17 November 2017

Don’t Miss Them

Welcome back. I just wanted to remind you that I’m now blogging on a different website, Warren’s Noticewww.warrensnotice.com. If you haven’t visited my new site yet, here are the blog posts you’ve missed:


Cat Bites - 27 Oct 2017
OK, so Vicki got bitten by Mindy, one of Vicki’s barn cats, after I drove into or over her (Mindy, not Vicki). C’mon, how bad could a cat bite be? -  www.warrensnotice.com/2017/10/cat-bites.html

Halloween Wishes - 31 Oct 2017
Trick or Treat? Treat! There’s a Halloween blog post. -
www.warrensnotice.com/2017/10/halloween-wishes.html

Intuition and Conspiracy Theories - 3 Nov 2017
Have you seen the released JFK files? Try this on: Those who rely more on gut feelings than on evidence and reason are more likely to accept conspiracy theories and misperceptions, including fake news. - www.warrensnotice.com/2017/11/intuition-and-conspiracy-theories.html

Hiring Discrimination - 10 Nov 2017
Title VII of the Civil Rights Act of 1964 prohibits discrimination in any aspect of employment, including hiring. But here’s what one study found. - www.warrensnotice.com/2017/11/hiring-discrimination.html

Cookbook Food Safety - 17 Nov 2017
Have you got the recipes ready for next week? Today’s blog post provides some guidance--ok, warning--about following cookbook recipes. - www.warrensnotice.com/2017/11/cookbook-food-safety.html


I hope you’ll stop by.  – warren

20 October 2017

Blog is Moving

ALERT! HEADS UP! ALERT!

I apologize for any inconvenience this may cause, but today (Fri, 20 Oct 2017), I will be moving to a new blog website: Warren’s Notice


The URL is www.warrensnotice.com.

I hope you’ll follow me there. The nature of the blog content you’ve found here on Retired--Now What? will continue on Warren’s Notice essentially unchanged. -warren

13 October 2017

Trauma Center Transport

Welcome back. Earlier this year, I blogged about Gun Research. I mentioned a Boston University study that found nearly every American is likely to know a gun violence victim in their social network during their lifetime. That result alone, never mind stabbing victims, underlines the importance of a recent study that assessed the best mode of transporting penetrating injury victims to a trauma care center.

What is the best way to transport
gunshot and stab wound victims
to the trauma center? (photo
from multiple websites)
Wait! Best mode? Am I suggesting that transport by emergency medical services (EMS) ambulance may not offer the best chance for survival? Here’s the story.

Ground EMS vs. Private Vehicle Transport
Collaborating medical specialists from Northwestern University, American College of Surgeons, University of Toronto and Johns Hopkins analyzed information available from the National Trauma Data Bank for the years 2010 through 2012.

From over 2.3 million patient records, they selected 103,029 at 298 hospitals for study. Those were the gunshot or stab wound patients age 16 or older, who were transported by ground EMS or private vehicle to a level 1 or level 2 trauma center in the 100 most populous metropolitan areas. (Level 1 and 2 centers have the most comprehensive resources and admit the most patients.)

Patients in the study sample were predominantly male (88%), average age 32, 48% black, 26% white and 18% Hispanic. Black and Hispanic patients were over 4 times more likely to have been transported by private vehicle than by ground EMS; white patients were over 6 times more likely to have been transported by ground EMS.

Risk-adjusted mortality was assessed and evaluated after stratifying by injury severity. Variables included presenting heart rate, presenting systolic blood pressure, presenting Glasgow Coma Scale Motor Score (describes level of consciousness after traumatic brain injury), Injury Severity Score (assesses trauma severity), age, sex, race/ethnicity, insurance status and year of admission.

The average Injury Severity Score for patients transported by private vehicle (5.5) was about half that of patients transported by ground EMS (10.1); both averages were below moderate/severe (15), which is considered major trauma.

Lowest Mortality Transport
The researchers found that, after risk adjustment, the odds of penetrating injury patients dying when transported by private vehicle were on the order of 38% lower than when transported by ground EMS. This broke down to about 45% lower for gunshot wound patients and about 32% lower for stab wound patients.

Does that say forget about calling for an ambulance for your next heart attack or injury? Absolutely not. The study was limited to gunshot and stab wound victims because penetrating injury victims are least likely to benefit significantly from prehospital interventions and most likely to benefit from timely surgical intervention.  


Gunshot and stab wound victims
need timely surgical intervention
more than prehospital
interventions. (photo from
multiple websites)
Although data were not available to compare EMS “stay and stabilize” policy with EMS “scoop and run” policy, the results suggest the latter might be more beneficial for gunshot and stabbing wound patients.

Wrap Up
I felt urged to review this study when I saw that the State of Wisconsin, where I currently reside, will probably join a dozen other states and allow permitless carry (aka constitutional carry) of concealed guns. As I understand it, none of these states requires the gun buyer to receive any safety training.

Whatever my views on gun rights and gun control, I am a realist. I expect the number of gunshot wounds to increase with permitless concealed carry, and thus, I see the need to alert the public that private vehicle transport might be the way to go, at least if you’re in range of a level 1 or 2 trauma center. (While nearly all Wisconsin hospitals participate in the trauma system, only 9% are level 1 or 2.)

I hope I’m wrong. Thanks for stopping by.

P.S.
Study of penetrating injury transport to trauma center in JAMA Surgery: jamanetwork.com/journals/jamasurgery/fullarticle/2654239
Article on study on ScienceDaily website: www.sciencedaily.com/releases/2017/09/170920131648.htm
American College of Surgeons National Trauma Data Bank: www.facs.org/quality-programs/trauma/ntdb
American Trauma Society - Trauma Center Levels: www.amtrauma.org/?page=traumalevels
Injury Severity Score: dphhs.mt.gov/Portals/85/publichealth/documents/EMSTS/trauma/coordinator/ISSHandoutTC.pdf
Example articles on Wisconsin permitless concealed carry law:
www.jsonline.com/story/news/politics/2017/05/31/wisconsin-lawmakers-debate-permitless-carry-concealed-guns/358080001/
www.tmj4.com/news/local-news/wisconsin-right-to-carry-weapons-bill-passes-committee

06 October 2017

Dance Versus Fitness Training

Welcome back. Vicki and I danced at a wedding in August. We hadn’t danced in years, at least I hadn’t. A year or two ago, she confessed that George had her doing the polka when they were alone in the shop, after he made the coffee for the Saturday morning coffee klatch. George is about 90, and he makes phenomenal matchstick structures when he isn’t making coffee or dancing the polka.

Growing up, before and through high school, I was not a good dancer. I never learned how to jitterbug or whatever we called it. And though I liked slow dancing, as I learned repeatedly through life, I wasn’t cut out to be a leader.

I metamorphosed in college when the twist, jerk, mashed potato and other non-contact dances swept the country in the early 1960s. Freedom of expression! Who needed a partner? I became a very good dancer.  


Uma Thurman and John Travolta doing the twist plus a few other dances in Tarantino’s 1994 film Pulp Fiction. (Photo from video: www.youtube.com/watch?v=Ik-RsDGPI5Y)

All this personal history is going somewhere, of course. As you might expect even if you missed the blog post title, I happened upon a recent study about dancing. This one compared the anti-aging effects of dance training with those of fitness training. Guess which was better for healthy seniors. A little brain science will help.

The Hippocampus
The brain’s hippocampus is key to memory, learning and spatial navigation. Although the hippocampus is affected by normal and pathological (e.g., Alzheimer’s) aging, it’s one of the few brain regions that can generate new neurons throughout our lives. Producing those new neurons might help to slow cognitive losses.

How can we do that? Exercise is one way. Research has shown higher cardiorespiratory fitness levels are associated with larger volumes of the hippocampus in late adulthood, and larger hippocampal volumes may, in turn, contribute to better memory function.

Independent of cardiorespiratory fitness, motor skill learning and motor fitness that come with dancing can also affect hippocampal volume.

Study Parameters
A team of scientists led by researchers from the German Center for Neurodegenerative Diseases set out to compare how dance and fitness training affect the volumes of the hippocampus and hippocampal subfields and, in addition, balance.

The researchers screened and assigned 52 volunteers to either an experimental dance group or a traditional fitness group. After 18 months of training, only half of the volunteers remained, 14 in the dance group and 12 in the fitness group. Those who completed the training did not differ significantly in age (average 68), gender, body mass index or education.

The fitness training followed recommended health sport guidelines and addressed endurance, strength-endurance and flexibility. The dance training included both permanent and changing choreographies, focusing on turns, head-spins, shifts of center of gravity, single-leg stances, skips, hops and different dance steps to challenge the balance system. 


For the first six months, training for both groups lasted 90 minutes, twice a week. That had to be reduced to once a week for the last 12 months.

Pre- and post-training measures of hippocampal subfield volumes were derived from magnetic resonance images. Those for balance were obtained with the Sensory Organization Test, which assesses the three sensory systems--somatosensory, visual, and vestibular.

Shall We Dance or Work Out?
Insofar as the hippocampus volume is linked to memory and learning, dance training was shown to be at least as beneficial as fitness training for slowing cognitive losses. Beyond that, the study found that dance training excelled for improving balance.

Dance and fitness training both led to increases in hippocampal subfield volumes; however, the dancers showed volume increases in more subfields. Further, only the dancers showed an increased balance composite score, improving in all three sensory systems.

Wrap Up
Vicki and I should probably start dancing again (not the polka), though I doubt I could handle the dance training given in the study. That seemed rather intense, more like brain training. I would just want to dance, not think too much about it and take whatever anti-aging effects I can get. Thanks for stopping by.


The bride and bride’s father dance with freedom of expression at a wedding Rachel photographed. (www.rachelphilipson.com)

P.S.
Dance vs fitness training study in Frontiers in Human Neuroscience journal: http://journal.frontiersin.org/article/10.3389/fnhum.2017.00305/full

Article on study on ScienceDaily website: www.sciencedaily.com/releases/2017/08/170825124902.htm
Example of earlier article on dancing versus exercise: www.hss.edu/newsroom_health-benefits-dance-fitness-trend-dancing-with-the-stars.asp