Month: November 2018

Categories
Mental Health

How to be more open-minded…

Most people think of themselves as being open-minded… In a survey of thousands of American workers, 95% thought they were more open-minded than average! Of course, that’s statistically impossible… So, what does it really mean to be open-minded?

Being open-minded means that, even if you are smart and strong-willed enough to influence opinions of others, you remain flexible enough to:

  • change your mind when presented with new information,

  • admit when you are wrong and

  • adapt to changing conditions.

Being open-minded is also known as having “cognitive flexibility”, and it’s a crucial skill in today’s fast-changing environments. “Cognitive humility” (being humble about your knowledge) and “openness to new experiences” are also characteristics that psychologists tell us contribute to open-mindedness.

So, why do some people quickly accept new beliefs when presented with conflicting information while others cling stubbornly to their old beliefs, denying new facts are true? Researchers suggest 6 characteristics are important:

  1. Respecting viewpoints of others

    1. Each of us has had different experiences and, therefore, may have developed different points of view.

  2. Avoiding overconfidence in your knowledge

    1. It is not possible to know everything. We all need to be aware of how much we don’t know.

  3. Separating your ego from your intellect

    1. Having incomplete knowledge on a subject does not mean you are less of a person. Similarly, there is more to the person you are speaking to than simply their intellect. Don’t belittle someone who doesn’t know all the facts or has an opinion different than yours.

  4. Being willing to change your viewpoint

    1. It is important to be able to admit you didn’t know something and be ready to learn.

  5. Being curious enough to listen to other opinions and points of view

    1. It can be worthwhile to understand WHY someone believes what they do as well as WHAT they believe. Learn where they’re coming from…

  6. Being open to trying new experiences, such as travel and new foods, that may provide a new point of view

    1. New experiences introduce you to new information and broaden your point of view.

Wondering how much “cognitive flexibility” you have? Try this open-mindedness test . I tried it and, while my result said I’m more open-minded than average, I scored below average on separating my ego from my intellect. The questions made me aware that I sometimes feel small or inadequate when I don’t know everything about a subject… I guess that’s something to work on! Perhaps I’ll try telling people when I feel this way, to help myself work through this emotion.

But we can all try to follow Benjamin Franklin’s example of intellectual humility: he would often start a discussion by saying “I could be wrong but…”. These words can make others feel less defensive and allow you to change your opinion more easily if you learn something new in the discussion.

References:

A New Way to Become More Open-Minded

Open-Mindedness test

Categories
Public Health

What Do the Metric System, Smoking, Carbon Tax and Plastics Have in Common?

The metric system, smoking, carbon tax and reducing plastic pollution all require us to accept change to make things better in the future… for our children and our grandchildren. What can we do to help people change when it’s really important?

The Metric System

Canada changed from miles, ounces and Fahrenheit degrees to the metric system of kilometers, grams and Celsius degrees back in the 1970’s. I was in university then and found it a bit easier since my high school science labs had been in metric, but they made it easier by giving measurements, like weather temperatures and speed signs, in both systems for years until everyone got used to the new system.

We also bought thermometers and rulers with both scales on them. I told customers not to convert fever temperatures but, instead, to just remember that 37C was normal and 40C was really high (equal to 104F). For pharmacists, actually, it was a relief…as we had to learn the Canadian system of weights and measures (like the British), the American system (with it’s slightly different ounce and gallon), the metric system AND the obscure Apothecary system with it’s grains, scruples, drams and ounces (yes…pharmacists do have scruples!). It was a relief to use the simple conversions of the metric system!

So, our government legislated the change but continued the old system until everyone became used to the new way of measuring.

Smoking

To discourage smoking, based on research showing second hand smoking is harmful, cities banned smoking in public and eventually in restaurants and other public areas. This made smoking an activity that had to be done in a special area and not acceptable everywhere as it had been. Along with government-sponsored education, this “denormalization” of smoking has led to steadily decreasing rates of smoking in North America.

A combination of restricting where smoking was acceptable and educating people why it was dangerous worked to gradually change behaviour. However, I read this week that smoking rates have increased again recently, possibly due to the availability and popularity of e-cigarettes. There’s still more work for governments to do to eliminate this harmful habit, but there are still fewer smokers than there once were!

Carbon Tax

The Carbon Tax is a fee imposed on the burning of polluting carbon-based fuels, like coal, oil and gas. While the tax is much debated, experts say it will change behaviour: The tax will encourage people to choose products and services that are less polluting to avoid the tax. Nothing like money to make people consider changing! Our Canadian government tells us the Canadian version of this tax will be revenue-neutral for government and much of the population – the tax collected will be rebated to consumers – but studies say it will still work as an incentive to change.

Plastics

There’s a huge problem with plastic that most of us don’t see… tons of plastic waste are ending up in our oceans and lakes and it takes years and years to degrade. As it breaks down it becomes “microplastics” that enter our food supply. Substances in plastics affect our hormone function and our health.

So, what can be learned from other system changes we’ve made that can be applied to plastics? We need awareness, education and system changes to make us want to correct what we’re doing. Scientists estimate that by 2050 there will be more plastic by weight in oceans than sea life…

Here are 9 suggestions for things you can do:

  1. Use reusable items instead of disposable:

    1. This includes bags, cutlery, straws, coffee cups, plastic wrap and anything else you can think of.

  2. Stop buying bottled water

    1. Filter water instead and use reusable bottles. You can even get bottles with a filter built in!

  3. Boycott products with plastic microbeads, such as soaps, body wash, toothpaste.

    1. These tiny beads often slip through water treatment systems and look like food to fish.

    2. Microbeads are already banned in some countries.

  4. Cook more at home to avoid packaging.

    1. If you do order out, ask for no cutlery to be added to your order.

  5. Buy second-hand.

    1. Second-hand items are not packaged, you’ll prevent these items from ending up in landfill and you’ll save money!

  6. Recycle!

    1. Already many communities require us to separate plastics and other items in our garbage, so they can be recycled. And in some communities, if you don’t, they may just leave your garbage at the curb (my neighbours call them the garbage police!). So, changes are happening at the community level. However, not all communities participate in separating and recycling garbage. If yours doesn’t, suggest it!

    2. And recycle in your home too! Reusing plastic bags and containers means fewer will end up in the garbage.

  7. Support bag charges and bans.

    1. These can be one of the fastest ways to make people change their habits quickly.

  8. Buy in bulk (yogurt, snacks, etc.).

    1. Buy large sizes and repackage these into reusable containers or, better yet, make your own snacks! Might be tastier and better for you too…

  9. Put pressure on manufacturers and retailers to change.

    1. Email, Tweet or just buy elsewhere when you notice bad plastic practices!

Please watch the short video on the plastic problem on the Plastic Pollution Coalition website. In addition to further explaining the problems we are facing with excess use of single-use plastic, there are links to information on how to reduce the problem and live “plastic free”.

Categories
Public Health

It’s time to decriminalize drugs

Written by Dr. Barbara Watts on November 13, 2018 for CanadianHealthcareNetwork.ca

(Reprinted with permission)

Dr. Barb Watts

Currently in Canada, if you are caught in possession of any number of psychoactive drugs you are criminally charged. This is supposed to protect people by acting as a deterrent.

Unfortunately, we know from extensive experience and research, that this just does not work. Adolescence is a time of increased risky behaviour and decreased judgment. In Canada, 5.5% of youth use prescription opioids recreationally, 40% of youth aged 12-17 and 83% of youth aged 18-24 drink alcohol, 25% use cannabis, 3-5% use cocaine, 3.5% use ecstasy and up to 6% use stimulants not prescribed to them. (Statistics Canada, 2015 CTADS)

Adults and adolescents already in the grip of moderate to severe substance use disorders have lost the ability to choose. By definition, they will harm themselves and their families, in order to obtain the needed substance. Substance use hijacks the motivational centres of the brain, supplanting all other goals, even as the pleasure of using diminishes.

The futility of trying to stop drug use by punishing users is increasingly being recognized by the criminal justice system and law enforcement.

Many U.S. and Canadian large urban areas have instituted a system to divert drug users into treatment programs. Drug treatment courts attempt to replace punishment for drug possession and drug related crimes, with treatment. Certainly this has been more effective than punishment with fines and jail sentences, but the treatment provided is exclusively abstinence based and the accused must plead guilty to the charge in order to access drug treatment court. The consequences of a criminal charge and/or conviction are lifelong, adversely affecting someone’s chances of employment, professional education, travel, volunteer work and even citizenship.. And it is clear that medication assisted treatment is the most effective treatment for opioid use disorder.

Decriminalizing the possession of drugs for personal use is not the same as legalizing all drugs. Legalizing a drug means it is legal to sell the drug and the government can regulate and control the industry.

Decriminalization, on the other hand, simply means it is not a criminal offence to possess the drug for personal use. It is still illegal to sell the drug.

Instead of judging and punishing our patients with substance use disorder (SUD), we need to take them into our health care system and help them to recover.

Since prohibition does not deter many people from using illegal drugs, we need to switch to a public health approach to SUD. We need to provide evidence-based treatment, including social supports and medication assists. We need to make it possible for our loved ones with SUD to recover from the horrors of uncontrolled SUD and enter back into a productive and fulfilling life.

Portugal has shown how successful this strategy for dealing with substance misuse can be. In 2001 they decriminalized possession of drugs for personal use, while simultaneously instituting treatment and social support initiatives to deal with their burgeoning heroin problem. Today Portugal has seen dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates.

The organizations calling for the decriminalization of drugs include the World Health Organization (WHO), the Global Commission on Drug Policy, the Lancet Commissions, the American College of Physicians, the Canadian Public Health Association (CPHA), the Canadian Society of Addiction Medicine (CSAM), the Toronto Board of Health and the Canadian Drug Policy Coalition (CDPC) among others.

It is time the Canadian Medical Association and all the provincial medical associations called for decriminalization.

Barb Watts is a family doctor with 35 years experience. She retired from solo family practice a number of years ago. Since then she works part time in the ER in Orangeville and takes the winters off to travel somewhere warm and spends the summers at her cottage in Northern Ontario. She is a board member for Families for Addiction Recovery.

Opinions expressed in this article are those of the writers, and do not necessarily reflect those of CanadianHealthcareNetwork.ca or its parent company.

Originally published by Canadian Healthcare Network

Categories
Health

Why Are Strokes Worse in Women?

Each year in Canada, about 32,000 men and 30,000 women have a stroke. But one-third more women die from stroke: 59% compared to 41% of men. Women’s disability from stroke is more severe too — almost twice as many end up in nursing homes, compared to men.

Why is this? Stroke treatment, awareness and research has increased over the past 20 years but fewer women are involved in the studies, so the reasons are not well understood. However some researchers have thoughts on what some of the reasons might be…

Risk factors for Stroke

First, researchers found that seventy percent of women don’t know any of the risk factors for stroke. They could be at increased risk but they don’t know it, and don’t do anything to prevent it. Time for more public education directed at women. So, read on, ladies (and gents too…)

Some risk factors can’t be controlled: increased age, family history, being of South Asian, African or Indigenous descent, or just being female! Other risk factors can be changed, like high blood pressure (an important one!), diabetes, unhealthy diet, physical inactivity, unhealthy weight, smoking, stress and excess alcohol.

High cholesterol is often included in risk factors for stroke: it’s accepted as being a risk factor for heart disease, and established heart disease puts you at higher risk of a stroke. But low cholesterol was identified as a risk factor for bleeding stroke in Japan decades ago, so there’s some controversy about this one. Read my earlier blog, The Cholesterol Controversy, for more information on that ongoing discussion.

Atrial fibrillation, an irregular beat in the upper part of the heart, is another important risk factor for stroke. In this condition, blood tends to pool in the upper chambers of the heart instead of being sent through to the lower chambers, promoting formation of blood clots that can later be sent to the brain, causing a stroke.

Women are also at increased risk of stroke during pregnancy (3 times increased risk), during the menopausal change and in their elderly years. So, although stroke is more common in older women, it can occur in adult women of all ages. Both birth control pills and hormone replacement therapy can increase risk of stroke, just as our own hormones do during pregnancy, by making blood clots form more easily. Blood clots are at the root of the majority of both strokes and heart attacks. Some people refer to a stroke as a “brain attack” because the process is often similar.

What exactly is a stroke?

There are two main types of stroke plus a few other less common types:

  1. Ischemic stroke, where a blood clot or other type of material blocks an artery in the brain. This accounts for 90% of strokes.

  2. Hemorrhagic (bleeding) stroke, where a blood vessel in the brain bursts, allowing blood to leak rather than travelling to supply an area of the brain.

  3. Transient Ischemic Attack (TIA), is caused by a small clot that temporarily blocks an artery in the brain, giving temporary symptoms. Sometimes it precedes a major stroke.

  4. A tumor, infection or brain swelling from an injury can also cause a stroke in rare occasions.

Signs that a stroke is happening

A Heart and Stroke Foundation survey found that only 60% of women knew exactly what a stroke is, and only 8% knew all 3 signs that a stroke was occurring. Use the acronym FAST to remember them:

  • Face – Is it drooping?

  • Arms – Can they raise both?

  • Speech – It is slurred or jumbled?

  • Time – Time to call 9-1-1 right away!

Act FAST because the quicker you act, the more of the person’s brain you save!

Poorer outcomes in women

The emergency treatment for a stroke is to unblock the artery (for a blood clot stroke) or to stop the bleeding (for a bleeding stroke). Because brain damage is caused by lack of blood to an area of the brain, the more quickly the artery is unblocked (or the bleeding is stopped), the less damage and disability that will occur.

But women’s stroke symptoms are not always as clear as those in men, so strokes are sometimes not identified as quickly. Cases diagnosed as a TIA (a temporary stroke) in some women have later been discovered to be a full stroke. Studies have found, on average, women receive treatment more slowly than men.

Researchers looked at the “door to needle” time – the amount of time from when women arrived at hospital until she received an injection of a clot-busting drug to open the blocked artery in an ischemic stroke. On average, this time was 12% longer in women. Women are also less likely to be sent for the specialized surgery to remove a blood clot. And more women live alone, so often no-one is there to help them call for emergency transport to hospital when a stroke occurs.

Recovery from stroke is possible

The good news is that the brain can continue to recover and improve for several years after a stroke, if you do have one. Rehab and physiotherapy services can help improve function and mobility greatly. And the harder you work, the better your results.

However, women have been found to be 2 to 3 times more likely to have a poor outcome from rehab after a stroke than men. Experts suspect that women may have more difficulty getting to therapy sessions, or return to family and work responsibilities before they are fully recovered, but we need more research to find out why women don’t recover as well as men. Then we can work to change these factors and help women to better stroke recovery.

Conclusion…

So, know your risk factors for stroke, and work to reduce your risk. Know the FAST warning signs for a stroke and act quickly to get treatment to reduce damage to the brain: call 9-1-1-! When the ambulance arrives, tell them you think you might be having a stroke, even if the signs are not completely clear. Symptoms are not always as clear in women as in men.

If you do have a stroke, know that rehab and physio exercises will help you improve, and you can keep improving for several years. But you have to do the work, take the time, and stay determined to heal and recover as much as possible. The brain can reorganize itself and make new connections, but you need to stay in training mode to make it happen!

Read the link below (“Lives Disrupted”, for stories of women of all ages who have recovered well from stroke and returned to normal life…

References/Resources:

Lives Disrupted: The Impact of Stroke on Women

FAST signs of stroke

Types of stroke

Categories
Book review Health

Are You a Napper?

“In a perfect world, all humans would nap”…Sara Mednick, PhD; nap researcher and author.

My grandfather always had his “snooze” after lunch; my husband loves his naps, and will snatch 15 to 30 minutes whenever he feels the least bit tired. But I rarely have trouble sleeping at night, so I’ve always felt I didn’t need a daytime nap. And I didn’t want to “waste” the time…

Then I stumbled across Sara Mednick’s book, “Take a Nap! Change Your Life” She, too, didn’t believe in naps but was amazed at how much better she felt afterward when, exhausted, she succumbed one afternoon. Being a sleep researcher, she decided to investigate what science tells us about daytime napping. Finding essentially no nap research, she decided to investigate herself. This developed into a career of nap research! Here’s some of what I learned from her book.

Essentially all other animals take daytime naps – they call this “multi-phasic” sleep. In Europe, the daytime “siesta” is part of the culture, although they are gradually succumbing to the North American idea of pushing through the day, regardless how tired. I’ve been surprised more than once at finding a shop closed at mid-day, especially in smaller towns and villages. But now I understand it better… and I should have been napping myself at midday, not shopping!

The early afternoon “slump” in energy has often been blamed on what we ate for lunch or simply overeating. But it’s really part of our Circadian (daily) rhythm, a pre-programmed mini-dip in energy, and a signal that it’s time to nap. A 20 to 30 minute sleep, about 6 hours after morning waking is beneficial for alertness, mental ability and overall health. Our brains are programmed for it.

And, in case you feel silly about napping, you should know that some of the greatest minds benefited from regular naps: Leonardo da Vinci, Isaac Newton, Napoleon Bonaparte, Albert Einstein, John F. Kennedy and several other presidents, and Winston Churchill. Think of it as a new wellness technology… although it’s really nothing new. We’re just finally doing proper research to learn about it.

Sadly, the trend in recent years has been toward longer work hours. I remember talk of a four-day work week years ago, but it never happened. With rising housing costs in large cities, many have moved to the fringes for affordable housing, and the longer commute to work compounded with longer work hours can often result in less time for sleep.

Although many of us depend on caffeine to get through the day and we have medications for sleep disorders like narcolepsy, no drug has yet been invented that is a substitute for sleep, scientists say. Sleep deprivation has many detrimental health effects, including increased heart disease and stroke, increased car accidents, decreased immune function, decreased sexual function, premature aging, obesity, diabetes, irritability, depression, and all the symptoms of stress. Researchers say we may be confusion the symptoms of fatigue with the signs of stress. Both increase blood levels of the stress hormone, cortisol, that causes all of these effects.

The simplest solution is to incorporate naps into the our day! Science tells us there are at least 13 good reasons to nap (and 13 is my favourite number) :

  1. Increased alertness – A brief daytime nap can increase alertness by as much as 100%.

  2. Speed up motor performance – Improved coordination after a nap can mean fewer accidents.

  3. Improve your accuracy – Your boss will be happy you’re making fewer mistakes, and better decisions

  4. Look younger – Naps increase growth hormone production, which can result in improved skin texture and tissue regeneration. Naps are truly “beauty sleep”

  5. Improve your sex life – Daytime napping can increase sex drive and function. Nap now, love more later…

  6. Lose weight – Sleepy people crave high fat, high sugar foods more than people who are rested. Naps can also help you produce more growth hormone that reduces body fat.

  7. Reduce risk of heart attack, stroke and diabetes – Fatigue results in increased cortisol production, and this leads to increased blood pressure, heart attacks, stroke and other cardiovascular disorders and increased blood sugar.

  8. Improve your stamina – Naps give you extra energy for running a marathon or staying alert at meetings. A nap can make the second half of your day just like a brand-new day!

  9. Elevate mood – Lack of sleep makes you cranky.

  10. Boost creativity – Naps help your brain create connections needed for a fresh burst of creativity.

  11. Reduce stress – Naps can lower cortisol and make you a less-stressed, calmer person.

  12. Improved nighttime sleep – Contrary to some sleep advice, research shows a midday nap can actually improve your nighttime sleep. Going “beyond” with fatigue can rev you up so you’re too “wired” to fall asleep when you have the chance.

  13. It feels good! – Millions of nappers (and essentially all animals) can’t be wrong…

So, create opportunities for a nap during your day, ideally about 6 hours after you wake up in the morning. You’ll feel better, be healthier, increase your productivity and make better decisions. Even your boss should be interested – introduce him/her to the science of napping!

Further reading:

Take a Nap! Change Your Life: The Scientific Plan to Make you Smarter, Healthier, More Productive (Amazon.com or Amazon.ca )

Note: I have no affiliation with the author or seller of this book…just sharing a book I enjoyed reading and learned from!