonds presents a nifty trick to get yourself through those tasks! We’ll also be taking some time to reply to your questions and comments, in our weekly interactive Q&A.
First of all though, we’ve a promise to make good on, so…
How To Stay On The Ball (Or The Tomato?) The Easy Way
For most of us, we face three main problems when it comes to tackling our to-dos:
- Where to start?
- The task seems intimidating in its size
- We get distracted and/or run out of energy
If you’re really not sure where to start, we recommended a powerful tool in last Friday’s newsletter!
For the rest, we love the Pomodoro Technique:
- Set a timer for 25 minutes, and begin your task.
- Keep going until the timer is done! No other tasks, just focus.
- Take a 5-minute break.
- Repeat
This approach has three clear benefits:
- No matter the size of the task, you are only committing to 25 minutes—everything is much less overwhelming when there’s an end in sight!
- Being only 25 minutes means we are much more likely to stay on track; it’s easier to defer other activities if we know that there will be a 5-minute break for that soon.
- Even without other tasks to distract us, it can be difficult to sustain attention for long periods; making it only 25 minutes at a time allows us to approach it with a (relatively!) fresh mind.
Have you heard that a human brain can sustain attention for only about 40 minutes before focus starts to decline rapidly?
While that’s been a popular rationale for school classroom lesson durations (and perhaps coincidentally ties in with Zoom’s 40-minute limit for free meetings), the truth is that focus starts dropping immediately, to the point that one-minute attention tests are considered sufficient to measure the ability to focus.
So a 25-minute Pomodoro is a more than fair compromise!
Why’s it called the “Pomodoro” technique?
And why is the 25-minute timed work period called a Pomodoro?
It’s because back in the 80s, university student Francesco Cirillo was struggling to focus and made a deal with himself to focus just for a short burst at a time—and he used a (now “retro” style) kitchen timer in the shape of a tomato, or “pomodoro”, in Italian.
If you don’t have a penchant for kitsch kitchenware, you can use this free, simple Online Pomodoro Timer!
(no registration/login/download necessary; it’s all right there on the web page)
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