Digit-al Overload

Nintendo, of course, was – and still is! – the games maker that popularised the game console offering multi-dimensional movement easily by the use of thumbs. Before Nintendo invented their games console, if you wanted a game character to make a diagonal movement, you would have to hold the Up arrow at the same time as you held the Left or Right arrow, depending on which direction you were aiming to go. Circular flowing movements were impossible. But the rotary joysticks on the top of the distinct console meant new movements were possible, bringing gameplay into a whole new era.

Much of the control of the Nintendo console is operated by the thumbs, forefinger and middle finger. The ring finger and pinkie are there to stabilise the console. The thumbs are responsible for most of the buttons; a large arrray of controls is slaved to them. The thumbs are responsible for movement and activating special functions, so during gameplay a large part of the time, the thumbs are engaged in active operation, unlike the other fingers that sit passively until recalled. And since Nintendo games are addictive, incentivising the user to stay playing for hours, many spend a lot of time over-using their thumbs without being aware of it – until the onset of pain.

Many people often speak of how the younger generation suffer from Nintendo thumb. They attribute it to the lack of awareness among the young. But adults are equally guilty too. The New York Times reports how adults are increasing seeking medical intervention for a kind of localised RSI, “texting thumb”, caused by the use of over texting. The world of technology has evolved and the pace of life has accelerated to the point where people are on their phones all their times, and phones are increasingly the choice of communication – whether texting, or responding to emails. You may blame the Blackberry, which popularised the texting and typing using thumbs. But thumb overuse is increasingly common and can become very debilitating.

Many people type as part of their job – it is hard to find someone who doesn’t, even on a subsidiary level – so the overuse of the thumb can lead for strain on the tendon, which may prove to be debilitating to the point of having to stop work. The cited report mentioned how some people couldn’t even use forks! An extreme case of a hand injury could be the pianist Robert Schumann, who after a hand injury, had to give up his performing career, and become more of a composer. Our hands are valuable assets – just ask the pianist Sergey Rachmaninov, who was said to have larger hands than the average pianist which he used to great effect in playing chords and show more technical skills. Who knows what these pianists would have done had they suffered from Texting Thumb or Nintendo Thumb?

Is the solution to phone addiction and thumb overuse a poorer phone? Hardly. Poorer phones have worse designs – remember having to press the “2” button three times to get a “c” character and stress digits even more. The solution to phone addiction is a conscious human being.

Exercise, depression and newspapers

Can the Mail Online be true? A recent headline claimed that suddenly stopping exercising, or what might be termed as exercise cessation, could trigger depressive symptoms in adults.

If you have been reading the Mail Online for long enough, your first thought should be – its the Mail Online.

The Mail Online has consistently resorted to sensationalist headlines, and its paper publication, The Daily Mail is also no different. The reason, as I have explained before too, is that the latter hooks you into buying a paper to satiate your interest, while the former hooks you into reading in order to have more “dwell time” on the page – which is stuffed with adverts which play as you scroll down the article, giving them a side earning, as well as giving the site an overall boost in terms of SEO. If you look at the Mail Online web page, you will notice that the side bar is chock full of sensationalist articles which induce you to keep clicking and keep remaining within the site. But first of all a hook is needed, which is where a sensationalist health article comes in.

The sensationalist article takes the slightest tenuous link between facts and links them to form fiction which you would not normally read. As I have said before, this is how it works: A shark swims. A whale swims. The Mail Online then says a shark is a whale.

So the Mail Online (and no other newspaper, it must be mentioned), based its article on a University of Adelaide study of just 152 participants which stated that after stopping exercise, participants started to feel depressed.

First of all, if you haven’t guessed by now, I refute the claims. Of course, when you have made a plan to exercise and end up not doing so, you feel guilty, but not depressed – that would be taking the guilt symptoms too far.

Secondly, the biggest group of participants in any study was 40 – and the total from all six studies that the university referred to was 152.

There were also other anamolies reported. Some participants had guilt in the second week but not the first. It is not clear if any of the participants had depression in the first place, but it is likely the Mail Online substituted “guilt” with the more extreme “depression”.

Let’s use a bit of common sense. If you lead a fairly active lifestyle, exercising three times a week for about 1.5 hours in total, and then you stop for an extended period, you are likely to feel you should be exercising but are not, and this disconnect will trigger guilt within you – not depression. It is even arguable that any depressive symptoms you feel will be alleviated when you return to exercise, not because of any physical benefit, but more because your guilt will dissipate with the ticking off of the mental checklist.

But at least it sells papers or web traffic, and that is all what some publications are about. As long as there is enough padding to mask the business end of the publication, the selling of adverts, then it appears publications can make the news up.

Ultra-processing the causes of cancer

Diet is one of the most basic human concerns. And why shouldn’t it be? The human body needs food and water to survive. But perhaps over the last few decades there has been a sort of over-focus on foods, fads, low-carb diets, low-fat diets, high protein-diets and others that have been taken a bit to extreme. And when you realise that another of the human obsessions (at least the media one anyway) is exercise – low-intensity? high intensity? intervallic? strength? – you realise that these two can be a deadly combination. While they purport to help you lose inches, the amount of column inches they generate is amazing!

It is no surprise to find the Guardian reporting that ultra-processed foods can be linked to cancer in a recent study done by French researchers. Ultra-processed foods are those that have undergone processing that relies on chemicals outside the normal realm of preservation. In the kitchen, we normally put salt on meat to preserve it, but an ultra-processed food could be one that is cooked and then preserved using special chemicals to allow it to be stored in a can and have a long shelf life.

The diets of 100,000 people were studied and those individuals who consumed the highest proportion of processed food were found to have increases in the overall rate of cancer.

But because the consumption of processed foods covered a wide umbrella, it was difficult to isolate the specific chemical purporting to create a rise in cancer.

The rise in cancer may not necessarily be linked to a specific chemical either.

Certain chemicals might work in combination to create an increased cancer risk. The chemicals themselves may be safe, but may interact in unknown ways.

Furthermore, it might be a lifestyle issue anyway – as those who eat more ultra-processed foods are more likely to live a more stressful or hectic lifestyle, consume a higher-fat diet, exercise less and be more likley to smoke.

The risk of cancer is minimised with a reduction in smoking, and increased in physical activity, and a healthy diet that includes minimising the consumption of alcohol and eating fruits and vegetables. It is also perhaps managed by a comfortable level of stress. We could take the combination of these factors to give a “lifestyle score” to assess the risk of developing cancer, instead of looking at individual factors and trying to determine their individual impact. While certain individual factors do have a pre-dominant influence when taken far beyond the boundaries of normal well-being – for example, a person who drinks excessively and then develops cancer can have his cancer retrospectively linked to his alcohol consumption – the examination of how factors combine within a smaller boundary is perhaps useful research for the future. For example, if a person does not exercise, but eats healthily, is he or she more likely to develop cancer than someone who eats healthily but has a stressful lifestyle?

It is these kinds of combinations that could form the basis for useful research in the future.

Dogs can sense fear – and seek release

What makes some people more susceptible to being bitten by dogs? A recent study suggests that dogs, with a sense of smell keener than humans, can sense fear in us. And this suggests that perhaps the sense of fear trips or triggers the dog into a fright or flight response that results in the human being bitten.

The Daily Telegraph reported that the best form of prevention against a bite from a dog could be to adopt a slight self-confident front, almost seemingly like a swagger, in order to convince the dog of a sense of confidence to override the inner sense of fear. However, this approach does not address how the dog might deal with the presentation of a confident person yet sense the underlying fear. It is like you meeting a person who you know is lying, yet smiling at you. What do you know? You revert to what psychologists might call the memory bank, the “type 2” kind of thinking which is more analytical, and less immediately responsive – but do dogs have that kind of ability to think and fall back on?

The research was carried out by researchers from the University of Liverpool in the form of a survey in a bit to understand why the likelihood of people being bitten by dogs seemed to be in a higher case of incidence for certain individiuals.

The results from the survey said that the likelihood of taking a nip from a four legged friend was almost 2.5 times more common than the current official figure, which estimates that 7.4 in 1,000 people get bitten by a dog every year in the UK. The figure is likely to be higher, because dog owners who get bitten by their own dogs are unlikely to report them for fear of getting their own dogs put down. Dog bites which also happen within the family – where the dog belongs to a family member – are unlikely to be reported for the same reason.

The results also showed that people who are nervous, men and owners of several dogs were more likely to be bitten.

This study was dependent on the date from questionnaires. This sort of information collection is a good way to obtain responses quickly. However, the limitations of this study include the fact that in this particular instance an assessment of behaviour is difficult, both in a recollection situation – having to do it in hindsight. Also there was the earlier reported case of perhaps dog owners not wanting to get their dogs taken in, and amending their queries.

The current guidelins for dog bit preventions suggest the following:

Never leave a young child unsupervised with a dog – regardless of the type of dog and its previous behaviour.

This is of course a good point, especially with attack dogs or more aggresive breeds. Even if the child is known to the dog, there have been many cases where dogs left alone with toddlers have seized the chance and attacked them. It is almost as if the removal of an adult boldens the dog into an attack it would not normally make, and being left alone with a young child heightens the fright or fight syndrome within a dog.

Another guideline is to treat dogs with respect – don’t pet them when they’re eating or sleeping. Dogs dislike being disturbed when they are meeting their basic needs, and the disturbance awakes and breeds aggressive responses that may evolve later.

A third guideline is to avoid stroking or petting unfamiliar dogs – when greeting a dog for the first time, let it sniff you before petting it. A good idea is to actually converse with the owner first so that the dog has already established you are friendly.

This study was carried out by researchers from the University of Liverpool and was funded by the Medical Research Council Population Health Scientist Fellowship. While the media reporting of the study was fairly accurate, The Guardian pointed out that people’s emotional stability was self-rated. In other words, if respondents were asked to rate their feelings, this may not be an accurate assessment – one person’s level of anxiety may not be the same as another’s.

So can dogs actually sense fear and anxiety? How does this explain the incidence of people being bitten by dogs? The answer to these questions can be answered best perhaps in two parts.

The first is the level of aggression in the dog. This depends of course on the genetic makeup, but also how it is treated. If its needs are met then it is likely that the level of aggression is typically lower than what it would be than if it were harrassed or disturbed persistently, which can build up latent aggression.

The second is the dog’s sense of fear. If a dog is often emotionally angered and there is opportunity to release this tension, even in a moment of madness, then this may result in biting as an emotional release.

So can dogs sense fear? Possibly. Does this explain their tendency to bite? Well, dogs that are treated well and genetically not prone to attacking will be less prone to nipping. Dogs that are not attack dogs but mistreated, or dogs that habitually have their attack responses nurtured, are more prone to biting, when the opportunity presents itself in the form of a less defensive target.

How the dangers of e-cigarettes extend beyond DNA damage

Studies done on laboratory mice suggest that e-cigarettes can be harmful to humans, although to a lesser degree compared to the traditional tobacco they are supposed to replace. This suggests that  cigarette smokers could do themselves some good in switching to e-cigarettes, although those who have yet to pick up the habit should avoid it because it can actually do the body harm – and is not zero-risk smoking as some might view it.

E-cigarettes have been growing in use over the last few years. Because they are aerosol-based, they use compounds to deliver nicotine to the user. This means they avoid the smoke associated with traditional tobacco cigarettes. In the latter, the burning of tobacco releases carcinogens, which cause cell damage and cancer when they are inhaled. The delivery of nicotine by aerosol in e-cigarettes avoids these, although the recent study proposes that this is not enough.

The most recent research into the use of e-cigarettes suggests that they still cause cancer because they damage string DNA and the body’s ability to repair itself.

Laboratory mice were exposed to the vapour of e-cigarettes for a period that simulated normal human consumption. The vapour of e-cigarettes contains both nicotine and solvent, and while the solvent itself had no effect on the mice, the combination of solvent and nicotine had the same impact as nicotine itself.

The limitations of the study were that it was unclear the vapour inhaled by the mice was equal to the amount a human being would, or pro-rated for the difference in mass! Furthermore, the impact on mice may not be comparable to those on humans.

The research does highlight, nevertheless, that there is a potential danger in e-cigarettes. While guidelines in 2016 recommended them as a safer alternative to tobacco, they are not 100% safe. Various groups of people such as the younger generation, for whom smoking is a perceived sign of maturity, think that just because there is no burnt substance, that they are perfectly safe. Unfortunately, the easy availability of these e-cigarettes, just like nicotine gum, means that rather than getting individuals off cigarettes, they may only be building up a lifelong addiction instead.

The higher cost of body embarrassment

If you were a bloke, would you avoid going to the doctor’s if it meant you had to strip off for the doctor to examine an area of your body you had concern about? Chances are men who have found a lump in their testicles might put off going to the doctor’s for a couple of days, drinking lots of water in the hope that it would go down, and if the lump remained, then work up the courage to make an appointment to see a doctor about it. Why put it off for a few days? It is probably down to the fact that it is slightly awkward and embarrassing to strip off to your private areas in front of someone else, despite the fact that doctors are professional and the health concerns are pressing. Despite the risk that the lumps may need to be operated on, some leave it late – and even a bit too late – because of the embarrassment.

But the embarrassment is not just down to men. Women put off going for tests and checkups because of the awkwardness around their perceived bodies. The BBC News website reported that women were avoiding smear tests to detect cervical cancer, with some either delaying making an appointment, or skipping screening altogether.

Cervical cancer accounts for an average of more than two deaths a day. Over 900 women die annually from it. Each day an average of nine women a day are diagnosed with it. All women aged 25 to 49 are invited for a screening test every three years. From the ages of fifty to sixty-four, this is reduced to once every five years.

Among those aged 25 to 29, more than one in three skip the cervical screening, a statistic that is worrying as the women more likely to get such cancer is the age group most likely to avoid the screening tests meant to catch it.

For what reasons do women avoid such tests?

One survey of around 2000 women found that their embarrssment about body shape was the most largely quoted reason for not attending. In other words, women were not comfortable with their own bodies in front of others. Other women also thought that they were healthy, being regulars of exercise or the gym, and thought that they were of a lower risk than others. A third did not believe that cervical screening reduces the risk of cancer at all. The results of the survey suggest that more importance needs to be placed on educating women of the benefits of screening.

The test only takes five minutes but perhaps one of the biggest barriers facing women was the awkardness if a male doctor or nurse was the one conducting the cervical screening. But women do have the option of asking in advance for a female to carry out the test, and many already do.

Jo’s Cervical Cancer Turst, the only charity in the UK dedicated to women suffers of this form of cancer, is working to improve detection rates and hence reduce the emotional impact of cancer on women and their families. The current screening is the greatest form of protection against such cancer, and helps save the NHS money by preventing the need for later surgery. The treatment of early stage cancer iis estimated by the charity to cost less than a tenth of later stage cancer.

It is not clear from the survery whether the women were representative of different regions, beliefs, or socio-economic groups. Women from certain cultures may find it more socially unacceptable to be naked in front of other individuals, let alone male doctors, and hence not attend screening for such reasons and are likely not to.

Appearance of the body shape and the vulva accounted for 84% or cervical smear absentees. Of these, 38% were also concerned that they might not smell normal, while 31% would not have gone had they not shaved or waxed their bikini area.

A senior nurse mentioned that nurses are aware of the awkwardness of showing an intimate part of the body to someone else but are sensitive to make the procedure less embarrassing so that women continue to have acceptable experiences that do not put them off screening for cancer. A chaperone is always offered and if women prefer to take a friend or partner with them that is fine too. It would be a great shame if women were put off seeking medical advice because of their embarrassment – it would be too great a price to pay for a small period of minimal inconvenience. The same goes for men and visits to their doctors too.

Ibuprofen and the fertile imagination

There is an astounding variety of painkillers available for purchase both in supermarkets, chemists, and corner shops. Just take a look at the shelf of your nearest Tesco or Sainsbury. You have various types of paracetamol, both made by pharmaceutical companies as well as in house versions of the supermarkets.

What is the difference between them and why are there so many varieties?

When pharmaceutical companies take on the decision to manufacture a new drug, they are given a twenty-year patent which covers the research into the product, testing and manufacturing, and sales. The period of twenty years, a monopoly as such, is to reward them for the time invested into the research. In the course of the research into the product, pharmaceutical companies must publish various forms of medical evidence and put it into public domain, so that if there is any medical evidence that points to the contrary, these can be debated both by the medical community and the pharmaceutical world.

The problem, if we can call it that, is that business is a very competitive world, and if research is put out in the open without any form of intellectual protection, any manufacturer can pounce on the research undertaken by someone else who has taken the effort and trouble to do it, and produce their product off the back of it. They would have saved the time and cost investment.

Imagine if a writer has taken the time to research a topic, organise his thoughts succinctly, and find a publisher. And when his book is published, someone else photocopies it, binds the copied pages and subsequently peddles it as their own.

Within the period of twenty years, a pharmaceutical company has to research, market and sell enough of the product to recoup the investment costs and profit. It is after the twenty period has expired that the other sharks enter the fray. This is where you get the supermarket brands of the product, which are cheaper because they don’t need to pay for research.

What is the difference between brand names and generics? They essentially do the same thing. But if the original company has done a good job in making the product synonymous with its own brand, then you might think they are better. If you take Neurofen for headaches, then you might think it better than Tesco ibuprofen, even though they both contain the same active ingredient.

But pharmaceutical companies have to reinvent themselves, to make varieties of the same product, otherwise they will lose their market share and eventually die out. If you realise that Neurofen is matched in ability by the cheaper Tesco ibuprofen, you would buy the latter, unless you are persuaded that Neurofen for Flus and Colds, or Neurofen Muscle Pain has something clinically formulated for that specific purpose.

So the shelves of supermarkets are stacked with different priced products with the same active ingredient, as well as different varieties of the same product.

Painkillers are a common medicine because there will always be a demand for pain management.

The availability of pain relief medicine means it is easy for the average individual to obtain them. There is the possibility of overdose, and while this may be a rarity, there is a higher likelihood that the greater availability may mean individuals are taking more doses than they should.

What are the long term health impacts of taking ibuprofen for prolonged periods?

One problem is that the body adapts and so the long-term resistance is affected. In certain groups such as the elderly, aspirin also increased the risks of stomach bleeding.

A clinical trial seemed to suggest it may impact on testosterone production and hence affect fertility.

Test subjects were administered 2 x 600mg doses of ibuprofen daily for six weeks, much higher than the average dose. The sample size was only a small group of 30, and half received ibuprofen, while the others received a placebo. It would have been better if the subject group had been greater, so that there could be more confidence in the test results, but because a test of such nature is to examine human resistance to what is essentially toxicity, it would have been unethical to involve a large group of participants. The research findings found that there was no impact on testosterone already in the body, but the pain relieving nature of ibuprofen, as a relaxant of sorts, had impact on the production of testosterone and appeared to slow down production.

How did these reports end up in the media? The tabloids had a field day, and you would undoubtedly have found one with the usual wisecracks about balls and other man-related genitalia, along the lines of “Ibuprofen shrinks your balls” or “Ibuprofen smalls your balls”.

Maybe instead of Ibuprofen for colds or fast relief, we need Ibuprofen for Dummies.