Oh, That Brain: It Doesn’t Have A (Complete) Mind of Its Own…

You Are in Control of Your Brain

Sometimes when you make a sudden decision, or feel you are doing something without much thought, you might feel that the brain has a mind of its own.

Well, it kind of does. The brain has collected your past decisions, so you don’t have to overthink, a process called conditioning.

But when it comes to the brain, that’s a simplicity that ends there. You have the power of breaking patterns of behavior and changing your focus.

The brain likes to do things to ensure it keeps going. It’s not specifically interested in the intricacies of what you do. So it may be used to following preconditioned patterns. But some patterns, such as certain behaviors, can hurt you.

But the brain’s ways can be changed, by what scientists call its durability and neuroplasticity, and you have an impact on what you do. You can change your brain’s behavior – and train it, researchers say.

How the Brain Works

Scientists note that different regions of the brain often work on their own, relying on neurons inside that region to do the work. At other times, the regions must cooperate. Each region of the brain contains millions of neurons.

With separate networks in the brain, one area may determine the risk versus reward of individual choices, and another may guidehow you actually behave.

Cognitive Control

It’s cognitive control within the brain that keeps you on track despite distractions, scientists say. “Cognitive control and value-based decision-making tasks appear to depend on different brain regions within the prefrontal cortex,” said Jan Glascher, lead author of the study at the California Institute of Technology at Pasadena, according to Time.

You Guide the Way

You should direct your mind to focus on what you want rather than repeating past mistakes, and that can help you make better decisions.

Break Bad Habits

That’s why it’s important to examine your decision-making process. That could be a key to breaking bad habits or addiction.

“Understanding the neuroscience behind making a decision can be helpful when targeting new behaviors and changing bad habits,” says Psychology Today. “Decision-making is in the locus of your control. You have the power to break patterns of behavior simply by making better decisions.”

Changes in behavior and attitudes can be a powerful way to make your thinking go on a different course.

“Unfortunately, the brain’s responses follow preconditioned patterns regardless if they are good or bad habits, so not all of its functions are serving you for the maximum growth,” according to Psychology Today. “The untrained brain is focused survival, not creativity. This means your brain may continue to repeat old patterns of decision-making to keep you in your comfort zone rather than help you reach your full potential.”

Don’t Over Do!

And yes, the brain gets tired.

“The brain works like a muscle: when depleted, it becomes less effective,” says Time.  “We should take this knowledge into account when making decisions.”

For instance, if we spent a lot of time focusing on a task, exercising self-control, or many choices, you probably shouldn’t make significant decision then, the article states.

Think of Other Parts of Your Body

And maybe don’t over rely on your brain; think about the connections to your body and environment, says Alan Jasanoff, professor of biological engineering at MIT and author of The Biological Mind.

 

“If we want to solve our problems, we shouldn’t reduce them to problems of the brain,” Jasanoff says in an interview with National Geographic.

He adds: “We need to keep a broad view, which recognizes how the brain is connected both to the body and to the environment; and look for solutions wherever they happen to lie.”

“Explaining human behavior in terms of brain function alone stems from a kind of mystical view of the brain and keeps us from advancing in a way that science can encourage us.”

 

REFERENCES:

 

Debra Maldonado, CEO Creative Mind Media, Inc. online. 2018. Want to Make A Better Decision? Start By Understanding Your Brain. Here’s How: Retrieved from: https://www.inc.com/debra-maldonado/want-to-make-better-decisions-start-by-understanding-your-brain-heres-how.html

 

Christopher Bergland. Psychology Today. 2018. The Neuroscience of Making a Decision. Retrieved from: https://www.psychologytoday.com/us/blog/the-athletes-way/201505/the-neuroscience-making-decision

 

Mark Humphries. Medium. How Your Brain Decides What You Are Seeing. 2017. Retrieved from: https://medium.com/s/theories-of-mind/how-your-brain-decides-what-youre-seeing-b9729670ec6d

 

Maia Szalavitz. Time. Making Choices: How Your Brain Decides. 2012. Retrieved from: http://healthland.time.com/2012/09/04/making-choices-how-your-brain-decides/

 

On Amir. Scientific American. How Making Tough Choices Tires Your Brain. 2008. Retrieved from: https://www.scientificamerican.com/article/tough-choices-how-making/

 

Simon Worrall. Book Talk. National Geographic. 2018. Retrieved from: https://news.nationalgeographic.com/2018/03/why-the-brain-body-connection-is-more-important-than-we-think/

 

Dentists Retooling Anti-Opioid Initiatives

While there is much discussion about the opioid crisis, you may not immediately think of dentistry. Yet in the 1990s, dentists were the top clinical prescribers of opioids. With a number of innovative and educational initiatives, prescriptions ordered by dentists dropped more than 50 percent by 2012, according to the Journal of the American Dental Association.

There can be lessons learned by dentists and also physicians and other medical care practitioners. Dentists themselves say they are working to continually improve their oversight of opioid prescriptions to reduce opioid misuse and abuse.

For years, dentists have prescribed opioids, but are routinely making limits on such prescriptions. They prescribe the opioids for different reasons: such as controlling acute pain following dental procedures, including when tooth are extracted, where dental implants are placed. Periodontal and endodontic surgeries are also included, according to Dr. Martha Somerman, director of the National Institute of Dental and Cranofacial Research, Journal of the American Dental Association, and Nora Volkow, director of the National Institutes of Drug Abuse.

Whether it’s prescribed from dentists or physicians, routine use of opioids has resulted in much dependence among American patients, and misuses sparked by such dependence. The results have been catastrophic, what the Trump Administration has called a public health emergency in America.

When dentists were considered the top specialty prescribers of immediate-release opioids, they accounted for more than 15 percent of all immediate-release opioid prescriptions. Immediate-release opioids are usually conventional drugs, such as tablets and capsules, taken orally or by the mouth. By the 2000s, dentists prescribed fewer opioids in relation to other medical professionals. In 2009, dentists represented 8 percent of immediate-release opioid prescriptions, but that amount dropped to 6.4 percent.

Opioids are also prescribed in emergency departments (EDs) to manage dental pain until treatment can be started.

Dentists Make Prescription Changes

Over the years, however, dentists used alternative approaches toward treating pain, following plans initiated by the American Dental Association, and the rate of opioid prescriptions that dentists ordered dropped “considerably.”

The American Dental Association launched a new policy earlier this year to reduce the misuse of opioids and to “keep prescription opioids from harming dental patients and their families.”

Among other things, the policy establishes prescribing limits on opioid dosages, such as no longer than 7 days for treatment of chronic pain. The policy also advises mandatory continuing education on prescribing opioids and other controlled substances. Dentists are developing educational interventions to encourage what is known as “risk mitigation strategies,” such as registering with and using Prescription Drug Monitoring Programs before prescribing opioids for pain management.

Databases

Prescription Drug Monitoring Programs are electronic databases that track controlled substance prescriptions in a state. As such they can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate a nimble and targeted response, according to the Centers for Disease Control and Prevention.

Experts say that more must be done, however. Some of the problems involve general physicians and nurses who treat dental pain. For instance, emergency department physicians often prescribe opioid and other analgesic medications to manage acute dental pain. Indeed, “an examination of a nationally representative data set suggested no reduction in the rate of opioid analgesic prescriptions for dental pain in emergency settings,” according to the studies.

The reports noted that a separate study of Medicaid recipients found that patients having a dental condition were almost three times as likely to receive an opioid from a nurse practitioner as a dentist.

More Research Necessary

To better understand dentists’ opioid prescribing practices, the National Institutes of Dental and Craniofacial Research (NIDCR) is using the National Dental Practice-Based Research Network. The Network includes than 6,000 dental practitioners who regularly see patients and seek to conduct research on their work.

The network seeks to develop tools to improve clinical-decision making related to alternatives among other plans.

“Dentists play a key role in addressing the opioid crisis,”  researchers said. “(American Dental Association’s) new opioid policy has the potential to lead to further reductions in opioid prescribing for acute dental pain and may serve as a model for other clinical professions.”

The ADA says it is partnering with the National Institutes of Health “that underscores the importance of scientific evidence to guide clinical decision- making and helps ensure that dental practitioners are kept abreast of the latest research.” – Joe Cantlupe, HealthDataBuzz

References

Centers for Disease Control and Prevention. Opioid overdose. 2018. National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. https://www.cdc.gov/drugoverdose/index.html.

Ibid. What States Need to Know about PDMPs. 2017. Retrieved from: https://www.cdc.gov/drugoverdose/pdmp/states.html

 

Dr. Martha Somerman, director of the National Institute of Dental and Craniofacial Research, Journal of the American Dental Association, and Nora Volkow, director of the National Institute of Drug Abuse. The Role of the Oral Health Community in Addressing the Opioid Overdose Epidemic. Retrieved from: https://jada.ada.org/article/S0002-8177(18)30419-7/fulltext and

https://www.drugabuse.gov/news-events/news-releases/2018/07/journal-commentary-addresses-role-dentists-in-opioid-crisis 

Dr. Nora Volkow. National Institutes of Health blog: NIH Partners with the Dental Community to Help Curb the Opioid Crisis.

Miriam Valverde, Donald Trump declares public health emergency over opioid crisis. Here’s what that means. 2017. Politifact. Retrieved from: https://www.politifact.com/truth-o-meter/article/2017/oct/30/opioid-epidemic-united-states-and-trump-administra/

 

 

Physicians’ Education Journey Beyond Journals

Physicians opined for years how important – and difficult — it was that they keep up with journals and academic literature in their respective fields of expertise, either in general, primary care, or specialty practice.

“Keeping one’s personal fund of knowledge current is one of the most formidable challenges that physicians face,” wrote Christine A. Laine and David S. Weinberg in the Annual Review of Medicine in 1999.

Today, “literature” or “journals” is only a mere collective speck of that knowledge landscape as the terrain has shifted seismically, reflecting the information surge through society. For doctors, there is not only the barrage of new information to sort through, but the fact is: they want information now. Staying on top of evolving clinical practice knowledge helps ensure the best patient care and improves physician work and well-being.

And there is certainly a vast array of resources vying for physicians’ attention. There is email, social media, podcasts, live meetings, Facebook and Twitter, which can be absorbed in real time, and practitioners can glean that information in different ways.

Years ago, physicians were known to read a select group of favorite journals cover-to-cover. As doctors keep up with their daily demands, they are spending in some cases mere minutes or seconds perusing abstracts of journals, written or online. In a survey of cardiologists, TCTMD asked 130 respondents how many read journals. An overwhelming majority – 90 percent – did, but only 2.3 percent said they read them from beginning to end, as they might have done a generation ago.

“”The average physician does not receive a physical copy of a journal at their office or home, but instead, receives email notifications of new issues,” wrote Milton Packer, MD in MedPage Today. “Some dutifully click on the table of contents, but they spend less than 30 seconds perusing the titles.”

“There is no guilt associated with ‘not keeping up,’’ Packer added. “Everyone has conceded that they can’t – and won’t be current in their medical reading. How bad is it? Much worse than you think.”

Anticipation may be too great, in some cases. It may take years for a journal article, for instance, to be published, and by then some physicians think they can get more updated information and have a virtual conversation on Twitter to debate the clinical issue at hand.

As information flows constantly, more physicians and researchers continually explore new channels of obtaining information, with many new innovations at their disposal. They are looking for depth, breadth, and better and speedy access to information as clinical inquiries mount.

There are a host of possibilities: There are point –of- care references at hospital computers, independent networks and journal clubs that make medical research databases available. U.S. Department of Health & Human Services offers a set of clinical practice and education tools to help them manage their care.

In 1950, doctors could expect the total amount of medical information to double every 50 years, according to the NEJM Knowledge. By 2020, it would take just 73 days. – Joe Cantlupe, Health Data Buzz.