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Train you brain and other bollocks

Along with at least half of Australia I watched the highly entertaining series “Redesign my brain – with Todd Sampson”  http://www.abc.net.au/tv/programs/redesign-my-brain-with-todd-sampson/.  Everyone’s been telling me how great brain training is which is funny as everything I’ve been reading recently tells me it doesn’t work  (see below for further bollocks, bogus and bullshit brain training blogs written by people better qualified than me).

http://www.newyorker.com/online/blogs/elements/2013/04/brain-games-are-bogus.html

http://www.ironmanmode.com/archives/5736

http://neurobollocks.wordpress.com/category/brain-training/

I only managed to check in for the last of the series and was very pleasantly surprised to find that under the whacky t-shirts Mr Sampson brings to the Gruen Transfer he is totally buff.  I couldn’t help but noticing his rippling biceps during the extended shots of him underwater, chained up and in danger and it nearly managed take my attention off his very annoying fringe.  Sorry, I’ll get a grip and get back on topic.  In case you missed it the central premise in the “radical 3 part documentary we see TV personality and ‘non swimmer’ Todd Sampson face his greatest fear – being chained, handcuffed and blindfolded underwater with only his radically improved brain to help him escape.”

The finale then had Michael Merzenich – the father of neuroplasticity and co-founder of Posit Science a brain training company – lauding the benefits of brain training for everything from age related detrioration to autism to ADHD.  It would wouldn’t it – its his business to sell brain training.

The big question that this series didn’t answer is “Would Todd have been able to face his greatest fear and escape underwater etc. etc. if he had just had 3 months regular training in relaxation, escape techniques and swimming?”.  Why didn’t we have the other Gruen Transfer bloke doing standard training in parallel – is it because he wouldn’t have looked that hot in his kecks?  True it wouldn’t have been a great experiment with only one member in test and the other in the control but it would at least have opened the conversation to the fact there might be other reasons than brain training for his Houdini performance.

It brain training sales pitch is so seductive and all encompassing. What ever ails you we can cure in almost no time at all.  Are you unhappy? Memory problems? Distractible?  Brain training can cure it all.

Unfortunately the research just doesn’t back this up.

The original research by Jaeggi that got everyone excited about the propects of brain training http://www.pnas.org/content/early/2008/04/25/0801268105.abstract was not successfully replicated http://www.ncbi.nlm.nih.gov/pubmed/22708717, or here http://www.sciencedirect.com/science/article/pii/S0160289612000839 .  Indeed my Stats I lecturer last year used the Jaeggi  study as a case study in poor experimental design.

A meta-analysis (a summary of 23 other studies) http://www.ncbi.nlm.nih.gov/pubmed/22612437 found that you do get better at the games but that this doesn’t transfer to other general skills.

A recent study on video game improving cognitive control in older adults http://www.nih.gov/researchmatters/september2013/09162013training.htm looks like it hit the jackpot and demonstrated real and significant effects.  However we are reminded by BPS research http://www.bps-research-digest.blogspot.co.uk/2013/09/driving-video-game-reverses-age-related.html that the groups had only 15 members in them, that we don’t know if the researchers were blind to the conditions and that these results can be created just by researcher enthusiasm and participant expectations.

So if you are enjoying playing the brain training carry on until your hearts content.

If you want to train your brain I’m still recommending learning an instrument, a foreign language, singing, yoga or dancing as the best brain training out there.  Try these as part of a group and you will get fitter, improve your social interactions, your rythymn, your coordination, your mood and yes your brain.

Relationships (with your doctor) make you feel better, get better

Yesterday my daughter had her hearing tested by a bored audiologist.  Her hearing is fine.  Her audiologist would rather have been doing almost anything than testing another 4 year old.  I don’t know why, maybe he was having  bad day, maybe he’s not enjoying his job but his every action, tone and gesture communicated the fact that he wasn’t interested.  For us – not such a big deal – a routine test with no adverse outcome.  However in different circumstances the impact can be significant.

 

A few years ago a study demonstrated that the tone of a doctors voice determined their likelihood of having been sued. http://www.sciencedirect.com/science/article/pii/S0039606002000223 “Surgeons tone of voice – a clue to malpractice history” Ambady, 2002.  People only tend to sue people they don’t like so when things don’t turn out the way a patient expects if they didn’t like their surgeon, they sue, if they had formed a relationship, they didn’t sue.  The study which rated the surgeons tone only – not their actual words – found that  “ratings of higher dominance and lower concern/anxiety in their voice tones significantly identified surgeons with previous claims”.

 

In the same sort vein a recent study has shown that knowing who your physician is boosts patient satisfaction.

 

http://news.vanderbilt.edu/2013/10/knowing-who-their-physician-is-boosts-patient-satisfaction/

 

(Morris, 2013) .  Faced with the knowledge that around 85%+ of patients couldn’t name their treating physician after admission orthopaedic trauma surgeon Alex Jahangir, M.D., and his Vanderbilt colleagues studied the effects of giving a randomized group of patients a simple biosketch card about their doctor.

A patient having his blood pressure taken by a...

A patient having his blood pressure taken by a physician. (Photo credit: Wikipedia)

What they learned is that patient satisfaction scores for the group receiving the card were 22 percent higher than those who did not receive the card.

 

“I think, in general, people recover better when they are more comfortable with the care they are receiving,” said Jahangir, associate professor of Orthopaedic Surgery and Rehabilitation. “So it matters to patients and physicians who want a quick recovery, and now because of provisions in the Affordable Care Act, it matters to the institution because there are millions of dollars that can be at risk if patient satisfaction is low.”

 

So bored audiologist, maybe time to brush up on those patient interactions skills.

 

  1. Brent J. Morris, Justin E. Richards, Kristin R. Archer, Melissa Lasater, Denise Rabalais, Manish K. Sethi, A. Alex Jahangir. Improving Patient Satisfaction in the Orthopaedic Trauma PopulationJournal of Orthopaedic Trauma, 2013; : 1 DOI: 10.1097/01.bot.0000435604.75873.ba

 

 

Under stress we go with what we know – even if its crawling with zombies

People fleeing a zombie filled room chose to exit the way they came in – even when this was the most congested.  Without zombies they didn’t show a particular preference for the familiar – at least on the screen during this computer simulation study that was part of the catchily named Zombielab at the London Museum.

Dansk: Tegning af en Zombi.

Dansk: Tegning af en Zombi. (Photo credit: Wikipedia)

http://www.sciencedirect.com/science/article/pii/S0003347213002443

This result sounds like it makes sense.  We’ve seen how stress impacts our decision making and Amy Arnsten’s work showed us the inverted U of Pre Frontal Cortex performance as stress increased.  So going with what we know, i.e.  the exit through which we entered, rather than making a decision to use a less congested exit could be a function of increased stress.  It could on the other hand be a rational decision since we actually know that exit works.  This sort of behaviour is also seen in real life where people haven’t used available exits preferring the one they entered through causing at best longer exit times and at worst crushing.  The authors said “”We suggest that in evacuations with higher stress levels evacuees will be more likely to use known exit routes and less able or willing to adapt their route choices, even if this results in longer evacuation times.”   So what to do – maybe have more patrons enter through different routes?  Maybe make other routes more appealing – i.e. by automatically swinging open?

Our tendency to go with the familiar under stress can land us in plenty of trouble in business and life.  When the “do nothing” option is the worst option, when we don’t act on climate change, when we stay in a bad job because we are under stress in that job.  Once we understand this reaction in ourselves and others it may start to give us clues on how to get around it.

Work seems life threatening

Work seems life threatening

A new book of 15 essays says work seems life threatening to those suffering from stress.  Whats new?  Current quick fixes don’t work.  Employers get it wrong in creating more rather than less stressful situations.  Stress management consultancy is big business because everyone wants it even though the interventions are dubiously successful.  Hmm sounds a lot like weight loss that other big business with a very dubious success record.

Neuro painkillers for coping with rejection

We know that social pain hurts – Naomi Eisenberger showed us back in 2003 with her breakthrough studies on the shared brain mechanisms for social and physical pain.  Since then we’ve seen that those who are more prone to physical pain are also more likely to be emotionally sensitive.   So new research showing that the brain is releasing the same sort of painkillers to cope with social pain as it does to cope with physical pain isn’t entirely surprising.

A Pain That I'm Used To

A Pain That I’m Used To (Photo credit: Wikipedia)

The set up to induce feelings of social pain was particularly interesting/effective/brutal depending on your point of view.  I’m tending towards all three.  Participants selected a prospective date in an online dating scenario and were then told their preferred partners wasn’t interested in them whilst their brain’s opioid production was tracked in a PET scanner.  Yes they watched people getting dumped.  Well all’s fair in love and science (they did tell them it was fictional) .  Those who scored highest for resilience also had the highest opioid production.

http://www.uofmhealth.org/news/archive/201310/opioid-social

 

My Friends Are Fabulous

Two friends

Two friends (Photo credit: Wikipedia)

My Friends Are Fabulous

My friends are fabulous and so are yours.   It doesn’t really matter what they actually do, we’re going to judge them according to our preconceptions of them.  This is probably pretty handy when it comes to holding onto our friends and maintaining social glue.  Maybe not so helpful if we are supposed to be objectively evaluating performance of say friends who are also peers, employers, trainees, students, direct reports.  The study here asked friends and strangers to evaluate peoples performance in standard clinical situations.  Unsurprisingly, friends put a positive spin on the performance and referenced it to their prior view of that friend.  I think we already suspected that but its interesting to have these suspicions clinically tested.

Put a Sleeve on it

Anterior view of the small intestine. Small In...

Anterior view of the small intestine. Small Intestine consists of 3 parts: the duodenum, jejunum and the ileum. (Photo credit: Wikipedia)

Put a Sleeve on it

Rats that had a small flexible sleeve inserted into their small intestine lost weight and “enhanced their glucose metabolism”.  The catchily named duodenal-endoluminal sleeve (DES) is therefore being touted as an alternative to other methods of bariatric surgery.   I don’t know how long it will be until trials in people start.   Would you be interested in a sleeve?  I wonder what the benefits and drawbacks of this procedure will be compared to other bariatric surgery options.

Lose weight lose years?

Take a close look at this table before you think about embarking on that diet. Everyone losing weight increases their mortality, i.e. they die sooner.  Food for thought?

This table taken from  “The downside of weight loss: Realistic intervention in body-weight trajectory” by N. John Bosomworth in the Canadian Family Physician (Vol 58: May 2012) perfectly sums up the mortality outcomes of different weight strategies

its complicated

Image

Its health not weight that’s important

Society has been gripped by obesity mania.  The ideal shape for woman has shrunk and shrunk from Marilyn Monroe to Victoria Beckham.  ImageVictoria, or Posh as we knew here then wasn’t always so skinny, but she’s certainly more than made up for it since and has created the blueprint for the skinny personality.

Funnily enough if you ask any man (go on try it) I bet they’ll say they prefer the shape of Marilyn.  It’s possible that David Beckham does too. Irma Nici, who is about as far from the emaciated boy look as you can get, claims to have had an affair with him, you’ll have to be the judge on that one.Image

But what does this matter, I hear you say?  Celebrities influence our culture which influences society into unrealistic expectations of the ideal body.   People who are as thin as Posh (i.e. underweight) have much higher mortality rates than those of “normal” weight which in turn are higher than those of “overweight” people.  Yes, you did read that last sentence correctly, there is a lower mortality in the “overweight” than the “normal” weight. Image

 The risks of being underweight (BMI<18.5) are greater than those of having a BMI >35.

 

The International Journal of Epidemiology, in 2005, stated “numerous large-scale studies that have found no increase in relative risk among the so-called ‘overweight’.”   But we all know that being overweight puts us at risk, we’re being told that all the time so it must be true.  OK, back to those epidemiologists “the vast majority of people labelled ‘overweight’ and ‘obese’ according to current definitions do not in fact face any meaningful increased risk for early death. Indeed the most recent comprehensive analysis of this question within the context of the US population found more premature deaths associated with a BMI of <25 than with a BMI above it.”

 So why is being obese unhealthy?  Well it’s been suggest that its because obesity a surrogate measure for being unfit.  The same study says “Fitness is closely intertwined with obesity, and has powerful influences on health and mortality. Data from the Aerobics Center Longitudinal Study show that low cardiovascular fitness accounted for all of the excess all-cause mortality among obese men”

So forget what you thought you knew, its health, not weight that’s important.   Our obsession needs to move from weight to health if we want to stay alive.  We need to find a way to celebrate and value people of all sizes and to stop beating ourselves up over being the size we are today.