The quieter you become, the more you can hear. ~ Ram Dass 
Tuesday 27 February 2018
COOKING X HUMAN EVOLN
The shift to a cooked-food diet was a decisive point in human history. The main topic of debate is when, exactly, this change occurred.
All known human societies eat cooked foods, and biologists generally agree cooking could have had major effects on how the human body evolved. For example, cooked foods tend to be softer than raw ones, so humans can eat them with smaller teeth and weaker jaws. Cooking also increases the energy they can get from the food they eat. Starchy potatoes and other tubers, eaten by people across the world, are barely digestible when raw. Moreover, when humans try to eat more like chimpanzees and other primates, we cannot extract enough calories to live healthily. Up to 50 percent of women who exclusively eat raw foods develop amenorrhea, or lack of menstruation, a sign the body does not have enough energy to support a pregnancy—a big problem from an evolutionary perspective.
Such evidence suggests modern humans are biologically dependent on cooking. But at what point in our evolutionary history was this strange new practice adopted? Some researchers think cooking is a relatively recent innovation—at most 500,000 years old. Cooking requires control of fire, and there is not much archaeological evidence for hearths and purposefully built fires before this time.
M COPD X STEROIDS X FRACTURE
Long-term, high-dose, inhaled steroids were associated with excess fractures in a case-control analysis
Monday 26 February 2018
Heart Rate increases by approx 10 beats/min and Respiratory Rate by 5 breaths/min for every Celsius degree (1.8 degree of Fahrenheit) of fever >38°
Heart Rate increases by approx 10 beats/min and Respiratory Rate by 5 breaths/min for every Celsius degree (1.8 degree of Fahrenheit) of fever >38°
The precise height of the fever is not as important as it’s duration in predicting bacteremia
The precise height of the fever is not as important as it’s duration in predicting bacteremia
Sunday 25 February 2018
PAIN BRAIN
Major Brain Areas Where Pain Is Processed
Somatosensory 1 and 2 (the sensory maps for our body parts): Pain; touch, temperature sense, pressure sense, position sense, vibration sense, sensation of movement
Prefrontal Area: Pain; executive function, creativity, planning, empathy, action, emotional balance, intuition
Anterior Cingulate: Pain; emotional self-control, sympathetic control, conflict detection, problem solving
Posterior Parietal Lobe: Pain; sensory, visual, auditory perception; mirror neurons (neurons that fire when we see other people move), internal location of stimuli, location of external space
Supplementary Motor Area: Pain; planned movement, mirror neurons
Amygdala: Pain; emotion, emotional memory, emotional response, pleasure, sight, smell, emotional extremes
Insula: Pain; quiets the amygdala (the brain area just above); temperature, itch, empathy, emotional self-awareness, sensual touch, connects emotion with bodily sensation, mirror neurons, disgust
Posterior Cingulate: Pain; visuospatial cognition, autobiographical memory retrieval Hippocampus: Helps to store pain memories
Orbital Frontal Cortex: Pain; evaluates whether something is pleasant vs. unpleasant, empathy, understanding, emotional attunement
Somatosensory 1 and 2 (the sensory maps for our body parts): Pain; touch, temperature sense, pressure sense, position sense, vibration sense, sensation of movement
Prefrontal Area: Pain; executive function, creativity, planning, empathy, action, emotional balance, intuition
Anterior Cingulate: Pain; emotional self-control, sympathetic control, conflict detection, problem solving
Posterior Parietal Lobe: Pain; sensory, visual, auditory perception; mirror neurons (neurons that fire when we see other people move), internal location of stimuli, location of external space
Supplementary Motor Area: Pain; planned movement, mirror neurons
Amygdala: Pain; emotion, emotional memory, emotional response, pleasure, sight, smell, emotional extremes
Insula: Pain; quiets the amygdala (the brain area just above); temperature, itch, empathy, emotional self-awareness, sensual touch, connects emotion with bodily sensation, mirror neurons, disgust
Posterior Cingulate: Pain; visuospatial cognition, autobiographical memory retrieval Hippocampus: Helps to store pain memories
Orbital Frontal Cortex: Pain; evaluates whether something is pleasant vs. unpleasant, empathy, understanding, emotional attunement
Plasticity can be a blessing when the ongoing sensory input we receive is pleasurable, for it allows us to develop a brain that is better able to perceive and to savor pleasant sensations; but that same plasticity can be a curse when the sensory system that is receiving ongoing input is the pain system. That can happen when a person slips a disc, which then presses repeatedly on a nerve root in her spine. Her pain map for the area becomes hypersensitive, and she begins to feel pain not only when the disc hits the nerve when she moves the wrong way, but even when the disc is not pressing hard. The pain signal reverberates throughout her brain, so that pain persists even after its original stimulus has stopped
Plasticity can be a blessing when the ongoing sensory input we receive is pleasurable, for it
allows us to develop a brain that is better able to perceive and to savor pleasant sensations; but that
same plasticity can be a curse when the sensory system that is receiving ongoing input is the pain
system. That can happen when a person slips a disc, which then presses repeatedly on a nerve root in
her spine. Her pain map for the area becomes hypersensitive, and she begins to feel pain not only
when the disc hits the nerve when she moves the wrong way, but even when the disc is not pressing
hard. The pain signal reverberates throughout her brain, so that pain persists even after its original
stimulus has stopped
CHRONIC PAIN IS NEUROPLASTICITY GONE WRONG
Neuropathic pain occurs because of the behavior of neurons that make up our brain maps for pain.
The external areas of our body are represented in our brain, in specific processing areas, called brain
maps. Touch a part of the body’s surface, and a specific part of the brain map, devoted to that spot,
will start to fire. These maps for the body’s surface are organized topographically, meaning that areas
that are adjacent on the body are generally adjacent on the map. When the neurons in our pain maps
get damaged, they fire incessant false alarms, making us believe the problem is in our body when it is
mostly in our brain. Long after the body has healed, the pain system is still firing. The acute pain has
developed an afterlife: it becomes chronic pain.
HEAL X CURE
The word heal comes from the Old English haelan and means not simply “to cure” but “to make
whole.” The concept is very far from the idea of “cure” in the military metaphor, with its associated
ideas of divide and conquer.
But that view of an imperial brain is not accurate. Brains evolved many millions of years after bodies did, to support bodies. Once bodies had brains, they changed, so body and brain could interact and adapt to each other. Not only does the brain send signals to the body to influence it; the body sends signals to the brain to affect it as well, and thus there is constant, two-way communication between them. The body abounds with neurons, the gut alone having 100 million. Only in anatomy textbooks is the brain isolated from the body and confined to the head. In terms of the way it functions, the brain is always linked to the body and, through the senses, to the world outside. Neuroplasticians have learned to use these avenues from the body to the brain to facilitate healing. Thus, while a person who has had a stroke may not be able to use his foot because the brain is damaged, moving the foot can, at times, awaken dormant circuits in the injured brain. The body and mind become partners in the healing of the brain, and because these approaches are so noninvasive, side effects are exceedingly rare.
But that view of an imperial brain is not accurate. Brains evolved many millions of years after
bodies did, to support bodies. Once bodies had brains, they changed, so body and brain could interact
and adapt to each other. Not only does the brain send signals to the body to influence it; the body
sends signals to the brain to affect it as well, and thus there is constant, two-way communication
between them. The body abounds with neurons, the gut alone having 100 million. Only in anatomy
textbooks is the brain isolated from the body and confined to the head. In terms of the way it functions,
the brain is always linked to the body and, through the senses, to the world outside. Neuroplasticians
have learned to use these avenues from the body to the brain to facilitate healing. Thus, while a
person who has had a stroke may not be able to use his foot because the brain is damaged, moving the
foot can, at times, awaken dormant circuits in the injured brain. The body and mind become partners
in the healing of the brain, and because these approaches are so noninvasive, side effects are
exceedingly rare.
HIPPOCRATES Life is short, and Art long; opportunity fleeting, experience misleading, and decision difficult
Life is short, and Art long; opportunity fleeting, experience misleading, and decision difficult
Want not, waste not In the UK, almost three-quarters of discarded clothing ends up in landfill or being burned, with less than 1 per cent being recycled into other garments. In part, that’s because recycling clothes isn’t easy. “There is a lack of thought at the design stage, which makes it challenging for recycling to be viable,” says Richard Thompson at the University of Plymouth, UK. Buttons, toggles and other parts have to be removed, but the materials themselves are also tricky to break down and reuse. That could soon change. A Japanese company called Teijin has developed a way to chemically decompose polyester so it can be used again as a raw material, while a European Union-funded project called Trash-2-Cash is investigating how new, high-quality fibres can be created from unwanted clothing. And in 2017, Herbert Sixta from Aalto University in Finland and his colleagues found an ionic liquid that could be applied to polyester-cotton blends to separate the two types of fibres. Without any further processing, the cotton could then be used to make new clothing.
Want not, waste not
In the UK, almost three-quarters of discarded clothing ends up in landfill or being burned, with less than 1 per cent being recycled into other garments. In part, that’s because recycling clothes isn’t easy. “There is a lack of thought at the design stage, which makes it challenging for recycling to be viable,” says Richard Thompson at the University of Plymouth, UK. Buttons, toggles and other parts have to be removed, but the materials themselves are also tricky to break down and reuse.
That could soon change. A Japanese company called Teijin has developed a way to chemically decompose polyester so it can be used again as a raw material, while a European Union-funded project called Trash-2-Cash is investigating how new, high-quality fibres can be created from unwanted clothing. And in 2017, Herbert Sixta from Aalto University in Finland and his colleagues found an ionic liquid that could be applied to polyester-cotton blends to separate the two types of fibres. Without any further processing, the cotton could then be used to make new clothing.
Across the planet, more people are wearing more clothes for shorter times. Those garments tend to start their lives in factories in South and East Asia, often far from their end users. Meanwhile, the equivalent of a truckload of clothing is thrown away globally every second, the vast majority ending up either in landfill or being burned.
Across the planet, more people are wearing more clothes for shorter times. Those garments tend to start their lives in factories in South and East Asia, often far from their end users. Meanwhile, the equivalent of a truckload of clothing is thrown away globally every second, the vast majority ending up either in landfill or being burned.
It is possible that being less aggressive and more cooperative was also an advantage for early humans, giving those with these traits a better chance of surviving and reproducing. Alternatively, researchers have argued that humans became less aggressive and more cooperative simply as a consequence of their large bodies and brains. Animals with these features typically show more self-control, so it is conceivable that our ancestors became less impulsive or quick to anger simply by virtue of their size. Sexual selection could also have played a role, with females finding less aggressive males more attractive, perhaps because they provided better care for their young. Wrangham and Brian Hare at Duke University in North Carolina have suggested that a similar process could explain why bonobos have evolved to be so much less violent than chimpanzees.
It is possible that being less aggressive and more cooperative was also an advantage for early humans, giving those with these traits a better chance of surviving and reproducing. Alternatively, researchers have argued that humans became less aggressive and more cooperative simply as a consequence of their large bodies and brains. Animals with these features typically show more self-control, so it is conceivable that our ancestors became less impulsive or quick to anger simply by virtue of their size. Sexual selection could also have played a role, with females finding less aggressive males more attractive, perhaps because they provided better care for their young. Wrangham and Brian Hare at Duke University in North Carolina have suggested that a similar process could explain why bonobos have evolved to be so much less violent than chimpanzees.
FIRST came the dog, followed by sheep and goats. Then the floodgates opened: pigs, cows, cats, horses and a menagerie of birds and other beasts made the leap. Over the past 30,000 years or so, humans have domesticated all manner of species for food, hunting, transport, materials, to control pests and to keep as pets. But some say that before we domesticated any of them, we first had to domesticate ourselves.
FIRST came the dog, followed by sheep and goats. Then the floodgates opened: pigs, cows, cats, horses and a menagerie of birds and other beasts made the leap. Over the past 30,000 years or so, humans have domesticated all manner of species for food, hunting, transport, materials, to control pests and to keep as pets. But some say that before we domesticated any of them, we first had to domesticate ourselves.
The clothing industry creates carbon emissions of 1.2 billion tonnes a year – more than aviation – and making and maintaining our clothes consumes shedloads of water, energy and non-renewable resources, too.
The clothing industry creates carbon emissions of 1.2 billion tonnes a year – more than aviation – and making and maintaining our clothes consumes shedloads of water, energy and non-renewable resources, too.
MONTGOMERY Twilight drops her curtain down, and pins it with a star."
Twilight drops her curtain down, and pins it with a star."
To her great surprise, she found that two hours of silence per day prompted cell development in the hippocampus region of the brain.
To her great surprise, she found that two hours of silence per day prompted cell development in the hippocampus region of the brain.
Two-minute silent pauses proved far more relaxing than either “relaxing” music or a longer silence played before the experiment started.
Two-minute silent pauses proved far more relaxing than either “relaxing” music or a longer silence played before the experiment started.
In a loud world, silence sells. Finland saw that it was possible to quite literally make something out of nothing.
In a loud world, silence sells. Finland saw that it was possible to quite literally make something out of nothing.
Saturday 24 February 2018
ICE MODEL OF DR PT CONSULTATION
Ideas, concerns and expectations
Examples of phrasing when asking about patients’ ideas, concerns expectations
Ideas (beliefs)
- ‘Tell me about what you think is causing it.’
- ‘What do you think might be happening?’
- ‘Have you any ideas about it yourself?’
- ‘Do you have any clues; any theories?’
- ‘You’ve obviously given this some thought, it would help me to know what you were thinking it might be’.
Concerns
- ‘What are you concerned that it might be’.
- ‘Is there anything particular or specific that you were concerned about?’
- ‘What was the worst thing you were thinking it might be?’
- ‘In your darkest moments ...‘
Expectations
- ‘What were you hoping we might be able to do for this?’
- ‘What do you think might be the best plan of action?’
- ‘How might I best help you with this?’
- ‘You’ve obviously given this some thought, what were you thinking would be the best way of tackling this?’
NN SZR PX
Outcomes after acute symptomatic seizures in neonates.
Abstract
ALAN WATTS WISDOM
Wisdom From Alan Watts
Born in Britain in 1915, Alan Watts was a philosopher, priest, and writer. And long before meditation was something you could do at the local yoga studio, Watts was knee deep in Eastern philosophy.
Watts developed an interest in Asian culture as a child and later went on to join the local Buddhist Lodge. Throughout his life he devoted himself to studying Eastern religion and philosophy. He harbored a special interest for Zen and Taoism.
Though Watts was never ordained as a Zen monk, he is credited as being one of the first to introduce Buddhist ideas to the West. Famous for his clarity and articulate writing style, Watts made some of Zen’s most vital concepts palatable for Western audiences. Throughout his life, he published over 25 books and delivered lectures on topics like meditation, nothingness, and the ego.
Watts passed on in 1975. His writings left us not just with a better knowledge of Zen and Buddhism, but with an understanding of how we can embrace life’s fickle and tricky nature. In celebration of his legacy, here are 10 bits of Watts’ profound wisdom.
On Mindfulness
“This is the real secret of life -- to be completely engaged with what you are doing in the here and now. And instead of calling it work, realize it is play.”
On Embracing Change
“The only way to make sense out of change is to plunge into it, move with it, and join the dance.”
On Suffering
“Man suffers only because he takes seriously what the gods made for fun.”
On Living In The Present
“The art of living... is neither careless drifting on the one hand nor fearful clinging to the past on the other. It consists in being sensitive to each moment, in regarding it as utterly new and unique, in having the mind open and wholly receptive.”
On Zen Spirituality
“Zen does not confuse spirituality with thinking about God while one is peeling potatoes. Zen spirituality is just to peel the potatoes.”
On Letting Things Be
“Muddy water is best cleared by leaving it alone.”
On Emotions
“One is a great deal less anxious if one feels perfectly free to be anxious, and the same may be said of guilt.”
On Acceptance
“Things are as they are. Looking out into the universe at night, we make no comparisons between right and wrong stars, nor between well and badly arranged constellations.”
On Meaning and Meaninglessness
“And people get all fouled up because they want the world to have meaning as if it were words... As if you had a meaning, as if you were a mere word, as if you were something that could be looked up in a dictionary. You are meaning.”
On Gaining Perspective
“Problems that remain persistently insoluble should always be suspected as questions asked in the wrong way.”
SUICD
Hence, we say the pain is too much to bear. The only escape will be to not feel anything at all. We do this through many ways, one of which is suicide. Death is the ultimate pain-ender and stopper. The other ways are through drugs, alcohol, and even sex.
CORN OVER WHEAT
Compared to some of the world's other domesticated grains, maize was an enormously productive crop that didn't require intensive labor. Wheat, for example, demanded more time and effort from the European peasant. Corn grew in poor or rich soils and happily shared space with other local crops as well as beans and squash. Once harvested and dried, the cobs or kernels could last all winter in covered pits or mounds. This was not the sweet, juicy yellow corn we buy today. The kernels were hard and variously colored -- like the decorative Indian corn that stores sell now in the fall, only the cobs were smaller. Different kernel colors and cob sizes were identified with different localities.
Pre-diagnosis use of statins associates with increased survival times of patients with pancreatic cancer
Pre-diagnosis use of statins associates with increased survival times of patients with pancreatic cancer
GO KINDLE
During a two-week study, Brigham and Women’s Hospital researchers assigned 12 participants to read either an e-book on an iPad or a printed book before they went to sleep each evening for five nights. Then they switched formats and read for another five nights. When people read on the iPad, they
took longer to fall asleep
and spent less time in
REM sleep than with
the traditional books.
Researchers say using
devices that emit blue light—including cell
phones and laptops—
before bedtime can
have negative long-
term health effects
AVOID PREMADE SANDWICHES
You may want to reconsider your daily midday meal selection. Sandwiches contribute about 30 percent of the daily sodium limit of 2,300 milligrams recommended for most Americans, according to a study in the Journal of the Academy of Nutrition and Dietetics. For those ages 50 and older, they contribute nearly 50 percent. In the study, sandwich eaters also consumed an average of 300 more calories and 600 more milligrams of sodium than those who munched on other fare
EAT BRFAST X GOOD
Diabetes patients who ate a large, nutritious breakfast for three months had a reduction in blood sugar and blood pressure three times greater than that of people who ate a smaller meal, according to a 2013 Israeli study. Breakfasts high in protein may lower levels of ghrelin, the “hunger hormone
PRE MEAL QUICK WALK 1 MIN X GOOD
The best pre-meal appetizer: ultra-short bursts of activity. A New Zealand study found that overweight people who did just six 60-second bursts of intense activity before a meal (such as walking quickly up
a steep hill) saw a 13 percent greater drop in blood sugar after they ate than those who did a moderate- intensity workout for a half hour
AVOCADO SWICH REDUCES INFLAMMATION
After people ate hamburgers, UCLA researchers documented a harmful reaction in their arteries within two hours. When the people topped the burgers with a slice of avocado, the harm nearly disappeared. Nutrient-packed produce (even an avocado, with high fat content) seems to neutralize the inflammatory effects of FOOD
24 ALMONDS A DAY
People who ate one ounce of nuts
a day (that’s about 25 almonds or
50 pistachios) were less likely to die over a 30-year period than people who didn’t eat them at all, found a study of 119,000 people published
in the New England Journal of Medicine.
SNACK X POCO
Jonesing for chocolate-covered pretzels? Have one or two—then wait 15 minutes to see if you really want more. That’s the lesson from Cornell research on 100 adults who ate either a small or large serving of the same snack. While the group who ate the bigger portion consumed about 100 more calories on average, both groups reported equally fewer cravings 15 minutes later—a sign that it’s the pleasure of eating, not the portion size, that satisfies
COMEDY X WILLPOWER
Watching a funny video restores depleted willpower, research shows, and can help you get back on track with difficult tasks.
DESTRESS X DEFEAT PERF ANXTY X LT WRIST FIST
Next time you’re facing a stressful situation that requires physical accuracy (such as walking on a treacherous path), squeeze your left hand into a fist. This simple trick helped athletes keep their cool during a game’s high-pressure moments in a recent study. Choking under pressure seems to be caused by brain activity in the nondominant hemisphere, and distracting that side of the brain (by clenching your left hand if you’re right-handed) can stop the overthinking that leads to error.
APPLE X LOWERS LDL
Middle-aged participants who started eating an apple a day saw a dramatic 40 percent drop in their oxidized LDL, which is a particularly dangerous, artery-hardening form of “bad” cholesterol. In the small, month-long study, participants who took pills containing the same amount of polyphenol antioxidants contained in apples also saw a decrease, though significantly smaller. Further studies are needed to discover why eating whole apples maximizes the heart-happy benefits
COOK X LIVE LONGER
Research in the journal Public Health Nutrition that found that people who cooked at home five times a week were nearly 50 percent more likely to be alive after ten years than those who steered clear of the kitchen.
STEEP TEA X 5 MINS
Research links tea to lower risks of heart attack, certain cancers, type 2 diabetes, and Parkinson’s disease. More antioxidants were unleashed in tea steeped for five minutes than for just one or two, according to a British study
READING DESTRESSES -REDUCES CORTISOL
A good read can lower levels of unhealthy stress hormones such as cortisol. Participants in a British study engaged in an anxiety-provoking activity and then either read for a few minutes, listened to music, or played video games. Readers’ stress levels dropped 67 percent, a more significant drop than that of the other groups
Imperfections are part of the display of life. Joy and sorrow, birth and death are the dance of existence throughout which our awakened consciousness can shine. Yet we long for perfection. The perfect partner, house, job, boss, and spiritual teacher. And when we find them, we want them to stay that way forever, never to lose the glow, never to grow old, never to have the roof sag, the paint peeling. We’re also taught to seek perfection in ourselves. Novelist Florida Scott Maxwell writes, “No matter how old a mother is, she looks at her middle-age children for signs of improvement.” You are told that if you do enough therapy, work out at the gym, eat an especially healthy diet, watch documentaries on TV, manage your cholesterol, and meditate enough, you will become more perfect.
Imperfections are part of the display of life. Joy and sorrow, birth and death are the dance of existence throughout which our awakened consciousness can shine. Yet we long for perfection. The perfect partner, house, job, boss, and spiritual teacher. And when we find them, we want them to stay that way forever, never to lose the glow, never to grow old, never to have the roof sag, the paint peeling. We’re also taught to seek perfection in ourselves. Novelist Florida Scott Maxwell writes, “No matter how old a mother is, she looks at her middle-age children for signs of improvement.” You are told that if you do enough therapy, work out at the gym, eat an especially healthy diet, watch documentaries on TV, manage your cholesterol, and meditate enough, you will become more perfect.
Drinking about two glasses of wine or beer a day was linked to an 18% drop in a person’s risk of early death—an even stronger effect than the life-preserving practice of exercise, according to the researchers. The results came from the 90+ Study, a research project out of the University of California Irvine’s Institute for Memory Impairments and Neurological Disorders that examines the habits of people who live to at least 90
Drinking about two glasses of wine or beer a day was linked to an 18% drop in a person’s risk of early death—an even stronger effect than the life-preserving practice of exercise, according to the researchers. The results came from the 90+ Study, a research project out of the University of California Irvine’s Institute for Memory Impairments and Neurological Disorders that examines the habits of people who live to at least 90
SG The very way you breathe, sit, stand, eat, walk, work – everything can become yoga. You can use any process of life to transcend your limitations.
The very way you breathe, sit, stand, eat, walk, work – everything can become yoga. You can use any process of life to transcend your limitations.
|
PREDICTING SEIZURES
Patterns of epileptic seizure occurrence
Highlights
- •
- Seizures tend to occur following complex non-random patterns.
- •
- Rhythmic generators may underlie seizure rhythmicity.
- •
- Mathematical models try to describe these complex patterns.
- •
- Seizure prediction may revolutionize the field of epilepsy.
- •
- Closed-loop systems may improve quality of life in patients with epilepsy.
Abstract
Background
The occurrence of epileptic seizures in seemingly random patterns takes a great toll on persons with epilepsy and their families. Seizure prediction may markedly improve epilepsy management and, therefore, the quality of life of persons with epilepsy.
Methods
Literature review.
Results
Seizures tend to occur following complex non-random patterns. Circadian oscillators may contribute to the rhythmic patterns of seizure occurrence. Complex mathematical models based on chaos theory try to explain and even predict seizure occurrence. There are several patterns of epileptic seizure occurrence based on seizure location, seizure semiology, and hormonal factors, among others. These patterns are most frequently described for large populations. Inter-individual variability and complex interactions between the rhythmic generators continue to make it more difficult to predict seizures in any individual person. The increasing use of large databases and machine learning techniques may help better define patterns of seizure occurrence in individual patients. Improvements in seizure detection –such as wearable seizure detectors— and in seizure prediction –such as machine learning techniques and artificial as well as biological intelligence— promise to provide further progress in the field of epilepsy and are being applied to closed-loop systems for the treatment of epilepsy.
Conclusions
Seizures tend to occur following complex and patient-specific patterns despite their apparently random occurrence. A better understanding of these patterns and current technological advances may allow the implementation of closed-loop detection, prediction, and treatment systems in routine clinical practice.
Nurses should call doctors by their first names to prevent patient deaths, says Jeremy Hunt
Nurses should call doctors by their first names to prevent patient deaths, says Jeremy Hunt
Pinker’s ideal for science — the objective search for the truth that sets aside all assumptions, presuppositions, and biases in favor of observation and experimentation — is certainly laudable, and I agree with him that we should pursue this ideal. However, let’s not delude ourselves into thinking that scientists — himself included — can entirely lay aside all their biases and assumptions that color their ideas and theories. Science is a good thing, to be sure, but let’s not turn it into another religion by insisting that whatever is considered “consensus science” is always the gospel truth and anyone questioning the scientific consensus is a heretic worthy of scorn (or worse).
Pinker’s ideal for science — the objective search for the truth that sets aside all assumptions, presuppositions, and biases in favor of observation and experimentation — is certainly laudable, and I agree with him that we should pursue this ideal. However, let’s not delude ourselves into thinking that scientists — himself included — can entirely lay aside all their biases and assumptions that color their ideas and theories. Science is a good thing, to be sure, but let’s not turn it into another religion by insisting that whatever is considered “consensus science” is always the gospel truth and anyone questioning the scientific consensus is a heretic worthy of scorn (or worse).
SAT QDU RV CRSS- amber problems need amber solution
QT IN WARD 7 AT 6PM FRIDAY
3 WK OLD VOMITING PROJECTILE
? PS
OBSERVED X 2 HRS
GAS NORMAL
OTHER BLOODS NOT BACK
CANNULA LEFT IN SITU
NEEDS R/V NEXT DAY TO SEE THERE IS NO WORSENING AND WHETHER NEEDS US ABDOMEN
WHY WEEKEND STOP TO ALL PROCESSES
SAT R/V TO ENSURE WILL NOT NEED URGENT ULTRASOUND
AMBER SIGNS WILL NEED AMBER APRROACH, EG BREAKING RED AND GREEN NORMS.
even if Cons takes decision without seeing patient Reg does not need to be part of it
3 WK OLD VOMITING PROJECTILE
? PS
OBSERVED X 2 HRS
GAS NORMAL
OTHER BLOODS NOT BACK
CANNULA LEFT IN SITU
NEEDS R/V NEXT DAY TO SEE THERE IS NO WORSENING AND WHETHER NEEDS US ABDOMEN
WHY WEEKEND STOP TO ALL PROCESSES
SAT R/V TO ENSURE WILL NOT NEED URGENT ULTRASOUND
AMBER SIGNS WILL NEED AMBER APRROACH, EG BREAKING RED AND GREEN NORMS.
even if Cons takes decision without seeing patient Reg does not need to be part of it
Friday 23 February 2018
HUMN EVOLN
How we became human
Today, we sit alone on the only remaining branch of the human family tree. But we are only one character in the story of human evolution.
To truly understand who we are, we must look at how we got here and the key physical traits that make us human.
Bipedalism
The ability of humans to comfortably stand on two feet for extended periods of time marks us out from almost all other animals.
This feat has come about over time through a series of anatomical changes to our skeleton, affecting our cranial base, spine, pelvis, femur, knees and feet.
Australopithecus sediba (centre) and modern human (far right) skeletons are adapted to walking upright, but a chimpanzee's skeleton (left) isn't
These features serve as useful identifiers in the fossil record of likely bipedalism in our ancestors, the earliest evidence of which may come from the six-million-year-old Orrorin tugenensis.
But it's not until Homo erectus came on the scene about 1.9 million years ago that we see the long-legged form, similar to our own, that makes us so well suited to running and walking over long distances.
Big brains
Humans are big headed - our brains are around three times larger than would be expected for an animal of our size.
The brains of our early hominin relatives (species more closely related to us than to chimpanzees) were not especially large. Australopithecine brains were little bigger than those of other apes, about the size of a grapefruit.
Australopithecus africanus had a much smaller brain than humans
It isn't until the emergence of the genus Homo that we begin to see a more significant increase in the size of brains, dominated by a swelling of the cerebral cortex.
Between 1.8 million and 700,000 years ago the average brain size of Homo erectus doubled, and the brains of Neanderthals and Homo sapiens are even larger.
What caused this drastic increase in size is unclear, but it was made possible by changes in diet that allowed humans to extract more energy from their food. The production of tools and fire that allowed pre-processing of plant foods - reducing the work load of jaws, teeth and digestive systems - probably played a part. So did access to meat, a rich source of protein.
A larger brain is clearly linked to a number of distinctly human traits: the ability to create more complex tools, more advanced hunting techniques, complex social structures and the advent of language.
This 400,000-year-old spear tip made from yew wood was whittled to a point with a stone tool. It would have made a lethal weapon for hunting with.
Similar sized sexes
Although not as obvious a human trait as some of the others, a reduction in sexual dimorphism - the difference in size and shape between males and females - is closely linked to one of the most important human features of all: widespread cooperation in a population.
High sexual dimorphism in most primates is associated with competition between males for access to females. Most commonly, this leads to males having much larger bodies and canine teeth, which are used in displays of aggression.
A chimpanzee bares its large canine teeth. Male chimps have much larger canines than female chimps and use them to signal aggression, unlike humans. © Sergey Uryadnikov/ Shutterstock.com
All known hominins have smaller canines than our closest living relatives, the chimpanzees and bonobos. Among some of our early hominin relatives, such as Australopithecines afarensis, we see quite a large difference in body size between males and females. But species in the genus Homo start to show a level of sexual dimorphism similar to our own.
Why is it an important trait for becoming human?
Since reduced sexual dimorphism correlates with less aggression between males, it is likely to be associated with greater cooperation within a population and probably made the development of successful societies and civilisations much easier.
Childhood
The existence of a childhood appears to be an important development on the road to becoming human. We define it as the period of time following infancy, when the youngster is weaned but is not able to care for itself.
It is essentially an extended period of growth with continued rapid development of the brain. This period allows us to learn the complex set of skills and social intricacies that equip us to exist in complex human societies.
Childhood also brings with it another, less obvious benefit for human populations.
Unlike most primates, we are still relatively helpless once we stop feeding on our mother's milk. A child is therefore still dependent on the care of others. Importantly however, provision of care is not limited to the mother, but could instead come from a grandmother, elder sibling, or another close relative.
This frees up the mother's time, enabling her to engage in other activities and also to have another child much sooner than would be possible if she was still nursing.
An extended childhood appears to have first developed in the Homo genus. The beginnings of this are found in Homo erectus after about 1.9 million years.
A precision grip
Although other animals use tools, our mastery is second to none, and distinctly human. Ultimately, it stems from the development of a precision grip, the result of changes to the anatomy of the hand. One of the key anatomical features that has enabled this is the presence of a little projection of bone called the metacarpal styloid process.
This bone allows us to apply greater amounts of pressure to the wrist and palm. Together with changes in the proportion of our digits, it means we can squeeze objects between our thumb and the tips of our fingers.
Considerable manual dexterity was needed to carve this harpoon point from reindeer antler. Around 14,000 years old, it was found in Kent's Cavern, Devon.
A chimpanzee, by contrast, is unable to touch the tip of its thumb with the tips of all its fingers, and as a result does not have the same manual dexterity.
Some of our more distant relatives such as Australopithecus afarensis, including the famous fossil known as Lucy from 3.2 million years ago, also lacked a precision grip. But recent research using CT scanning suggests that Lucy's close cousin, Australopithecus africanus, may have possessed the required anatomy and grip to wield stone tools more than three million years ago.
This grip may have become even more refined by the time of Homo erectus 1.8 million years ago. Coupled with an increased intelligence, it has equipped humans with incredible influence over the world around us.
This film shows the making of a Levallois core and flake, an innovative stone tool developed by the Neanderthals and early Homo sapiens.
Around 300,000 years ago, they began to shape stone cores from flint that they could carry as a kind of toolkit. They would strike off flakes from this portable core and skilfully turn them into tools for specific purposes such as cutting, scraping, piercing and carving.
You can learn more about our origins and evolution in the Museum's new Human Evolution gallery and this feature about the origin of our species.
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