May 23, 2016

Absoultely Relative, Keith Windschuttle, 1997

MICHEL Foucault opens his book The Order of Things with a paragraph that has become one of his most famous. Foucault describes a passage from ``a certain Chinese encyclopedia'' that, he claims, breaks up all the ordered surfaces of our thoughts. 

By "our'' thoughts, he means Western thought in the modern era. The encyclopedia divides animals into the following categories: 

a) belonging to the Emperor, 

b) embalmed, 

c) tame, 

d) sucking pigs, 

e) sirens, 

f) fabulous, 

g) stray dogs, 

h) included in the present classification, 

i) frenzied, 

j) innumerable, 

k) drawn with a very fine camelhair brush, 

l) et cetera

m) having just broken the water pitcher, 

n) that from a long way off look like flies.'' 

Foucault writes that, thanks to "the wonderment of this taxonomy,'' we can apprehend not only "the exotic charm of another system of thought'' but also "the limitation of our own.''

What the taxonomy or form of classification reveals, says Foucault, is that "there would appear to be, then, at the other extremity of the earth we inhabit, a culture . . . that does not distribute the multiplicity of existing things into any of the categories that make it possible for us to name, speak and think.'' The stark impossibility of our thinking in this way, Foucault says, demonstrates the existence of an entirely different system of rationality.

In May 1995 I gave a paper to a seminar in the Department of History at the University of Sydney, Australia. Although most of the postmodernists in the department declined to attend, they deputized one of their number, Alastair MacLachlan, to reply and, they hoped, to tear me apart. My respondent opened his remarks by citing Foucault and the Chinese taxonomy. 

Didn't I realize, he chided, that other cultures have such dramatically different conceptual schemes that traditional assumptions of Western historiography are inadequate for the task of understanding them?
There is, however, a problem rarely mentioned by those who cite the Chinese taxonomy as evidence for these claims. No Chinese encyclopedia has ever described animals under the classification listed by Foucault. In fact, there is no evidence that any Chinese person has ever thought about animals in this way. The taxonomy is fictitious. It is the invention of the Argentinian short-story writer and poet Jorge Luis Borges.

This revelation would in no way disturb the assumptions of the typical postmodernist thinker, who believes that the distinction between fact and fiction is arbitrary anyway. Foucault himself openly cites Borges as his source. The example is now so frequently cited in academic texts and debates that it is taken as a piece of credible evidence about non-Western cultures. It deserves to be seen, rather, as evidence of the degeneration of standards of argument in the Western academy.

THE American ethnographer Marshall Sahlins cites Foucault and the Chinese taxonomy as part of his case against his opponent Gananath Obeyesekere, in what has developed into the most hotly contested debate in anthropology of recent times. In his 1992 book, The Apotheosis of Captain Cook, Obeyesekere denied the thesis of Sahlins that the natives of Hawaii in 1779 had regarded Captain James Cook as their returned god Lono. Obeyesekere claimed that the Hawaiians had too much "practical rationality'' to mistake an Englishman, who wore strange clothes, spoke no Hawaiian, and knew nothing of their religious beliefs or practices, for one of their gods. 
In his 1995 book How "Natives'' Think, Sahlins replied that Obeyesekere, although Sri Lankan, is captive to Western concepts, a man who cannot think outside this form of rationality and who imagines that Western thought constitutes the universal mind of humanity. However, says Sahlins, the existence of radically different systems of classification like that of the Chinese encyclopedia is evidence that different cultures order their perceptions in radically different ways.

Sahlins does not rely entirely on fictional evidence but also cites some findings by anthropologists. He gives the example of the Chewa people of Malawi, who classify certain mushrooms in the same group with game animals, rather than with plants, on the basis of the similarities of their flesh. For the Chewa, domestic ducks are not classified with birds, nor with wild ducks.

Unfortunately for Sahlins, it is not difficult to show that this more empirical type of evidence still provides no support for his claim. Let me give one simple example. I have in front of me a recent document from the National Heart Foundation of Australia. It contains a table classifying plant and animal products. It puts the following items into one group: skim milk, lean red meat, skinless chicken, fresh fish, egg whites, bread, pasta, all fruit and vegetables, legumes, water, tea, coffee, fruit juices. And it links the following together into a second group: coconut oil, butter, whole milk, fried meat, bacon, sausages, egg yolks, croissants, milkshakes, coffee whiteners.

According to the Sahlins view, this table should be a demonstration of the mentality of a radically different culture, which, like the Chewa, puts plant and animal products into the one category. Should we assume that the National Heart Foundation has become possessed of some unfathomably different rationality? Sadly, the answer is more mundane. The first category comprises foods low in cholesterol and saturated fat; the second, foods high in cholesterol or saturated fat.

Surely it is obvious that within any one culture, different uses generate different classifications. There is nothing surprising about a tribe that puts domestic ducks and wild ducks into different categories. We make exactly the same distinction in Western culture, else we would have little use for the words "domestic'' and "wild.'' Indeed, when we classify animals and plants for our own consumption we use groupings not dissimilar to those of the Chewa.

The big difference between our culture and theirs is that we also have a method of classification derived from the science of biology. In fact, biology is the most obvious example of a science whose classifications derive objectively from nature, despite the claims of postmodernists that such a thing is impossible. If animals or plants do not reproduce with each other, they do not constitute a species. This is a taxonomy that existed in nature eons before the emergence of Western science; indeed, it would have existed even if human beings had never evolved to discover it.

SAHLINS places his biggest single emphasis on the "different rationality'' of the Hawaiians because of the nature of the charge made against him by Obeyesekere. The Sri Lankan had accused the American not only of not properly understanding the Hawaiian mind but also of perpetuating European myths. As a non-European, Obeyesekere said he was able to spot a European myth when he saw one, and the belief that the natives mistook the white explorers for gods is in this category. 

The idea that Cook was taken for a god first appeared in print in the oral histories of Hawaiian beliefs recorded by American missionary schools in the 1830s. Since some of these texts contain a number of decidedly non-Polynesian concepts -- for instance, that before the Europeans arrived the natives were led by Satan and "living in sin'' -- the Hawaiians' oral histories had obviously been contaminated by their subsequent conversion to Christianity.

From Obeyesekere's perspective, two issues are raised. First, Sahlins's reputation as an ethnographer who can read a culture of "the other'' in its own terms is seriously called into question. Like the missionaries, he seems just another American with a low opinion of the gullible native mind.

Second, there is the broader issue of theoretical interpretation. The theoretical framework in which Sahlins is operating derives from the French structuralist Claude Lévi-Strauss, who proposed that tribal mentalities are locked within their cultures. Events that European ``common sense'' might suggest would explode their world view -- such as the arrival of English sailors with vastly superior technology and with tales of other countries and peoples far beyond the limits of the world previously imagined by the natives -- do not have this shattering effect, since people cannot take off their culture as they take off their clothes. Obeyesekere, on the other hand, says that Cook's visit did have a profoundly disruptive impact on Hawaiian culture, all in a matter of weeks. Hence, major events can change people's ideas rapidly, and so structuralist theory does not provide a good account of native mentalities in the post-contact period.

The reason there can be such divergent opinions on this issue is that, apart from Hawaiians' memories of their former religion recalled fifty years later, the principal evidence about native beliefs in 1779 comes from the diaries and journals kept by officers and sailors during the relatively brief visits by the English ships. These men had only a smattering of the local language and gleaned what they could of native religious beliefs from observation of their ceremonies.

When Cook landed on Hawaii in January 1779 he landed at Kealakekua Bay, close to the site where the procession associated with the Makahiki Festival began and ended. Sahlins's thesis is that Cook was greeted by the natives as the manifestation of Lono -- a god associated with peace, games, and agricultural fertility -- and worshipped by both commoners and priests as the god. The priests took him to their temples for the appropriate ceremonies.

Cook departed the island but returned ten days later to repair a sprung mast. His return, however, coincided with the period dominated by the warlike god Ku. There were no welcomes this time; rather, the people and their chiefs were sullen and insolent. After an attempt to take the high chief Kalani'opu'u hostage for the return of a stolen cutter, Cook was turned upon by the natives and killed. According to Sahlins, the Hawaiians assaulted Cook because, in the season of Ku, Kalani'opu'u eclipsed the authority of Lono and killed his embodiment to usurp his godly powers.

Obeyesekere's counter-claim is that, instead of treating Cook as a god, the Hawaiians treated him as a chief, most probably to enlist his support in the interminable warfare with the chiefs of other islands in the group. Cook was an obvious foreigner: he did not speak the Hawaiians' language and knew nothing of their religion -- unlikely behavior for an Hawaiian god. And instead of conforming to Lono's mythical procession around the island by land, Cook circled the island by sea.

Moreover, the rituals the islanders performed on Cook's arrival show he was not regarded as a god; for example, he was made to genuflect in a temple before an image of the god Ku. This was something a chief could do but a god could not. At the ceremony, Cook was wrapped in red tapa cloth, a garment that other chiefs wore. The Hawaiian chiefs and priests did not prostrate themselves before Cook as they would before a god. Only the common people prostrated themselves, as they normally did for their chiefs. While Cook was certainly given the name Lono, it was not unusual for chiefs and priests to be given divine names. One of the priests who greeted Cook was also named Lono.

Above all, Cook's death did not conform to Hawaiian beliefs about the legendary clash between Lono and the chief. This clash happened during the Kal'i ritual in which the king comes ashore with his warriors to confront the god, who stands before his temple. A warrior of the god attacks the king with spears. One of these touches the king and he dies a symbolic death as a foreign being, but at the same time is reborn as a Hawaiian sovereign. A sham battle ensues in which the king emerges as conqueror. 

Sahlins argues that Cook met his death because the warriors of King Kalani'opu'u were re-enacting the Kal'i ritual. But he also acknowledges that the events on the fateful day, February 14, 1779, diverged in a number of ways from the detail of the ritual.

This is where Sahlins loses the argument. There is so much discrepancy between his own account of what Hawaiian religion expects to occur between Lono and the warrior king, and what actually happened. First, when Cook went to Kalani'opu'u's house he was not treated as some kind of hostile god who had returned ``out of season.'' He was still regarded highly by the Hawaiians, who prostrated themselves before him and, while he waited for Kalani'opu'u to waken, presented him once again with gifts of pigs and red tapa cloth. Second, in the Kal'i ritual, it is not the god who comes in from the sea but the king. He then confronts the god on shore. Sahlins acknowledges this but still insists that the scene was "reminiscent of the climactic ritual battle, the Kal'i, but played in reverse. The god Lono (Cook) was wading ashore with his warriors to confront the king.'' However, even in this ``mirror image'' version, the ``cosmic confrontation'' did not occur in the way Sahlins says it did. Cook was not killed while wading ashore but had been on land for hours. When the attack occurred, the English were running through the water away from the beach, trying to get to their boats. Third, the king himself did not initiate any confrontation with Cook. If he was the "upstart'' representative of Ku, he appeared completely unaware of it himself until his wife persuaded him that Cook threatened his life. In direct opposition to the ritual, it was Cook, the supposed manifestation of Lono, who was the aggressor.

The credibility of Sahlins's account thus depends on his readers' accepting the notion that so many aspects of the ritual could actually be "played in reverse'' and that the ancient Hawaiians would see it that way, despite their religious traditions. On the other hand, a "Western bourgeois'' interpretation would read the events in far more prosaic fashion. Kalani'opu'u's wife was worried that if he went with Cook he would suffer the same fate as Kalimu, who had just been shot by Cook's blockading party. So the Hawaiians attacked the English to save their king's life. The central issue comes down to a matter of choice between anthropological "readings'' of the events on the beach that day, and the "bourgeois'' reading is less inconsistent and inherently more probable. Plainly, it is the reading by Sahlins that imposes its own interpretation on the native mind.

And not accidentally. Anyone who adopts a structuralist approach has already decided a great deal about how the story of what happened in history will be told. Structuralism imposes the primacy of culture onto history in the same way that Marxism imposes the primacy of the class struggle. It believes the world is made of language and culture in the way that Marxism believes the basis of society is the means of production. In postmodernist jargon, both structuralism and Marxism "decenter the subject'' -- they reduce or omit the impact of the individual upon history. Every one of these concepts and assumptions is a product of Western social theory and, from the perspective of "the other'' -- such as the ancient Hawaiians who believed that the gods were immanent in animate and inanimate objects alike -- makes no sense at all.

May 19, 2016

Ten books to make you a better business technologist | McKinsey & Company

ter going through the slightly traumatic process last year of writing a book about the intersection of business and technology,1I started to think about which books had an impact on me as a business technologist—especially beyond the obvious ones like The Soul of a New Machine and The Mythical Man-Month.2None of the books that came to mind related to the latest technology trends (social! mobile! machine learning!)—those are important, but they change quickly. The books that really shaped my thinking provided perspectives, often historical, on the organizational, strategic, and human dimensions of business technology. I hope you enjoy them as much as I have.

1. Code: The Hidden Language of Computer Hardware and Software, Charles Petzold, (Microsoft Press, 1999)

I don’t have a background in electrical engineering, and this book helped me get beneath the logical to the physical layers in the stack. Starting from first principles, and including a lot of history, Petzold explains how simple on-off switches can be combined into the mightiest of computational machines. Having read this book, you won’t be able to design circuits, but you’ll be able to understand how circuits get designed.

2. Accidental Empires: How the Boys of Silicon Valley Make Their Millions, Battle Foreign Competition, and Still Can’t Get a Date, Robert X. Cringely (Addison-Wesley, 1992)

Microsoft’s acquisition of Q-DOS. IBM’s decision to build the PC. Apple’s growing pains. Many of the seminal events of the early personal-computer industry have been told again and again. Yes, Cringely touches on some many-told tales, but he also delves into aspects of the technology industry that few talk about. Just one example: how Microsoft applied Charles Simonyi’s concept of the “metaprogrammer” to build a “software factory” that hired thousands of inexperienced computer-science majors to build the world-conquering applications of the 1980s and 1990s.

3. The Reckoning, David Halberstam (William Morrow, 1986)

Is any business story more fascinating or more terrifying than the decline of US auto manufacturers in the 1960s and 1970s? By my lights, this is the best of Halberstam’s many books, far better than, say, The Best and the Brightest, which is mostly about people writing memos to each other. The Reckoning documents the rise of Nissan and the declining market share of US automakers. Why is this an important technology book? Because it provides a cautionary tale of many of the pitfalls business technologists must avoid: suspicion of new approaches, short-term decision making, managerial distance from frontline operations and distortive managerial accounting.

4. The Visual Display of Quantitative Information, Edward Tufte (Graphics Press, 1982)

Design know-nothings will tell you not to simplify your slides and not put too much information on any of them. Tufte points out that communicating information is the purpose of written communications, that far too many charts don’t have much information in them at all, and that well-designed graphics allow us to absorb tremendous amounts of information quickly. For example, what Tufte describes as “layering” allows you to drill into the information you need. Think of a newspaper front page. You can scan all the headlines, then look at the sub-headlines for interesting articles, and then decide whether to read the first few paragraphs. Fortunately, the same type of layered structure can be used to communicate the business case for new initiative or project.

5. Military Power: Explaining Victory and Defeat in Modern Battle, Stephen Biddle (Princeton University Press, 2005)

Using compelling case examples, Biddle shows that force deployment—a tightly interrelated complex of cover, concealment, dispersion, suppression, small-unit independent maneuvers, combined arms, depth, reserves, and differential concentration—has been winning battles since World War I, not technological innovation or sheer mass. You can make the same case about enterprise IT. I don’t think anyone would argue that IT shops with the largest budgets are the most efficient or the most effective. Likewise, any of us can list examples of companies that introduced exciting new technologies to little effect. Instead, breakthrough value in business technology seems to depend on how organizations can employ people and technology in a coherent and consistent fashion. One could even ask if there’s a “modern system” for enterprise IT that combines agile, lean, service orientation, and other practices.

6. A Fiery Peace in a Cold War: Bernard Schriever and the Ultimate Weapon, Neil Sheehan (Random House, 2009)

I should start by saying that I think Sheehan botched the framing of this book. General Bernard Schriever may have been responsible for developing the first Intercontinental Ballistic Missile (ICBM), but he’s also a cold and remote figure. It would have been more interesting to focus on the Hall brothers—Edward, the architect of America’s first ICBMs, and Theodore, who betrayed secrets from the Manhattan project to the Soviet Union. That said, A Fiery Peace in a Cold War provides fascinating insights into how Curtis LeMay’s Strategic Air Command deteriorated from an innovative, nonhierarchical organization into a dogmatic bureaucracy and how Schriever and his team convinced the Eisenhower administration to bet on a generational leap from bombers to missiles.

7. Why the Allies Won, Richard Overy (W. W. Norton, 1996)

People who work with me know that I can’t stand the word governance. It means something different to pretty much everyone, and I suspect that talking about decision-making processes provides an easy excuse for people who don’t want to engage on strategic, operational, and technical content so as to avoid making decisions. Overy demonstrates that the Allies didn’t just out-produce the Axis—they made better and more rational decisions using the resources they had. The British proved especially adept at running a war on a shoestring, but even the Soviet Union succeeded in getting a workable set of management processes in place. Any IT executive who has argued that his or her servers must be configured just so should read the passages comparing the how the Red Army deployed a few types of trucks and tanks at scale, even as Wehrmacht infighting resulted in a hard-to-maintain array of vehicles.

8. The Cuckoo’s Egg: Tracking a Spy Through the Maze of Computer Espionage, Cliff Stoll (Doubleday, 1989)

Stoll’s account of tracing a 75-cent accounting anomaly back to a KGB-funded, German spy ring introduced many of us who grew up in the 1980s to the idea of information security. It provides an invaluable reminder that protecting sensitive information depends far more on the ability to ask intelligent questions than on the latest and most loudly promoted security tools. It also provides a fascinating introduction to the process of security forensics.

9. Show Stopper! The Breakneck Race to Create Windows NT and the Next Generation at Microsoft, G. Pascal Zachary (Free Press, 1994)

Developing a new commercial operating system is a monumental undertaking, requiring not only big technology bets, but also the coordinated effort of thousands of business analysts, technical architects, developers, testers, product managers, marketers, and others. Zachary’s book provides an all-but-unique window into the mechanics of a complicated, expensive, multiyear development effort. It also recognizes that such efforts are as much human events as technological ones, with developers and managers anxious to advance their careers, terrified about making the wrong architectural choices, terrified that the code just won’t work, and exhausted by hours required to shipping deadlines.

10. Racing the Beam: The Atari Video Computer System, Nick Montfort and Ian Bogost (MIT Press, 2009)

In today’s multicore world, developing for a platform with the processing and memory limitations of an Atari 2600 is all but unimaginable. Heck, it was hard to fathom back in the 1990s when I was developing for 286s with 640Kb of main memory. Montfort and Bogost’s book gets into the details of the 2600 platform and explains the coding techniques the era’s developers used to deliver exciting, compelling games. Their creativity and problem solving is an inspiration to technologists struggling to deliver compelling user experiences with today’s far more advanced platforms.

Business technology is a demanding profession. Getting value from technology investments at scale requires integrating insights across business strategy, engineering, information theory, communications, operations, group psychology, and other areas. Personally, I find insights from previous generations of technology and other disciplines such as military history to be invaluable. Whether you’re on the beach in the northern hemisphere or sitting by a log fire in the southern, I hope this list provides interesting reading.

China is ditching Western fast food joints for healthier options — Quartz

Hold the fries. Actually, hold everything.

That’s increasingly the message Chinese consumers are sending Western fast food chains. Only 51% of consumers in China said they ate Western fast food in 2015, according to a report (pdf) by McKinsey & Company, a consultancy. That’s a drop from the 67% who said they consumed fast food in 2012. They have since shifted to healthier, more environmentally-friendly brands.

The survey by McKinsey included 10,000 respondents from 44 cities, representing approximately 75% of
China’s GDP and one-half of the Chinese population. The survey took place between September and November 2015.

In all, 38% of Chinese consumers reported food branded as “organic” and “green” was one of the top ways they identify the safety of food products, despite the fact no credible organic certification exists yet.

“Some companies developing credible food certification standards have shown promise,” the report states. “For example, in 2009, Olé became one of the first supermarkets to focus on selling organic and imported foods.” Olé is the premium brand supermarket chain of China Resources Vanguard Co.

The trend toward healthier food is entwined with food safety concerns, which remain a source of worry throughout the Chinese population. The Chinese government in 2015 began implementing a sweeping food safety policy (pdf). For many years, big Western brands, including Yum Brands’s KFC, benefitted because Chinese consumers saw them as a cleaner, safer alternatives to local options. But Yum, in particular, took a major hit in 2014 when a tainted meat scandal hit it following problems with avian influenza.

May 18, 2016

Antidepressants may not be as effective as we thought - Business Insider

The treatment of depression too often means treatment with antidepressants. Australia has one of the highest rates of antidepressant use in the world.
This continues to increase despite mounting evidence they are not especially effective.
My colleague Andrew Chanen and I have just published an article that describes the apparent falling effectiveness of the medications. We argue that doctors have become too reliant on them.
When medications are used to treat depression they should be part of an overall treatment plan and shouldn’t be the treatment plan.

The falling effectiveness of antidepressants

Why are antidepressants becoming less effective? Partly because we haven’t always had all of the data.
The clinical sciences have a problem with negative trial results– trials where the experimental treatments don’t appear to work. They are seen as uninteresting, and as undesirable by drug companies, and have often gone unpublished.
Drug trials are, however, regulated and require registration with authorities before they begin. So, over the past decade, researchers have tracked them down. Once they have found the registered-but-unpublished trials, they have included the data in their overall assessment of the medications’ effectiveness. Unsurprisingly, the result has been that the recorded effectiveness of the medications has fallen.
Early drug trials are usually conducted in highly controlled university research environments. The researchers, often working in partnership with the pharmaceutical companies, enrol uncomplicated, motivated, middle-class patients into the trials in an effort to give the trial medications the best chance of success.
Later, researchers are keen to see if the medications work in “real world” patients: the sorts of patients we see in mental health clinics and GP practices, who may not only be depressed but also anxious, drinking too much and distressed about their mounting bills. The medications don’t work as well in these patients.

The increasing effectiveness of placebos

Perhaps the biggest reason for the declining effectiveness of the antidepressant medications is that placebos are becoming more effective. The gap between the medications and placebos is steadily narrowing.
The placebo response is a complicated phenomenon. In part it illustrates the statistical concept of “regression to the mean”, where a measure that is extreme when first measured (depressive symptoms in this case) will tend to be less extreme when remeasured.
The other component of the placebo response is a positive expectation bias. When people expect to improve, this makes it more likely they will improve. This is particularly important for depression, because by providing someone with treatment, if only a placebo pill, we are directly addressing the sense of hopelessness that is one of depression’s core symptoms.
The increasing placebo response rate in depression is likely driven by an increasing expectation that treatment will work. Notwithstanding recent evidence about the declining effectiveness of antidepressant medications, there is a broad cultural belief – one that has been emphasized in recent decades – that taking a pill can help depression.
pillGetty Images/Christopher Furlong

Combining treatments

Antidepressants might not be as effective as we once believed. But, overall, they are effective.
Other treatments have similar problems with declining effectiveness. In fact, there are no well-studied treatments for depression that have consistently strong effects.
This suggests combining treatments might be the best approach. And the evidence bears this out: combined treatment with medication and psychotherapy is more effective than either alone. We should be moving beyond a simplistic view of alternative treatments as competition for medications and consider whether they might be usefully combined to deliver even more effective treatment.

Treatment recommendations

When medications are used they should be part of a broader treatment plan. When therapy is available – and it isn’t always – there can be few good reasons for not recommending it. Medication should be considered when the depression is reasonably severe, when psychotherapy is refused (not everyone wants to see a therapist), or when psychotherapy hasn’t been effective.
When medication is used, it should be used in a way that maximizes its chances of being effective. This means not remaining on the same ineffective low dose for months and months. It means close monitoring by a doctor, so when the medication isn’t effective there is consideration of a dose increase or a change to an alternative medication.
Other treatments can also be added. Improving diet and exercising more are good for depression, and combining antidepressants with nutraceuticals – food-derived nutrients such as fish oil and vitamin D – has been shown to improve the effectiveness of the medications.

Future treatment approaches

It is unlikely we are going to see treatments with significantly greater effectiveness than existing treatments in the near future. Drug companies have reduced their investment in developing new drug treatments for mental illnesses, largely because they have been burnt by so many failures.
And the psychotherapies, while requiring a lot of training and skill to deliver competently, essentially comprise two people in a room talking. It is difficult to see how new therapies could be much more effective than existing ones.
Our task as clinicians is to consider the broad range of treatments that are available, and how they might best be combined in treating the particular patient in front of us. Our task as researchers is to work out the characteristics of the patients who are most likely to respond to particular treatments, so that we provide evidence for delivering the treatments to those patients. There is still much work to do.
Christopher Davey, Consultant Psychiatrist and Head of Mood Disorders Research at Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne. This article was originally published on The Conversation. Read the original article.

More elderly people than young people for first time ever: World’s huge demographic shift

BEFORE the end of the decade, the world will experience an unprecedented “crossing” event.
For the first time in human history, there will be more elderly people than young children in the global population, Business Insider reports.
Specifically, just before the year 2020, adults aged 65 and over will begin to outnumber children under the age of five, according to a recent report by the US Census Bureau.
According to the report, by 2050 people aged 65 and over will make up 15.6 per cent of the global population, more than double young children, who will make up 7.2 per cent.
“These two age groups will then continue to grow in opposite directions,” the report notes. “This unique demographic phenomenon of the crossing is unprecedented.”
A commonly used indicator for the speed of population ageing is the number of years it takes for the older population to double from seven per cent to 14 per cent, and again from 14 per cent to 21 per cent.
In Australia, it took 73 years for the “doubling” to occur in 2014. The “tripling” will only take another 26 years, occurring in 2037, according to the US Census Bureau report.
While Europe will remain the oldest region through to 2050, the report notes that the size of Asia’s population and the speed of ageing means the total size of its older population will dwarf other regions.
The global population’s ‘crossing’. Source: US Census Bureau

Foods that make men better in bed

Having a healthy sex life plays an important part of our wellbeing. Low libido in men is much more common than we are lead to believe. There are many reasons why men can lose their sex drive and simple factors like tiredness, stress, depression, certain medications (antidepressants and hypertensive drugs), excessive alcohol consumption, illicit drug taking, and low testosterone levels may all play a part. Having a newborn can also put the breaks on your sex drive for a while due, primarily, to lack of sleep. Did you know that what you eat can also affect your desire for sex. Here are some foods that will help spice things up in the bedroom. Help you enjoy a better sex life. 

1. Pumpkin and sunflower seeds

Snacking on these nutritious seeds will help boost your zinc levels. Zinc is one of the most important minerals needed to improve sperm health and quantity and boost testosterone levels. Seeds also contain healthy fats that are vital for sexual health. Add a handful to breakfast cereals, salads or to a trail mix. 

2. Maca

This Peruvan superfood is considered ‘nature’s Viagra’ as it is a renowned aphrodisiac, improving sex drive and sexual performance. Maca is also rich in B vitamins, to help boost energy levels, and relieve stress. Add a spoonful to smoothies, soups or breakfast cereals. 

3. Meat

Beef and pork contains high levels of L-Carnitine, an amino acid that can help boost libido, sexual function and testosterone levels in older men. L-carnitine also helps improve energy levels by increasing the burning of triglycerides as fuel in the body. 

4. Bananas

Bananas are an excellent source of B vitamins, needed to increase energy production and to dampen your stress levels. Bananas also contain tryptophan, an amino acid needed for serotonin production, our ‘feel good’ hormones. Bananas are also packed with potassium, used to produce sex hormones, and improve heart health and sex drive. Bananas also contain an enzyme called bromelain, which helps improve blood flow and increase libido

5. Cacao

Cacao, or raw chocolate, is also a well-known aphrodisiac that is rich in potent antioxidants called phenols, which are good for your heart. Of course, a healthy heart means a healthy sex drive. Cacao can lower cholesterol levels and blood pressure. When you eat chocolate you actually get an increase in endorphins, the same chemicals you release when you are in love. Cacao also contains phenylethylamine, a chemical that boosts dopamine levels, which increases your feelings of desire. Add a spoonful of cacao to smoothies, or enjoy some good quality dark chocolate.

6. Raw nuts

Snacking on raw nuts can help bring a spark back to your bedroom. Nuts such as almonds, cashews, Brazil and hazelnuts are rich in the amino acids L-Arginine, which boosts the production of nitric acid in the body, this will increase the production of sex hormones, and promote a firmer erection and better sexual performance. Nuts are also an excellent source of essential fatty acids, which are healthy fats needed for male sexual health. Add some mixed crushed nuts to muesli or salads, or add to smoothies. 

7. Celery

Including more celery in your diet can also bring a spark back to your sex life. Eating celery can increase the pheromone androsterone, which is a natural aphrodisiac found in male perspiration. Celery also contains chemicals that can help dilate blood vessels, increase sex drive, and enhance climax. Try a vegie juice with celery, or snacking on this sex boosting vegie with hummus or almond butter.
Here are some great ways to get these libido boosting foods into your diet:
- The Wellness Warrior Smoothie is a super nutricious way to have maca.
Jazz up your roast beef with herbs and mustard.
- The Chocorama-banana smoothie is perfect for thos with a sweet tooth.
-Keep that chocalately goodness going with this easy recipe for Bliss Balls - plenty of nuts too!
-Chomp on celery raw, or add it to Body + Soul's own Green renewal juice.

May 16, 2016

Pain On The Side Of My Knee | Embrace The Brace

Sometimes patients are rightly concerned about pain on just one side of the knee. In this blog, I will try to sort out the most common causes of pain on the side of your knee.
We can start by talking about which side of the knee is painful. In order to do this, we have to understand a common language so we can accurately describe the location. It is very similar to your smart phone  gives you directions. Instead of using North, South, East and West to locate where you are in the world, doctors use the anatomic position to describe where your symptoms are located. The anatomic position is you facing forward with both arms extended and palms up. The front of the body is known as Anterior. The Back part of the body is known as Posterior. If you move up the body toward the head, this is called Proximal. If you move down the body, this is called Distal. Now, the most important location descriptor for your knee will be either the inside or outside of the knee. The inside part of the knee which is the part of the knee closest to your other knee is called Medial. The outer portion of your knee closest to your outstretched hand is calledLateral.
click on the link below if you want to see an example
Now that we have our bearing about the knee, we can start to talk about common causes of pain to either the outer (Lateral) or inner (Medial) parts of your knee.
Knee diagram / Public Domain Mark 1.0
Lateral (outside of the knee) pain can be caused by:
Nerves– Sometimes, the portions of your nerves exiting your spine can be irritated and end up causing pain down your sciatic nerve to the outer portion of your knee. You may say “hey how can this be since my back does not hurt?” and I would say…”Hey, this is a great question.” There are two branches of the nerves coming out of your back. The smaller branch exits the spine and enters into the joints and muscles around your back. When this branch is pinched, you will have “back pain.” However, a majority of the time, just the larger branch of the nerve exiting into your leg, buttock or thigh is pinched giving you the feeling of pain in the area where the nerve innervates (which means ends up). This is known as referred pain and is confusing for some patients to understand. If you have nerve pain, it is usually burning and radiating meaning it seems to move up or down the leg. It is normally worse with positions such as prolonged sitting in your car or even when you lay down at night since this seems to place more stress on the discs in your back. Most people with nerve problems can remember other events where they may have had “sciatica” or “lumbago” since this is a chronic problem which seems to worsen with time and age.
Tendons– The outer part of your knee has some very important tendons which help stabilize your knee and even your pelvis. The most common tendon to be inflamed is the Illio-tibial band otherwise known as the IT band. This becomes irritated with repetitive motions such as running and thus as the nickname “Runners Knee“. This tendon runs up the outer portion of your knee all the way to your pelvis. People sometimes complain of a dull ache which is occasionally sharp after activities such as running or cross country skiing. However, you do not need to be a runner or skier to experience this problem. Again, if you have a nerve problem, this can cause chronic weakness of the muscles in your leg leading to overloading of the tendons.
Muscles– If some specific muscles around your knee are affected, you may experience pain. The mot common is actually weakness to a muscle on the inside (medial) part of your knee called the vastus medialis oblique muscle which attaches to the medial side of your knee cap. When this becomes weak, it will cause the knee cap to start to move lateral and rub over the outer part of the knee cap. The knee cap can even tilt and rub more causing scaring and a chronic condition sometimes referred to as lateral patellar compression syndrome.  This pain is normally dull but can have periods of sharp pain when the knee cap tries to move out of it’s normal groove. The symptoms are worsened when there is excessive and prolonged pressure on the knee cap such as sitting with the knee bent for long periods (theater knee) or with squatting, kneeling or lunges.
Bursae- A bursa is a sack of fluid which is designed to allow tendons to glide over bones, muscles or other tendons. Sometimes, these sacks become inflamed and we add the ending “itis” to the bursa to give it the name bursitis. Patients with bursitis normally talk about a dull ache over the side of their knee which is worse with activity and better with rest. Some patients report a rubbing feeling.
Joint- Inflammation of your knee joint is technically known as arthritis. When this joint becomes inflamed, it can cause pain all over the entire joint or sometimes, just where the arthritis is most advanced. This is especially true if you are knock kneed meaning your knee makes an angle outward from the center of your body. Arthritis pain is again a dull ache and occasionally sharp with activity and better with rest.
Meniscus – When the stabilizing and shock absorbing rings of your knee are torn, they can cause pain and most importantly instability of the knee. A meniscus is a simple “c” shaped cartilage type washer in your knee desinged to help stabilize the knee during motion. There are two of these. The one on your outside is called the lateral and the one on the inside is called the medial. You do not need to have trauma to your knee to cause a meniscus tear. In fact, most tears are due to aging of the meniscus. When the meniscus tears, it becomes caught between the two bones of your knee especially during twisting motions of the knee and a sharp pain happens sometimes causing your knee to buckle or catch. Most patients with a meniscus tear will have a sharp pain to the knee usually when descending stairs or a downhill slope. Sometimes, these symptoms are followed by some mild to moderate swelling and continued dull ache. In some patients, the symptoms will subside for weeks and months at a time but most return to become a chronic problem.
Medial (Inside) knee problems include mainly some of the same problems as lateral with the following exceptions.
Ligaments– The medial collateral ligament (MCL) is more commonly sprained than the lateral collateral. This can be caused by a simple strain to the knee such as when stepping too harshly from a ladder or stool. However, it can also be associated with repetitive stress to the ligament such as walking sideways on an incline or even simple sports such as bowling. The pain is usually acute and can sometimes be associated with a pop to the knee. The pain is usually sharp and radiates a short distance to the upper (proximal) part of your shin bone (tibia). The pain is worse with weight bearing especially with side to side movements. This pain can also be present for months at a time because it is difficult to heal due to constant stress across this ligament with normal activity. Unfortunately, the medial collateral ligament has an attachment to the medial meniscus and it is very common to find both a ligament and medial meniscus problem together.
Bursae– The most common bursitis of the knee in maturing patients seems to be on the medial side of the knee over an area called the pes anserine bursitis. This is a literal Latin translation of a duck’s foot bursitis because the three tendons attaching to a common complex over the medial side of your knee resembles a small duck’s foot under your skin. Don’t worry, this will not quack like a duck but, it will hurt like a duck pecking at the inside part of your knee. The pain is normally a dull ache, sometimes sharp. It is worse when the two knees touch together such as when you are sleeping on your side at night. Many patients sleep with a pillow between their knees to prevent this pain.
Nerve pain– Nerves from your hip joint and your back as well as through a tunnel of muscles near the inside part of your thigh can also cause pain to the medial side of the knee. Referred pain from an arthritic hip joint is the most common. A branch of the obturator nerve from your pelvis runs over near the top of your hip joint near your groin. When this is irritated, you will notice pain to the anterior and medial part of your knee. This is normally worse with activities which irritate the hip joint such as placing on your shoes or socks or getting out of a chair or car.
Joint– Arthritis pain on the medial side of the knee is a very common cause of pain especially if you are bow legged (where your knee angles away from the middle). Again, this pain is dull and aching, occasionally sharp. It is worse with activity such as walking and better with some rest.
Now that you understand the most common causes of pain to the side of your knees, you can help your doctor make an accurate diagnosis so the both of you can come up with an appropriate treatment plan. Hopefully, this blog has helped you understand the language barrier between patients and physicians. Our goal is to work with you in obtaining good health and understanding the language is the first step in this process.