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Wednesday, 26 March 2014

8 Weird But Effective Exercises for Brain Power

In 1936, the American writer Dorothy Brandt in her book «Wake Up and Live» offered some fun exercises for the brain training to help you make your mind sharper and more flexible. These exercises are aimed to get you out of your usual environment, show a different perspective (even a different reality, if you want) and create a situation that will require ingenuity and creative solutions.

1. Spend 1 hour a day without saying anything, just answering direct questions in your usual surroundings, without creating the impression that you are offended or in a bad mood. Behave as normally as possible. Do not make any comments and do not give in to attempts to extract information from you.

2. For 30 minutes a day, think of one and only subject, being completely focused on it. You can start with five minutes.

3. For 15 minutes a day keep conversation without using the words “I, me, my, mine.“

4. Allow your interlocutor to talk only about himself without realizing it. Using polite questions, get him back to the mainstream of mutual conversation so that he does not feel any pressure or negative emotions.

5. Try to talk only about yourself without boasting, without complaining and without making your interlocutors get bored.

6. Make a strict plan for two hours a day and follow that plan.

7. Give yourself 12 random tasks, such as walking 20 miles from home without using any means, stay 12 hours without food, have breakfast in the most unexpected and unlikely place that you can find, not to talk all day except of giving answers to the questions.

8. During the day, say “yes” to all questions and suggestions (within reasonable bounds).

These exercises may seem silly and useless, but in fact they can bring much new in your life and get to know yourself better.

View the original article here

Tuesday, 25 March 2014

The Two Islands: An Unusual Personality Test That Will Surprise You!

Read the story below and answer as spontaneously and quickly as possible.

There are two neighboring islands. In the first one live two men: an uncivilized savage and a civilized man. In the other island there are several people, among them a girl who is in love and has a relationship with the civilized man.

The girl wants to go to the opposite island to meet her lover. She asks the only boatman of the island how much he wants to take her there. The boatman says that he does not want money and he will take her to the other island if she is naked in the boat.

The girl is shocked… not knowing what to do she goes to the wise man of the island to ask for help. He listens to her story with attention and gives the following advice: “Do what your heart tells you, my child…” So the girl decides to accept the proposal of the boatman in order to meet her beloved man.

So, they go to the other island. But when they arrive, the savage is on the seafront and gets crazy at the sight of the naked woman so he rapes her… At the same moment the civilized man comes and sees the scene. He goes mad and tells the girl that he does not want her anymore and she must leave immediately…

Evaluate the 5 characters of the story (savage, civilized man, girl, boatman, wise man) from the best to the worst, so that the number 1 is the character that you believe to be the best person of the story and the 5th is the worst of all.

…

Each character of the story represents a priority in your life:

Savage = how important is sex for you;

Civilized man = importance of other people’s opinion;

Girl = your need for emotional relationship;

Boatman = your need for earning money;

Wise man = how much you rely on logic.

View the original article here

5 Tips That Will Help You Believe in Yourself

Most people on the planet are divided into two types: people who believe in themselves and those who don’t. The one category of people goes with the flow, while the other one achieves positive results in life.

Here are a few tips that will help you discover your potential and believe in yourself:

With the help of simple logic we can conclude that our faith in our abilities has a great impact on our inferences that affect our choices and decisions. If a person on a subconscious level persuades himself that he cannot solve a problem, he will fail just because he has no faith in his own abilities. Be sure that any problem can be solved, and much depends on your attitude to it. The easier your attitude to life is, the faster you will overcome the difficulties you are facing.

Some people have a habit to compare themselves to those who have tried to do something and failed, thus not giving themselves the opportunity to resolve the problem they are facing. Remember that only you can find out if you can cope with this task or not because you are different from the others. Do not give up too soon! And if you choose to compare yourself with someone else, make sure that the other person’s experience in solving a specific problem is similar or equal to yours.

To rebuild belief in yourself, sometimes it is useful to recall the situation when you achieved tremendous success in a particular field. Successes of the past do not give you a guarantee of success in the future, but they encourage you and give you confidence, which is important for your future achievements.

Respect and self-confidence come when we achieve more than we can. Anyone would be glad if he amazes with his success a professional, not a child. It is important that your belief in yourself is not weakened, so always seek to improve yourself in the field of your work. Solving more complex problems, you believe in your potential and capabilities more and more, thereby getting the recognition of others.

Often on a subconscious level we compare ourselves with the child we were. For example, if in youth you had bad experiences with the other sex, it does not mean that being adult you will have face the same situations. Escalating the situation and persuading yourself that you are not worthy to be happy in the romantic relationship can result in serious emotional problems. Of course in childhood and adolescence, we are very hard to accept our failures, as people in this period have not yet formed as a mature personality.

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5 Simple Components of a Perfect Morning

Cannot bring yourself to wake up and go to work? Each morning turns into a nightmare? Tired of looking for a suitable motivation technique for waking up and still every morning you hate the whole world? To make your morning good, these 5 simple but effective components are needed:

It is not necessary to immediately turn into a professional athlete and put a bunch of unrealistic goals such as the number of sit-ups and push-ups or a certain distance to run. Start simple: each morning in all weather and at any mood, 10 minutes after waking up out of bed do a little workout with smooth movements, and then gradually increase the pace. The load, number and variety of exercises should be gradually increased every 3 days by adding new elements and movements. Strength exercises and heavy loads should be left for the second half of the day: do not try to wake yourself up with strength training. A proper morning exercise works better than any coffee and antidepressants or stimulants.

Morning shower should last no longer than 15 minutes. This is a quick way to refresh your mind and body, finally wake up and reinforce that boost of energy you got after 15-30 minutes of morning warm-up exercises.

Always take your breakfast, since it is the most important meal and the start of your day. Not only your mother and grandmother agree on the importance of the breakfast, but also eminent dieticians, therapists and doctors working with athletes and the military.

Emotional charge for your body is no less important than food. Something invigorating, rhythmic but unobtrusive should be your background music. Avoid listening to the radio or watching the TV with their advertising and news about politics and accidents! Start your morning with positive music, not with disturbing and negative influences of the media.

It is the final component of a good morning on our list, but not the least in importance. Even if you need just 20-30 minutes to get to your place of work or study, prefer to make this journey on foot.

View the original article here

People Treat You According to What You Think about Yourself

Once Sir Francis Galton, one of the most notable figures in the history of psychology, decided to conduct a kind of experiment. Before his daily walk through the streets of London, he persuaded himself: “I am a disgusting person and everyone in England hates me!” After that, he concentrated on this belief for a few minutes and then went for a walk as he usually did.

However, it just seemed that everything was going as usual. In fact, the following happened: at every step, Francis caught queasy and contemptuous glances of passers on him. Many turned away from him, and a couple of times he heard coarse language in his address. In the port one of the movers, when Galton passed him by, hit the scientist with his elbow so much that he plopped down in the mud.

It seemed that even the animals had this hostile attitude towards him. As the scientist passed by a harnessed horse, it kicked him in the thigh, so that he fell to the ground again. Galton tried to elicit some sympathy from eyewitnesses, but to his surprise, people were on the side of the animal.

Galton hurried home, without waiting until his thought experiment would lead to even more serious consequences.

This true story is described in many psychology textbooks. From it we can draw two important conclusions:

1. People treat you according to what you think about yourself.
2. No need to inform others about your self-esteem and emotional state. Be sure that they feel it anyway.

View the original article here

Friday, 21 March 2014

New Guidance Will Up Statin Use by 13 Million (CME/CE)

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Published: Mar 20, 2014 | Updated: Mar 21, 2014

Millions more people are now eligible for statin therapy under the 2013 guidelines from the American College of Cardiology and the American Heart Association.The increase comes mostly from those who would be eligible to take statins for primary prevention, mostly in adults ages 60 to 75, and would be expected to result in many fewer cardiovascular events.

An additional 12.8 million Americans ages 40 to 75 are eligible for statin therapy under the latest prevention guidelines from the American College of Cardiology and American Heart Association, researchers estimated.

That represents an increase from about 43.2 million individuals (37.5% of that age group) eligible for statins under the previous guidelines released about a decade ago to about 56 million (48.6%) under the new guidance, according to Michael Pencina, PhD, of the Duke Clinical Research Institute, and colleagues.

Most of the additional coverage would occur in the primary prevention setting and in individuals 60 and older, they reported online in the New England Journal of Medicine.

"I think this current study emphasizes the fact that if we were to fastidiously apply the new guidelines to the current population of patients we should all in our practices be expanding the indication for statins pretty significantly," commented Sahil Parikh, MD, an interventional cardiologist at University Hospitals Harrington Heart & Vascular Institute in Cleveland.

The authors acknowledged, however, that the estimates assumed that everybody eligible for statin therapy under the guidelines would actually receive a prescription even though "the new guidelines call for an informed risk-benefit discussion between the patient and physician before the initiation of statin therapy."

And that's a key consideration because the discussion should include information on lifestyle and other risk factors, potential adverse effects and drug-drug interactions, and patient preferences, Neil Stone, MD, of Northwestern Memorial Hospital's Bluhm Cardiovascular Institute, in Chicago, told MedPage Today.

"In older adults especially, even if they had a [10-year cardiovascular disease] risk of 7.5% or more, the risk estimator doesn't prescribe a statin, the discussion does," said Stone, who served as chair of the expert panel in charge of the cholesterol guidance. "Some patients whose only risk factor is age may decide with their clinician not to pursue statin therapy. Others who are slightly under the 7.5% but have other important factors mentioned in the report may decide to be on a statin."

"We hope, if careful attention is paid to the guidelines, that we're treating those people more likely to benefit," Stone added.

The ACC/AHA prevention guidelines, which were released in November, include guidance on better assessing the risk of atherosclerotic cardiovascular disease and on managing lifestyle, cholesterol, and weight. But the cholesterol guidance received the most attention because it moved away from treating to LDL cholesterol targets and toward treating the level of risk.

Concerns also were expressed about the increase in the number of individuals who would be deemed eligible for statin therapy in the new guidelines compared with the previous recommendations from the Third Adult Treatment Panel (ATP III) of the National Cholesterol Education Program first released in 2001 and then updated in 2004.

To estimate the actual increase, Pencina and colleagues started with data from 3,773 individuals ages 40 to 75 who participated in the National Health and Nutrition Examination Surveys of 2005 to 2010.

Of those individuals, 42% were receiving or would be eligible for statins based on the ATP III criteria, a figure that increased to 56.6% using the criteria from the new guidelines.

That information was then extrapolated to the population of 115.4 million U.S. adults ages 40 to 75 to identify the increase of 12.8 million who would be eligible for statin therapy under the new guidance. Of the newly eligible people, the median age would be 63.4 and 61.7% would be men. Also, the median LDL cholesterol would be 105.2 mg/dL, which is lower than the median of 120.4 mg/dL for those eligible under the ATP-III criteria.

Most of the increase in those deemed eligible for statin therapy (10.4 million) would occur in adults without cardiovascular disease (primary prevention) and in those in the upper end of the age range (60 to 75).

"Since the prevalence of cardiovascular disease rises markedly with age, the large proportions of older adults who would be eligible for statin therapy may be justifiable," the authors wrote.

They also determined that the increases would occur both in adults who would be expected to have future cardiovascular events and those who would not. Thus, sensitivity rises and specificity drops.

Still, they calculated that about 475,000 cardiovascular events would be prevented using the new guidelines instead of the older ones, assuming full adoption and adherence.

"I think what we'll look forward to seeing is what the economic impact of this is," Parikh said. "In the current era of [the] Affordable Care Act and accountable care organizations I think we're all looking very carefully at resource allocation, and we'll have to see -- is it, in fact, worth the extra money on a population basis to expand the indication for statins when it comes to event reduction?"

Pencina and colleagues noted some limitations of their analysis, including the reliance on NHANES data, the extrapolation of data from a relatively small sample to the larger population, the assumption that the new guidelines would be universally adopted and implemented, and the lack of information on treatment adherence.

The study was supported in part by the Duke Clinical Research Institute's research funds and unrestricted grants from M. Jean de Granpré and Louis and Sylvia Vogel.

Pencina disclosed relevant relationships with McGill University Health Center and AbbVie. One of his co-authors disclosed relevant relationships with Janssen, Eli Lilly, and Boehringer Ingelheim.

From the American Heart Association:

Todd Neale, MedPage Today Staff Writer, got his start in journalism at Audubon Magazine and made a stop in directory publishing before landing at MedPage Today. He received a B.S. in biology from the University of Massachusetts Amherst and an M.A. in journalism from the Science, Health, and Environmental Reporting program at New York University.

BMI Loss Lasting With 3 Bariatric Surgery Options (CME/CE)

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Published: Mar 20, 2014 | Updated: Mar 21, 2014

At 5-year follow-up in a meta-analysis, bariatric surgery appeared to provide sustained effects on weight loss.Sleeve gastrectomy appeared to be more effective in weight loss than adjustable gastric banding and comparable with gastric bypass.

Three commonly performed bariatric surgery procedures led to substantial and durable weight loss with a low mortality risk, concluded the authors of an expansive review and meta-analysis of both randomized clinical trials (RCTs) and observational studies.

Five years after surgery the 161,756 patients included in the analysis maintained 26% to 37% of the loss from baseline body mass index (BMI). Results from 37 randomized clinical trials (RCTs) showed a 30-day mortality of 0.08% and mortality beyond 30 days of 0.31%.

Complications remained fairly common (17% overall), and the reoperation rate was 7%.

Consistent with previous studies, gastric bypass resulted in the greatest weight loss, and adjustable gastric banding was associated with the lowest complication rate. The newer sleeve gastrectomy procedure seemed to offer the best combination of weight loss and safety, as reported online in JAMA Surgery.

"We observed higher mortality in observational studies than in RCTs, which could be attributed to longer follow-up time in observational studies or a higher chance that mortality recorded in observational studies was not associated with surgery," Su-Hsin Chang, PhD, of Washington University in St. Louis, and co-authors reported.

"We also found higher complication, reoperation, and comorbidity remission rates in RCTs. This could be explained by more detailed monitoring and reporting of outcomes in RCTs because of smaller sample sizes and shorter follow-up times. Despite these differences, the direction of the effects is the same in all aspects."

As the database for clinical outcomes in bariatric surgery has grown, several issues have emerged regarding generalizability. Early clinical trials provided data for specific procedures performed in different sets of patients. Some of the better known reviews did not include studies conducted after 2003, the authors noted in their introduction.

Recent meta-analyses focused on RCTs and excluded data from early publications. Moreover, advances in surgical technology and increased experience of surgeons are not adequately represented in previous reviews, the authors continued.

Chang and colleagues performed a systematic review and meta-analysis aimed at quantifying risks and benefits of specific bariatric procedures in adults. They defined risks as perioperative and postoperative mortality, complications, and reoperation rates. Benefits comprised weight loss and remission of obesity-related diseases.

The review encompassed studies reported from Jan. 1, 2003, to March 31, 2012.

The 164 articles included in the final analysis consisted of 62 publications from 2003 to 2007 and 102 from 2008 to 2012. A third of the studies (54) were conducted in North America, 72 in Europe, 13 in Asia, and 25 in other regions. A majority of the studies (92) had follow-up of at least 2 years.

The patients had a mean age of 44.6, preoperative mean BMI of 45.62, and preoperative mean weight of 274 pounds. Almost 80% were women.

Obesity-associated comorbidities included type 2 diabetes in 26%, hypertension in 47%, dyslipidemia in 27%, sleep apnea in 25%, and cardiovascular disease in 7%.

Observational studies reported higher mortality as compared with the RCTs (0.22% at 30 days, 0.35% >30 days). Also in the observational studies, adjustable gastric banding was associated with the lowest perioperative and postoperative mortality (0.07% and 0.21%), followed by sleeve gastrectomy (0.29% and 0.34%), and gastric bypass (0.38% and 0.72%).

Meta-analyses of complications comprised data from 64 studies. Complication rates were 17% in 16 RCTs and 10% in 48 observational studies. Similar rates were associated with each of the three surgical procedures evaluated.

Re-operation rates were similar in RCTs and observational studies (7% and 6%). The re-operation rate was lowest for gastric bypass (3%) in RCTs, whereas sleeve gastrectomy was associated with the lowest re-operation rate in observational studies (3%). Adjustable gastric banding had the highest re-operation rate in RCTs (12%) and observational studies (7%).

Change in BMI at 1 year was reported by 69 studies, and 11 studies had 5-year BMI data. BMI loss within 5 years of surgery ranged from 12 to 17 across observational studies. Two reports from the long-running Swedish Obese Subjects Study showed BMI loss of 6.5 at 10 years and 7.1 at 15 years.

The analysis of comorbidity outcomes comprised data from 53 studies. Remission of type 2 diabetes occurred in 92% of patients in RCTs and 86% of patients in observational studies. Hypertension remission rates were 75% in RCTs and 74% in observational studies.

The analysis of dyslipidemia remission included five RCTs, 20 observational studies, and almost 1,800 patients. Remission rates were 76% in the RCTs and 68% in the observational studies.

Sleep apnea remission was reported in five RCTs and 27 observational studies involving a total of 9,900 patients. The apnea remission rate was 96% for the RCTs and 90% for the observational studies. Of 27 patients with cardiovascular disease 58% met criteria for remission.

The study represents an important update of outcomes with different bariatric surgery procedures, said Vivek Prachand, MD, of the University of Chicago. The analysis relied on information published since 2003, whereas previous publications involved older studies.

The use of data from both RCTs and observational studies also distinguishes the analysis from prior reviews, most of which relied on RCTs.

The analysis shows that "bariatric surgery, overall, appears to be a very effective treatment for severe obesity, and it is a safe treatment in terms of mortality rate and complication rate," Prachand told MedPage Today.

"The fact of the matter is, there are several different operations that are being performed and there are differences in outcomes, differences in complications that need to be taken into account when recommending any particular procedure for any individual patient.

One caveat, he added: Chang and colleagues included data from the Swedish trial, which evaluated outcomes with bariatric procedures that are no longer used.

The study was supported by the National Cancer Institute, Foundation for Barnes-Jewish Hospital, and the American Cancer Society.

The authors disclosed no relevant relationships.

Working from Houston, home to one of the world's largest medical complexes, Charles Bankhead has more than 20 years of experience as a medical writer and editor. His career began as a science and medical writer at an academic medical center. He later spent almost a decade as a writer and editor for Medical World News, one of the leading medical trade magazines of its era. His byline has appeared in medical publications that have included Cardio, Cosmetic Surgery Times, Dermatology Times, Diagnostic Imaging, Family Practice, Journal of the National Cancer Institute, Medscape, Oncology News International, Oncology Times, Ophthalmology Times, Patient Care, Renal and Urology News, The Medical Post, Urology Times, and the International Medical News Group newspapers. He has a BA in journalism and MA in mass communications, both from Texas Tech University.