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Exceptional longevity: why some people live to be more than 100-year old

Interventions that promote longevity, remembered by mnemonic: DEEP purple - “eat colorful plant foods: Dietary modification, Exercise, active Engagement, Purposeful living (click here to enlarge the image).

Based on a Mayo Clinic Proceedings article (https://www.mayoclinicproceedings.org/article/S0025-6196(18)30792-4/):

Exceptional Human Longevity: the oldest old have an extreme phenotype of delayed onset of age-related diseases and/or resistance to lethal illnesses occurring earlier in life.

Centenarians have delayed onset of chronic diseases

During the span of human history the likelihood of living from birth to age 100 rose from 1 in 20 million to 1 in 50 as of year 1995 (for females in low-mortality nations such as Japan and Sweden). By 2009, this probability increased to 1 in 2. About 1 in 5,000 persons in the United States is a centenarian or older. Human longevity now exceeds 115 years. However, maximum life span has remained largely unchanged. There is a limit to human longevity, and it may be around 120 years.

In centenarians, the age at onset of common age-associated diseases is delayed: 43% of both male and female centenarians reach the age of 80 years before experiencing age-associated illness.

There is an absence of any disease diagnosis in some 15% and 30% of female and male centenarians, respectively, at the age of 100 years!

As many as 25% of centenarians are cognitively intact.

Geographic Clusters

Geographic Clustering of Exceptionally Long-Lived Individuals: Countries with the world's oldest populations in 2015: Japan, followed by Germany, Italy, Greece, Finland, and Sweden.

Long-lived Okinawans subscribe to the nutritional behavior of “hara haci bu” or “eat until you are only 80% full.” Their “rainbow diet” is based on diverse fruits and vegetables, with soy providing the bulk of protein intake. Their daily caloric intake is reduced, accounting for their low BMI of 20.

Life span is increased in regular churchgoers, whatever their faith. Seventh Day Adventists exhibit significantly lower levels of measured stress hormones.

Behavioral and environmental influences that may contribute to longevity in the so called “blue zones”:

- Eating in moderation, mostly plant-based diet. Small-portioned “regular” meals. Lighter meals at the end of the day.
- Purposeful living: life philosophy, volunteerism, “hard work” or “work ethic”
- Social support systems: interactions with family/friends, laughter/humor
- Exercise, especially walking, gardening
- Other nutritional factors: goat's milk, red wine, herbal teas
- Spirituality
- Maintenance of a healthy body mass index (BMI)
- Other possible factors: sunshine, adequate hydration, naps

Compression of Morbidity: diseases occur later in life. Fries' “compression of morbidity” hypothesis: chronic morbidity begins at a later age.

Why Are Some People Long-Lived?

Genes: Centenarians' offspring have an increased likelihood of surviving to 100 years and exhibit a diminished prevalence of age-associated diseases.

Environmental factors exert even greater effect than genes.

Sex Differences: Universally, women live longer than men. Despite the greater longevity of women, functional status is better in older men compared with older women.

Resiliency is the capacity to adequately respond to stressors. It helps resist age-related physiologic changes. Resiliency protects against insults that shorten life and health span. Resiliency can explain why some centenarians, despite onset of chronic disease before the age of 80 years, live exceptionally long.

How Is Exceptional Longevity Achieved?

Caloric restriction delays the aging phenotype in mammals. This is shown by abundant studies. Caloric restriction delayed the onset of diabetes, cancer, cardiovascular disease, and brain atrophy.

Reduced calorie intake by 20% to 60% retards aging. It only works if such reduction is quite substantial.

What about exercise? Regular physical activity promotes healthy human life span. However, it is unclear if exercise increases maximum longevity.

Normal body weight confers the most protection from mortality.

Active engagement and development of social networks and support systems confer longevity benefits. Lack of strong social relations is associated with a mortality risk roughly equivalent to smoking.

Interventions that promote longevity can be remembered by the mnemonic: DEEP purple - “eat colorful plant foods”:

- Dietary modification
- Exercise
- active Engagement
- Purposeful living

How to Measure Successful Aging?

Several algorithms have been proposed to estimate biological age. They are based on functional as well as biochemical measurements.

Biomarkers of Aging Processes and Longevity:

Disease-free survival or disability-free survival at 6-month intervals
Time to impairment in the next activity of daily living
Length of stay after hospitalization
Height, especially in men
Facial features
Gait speed, grip strength, muscle mass, mobility stress test
Daily and instrumental activities of daily living
Cognitive tests such as the Digit Symbol Substitution Test or Montreal Cognitive Test
Blood glucose or hemoglobin A1c, hypertension and elevated lipids, interleukin 6, insulin-like growth factor 1, and insulin-like growth factor binding proteins
CD4+, CD28− and CD8+, CD28− T cells; percentage of T cells that are naive vs memory (CD4 cells, CD8 cells)
Antibody response to annual influenza vaccination; delayed hypersensitivity skin test
Cataracts
Threshold for hearing high-pitched tones; tests of taste and smell
Tests of proprioception and balance
Forced expiratory volume in 1 second
Number of remaining teeth
One or two parents reaching 90 years of age
Educational attainment
More speculative: DNA methylation indices; senescent cell burden

References:

https://www.mayoclinicproceedings.org/article/S0025-6196(18)30792-4/

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For type 2 diabetes patients who require an injectable drug, GLP-1-based drugs are preferred over insulin

That's a pretty big change:

Diabetes Guidelines Updated: For patients with type 2 diabetes who require an injectable drug, a glucagon-like peptide 1 receptor agonist is preferred over insulin. https://buff.ly/2T0Kowc

Glucagon-like peptide-1 (GLP-1)-based therapies (eg, GLP-1 receptor agonists, dipeptidyl peptidase-4 [DPP-4] inhibitors) affect glucose control through several mechanisms, including:

- enhancement of glucose-dependent insulin secretion
- slowed gastric emptying
- reduction of postprandial glucagon and food intake

These agents do not usually cause hypoglycemia.

Short-acting GLP-1 receptor agonists have an effect on postprandial hyperglycemia and gastric emptying:

- Exenatide twice daily. Exendin-4 is a naturally occurring component of the Gila monster lizard saliva and shares 53 percent sequence identity with GLP-1. Exenatide (half-life 2.4 hours) is synthetic exendin-4. Brand Names: Bydureon; Byetta Pen.

- Lixisenatide is a GLP-1 receptor agonist that shares some structural elements with exendin-4. Compared with native GLP-1, it has a prolonged half-life (2.7 to 4.3 hours). Brand Names: Adlyxin.

Long-acting GLP-1 receptor agonists have a greater resistance to dipeptidyl peptidase-4 (DPP-4) degradation. They activate the GLP-1 receptor continuously and have a prolonged half-life, thus allowing for once-daily and even once-weekly subcutaneous injection. They have a marked effect on fasting glucose.

- Exenatide once weekly is a sustained-release formulation of the short-acting subcutaneous exenatide.

- Liraglutide is GLP-1 receptor agonist which binds to serum albumin, resulting in slower degradation (half-life 11 to 15 hours) and allowing for once-daily, subcutaneous dosing. Brand Names: Saxenda; Victoza.

- Dulaglutide is a long-acting GLP-1 receptor agonist with structural modifications to prevent degradation by DPP-4 and to prolong its half-life. The half-life of dulaglutide is approximately five days, which allows for once-weekly administration. Brand Names: Trulicity/

- Semaglutide is a long-acting GLP-1 receptor agonist (94% homology with native human GLP-1) with structural modifications to reduce renal clearance and decrease degradation by DPP-4, resulting in half-life 155 to 184 hours, thus allowing for once-weekly, subcutaneous (or potentially once-daily, oral) dosing. Semaglutide is the only GLP-1 receptor agonist that has shown to be effective when given orally. Brand Names: Ozempic.

Based on studies, liraglutide or semaglutide are the preferred options.

The medications have a US Boxed Warning for Thyroid C-cell tumor risk.

References:

https://www.jwatch.org/fw114893/2018/12/19/diabetes-guidelines-updated
http://care.diabetesjournals.org/content/42/Supplement_1
https://www.uptodate.com/contents/glucagon-like-peptide-1-receptor-agonists-for-the-treatment-of-type-2-diabetes-mellitus

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Piriformis muscle syndrome remains controversial and diagnosis is difficult

Piriformis syndrome is a controversial entrapment neuropathy

What is  piriformis muscle?

The piriformis muscle is a small but important external rotator of the hip that crosses the sciatic nerve and is believed by some to cause sciatica-type pain when it compresses the nerve. However, the existence of this so-called "piriformis syndrome" remains controversial and diagnosis is difficult.

Controversy is due to the limited research about the condition and the difficulty of making the diagnosis, particularly as symptoms mimic many other more common diagnoses.

How common is it?

Piriformis syndrome may account for 0.3-6% of sciatic-like syndromes.

What causes it?

The sciatic nerve normally passes inferior to the piriformis muscle. Entrapment of the sciatic nerve may develop following trauma to the buttocks or piriformis muscle strain causing scarring and fibrosis around the nerve, or due to the structure of the piriformis, such as when branches of the nerve pass through a bifid piriformis muscle.

During downhill running or sprinting, the piriformis muscle undergoes eccentric contraction and some runners may develop the syndrome via this mechanism.

The activities involved may include running, where the gluteus medius and tensor fascia lata are activated in the stance phase, but more often sports requiring cutting and turning, which involve the external rotators of the hip (eg, piriformis, gluteus medius). The onset of pain is less acute but usually within 24 hours.

What are the symptoms?

The most common presenting symptom is buttock pain of gradual onset that increases with sitting. The "wallet sign" associated with the syndrome is when a male patient finds he can no longer sit on his wallet without causing symptoms. Paresthesias may develop, but the classic radicular symptoms of sciatica are not common.

Piriformis syndrome in the runner may be associated with foot overpronation, weakness of the gluteal muscles and other hip abductors, and tightness of the hip adductors.

Clinically, the diagnosis of piriformis syndrome is considered when the classic signs of a lumbar radiculopathy elicited by provocative testing are absent, neurologic examination is normal, and other causes of gluteal and sacroiliac pain are ruled out.

Can you test for it during physical examination?

A provocative test (Freiburgs test) suggesting piriformis syndrome is performed by placing the hip in extension and internal rotation, and then resisting external rotation. Pain or sciatic symptoms denotes a positive test . Another test (Pace sign) involves having the seated patient resist abduction and external rotation. Pain and reproduction of symptoms marks a positive test.

Are there any imaging tests?

When necessary, plain radiographs and MRI of the hip and pelvis are obtained to rule out other causes of symptoms. EMG and nerve conduction studies are rarely positive in piriformis syndrome but can be useful for eliminating other diagnostic possibilities.

What is the treatment?

Treatment begins with physical therapy involving strengthening of the pelvic and hip region and stretching of the piriformis. Physical therapy is effective in the majority of cases.

YouTube search shows same of the exercises: https://www.youtube.com/results?search_query=piriformis+syndrome+exercises Always consider consulting a professional before any treatment is started.

The mainstay of treatment for both gluteus medius tendinopathy and piriformis syndrome is physical therapy and correction of biomechanical abnormalities. Orthotics and massage therapy may be useful; acetaminophen and nonsteroidal antiinflammatory drugs may be used for analgesia.

Ultrasound-guided glucocorticoid injections have been beneficial in some cases, and botulinum toxin injections have also been used. Surgery (typically a piriformis tenotomy) may be considered if symptoms are debilitating and persist despite conservative therapy.

Gluteus medius weakness and tendinopathy

The gluteus medius muscle originates along the external surface of the ilium and runs distally and laterally to its attachment on the greater trochanter of the femur. The gluteus medius abducts the hip and assists with pelvic stability during running. Weakness of the muscle causes pain with hip abduction and rotation. Pain generally increases when the muscle is stretched and there may be focal tenderness at the muscle's insertion, just medial and superior to the greater trochanter. Difficulty maintaining a level pelvis while standing on one leg is called positive Trendelenburg sign.

References:

https://www.uptodate.com/contents/overview-of-running-injuries-of-the-lower-extremity
https://www.uptodate.com/contents/approach-to-hip-and-groin-pain-in-the-athlete-and-active-adult

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Canned tuna is struggling to connect with younger generation

From the WSJ:

"Canned tuna is struggling to connect with younger generations who favor fresher, less-processed options."

In a country focused on convenience, canned tuna isn’t cutting it with consumers. “A lot of millennials don’t even own can openers,” said vice president for StarKist.

Younger consumers are opting for fresh or frozen fish over canned items.

Tuna first made inroads into American cupboards following a sardine shortage in 1903 and grew in popularity during wartime protein shortages that followed and as new canning technologies took hold. Since the late 1980s, its reputation has changed as consumers worried about potential mercury poisoning, the harm done to dolphins and its likeness to cat food.

Companies see promise in pouches vs. cans.

New cups of flavored tuna are designed to fit in car cupholders and are equipped with a plastic fork.

References:

https://www.wsj.com/articles/tuna-makers-look-to-hook-younger-consumers-1543766400

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Source: Department of Health and Human Services - PDF

via Exercise and Physical Fitness New Links: MedlinePlus RSS Feed Read More Here..

Physical Activity Guidelines for Americans: 2nd edition

Source: Department of Health and Human Services - PDF

via Exercise for Children New Links: MedlinePlus RSS Feed Read More Here..

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From Cupertino to San Francisco, a growing consensus has emerged that screen time is bad for kids: The benefits of screens as a learning tool are overblown, and the risks for addiction and stunting development seem high, as per the NYTimes.

“Doing no screen time is almost easier than doing a little,” said Kristin Stecher, a former social computing researcher married to a Facebook engineer. “If my kids do get it at all, they just want it more.”

Here is the problem: America’s public schools are still promoting devices with screens — even offering digital-only preschools. The rich are banning screens from class altogether.

Athena Chavarria, who worked as an executive assistant at Facebook and is now at Mark Zuckerberg’s philanthropic arm, the Chan Zuckerberg Initiative, said: “I am convinced the devil lives in our phones and is wreaking havoc on our children.” Ms. Chavarria did not let her children have cellphones until high school.

Chris Anderson has has 5 children and 12 tech rules. They include: no phones until the summer before high school, no screens in bedrooms, network-level content blocking, no social media until age 13, no iPads at all and screen time schedules enforced by Google Wifi that he controls from his phone. Bad behavior? The child goes offline for 24 hours.

His children attended private elementary school, where he saw the administration introduce iPads and smart whiteboards, only to “descend into chaos and then pull back from it all.”

Tim Cook, the C.E.O. of Apple, said earlier this year that he would not let his nephew join social networks. Bill Gates banned cellphones until his children were teenagers, and Melinda Gates wrote that she wished they had waited even longer. Steve Jobs would not let his young children near iPads.

References:

A Dark Consensus About Screens and Kids Begins to Emerge in Silicon Valley - NYTimes https://buff.ly/2SYOkhJ
Silicon Valley Nannies Are Phone Police for Kids https://buff.ly/2ENF3Gn
The Digital Gap Between Rich and Poor Kids Is Not What We Expected https://buff.ly/2Srcdyi

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C. Nicholas Cuneo, M.D. in the NEJM: "With every faux interaction I felt myself being forced to shed another layer of authenticity, and I quickly grew to dread the whole tedious charade.

PEARLS, it spelled out: Partnership, Empathy, Apology, Respect, Legitimization, and Support.

With a smirk, I tossed it in the trash."

Better understanding and educational approach are needed.

--

Just as a side note, here is an overview of some empathy/communication mnemonics with the corresponding references:

"PEARLS – which stands for partnership, empathy, apology/acknowledgment, respect, legitimation, and support"
https://www.mdedge.com/familypracticenews/article/88977/neurology/use-pearls-build-relationships-patients

"The NURSE mnemonic is a useful memory aid to assist you to comprehensively and appropriately respond to patients’ emotions"
https://www.stepsforward.org/modules/empathetic-listening

The NURSE mnemonic has been reproduced from Back A, Arnold R, Tulsky J. Mastering communication with seriously ill patients: balancing honesty with empathy and hope. Cambridge University Press; 2009 Mar 2.

"The 4 C's"
https://defenceupdate.mdanational.com.au/Articles/empathic-communication

"BATHE Mnemonic"
https://fpnotebook.com/Psych/Exam/BthTchnq.htm

Communicate with H.E.A.R.T®
https://my.clevelandclinic.org/departments/patient-experience/depts/experience-partners/training/communicate-with-heart

The H.E.A.R.T. program consists of 3 training modules: S.T.A.R.T. with Heart® focuses on nine key expected services behaviors to use in every interaction with patient, families and other employees. Respond with H.E.A.R.T.® is an innovative model for service recovery providing employees with tools to help consistently address patient concerns. Answer with H.E.A.R.T.® delivers training for exceptional phone service and crucial factors for de-escalating challenging calls.

R.E.D.E. to Communicate
https://my.clevelandclinic.org/departments/patient-experience/depts/experience-partners/training/rede-to-communicate

References:

https://www.nejm.org/doi/full/10.1056/NEJMp1808397

Posted at Clinical Cases and Images. Stay updated and subscribe, follow us on Twitter and connect on Facebook.

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Epigenetics

"Tthere is nobody who disputes that epigenetics predicts life span”. Aging eight or more years faster than your calendar age equates to twice the typical risk of dying, while aging seven years slower is associated with half the risk of death, Horvath says.

"Life span predictor" clock

His lab has developed a "life span predictor" they named it after the Grim Reaper: DNAm GrimAge. The epigenetic clock is more accurate the younger a person is. It’s especially inaccurate for the very old. “At this point, we don’t have any evidence that it’s clinically useful, because there are big error bars.”

Seed of the clock is strongly influenced by underlying genes: 40% of the ticking rate is determined by genetic inheritance, and the rest by lifestyle and luck: "I'LL do it" mnemonic:

Inheritance
Lifestyle
Luck

Eating a healthy diet including lots of vegetables and fish is associated with slower epigenetic aging. Sleep deprication speeds the clock. The big suprise: Regular exercise won’t add much more than a few months to your life! You probably spend way more time exercising that the time you are going to get at the end of your lifespan.

Nobody really knows about timing of the final day

From his opponents: Diane Meier, a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai in New York City: “I haven’t seen any of these purported predictive algorithms be precise in terms of timing of death—to the contrary,” says . “People live for a really long time with a very high burden of disease and frailty.”

References:

Want to know when you’re going to die?
https://www.technologyreview.com/s/612256/want-to-know-when-youre-going-to-die/

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A mother's campaign for autism care equality for all

A mother believes her son's death could have been avoided if the nurses and doctors were trained about learning disabilities and autism. via BBC News - Health Read More Here..

Why to be wary of eating 'pink' lamb

The Food Standards Agency says hundreds of people have become ill after eating the undercooked meat. via BBC News - Health Read More Here..

'Treatment may extend advanced breast cancer survival'

Combining a drug with hormone therapy may extend the lives of some women with advanced breast cancer. via BBC News - Health Read More Here..

Philip Morris accused of hypocrisy over anti-smoking ad

Philip Morris says its campaign is "an important next step" in its aim to stop selling cigarettes. via BBC News - Health Read More Here..

Infected blood victims' support payments 'must increase'

Victims of the NHS scandal have written to the health secretary asking for an immediate increase in support. via BBC News - Health Read More Here..

Doctors 'need to start early conversation with patients about dying'

They shouldn't shy away when patients want to talk about the end of their lives, a report says. via BBC News - Health Read More Here..

Silent disco for Hertfordshire dementia care home residents

People living with dementia put on their dancing shoes and boogie to Ol' Blue Eyes. via BBC News - Health Read More Here..

Mental health: Finding someone to talk to

Two people share their very different experiences of accessing help from mental health services. via BBC News - Health Read More Here..

Why is this African town letting mosquitoes in?

The genetically modified insects are part of a project which aims to tackle malaria in Africa. via BBC News - Health Read More Here..

Girl, 8, walks into school on new prosthetic leg

Friends of Amelia Eldred were ready with a group hug as she walked into school on her new leg. via BBC News - Health Read More Here..

Cardiff support worker helps man, 67, get his life back

A project will see the NHS and Cardiff council working closely to keep people living independently. via BBC News - Health Read More Here..

Michelle Heaton: Menopause is 'more than a hot flush’

Michelle Heaton went through early menopause aged 38 after a hysterectomy. via BBC News - Health Read More Here..

'I regret promoting my botched butt lift'

Ex On The Beach's Natalee Harris tells Victoria Derbyshire it encouraged others to have the same procedure. via BBC News - Health Read More Here..

'Facebook baby ads taunted me after stillborn'

Anna England-Kerr was shown ads for cots, cribs and IVF, despite trying to turn them off. via BBC News - Health Read More Here..

Baby box safety doubts raised by experts

They say babies should only sleep in them temporarily, with cots and Moses baskets thought to be safer. via BBC News - Health Read More Here..

My cheating boyfriend gave me HIV - here's how I got justice

When Diane Reeve discovered that her partner was sleeping around she ended their relationship, but then she found out that he had given her HIV. via BBC News - Health Read More Here..

I woke up unable to speak English

Hannah Jenkins survived a cycling accident - but woke up no longer being able to understand English. via BBC News - Health Read More Here..

Length of ring and index fingers 'linked to sexuality'

Women whose left index and ring fingers are different lengths are more likely to be lesbians, a study suggests. via BBC News - Health Read More Here..

'Miracle' baby whose heart stopped for 22 minutes turns one

Doctors say Lacey's recovery is remarkable and defies the odds - and she should live a normal life. via BBC News - Health Read More Here..

Kenyan schoolgirl Angel overcomes bullies to pursue dream of music career

Angel Wanjiru has overcome bullies and health problems to pursue her dream of a career in music. via BBC News - Health Read More Here..

Food allergies: What a severe reaction feels like

What having a severe nut allergy feels like and how navigating the daily risks affects your life. via BBC News - Health Read More Here..

Mystery donor gives thousands to ill Shropshire boy

Zac Oliver will now head to the United State for cancer treatment. via BBC News - Health Read More Here..

Legal cannabis in Canada: Should pot convicts get amnesty?

As cannabis becomes legal, 500,000 people with possession convictions want their records expunged. via BBC News - Health Read More Here..

Canada becomes second country to legalise recreational marijuana

The country becomes only the second nation in the world, after Uruguay, to legalise recreational use. via BBC News - Health Read More Here..

Self-lubricating condom designed to reduce infections

Scientists hope it'll make condoms easier to use and cut rates of sexually transmitted infections. via BBC News - Health Read More Here..

Pepper the robot tells MPs about artificial intelligence

Pepper the robot answers questions from MPs on the education select committee about helping to care for older people. via BBC News - Health Read More Here..

Which? testing reveals 'unsafe' child stair gates

Consumer group Which? urges parents not to use three models of stair gates, saying they could be unsafe. via BBC News - Health Read More Here..

Bill Turnbull: Prostate cancer battle 'relentlessly boring'

The presenter admits he asked doctors to stop his chemo as he "couldn't bear it any longer". via BBC News - Health Read More Here..

Robot seeks out skin cancer with suction

Fitted with a dermatoscope, the prototype can check for signs of skin abnormalities. via BBC News - Health Read More Here..

Celebrating Africa's aid workers on the frontline

From fighting fires to digging cars out of flooded roads - the unglamorous realities of the life of Africa's aid workers. via BBC News - Health Read More Here..

C-section births surge to 'alarming' rates worldwide - study

A doubling in worldwide cases of the birth procedure in 15 years is "unjustified", a study says. via BBC News - Health Read More Here..

Dance lessons for the lonely - on the NHS

GPs in England are to prescribe "social" activities, such as dance and cookery lessons, to tackle loneliness. via BBC News - Health Read More Here..

Children 'should be weighed up to age 18', report says

A report by child health experts warns England is falling behind other countries unless policies change. via BBC News - Health Read More Here..

Cwm Taf baby deaths: 'My baby is buried 4,000 miles away'

Chioma Udeogu's daughter Favour was stillborn after failings on a Welsh maternity ward. via BBC News - Health Read More Here..

The teen battling cancer and 'living every day as it comes'

Billy White, 16, has cancer for the third time, but he's not letting it get him down. via BBC News - Health Read More Here..

A day in the life of a 10-year-old patient at Alder Hey

She has cystic fibrosis and shared a day in her life to show what it's like for her. via BBC News - Health Read More Here..

Billy Monger: 'Why I don't want to compete in disabled sport'

Billy Monger, 19, had a crash 18 months ago which resulted in both his legs being amputated. via BBC News - Health Read More Here..

Princess Eugenie's dress showed off her scoliosis scar

14-year-old Georgie says Princess Eugenie’s decision to wear a wedding dress that showed off her scoliosis scar was “an inspirational thing to do.” via BBC News - Health Read More Here..

Festival organised in honour of disabled teenager

Unable to attend mainstream festivals, a 16-year-old girl has one organised in her honour. via BBC News - Health Read More Here..

Anorexic girl's porridge passion 'saved her life'

The hearty breakfast staple became Madeleine Harris's favourite food during her recovery from anorexia. via BBC News - Health Read More Here..

Age boys start puberty 'linked to mothers'

The age at which boys begin puberty is linked to when their mothers started having periods, a study suggests. via BBC News - Health Read More Here..

Princess Eugenie: 'I wanted my wedding dress to show my scar'

Princess Eugenie had major surgery on her back as a child. via BBC News - Health Read More Here..

Why my bones are crumbling at 27

Lizzie Porter was anorexic throughout her teens, and the years of starvation have left a permanent imprint. via BBC News - Health Read More Here..

Payton Summons: Brain dead girl denied further life support

The ventilator for Payton Summons, 9, is to be turned off after a judge refused an extension. via BBC News - Health Read More Here..

Same-sex mice have babies

Scientists break the rules of reproduction, so what does it mean for the future of sex? via BBC News - Health Read More Here..

'Obesity discrimination damaged my career'

Kathryn Szrodecki says obese people are passed over for promotion and paid less due to their weight. via BBC News - Health Read More Here..

4 personality types based on new data

Researchers from Northwestern University sifted through data from more than 1.5 million questionnaire respondents to find at least four distinct clusters of personality types exist — average, reserved, self-centered, and role model — challenging existing paradigms in psychology. Read more here: https://news.northwestern.edu/stories/2018/september/are-you-average-reserved-self-centered-or-a-role-model/

The personality types are based on 5 widely-accepted basic character traits - you can run a simple test created by Jordan Peterson for Dr Oz here: https://www.doctoroz.com/quiz/quiz-whats-your-personality-type?quiz=true

The simple test is more manageable than the full 100-plus questionnaire.

Video: Dr. Jordan Peterson Shares a Quiz to Help You Accomplish Your Goals:

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'Flexitarian' diets key to feeding people in a warming world

Eating more plant-based foods, ending waste and improving farming are vital for the future, say scientists via BBC News - Health Read More Here..

What works for treating children's colds?

They get twice as many colds as adults but there's no magic cure - or is there? via BBC News - Health Read More Here..

Standing desks 'boost work performance'

Employees who use desks that allow them to sit or stand are healthier and happier, research suggests. via BBC News - Health Read More Here..

Tai chi v Zumba: Do you have to work up a sweat to get fit?

Can we get the benefits of exercise without too much huffing and puffing, with an activity like tai chi? via BBC News - Health Read More Here..

Suicide focus on World Mental Health Day

Theresa May says "too many lives" are being taken, as she pledges £1.8m in funds for the Samaritans. via BBC News - Health Read More Here..

Turnbull: For heaven's sake, get tested

Former BBC Breakfast presenter Bill Turnbull gives an update on his cancer treatment. via BBC News - Health Read More Here..

Vaginal mesh implants: Australia apologises for 'decades of pain'

Women endured decades of "horrific outcomes" due to medical implants, the government acknowledges. via BBC News - Health Read More Here..

Under-25s turning their backs on alcohol, study suggests

Young people are rejecting alcohol - with abstinence almost doubling in a decade, a study suggests. via BBC News - Health Read More Here..

World Mental Health Day: Health anxiety 'weighing you down'

Philippa Patel has suffered from the mental health disorder for 30 years. via BBC News - Health Read More Here..

Ghana 'prayer camps' chain residents with mental health problems

The BBC finds religious centres in Ghana using chains to restrain people with mental health problems. via BBC News - Health Read More Here..

Disability access: Three things people often don't think about

Actress and disability campaigner Samantha Renke on the things people without a disability take for granted via BBC News - Health Read More Here..

Pioneering CJD treatment to be used on British patient

Doctors are given legal permission to use the man-made antibody on a person for the first time. via BBC News - Health Read More Here..

'Fry and Turnbull effect' on prostate cancer

More men are coming forward for help thanks to celebrities speaking out about their own experiences. via BBC News - Health Read More Here..

NHS waste handler stripped of contracts

Healthcare Environment Services has been stripped of NHS contracts. via BBC News - Health Read More Here..

The 23-year-old busting myths about Down's syndrome

Heidi Crowter, 23, lives in her own flat, has a job, has a boyfriend... and wants to challenge the image of Down's syndrome via BBC News - Health Read More Here..

Life is a 'tremendous gift', says Katie

Katie and her parents describe what it has been like adjusting to life since she received a rare face transplant. via BBC News - Health Read More Here..

Mesh 'last option' for incontinence

The controversial treatment should only be considered when other options have failed, says watchdog. via BBC News - Health Read More Here..

Gary Barlow opens up about stillbirth experience

The Take That star says he wrote about his stillborn daughter Poppy "to help other people". via BBC News - Health Read More Here..

Brain damaged boy, 6, awarded £37m in NHS compensation

The payout is believed to be the "highest ever" in a clinical negligence case against the NHS. via BBC News - Health Read More Here..

Spain court sets doctor free in 'stolen babies' case

A Spanish court lets off a former doctor over stealing newborns and giving them to infertile couples. via BBC News - Health Read More Here..

Irish smear scandal: Woman who highlighted failures dies

Emma Mhic Mhathúna was diagnosed with cervical cancer in 2016 after receiving two incorrect smear test results. via BBC News - Health Read More Here..

NHS waste backlog: Criminal probe launched

It had emerged that the waste from hospitals had not been disposed of in a timely fashion. via BBC News - Health Read More Here..

'Higher levels of PTSD among veterans', says study

Experts point to a loss of support when leaving the army as a probable cause of increased stress. via BBC News - Health Read More Here..

Panorama: Can violent men ever change?

BBC Panorama has been allowed inside the controversial courses trying to change abusive men. via BBC News - Health Read More Here..

Mothers in Ethiopia’s Oromia region are supported after childbirth for 40 days

Why women in Ethiopia's Oromia region hold a special ceremony for a mother, five days after she gives birth. via BBC News - Health Read More Here..

From cuddles to counting - PTSD coping strategies shared

A single post on Reddit about one woman's PTSD has prompted an influx of similar stories and advice. via BBC News - Health Read More Here..

Type-2 diabetes signs 'detectable years before diagnosis'

The findings suggest interventions to stop type-2 diabetes should begin earlier in life, experts say. via BBC News - Health Read More Here..

Vitamin D pills - what's the truth?

A study suggests they don't work, but health experts say there's no reason to change official advice. via BBC News - Health Read More Here..

fNIRS brain scans could identify novice from experienced surgeons

From WSJ:

Researchers studied surgeons as they performed surgical simulations and found they could identify novice from experienced surgeons by analyzing brain scans taken as the physicians worked.

Prefrontal cortex, the part of the brain involved in planning complex behaviors was more active in the novices. Skilled surgeons had more activity in the motor cortex, which is important for movement. The researchers, who developed a machine-learning system to analyze the scans, also showed that training resulted in a shift toward higher activity in the motor cortex.

Simple mnemonic:

Prefrontal cortex
Planning
Pre-proficient level

Motor cortex
Masters

The scans were not MRIs but fNIRS, short for functional near-infrared spectroscopy. A person wears a skull cap embedded with tiny lasers that beam near-infrared light into the skull. Some of that light reflects back out and can be captured by a detector placed nearby. The quality of the detected light gives scientists clues as to whether blood flowing to the brain is oxygenated or not. An increase in oxygenated blood suggests more brain activity.

References:

Brain Scans Can Detect Who Has Better Skills - WSJ
https://www.wsj.com/articles/brain-scans-can-detect-who-has-better-skills-1538589600

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