The ancient roots of fairness
Leave a CommentThe team concluded that a sense of fairness arose sometime before the chimp and human lines split some 5 million to 7 million years ago, and that doing right by others has a long evolutionary history. “When we see this kind of behavior in humans, we call it fairness,” says the study’s lead author, psychologist Darby Proctor, now of Emory University, who adds that researchers shouldn’t “hesitate to call it fairness in chimps.”
Bicycles win the race
This Prevention India piece focuses on the health benefits of cycling and how it could help save the planet.
One of the benefits of being so far behind in posting is that I can add a lot of good new stuff.
Today I learned the word “Copenhagenize” —- a great idea, though an infelicitous Neologism.
Pedal to the Metal
I’ve maintained for some time that the best solution to the exercise issue needs to be in the workplace. Our ancestors got a work out when they were at work. Us, not so much.
A paper in BMJ last summer showed how some small devices under the desk might be an important addition to our heretofore limited options. File this under the same category as James Levine’s treadmill desk.
L. J. Carr, K. A. Walaska, B. H. Marcus. Feasibility of a portable pedal exercise machine for reducing sedentary time in the workplace. British Journal of Sports Medicine. (The abstract is here).
The mini exercise bike can be set up in front of most standard office chairs for use while seated and is not noisy. In a volunteer study, subjects used the pedal machines for an average of 23 minutes each of those days. Distance covered per day ranged from a third of a mile to almost 13.5 miles, with 9 to more than 500 calories burned in the process. In theory that should matter. Now we just need the study that shows it!
The whole thing may sound a bit crazed, but that merely reflects how badly distorted work has become in the last fifty years, totally misaligned with what our bodies are best at doing. Our current computational devices, especially when deployed in factory-style, thwart our deepest biologic adaptations.
When trying to imagine the workplace of the future, after data input is not keyboard dependent, and data display is not a screen, interesting scenarios emerge.
It would be great if some tech startups actually tried to innovate and re-engineer the physical nature of cognitive work (beyond the office gym and massage service).
Pill of Pills
Here’s the article I did for Prevention India Magazine last spring on the ‘polypill’ debate. Since then, there’s been a “Polypill Summit” organized by Salim Yusuf at McMaster. More emerging data has shown these fixed dose combinations appear to be well-tolerated. But just like for big pharma campaigns, caution is warranted, since early adopter enthusiasm has a way of not translating into mass results. Moreover, it would be interesting to see what the full costs of scale up would be and how that compares to regulatory measures applied to processed foods, architecture, design and transportation policies. Moreover, it seems that this approach waves the white flag on the need for fully staffed village based primary care centers where a program customized to the patient is crafted . Which is it? One size fits all, or entrepreneurial elan aimed at the bottom billion?
We’re Doomed
One of my partners tells me about a patient he saw recently, describing her as “to the right of Mitt Romney”. A retired nurse from a major Harvard teaching hospital who was discussing the debate and lamenting ObamaCare. She drives a Mercedes (not that there’s anything wrong with that.)
Talking about how we need to get the government out of healthcare, especially programs like Medicare. When it was pointed out that Medicare is a government program — and that even private programs like Medicare Advantage were government funded she was incredulous.
I assure you my partner has good hearing and is well-anchored in reality. And this is a health care worker in a health care savvy town in Massachusetts.
Oy.
The House wants to defund AHRQ
From the Nature Blog:
In the bill, which funds the Departments of Labor, Health and Human Services (HHS), Education and Related Agencies in 2013, the Republican-controlled House appropriations subcommittee zeroes out the $405 million Agency for Health Care Research and Quality, which they see as Trojan horse for health care rationing. The bill declares it “terminated,” effective October 1, 2012.
AHRQ has been a small outpost for studying the wildly varying practice of medicine in the US. No one in their right mind thinks that American healthcare has no room for improvement — but that seems to be the message that would be sent by defunding an agency researching quality. What it really seems to be saying is that there are forces in the medical economy that don’t want scrutiny of their behavior. Next stop: 30% of GDP?
Prevention of Heart Disease Can’t Succeed Without Perturbing Our Social Networks.
I was asked by my editor at Prevention India to comment on the 5 things most affecting heart health in India. Here’s the column I called “Demand Change”
Having My Cake and Eating It Too!
When I work out with weights, I try to be sure I have loaded with protein about an hour before, and then indulge in something really sweet 15 minutes before. That’s the most guilt-free cake or cookie in my weekly routine. These days it is the orange-flavored semolina “Revani” at Anna Sortun’s bakery/bistro called Sofra. My goal is to get the insulin spike that drives amino acids into muscle.
Awhile ago,Future Pundit has had an interesting post about vascular function and protein synthesis.
In a paper by Timmerman et al in Journal of Endocrinology and Metabolism, researchers found that when insulin stimulates muscle protein synthesis in humans, it depends on endothelial-dependent vasodilation and the consequent increase in nutritive flow and mTORC1 signaling.
FP raises the interesting possibility that the well-known sarcopenia (loss of muscle tissue) of aging might be in large measure due to a decline in endothelial health with age.
Of course, we need to be reminded that there are many lifestyle measures which are proven to slow down the aging process of blood vessels. Among these, there are various dietary factors which favourably affect endothelial function. Tops on the list are the plant-derived polyphenols such as chocolate and resveratrol. While none of these to my knowledge is potent enough on its own to be a silver bullet, having a diet rich in deeply coloured fruits and vegetables is a good policy. I know, I know, I’m not the first to point this out.
But as people have known ever since “propaganda” was renamed ”public relations” by Freud’s nephew, repetition helps a message sink in.
Fruits and vegetables need their own Minsitry of Propaganda.
Data, data, data
I was at a conference of the American Heart Association focused on research of treatment outcomes recently. The thing that struck me in hearing the speakers and the process was that there is a striking need for a uniform method of collecting data and having a national repository of it. The future is datamining in every industry, and in this as in other aspects, health care is way behind.
I’ve been hearing about an all-payer database in Massachusetts for several years, but AFAIK, it ain’t available yet. I’ve recently heard that United Healthcare and other insurers are making large datasets available to researchers, which is a start. After that, all we need is an exponential increase in trained outcomes researchers and funding, and we might make rapid progress!
Last year, my only (relatively minor) contribution at a “National Summit on Chronic Diseases” in Delhi was to suggest to various people that part of the Indian Government’s rule-making of private insurance should include the proviso that all health insurers be required to submit their claims data to a national or regional database as a condition of licensure. Since then my friend Srinath Reddy has submitted a comprehensive proposal for universal coverage on behalf of the special committee that he chaired, but my modest proposal is undoubtedly irrelevant in the current situation in India from a practical point of view.
Since overtreatment runs amok in urban middle-class India, a little sunshine might help arm the lay public with some tools to shop around. One really painful aspect of the Indian health care system is the fact that educated Indians often know they are being fleeced, but are powerless to do anything about it.
Talk about asymmetric information, Mr Stiglitz!
Yikes there are 13 unposted items in my drafts folder!
Time to catching up on a slow holiday week.
