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Archive for October, 2008

Vitamin D

Posted in from the consulting room, health on October 13, 2008| 3 Comments »

I read some research recently linking low vitamin D levels to chronic pain in women. As the Scottish population is well known to be rather deficient in vitamin D (not enough sunlight, poor diet), and as I see a lot of patients with chronic pain, I’ve started sharing this research with female patients who have chronic pain. Already I’ve had back reports of quite dramatic reductions in pain levels in some of these patients. I hadn’t been aware of such a connection before but I had been aware that vitamin D insufficiency might be one of the factors behind the high levels of Multiple Sclerosis in Scotland. Well, it seems that vitamin D may have an even more extensive role to play in health than we realised

In a paper published in the August issue of the American Journal of Clinical Nutrition, Norman identifies vitamin D’s potential for contributions to good health in the adaptive and innate immune systems, the secretion and regulation of insulin by the pancreas, the heart and blood pressure regulation, muscle strength and brain activity. In addition, access to adequate amounts of vitamin D is believed to be beneficial towards reducing the risk of cancer. Norman also lists 36 organ tissues in the body whose cells respond biologically to vitamin D. The list includes bone marrow, breast, colon, intestine, kidney, lung, prostate, retina, skin, stomach and the uterus. According to Norman, deficiency of vitamin D can impact all 36 organs. Already, vitamin D deficiency is associated with muscle strength decrease, high risk for falls, and increased risk for colorectal, prostate and breast and other major cancers.

This research group is recommending that people take 2000 international units of vitamin D a day. This is considerably higher than other recommendations which range from 200 to 400 units depending on age (older people need more). It is possible to take too much vitamin D and be harmed by it but this is unlikely at doses under 10,000 units daily so the 2,000 units recommendation is well within safety limits.

This seems to be a developing story, but I think we’re going to see more attention being paid to this somewhat neglected vitamin!

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Selecting the evidence

Posted in science on October 12, 2008| 1 Comment »

There’s a strange presumption in some quarters that “science” (as if there was a “thing” called “science”) is the only way to know the TRUTH about reality. Research is a fascinating phenomenon to consider, and the more you consider it, the less straight forward it appears! One of the issues in medical research is the issue of bias produced by the funds for a study being put up by the pharmaceutical company which makes the drug. This is an issue which has been, and will continue to be, discussed and debated extensively. I’m not going to go down that road in this post. What I would like to draw your attention to however is an article published in PloS Medicine. The authors argue that the sheer size of the output from labs and research groups so outweighs the number of outlets for publication that there is an intense publication bias through the necessary highly limited selection process of the journals, that what is published amounts to a serious distortion of the reality of scientific endeavour.

The scarcity of available outlets is artificial, based on the costs of printing in an electronic age and a belief that selectivity is equivalent to quality. Science is subject to great uncertainty: we cannot be confident now which efforts will ultimately yield worthwhile achievements. However, the current system abdicates to a small number of intermediates an authoritative prescience to anticipate a highly unpredictable future. In considering society’s expectations and our own goals as scientists, we believe that there is a moral imperative to reconsider how scientific data are judged and disseminated.

An example of the kind of distortion of reality this selection process produces was highlighted in the New England Journal of Medicine which found this –

Results Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall.

The PloS article makes some suggestions for improving the system, not least recommending the digital publication of any research without significant errors rather than selection on the basis of what someone considers “important”. That would be a start! But the most important point here is that published research is not equivalent to Truth. We should consider it, but remain wary of claims to certainty.

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Is every day the same?

Posted in creativity, life on October 9, 2008| 7 Comments »

When I recently made myself a visual diary, I explored the origins of the names of the days of the week. In fact, a while ago, when I went to Japanese language evening class, I was struck by how the days of the week in Japanese were named after certain planets, and knowing a bit of French I was struck by the fact that the French too named the days of the week after the same planets. It’s not so clear in English because we’ve swapped the Greek and Roman Gods for Norse ones – like Woden and Thor, but in fact, these Gods are associated with exactly the same planets for each of the days as we find in the Japanese and French traditions.

One of the things which makes human beings unique is our ability to handle and play with metaphors and symbols. We are great at both applying and discovering meanings. Absolutely everything can be considered to be a representation of something else. This allows us to experience life in a rich variety of ways. So I got to wondering about the Classical myths associated with each of the planets and their associated gods. How would a Monday feel if I was more aware of its association with the Moon? Any different? How about a Friday and its association with Venus? Would the week develop a different rhythm if I reflected on each day and the different qualities related to the myths and stories we’ve associated with each of the planets? Let me be clear, I’m not talking about astrology, I’m talking about myth, narrative and symbolism……the way we use these ways of colouring and even creating our experiences.

I’m still working on this but before I say more about it, there’s another factor affecting my thoughts about it. I’ve just finished reading “La sagesse des jours”, by Andre Guigot. The translation of the book’s title would be “The Wisdom of the Days”, and in it, this French philosopher considers how each day has its own unique qualities which can stimulate our thoughts about different aspects of life and living depending on which particular issues are predominant on specific days of the week. In fact, it wouldn’t be possible to write a book like this in English, certainly not for a UK audience (and probably not for a US audience either), because we’ve lost the kinds of rhythms to life which the French still enjoy. To give you a flavour of his book, he identifies Saturday as market day for example, (I don’t know any towns in France which don’t have a market on a Saturday!) and he identifies Tuesday as the first day of commerce in the week (many shops in France, in fact most shops in smaller towns, close on a Monday) It’s an inspiring little book but translating it into a UK context isn’t very easy.

So I’m wondering how to ascribe certain qualities to particular days of the week. And I’ve come up with a few ideas already. For example, the moon is usually associated with feelings and with reflection. Could Mondays be days to be more aware of what’s going on inside? To be more aware of my emotional reactions throughout the day? Then, Tuesday is Mars day. Themes associated with Mars are themes of physical strength and fitness, and themes of the urge to distinguish oneself as a unique individual. This contrasts a lot with Friday which is associated with Venus. Whilst Mars is associated with maleness, or with yang energy, Venus is associated with femaleness, or yin energy. Whilst Mars is associated with distinguishing ourselves as individuals, Venus is associated with togetherness, with love, relationships and belonging. Wednesday’s name comes from Mercury, the “winged messenger”, a day to play with words and symbols, to be linguistically creative….hey, maybe a day for writing poetry, or for communicating. Thursday is named after Thor, or Jupiter, associated with expansion, of reaching out, of empathy and the understanding of others which comes with travel. Whilst Saturday is associated with Saturn and themes of conservation, of strengthening and consolidating. Which leaves Sunday as a day to celebrate Life and being alive.

You get the idea? This is just a brief outline, but I hope you can see the germ of an idea here. I hope you can see a way of creating your own personal rhythm to the week. I’ll work on this and return to it, but meantime, I’d be really interested to hear your own take on this. How do you distinguish the days of the week from each other? What qualities or characteristics would you ascribe to particular days?

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A Visual Diary

Posted in creativity, life, tagged , , , on October 5, 2008| 15 Comments »

It’s come to that time of year when I’m needing to put some events, meetings, trips and so on into a 2009 diary. For the last couple of years I’ve been using a small moleskine week over two pages diary but I’ve grown disenchanted with the linearity of such diaries. They are all divided up into sections (either per day, or per week, or month) and all the sections are of the same size but because days are all different (well, they are in my life anyway!) I find that some days the entries are spilling over into surrounding days and other days are virtually blank. This all comes down to how you use a diary. I’m pretty minimalist. Key points only for me.

So, having looked around in the stationery stores I decided to MAKE a diary which was better suited to my purposes. I won’t lay out here all the steps involved in the creative process but I thought I’d share the result. Maybe you’ll be inspired by some element of this, make your own, or borrow some of the ideas I’ve used.

I decided to stick with Moleskine, but to use what they call a “Japanese fold” notebook – like this –
Japanese fold moleskine
This is a continuous single sheet of paper which is folded instead of cut to make the separate pages. I wanted to use a double page spread for each week. I mark the top right hand corner of the right hand page with the starting and ending dates of that week (my week starts on Monday and ends on the Sunday).
I want to use the whole spread to lay out my commitments and information in a kind of “mind map” style, so I thought I’d put the days of the week down the middle of the spread. That looked pretty ugly and I am a very visual person (which you’ll have realised from all the photography on this blog!), so I decided instead to use a symbol for each day of the week. Well, it turns out that in many languages of the world the names of the days are related to the names of the sun, the moon and five planets – the same ones in many, many languages.
Sunday = Sun
Monday (French; Lundi) = Moon
Tuesday (French; Mardi) = Mars
Wednesday (French; Mercredi) = Mercury
Thursday (French; Jeudi) = Jupiter
Friday (French; Vendredi) = Venus
Saturday = Saturn
I didn’t want to draw all the symbols every week so I made a jpeg of the symbols and uploaded it to moo.com to get stickers made. Here they are –
moo stickers days of the week
I place one sticker just to the left of the centrefold (I have more entries usually on Monday, Tuesday, Wednesday, than I do on Thursday, Friday and Saturday). You’ll see I’ve got the Sun in the middle (it’s not a day I usually enter any commitments). There are Monday, Tuesday and Wednesday on the right, and Thursday, Friday and Saturday on the left, and they follow the sequence like a clock face (time goes clockwise in my life! 🙂 )
one week spread

To enter a new piece of info I draw a pencil line out from the day of the week and enter the details. I can follow this item out with branching lines, mindmap style, if necessary. (I’ve found it useful to put the actual date (numerical day of the month) at the root of the line.)
That’s it really.
I’m enjoying it. It’s aesthetically pleasing and it suits the way I think and I organise.
I’ve added two additional features to make it more functional. In the pocket at the back of the moleskine I put 3 x 5 index cards, one for each month ahead (carrying only 3 or 4 at a time). This gives me a kind of planner overview.
monthly index cards

And I’ve attached two small post-it pads inside the back cover, to write details of any dates not covered by the existing spreads or cards.
post-its

I’ve been using this new diary for about a month now and I’m finding it’s sparking off a whole chain of thought I hadn’t predicted. But I’ll tell you about that in a separate post!

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