The long-term implications of this law for health care are not at all clear, but there is an interesting question about the role of options in health care. Does it matter if people have a choice among a set of treatment options?
This question was explored in a paper in the October, 2013 issue of the Journal of Personality and Social Psychology by Andrew Geers, Jason Rose, Stephanie Fowler, Heather Rasinski, Jill Brown, and Suzanne Helfer. They were interested in whether the option to choose a treatment would influence people’s perception of pain and discomfort.
In one study, participants came to a lab set up to look like a medical testing facility. Prior to the experiment, the participants had filled out a questionnaire measuring how much they like to have control over situations in their lives. When they arrived at the experiment, they were told that they would be placing a hand in very cold water. Then, they were shown two jars of creams. One group was told that these creams were two different kinds of protection against the cold. One cream was described as warming the hand to protect like a glove, while the other was described as blocking pain receptors. A second group was told that the creams were different kinds of cleansers, one of which was organic and the other of which was made in the United States. Half of the people in each group were allowed to choose which cream they wanted to have applied, while the other had a cream selected for them by the experimenter. Then, they put their hand in the water for over a minute and then rated their discomfort.
The people who had no choice over the cream they got experienced slightly less pain when they were told the cream was a protector than when they were told it was a cleanser. This finding is a classic placebo effect. People who had a choice showed a different pattern. When people had a choice and like to have control over their lives, then they showed a large placebo effect. Choosing a protecting cream led them to feel much less pain than choosing a cleansing cream. People who do not desire control over their lives showed no difference in their perceived pain regardless of whether they were offered a choice between protecting creams and cleansing creams.
So, the placebo effect was most powerful for those people who desire control and were given a choice.
This finding was repeated in a second experiment involving a choice of colors that some people were told are soothing, where the pain was a loud noise. In addition, a third experiment found that the desire for control could be manipulated by having people imagine situations in which they did not have control and wanted it or had control when they didn’t want it. The same pattern was observed in both of these studies. When people had a high desire for control, then choosing a treatment led to large placebo effects. When they had a low desire for control, then choosing a treatment removed the placebo effect.
What does all of this mean?
Placebo effects are extremely powerful, particularly for pain relief. So, it is valuable to know when the largest placebo effects will be observed.
Choice of treatments can be good, but it depends on how much people like to have control. Those people who (either because of their personality or the situation) like to have control over their lives should be able to choose their treatments. Those people who do not like to have control over their lives should have their treatments chosen for them.
Finally, it is important to recognize that this study involved only placebos. There were no active ingredients in any of the treatments given in this study. It is not entirely clear what will happen when the treatments also involve actual drugs.
Sushi + Gummy Bears + Lilacs = Happy Birthday
I am not a birthday-party person. Inviting people over for a big gathering in honor of me feels embarrassing. And yet, I have noticed that people who are birthday-party people seem to know how to celebrate — not just others — but themselves. Two years ago, I decided I would try to learn from them. I thought, “What would make me happy on my birthday?” It was 8 a.m in the morning. I did not have the money to go to Paris. I did not have the energy to book a table at a happening restaurant where my kids would order french fries then knock over their ginger ales. I wanted to eat at home. But I did not want to cook, which is a skill that, sadly, my husband doesn’t possess. So: Sushi! You’re supposed to have a cake on your birthday, but I don’t like cake. So: Gummy bears! You’re also supposed to have streamers and balloons. But streamers and balloons feel like stuffing myself into frilly party dresses with patent shoes — at age 40. So: Lilacs!
Then I called my husband, who was able to purchase all this and arrive home by 7 p.m. and lay it out on the table. The party took 30 minutes. We ate. We sang a song. We blew out a candle on the gummy bears. And I felt great, just because I got what I wanted, but because I had an equation that would make me feel festive about this one loaded, inevitable day of the year — and I could simply repeat it the next year. It was not a complex equation. Nobody at Princeton was going to invite me on staff or invite me out to a desert to experiment with molecules. It was the simple math of how to make myself happy. And it occurred to me that there are times when all of us need to have these kind of no-fail formulas, specific to our needs, fears and understanding of ourselves. So I came up with a few for those situations that crop up and challenge us, again and again.
(62 Episodes Of “True Blood” + 1 Down Duvet) ÷ 2.5 Days = Monday Recovery
Let’s say you are like me. I wake up 5 a.m. to get “free time” which means I exercise or send emails or write creatively (aka sleep on keyboard). Then I go work nine to 10 hours a day. After that, my two kids need to eat, do homework and talk about things like “Who do you think is a faster runner? You or Daddy?” while sitting on the toilet for an hour, just to avoid going to bed. Somewhere after, they (finally) fall asleep; but before I (almost immediately) fall asleep, I read, hit “like” 600 times on Facebook and buy clothes online that don’t fit any of us but that we all wear because we’re too overwhelmed to return them.
Your schedule may be different. One woman I know sleeps until 8 a.m., works all day, puts the kids to bed then goes back to work from 9 to 11 p.m. Another takes care of her kids all day then works from 9 to 1 a.m. But regardless of the differences in schedules, most of us hit a Friday where we scream “No more!” For me this happens every six months. Then, like great old timber falling in a virgin forest, I topple into bed and line up four or five seasons of any show on Netflix or Apple TV. It doesn’t matter which one: “Breaking Bad,” “Mad Men,” “The Walking Dead,” “True Blood,” “Gossip Girl,” “Glee.” As long as I am swaddled in a soundproof, down duvet and not disturbed over two full days, plus Friday night, I can get up recovered on Monday morning and go on living my life. In a perfect world, we might say that we need to do less and avoid the whole burnout-meltdown cycle. But I can’t do less — and I hear the same thing from other women all the time — which is why all of us need this particular less-than-scientific formula, the one that lets us abandon multitasking, singletasking and anything other than pause, drool, repeat. (Note: Some women may have to put extra parentheses around the whole equation and subtract guilt).
Me x 21 Meetings = Functional Calm
I have a rule — a very new one and tailored to my personal style of paralysis and panic. When I need to get a new job or move to a new place or do anything that I’m totally and absolutely nervous about doing, I have to set up 21 meetings. None of these meetings have to come to anything. Nobody has to offer me anything on-the-spot or hand me the secret to my existence. But we do have to talk about the goal at hand.
In common sense terms, what this process does is let me gather information and learn from outside sources. But what it also does is force me to do something, just at the very moment I’m sitting at my desk thinking, “What if I can’t get another job?” or “What if there are no houses we can afford — ever?” I don’t have time for those kinds of thoughts; or, I have less time for them, at least, because I have to call somebody up and try to get them to go to coffee with me. The illusion of packed, high-power schedule — much like the illusion of decaf (which by the way does so have caffeine in it) — can be exceptionally calming. So much so that by meeting 22, I’m usually relaxed enough to make a decision — if not take action.
Two Equally Awkward People + One White Wine Spritzer + 2πr = Permission To Go Home.
In my 20s, my way of dealing with packed cocktail parties was to sit in the nearest potted ficus (there are always potted indoor trees in large public rooms, but so rarely chairs). After I’d polished off three glasses of wine and gotten mulch stains on the back of my skirt, I would go home. Something had to be done, I knew — and that thing would not be that I would suddenly become more extroverted or chatty with strangers, because, in my case, that was not possible. Instead, when faced with intimidating social situations that might lead to valuable personal or professional connections, I now have a formula: Circle the room (the perimeter of a circle is 2π times the radius) with (one!) white wine spritzer and, in the process, bump into or knock the drink out of the hand of an equally awkward person, engage in conversation while apologizing and cleaning off her skirt, then go home with some kind of contact information from her. Inevitably, this works because awkward people are very easy to spot (look for: people trying to look busy or wrapped up in their own thoughts, which really means just standing alone by the buffet). Further, they make the most interesting conversation because they are too befuddled to make witty banter. They just blurt out their true, undisguised thoughts and, in my totally biased opinion, honesty is always riveting.
Me – 17 Irrational, Emotional Flip-Out = What I’m Feeling About What Actually Happened
An irrational, emotional flip-out can be calling up the cable company and screaming at the customer service about the slow Internet connection. Or yelling at my husband about the ski rack he hasn’t put on the car even though it’s still summer. Or yelling at the kids about throwing water out of the bathtub. Or fixating on my neighbor who lives off a trust fund and never has to work and gets to stay home with her kids. Or throwing away half my closet because everything is lumpy and horrible on me. Or eating stale peanut brittle circa two Christmases past. Or — gulp — all of the above.
When these are removed, I no longer am able to work off a small portion of whatever is inside me (while alienating friends and family). Thus, I end up feeling very, very mad about the friend dying or very, very sad about the amazing promotion that didn’t work out. Neither of which are emotions I exactly want to have, but do let me examine what happened and how I might survive it. The upside is that this is the one equation in the world where, even if the answer is embarrassing or upsetting or not what anybody wants to hear at the time, it is always 100 percent right.
Leigh Newman is the deputy editor of Oprah.com and the author of Still Points North: One Alaskan Childhood, One Grown-up World, One Long Journey Home.
Vietnamese children can play a part in how their peers, parents and extended relatives impact the lives of rhinos. Rhinos are disappearing at an alarming rate because of demand for rhino horn from Vietnamese consumers. So far this year, 688 rhinos have died at the hands of poachers in South Africa.
Vietnam has experienced an increase in demand for rhino horns because many people are under the misguided impression that rhino horn cures cancer, reduces a fever, or counteracts the ill effects of drinking too much alcohol. Yet it has been scientifically proven that rhino horn has no medicinal value-it is made of keratin, the same substance found in human fingernails.
In a delicate and fun manner, I’m a Little Rhino illustrates how rhinos are killed for their horns and the danger of potential extinction for the species. HSI is working with the Vietnamese government to distribute this book to children throughout the country.
To date, more than 1,000 copies of the book have been distributed to children in Vietnam as young as five years of age. Dr. Quang Tung, director of Vietnam Convention on the International Trade in Endangered Species Management Authority, which enforces CITES regulations for species, flora and fauna in the country, explained that, “When we educate children, we also educate their parents and other family members. When we reach hundreds of children, we reach thousands of adults.”
In addition to the belief that rhino horns possess curative properties, newfound wealth in Vietnam has also spurred demand, as rhino horns represent a status symbol or coveted gift. Rhino horn, however, can be dangerous to human health if consumed. Increasingly landowners, conservationists and wildlife managers in South Africa are pumping rhinos’ horns full of toxic chemicals to thwart poachers. I’m a Little Rhino also explains this fact in a way that children can understand and explain to their family members.
Teresa Telecky, director of wildlife for HSI said: “We are working with the government of Vietnam to encourage Vietnamese children to learn about and cherish rhinos. By stopping the demand for rhino horns we will save rhinos from extinction so that our children and future generations will be able to live in a world with abundant wildlife.”
A children’s book may seem like an unlikely deterrent to killing rhinos, but it’s an important step. Helping educate children and the consumers of rhino horn about health hazards — as well as the misery and deaths rhinos suffer due to poaching — can go a long way in curbing demand and saving rhino lives.
In this first look at the interview, Nyad sits down with Oprah for a revealing conversation about chasing dreams, pushing limits and daring with intention and purpose. “What you showed us all is what a real warrior looks like,” Oprah says to Nyad in the video. “I can’t even imagine what that pain felt like.”
“The body is pathetic compared to what we have inside us,” Nyad says in the clip.
Nyad had tried to complete the approximately 110-mile swim on four prior occasions but barriers ranging from jellyfish stings to lightning forced her to abandon each effort. She tried three times in 2011 and 2012, and her first attempt was in 1978.
“It wasn’t so much what did I want to do, it was who I want to be,” she tells Oprah.
Watch part one of the full interview when it airs Sunday, Oct. 6 at 11 a.m. ET on OWN.
God and I have been on a long journey together with many twists and turns. I believe I have come to a good place, and I hope to keep going because I am enjoying the journey more than ever. And I know I would not be where I am now without all the varied experiences I’ve had.
Even so, I often find myself wishing I could tell my younger self some things about how life really works, about what’s real and true, and thereby dissolve some of the harmful preconceptions and assumptions I had way back then. That is a frustrating impossibility, but it’s worth thinking about.
So what would you tell your younger self? Here, in hopes that it might be helpful to you on your own journey, are 52 things I wish I could tell my younger self:
1. Life is good. Not always, but mostly. And when it is not so good, be assured it will get better.
2. It’s a good thing that we don’t know everything that’s going to happen to us. If I had known all the pains and heartaches I would encounter in life, even amidst the joys and victories, it would surely have been too much to bear.
3. If you tend to be shy, try your best to overcome it. Take it a step at a time, but work at it. It is a gift to get to know new people, especially those who are different from you in some way, culturally, ethnically, religiously. Pushing yourself out of your comfort zone may be painful for a time, but the benefits are everlasting.
4. Your hard work in school will be worth it. But come on, don’t kill yourself.
5. It may not be easy to stand up and speak out for what’s important to you, but you will be amazed how empowering, and important, it can be.
6. Keep exercise, eating well, and healthy living in balance. Schedule rest and recreation regularly. The older you get, the more you’ll understand why.
7. Accept yourself as God made you. I spent too many years fighting this battle and it took a long time to surrender, and by that time it carried extremely painful ramifications. How I wish I could tell the young me that it is okay to be true to yourself. Because God does not make mistakes.
8. You are not the only person in the world who feels this way, whatever “this way” is that you’re feeling. See if you can connect with some others so you can support each other.
9. You are terrific just as you are. But that doesn’t mean you shouldn’t work on your rough edges and areas of ignorance and inexperience.
10. You are on a journey, which means things will change. Even important things will change, sometimes shockingly. But it is a nevertheless a good journey, and it’s worth every step.
11. There is no one person in the whole world who is the one-and-only person God has selected for you to be with forever. So don’t waste time thinking you have to search for that one ideal person. Open yourself up, be patient, and it will all work out.
12. When you do connect deeply with one person, be serious about it. Work at it. Be open and honest with your significant other. It is a rare and wondrous thing to be in relationship, so make every effort to preserve and improve and deepen it.
13. But sometimes, for any number of reasons, it is time to move on, for your sake or theirs, or both. Recognize this.
14. If you are alone, you won’t always be, unless you don’t make any effort otherwise. Make the effort.
15. Your parents truly love you and want the best for you. Listen to them. Trust them. Love them. Honor them. But realize you will soon be on your own, and that’s a good thing.
16. Stop watching so much TV. Read more. (Although, young me, you did read an awful lot, so maybe you should get outside and play more.)
17. Work hard and carefully to figure out a career you will love. This will involve trying different things, new things. I’ve had four primary and very different jobs in my life, and have enjoyed each one (pretty much). Each one moved me forward into what was next.
18. Try not to be so gullible. Trust, but verify — with independent, objective sources, not mouthpieces for particular viewpoints or axes to grind.
19. Children are a blessing and a joy. Just keep in mind that they will break your heart and scare you to death more times than you could ever imagine.
20. The church (or any religious configuration) is composed of human beings, and so it possesses many human failings, which often reflect your own. Surrender to this.
21. There is nothing more sublime than serving in worship with your brothers and sisters. Unless maybe it’s participating in a service project with your brothers and sisters to help those who are in poverty and need.
22. You will never waste any moment you spend on getting to know Jesus better. You can do that by reading the gospels, by prayerfully reflecting on who he was, what he did, what he calls you to be and do, and by being in community with others on the same quest.
23. Not everything in the Bible is worth studying. In fact, some of it can even be harmful to true faith if taken literally. Read the Bible thoughtfully, open-mindedly, prayerfully, with discernment. Focus on the Psalms and the Gospels and you can’t go wrong.
24. Avoid people with closed minds, who tend to be negative.
25. You will have a tendency toward complacency. Resist this.
26. Be curious. Try new things. Strive for something that stretches you. Of course, there’s a limit to this, so be careful.
27. Travel as much as you can, especially to distant places. This will add incredible dimension to your life.
28. Sing more. And if you’re not that good at it, join a choir or take some lessons. This life needs all the music it can get.
29. Do something artistic. In fact, try lots of different things in different media. There is something primally meaningful and life giving about creating a thing of beauty.
30. Engage in self-reflection, but don’t let it become self-deception. Sometimes you will need to talk things over with a trusted counselor.
31. Don’t ruminate on how others have hurt you. Feel your feelings, but let them slip away. Move on.
32. Forgive. Forgive. And forgive again. You may never forget, but for your own sake, forgive. And try to forget.
33. And don’t forget to forgive yourself.
34. Be grateful. Gratitude leads to more happiness and wellbeing. Even scientists say so.
35. Bless others. Be a positive influence in any way you can. Even simple little helpful acts can make others — and you — much happier.
36. Don’t take yourself so seriously all the time. Laugh. Often. Laugh from your belly whenever possible, letting the tears run down your cheeks. It’s almost as good as sex.
37. By the way, young self, sex is wonderful, but it’s just one rather minor component of a healthy, happy, balanced life. You don’t need to obsess about it so much. And stop worrying, it’s big enough.
38. You can’t pray too much.
39. Sometimes bad things happen to good people. Sometimes very bad things happen to very good people. We will never fully understand this, but we may catch a glimpse of the why someday.
40. There are some people in your life you will never understand, and maybe not even like. Make the best of it. But if you realize they are harming you, avoid them. Don’t let them suck the air out of your spirit.
41. Nurture an active interest in public affairs and the common good. Work at whatever level you can to make your community and nation a better place. But be careful that you don’t let politics with its vitriolic ineffectiveness sidetrack you from the bigger picture.
42. Write. It will be difficult to find the time and energy at times, but it is a vital creative pursuit.
43. Technology is cool and can help you do fun and interesting things. But keep it in perspective; don’t let it consume you. Life in the real world is far more meaningful and important. And fun.
44. Don’t be afraid to tell someone you love him or her, as long as you really do. And I hope you do.
45. Some people will give you good advice; listen to them. Others don’t know what they’re talking about; learn to distinguish between the two. You will know in your gut when others’ advice is sound. (And I hope mine is.)
46. Freckles are beautiful. I don’t have them, but I love someone who does. Appreciate their uniqueness. Freckles form a map of the stars of the universe on one’s face, and every map is different.
47. You are just one infinitesimal speck of existence in the vast canvas of reality. Realize that. At the same time, God values you infinitely, and so should you.
48. Good things in life take a long time. (That’s from the Chicago song “(I’ve Been) Searchin’ So Long.” But it’s pretty true.)
49. All shall be well, and all shall be well, and all manner of thing shall be well. (Okay, I stole that one from Julian of Norwich. I hope she is right.)
50. God is good, all the time. All the time, God is good. (I borrowed that one, too. But I believe it.)
51. There are a few more things I’d like to say, but I can’t remember them right now. I’ll tell you later.
52. Actually, my younger self, I cannot tell you anything, let alone these 52 things. So try your best to figure this all out on your own as soon as you can. Learn from your mistakes. And live so that someday you won’t have to wish you could tell your younger self anything.
Follow Peter Wallace on Twitter @pwallace
Published: 09/29/2013 02:24 PM EDT on SPACE.com
There is a dinosaur on board the International Space Station where there wasn’t one before.
NASA astronaut Karen Nyberg, who since May has been working as a flight engineer as a member of the orbiting outpost’s resident crew, revealed the toy dinosaur floating on the space station on Thursday (Sept. 26).
“Made in space!” Nyberg, an Expedition 37 crewmember, exclaimed in her caption for a photo of the toy giant lizard she uploaded to the pinboard-style photo-sharing website Pinterest. “I made this dinosaur for my son last Sunday, September 22.” [Amazing Space Photos by Astronaut Karen Nyberg]
The dinosaur, which resembles a Tyrannosaurus Rex, has an olive green back and a lighter green belly. It is stitched together with white thread.
Story continues below photo.
Nyberg, a self-described crafter whose hobbies including quilting and sewing, packed threads, sewing needles and small fabric samples for her trip to space. But to make the dinosaur, she scavenged materials that she found around her orbital home.
“It is made out of velcro-like fabric that lines the Russian food containers [that are] found here on the International Space Station,” Nyberg wrote about the doll. “It is lightly stuffed with scraps from a used t-shirt.”
Astronauts have carried stuffed dolls to space before, and cosmonauts have a tradition of launching with small plush toys as talismans and “zero-g indicators.” When the dolls, which are suspended from the Soyuz spacecraft’s control panel, begin to float, the crew can tell they have entered orbit.
Nyberg’s crew launched with a plush white dog her Soyuz commander, Fyodor Yurchikhin, had received as a gift 30 years ago and had flown into space twice before. A small black cat doll, named “Dimlar,” served as the zero-gravity indicator for the crew that arrived Wednesday (Sept. 26), named after cosmonaut Oleg Kotov’s children, Dima and Lara.
Nyberg’s dinosaur however, may be a new breed of space toy. It may be the first stuffed animal created in space.
Story continues below photo.
Nyberg poses for a photo while floating freely in the Unity node of the International Space Station on Sept. 16, 2013.
In addition to sewing stuffed toys for him, Nyberg keeps in daily contact with her 3-year-old son Jack, sending down short videos for him every day. Nyberg’s husband, who is also an astronaut who last flew on the final space shuttle mission in 2011, sends up photos and videos of their son.
A photo Nyberg earlier shared on Pinterest revealed that Jack has his own handiwork in space, too. Hanging on the wall of her quarters is an orange and pink painting labeled “For Mommy.”
Nyberg is slated to return to Earth on Nov. 11, presumably with the toy dinosaur in tow.
Cosmic Playtime: Toys in Space (Photos) Pinterest In Space: NASA Astronaut ‘Pins’ Cosmic Photos from Orbit Space Station Photos: Expedition 37 Mission In Orbit (Gallery) Copyright 2013 SPACE.com, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. ]]>
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