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That happy medium.

You know, that nebulous line between hunger and gluttony, exercise and self-punishment, having one drink and having one too many.

For some, it can feel like navigating a narrow channel.

But by finding the happy medium, or a route of moderation, one can avoid many of life's potential problems, from extra pounds to alcohol abuse.

"For a human being to be healthy, you eat right, exercise, socialize," says Dr. Sharon Braun of the Community Counseling Center. "You improve your mind."

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The problem, surprising even to Braun, who helps individuals navigate life for a living, is how few follow a healthy path.

She cited a report published in U.S. News and World Report where just 2.7 percent Americans were graded as having healthy lifestyle habits from data on more than 4,700 people. The study assessed the four general principles of healthy living -- a good diet, moderate exercise, not smoking and keeping body fat under control.

The study, typical of standard lifestyle advice given by doctors, did not even address areas of behavior where moderation, if not exercised, can lead to problems on countless fronts.

"If you asked 10 individuals, you would probably get 10 different answers," Braun says about common areas where people have trouble exercising moderate behavior. "Some of which include gambling, shopping, eating, video games, exercise, perfection, drinking, drugs, hoarding, violence, sexual obsession, smoking, tattooing and so on. Some of these behaviors are addictions and some are compulsions."

She says the difference between excessive behavior and compulsive behavior lies in choice and control.

While both are problematic, Braun views moderate behavior as the opposite of excessive behavior.

Moderate behavior, she says, can be achieved through "experiential learning," and identifying behaviors that affect an individual positively or negatively. While trial and error is involved, she says "mindfulness" also plays into recognizing whether behavior is a good fit or not -- whether it's beneficial or detrimental.

That mindfulness helps individuals determine their limits and choose not to go beyond, which she defines as "moderate behavior."

That self-awareness can help in identifying situations, knowing personal tendencies and developing strategies to moderate behavior.

When mindful, there can be simple, practical approaches to moderation.

For example, in the pursuit of healthier eating, Charlotte Cervantes, an instructor of dietetics at Southeast Missouri State University, recommends being mindful of portion sizes.

"One of the biggest things that we will say to people who are wanting to lose weight or moderate their intake is pay attention to the plate you're eating off or the bowling you're eating off, because if they're enormous, then you're going to fill them up," Cervantes says.

She says using a smaller plate, and filling it, looks more visually appealing and satisfying than the same portion on a smaller plate.

She recommends questioning the size of the cup used when using higher-calorie drinks like milk. Mindfulness also comes into play when sitting down with a box of healthy food, only to consume multiple servings that pile up calories.

Braun says knowing oneself allows choices to be made, rather than imposing self-discipline.

For Cervantes, it's healthy choices.

"In terms of restaurant food, I think a good thing to do is usually if you get a plate, just immediately pack up half of it to go," Cervantes says. "Restaurant portion sizes are so big and you're probably only hungry for half of it, but you'll kind of stuff yourself to capacity because it's there. I'd say put half of it in a to-go box, and if you're really hungry at the end of that meal, then kind of get into it. If not, then you have a meal for tomorrow."

Applied to the rest of life one will find, like leftovers, moderation serves well for the future.

See the rest here:
Moderating diet and behavior can lead to a healthy, well-balanced life - Southeast Missourian

SAN FRANCISCO | At Facebook, mere sharing is getting old. Finding deeper meaning in online communities is the next big thing.

CEO Mark Zuckerberg is no longer satisfied with just connecting the world so that people can pass around baby pictures and live video or fake news and hate symbols. So the Facebook founder wants to bring more meaning to its nearly 2 billion users by shepherding them into online groups that bring together people with common passions, problems and ambitions.

Much like the creation of Facebook itself arguably the largest social-engineering project in history that shift could have broad and unanticipated consequences. Facebook will apply the same powerful computer algorithms that make its service so compelling to the task of boosting membership in meaningful groups to more than a billion people within five years.

If successful, that would also encourage people to spend more time on Facebook, which could boost the companys profits. While Facebook doesnt currently place ads in its groups, it said it cant speak to future plans. Advertising is virtually Facebooks only source of revenue ; it brought in almost $27 billion in 2016, 57 percent more than the previous year.

THE SEARCH FOR MEANING

The shift comes as Facebook continues to grapple with the darker side of connecting the world, from terrorist recruitment to videos of murder and suicides, to propaganda intended to disrupt elections around the world. For Zuckerberg, using his social network to build community and bring the world closer together two phrases from Facebooks newly updated mission statement is a big part of the answer.

When you think of the social structure of the world, we are probably one of the larger institutions that can help empower people to build communities, Zuckerberg said in a recent interview at the companys offices in Menlo Park, Calif. There, I think we have a real opportunity to help make a difference.

Zuckerberg outlined his latest vision at a communities summit held Thursday in Chicago. Its the companys first gathering for the people who run millions of groups on Facebook, a feature the company rolled out years ago to little fanfare. Facebook is also rolling out new administrative tools intended to simplify the task of screening members and managing communities in hopes that will encourage people to create and cultivate more groups.

COME TOGETHER

Facebook groups are ad hoc collections of people united by a single interest; they offer ways to chat and organize events. Originally conceived as a way for friends and family to communicate privately, groups have evolved to encompass hobbies, medical conditions, military service, pets, parenthood and just about anything else you could think of.

To Zuckerberg, now 33, the effort to foster meaningful communities reflects his recent interest in ways Facebook can make the world a less divisive place, one that emerged following the fractious 2016 presidential election.

He has previously talked about the need to bring people together in both a lengthy manifesto published earlier this year and during his commencement address at Harvard University last month.

MEANING, FACEBOOK STYLE

Data-driven to its core, Facebook has quantified meaning so it can be sure people are getting more of it. And what Facebook aims to maximize is the time people spend in its online groups. Whenever someone spends at least 30 minutes a week in a group, Facebook classifies it as meaningful. The company estimates 130 million of its users are in such groups; it aims to boost that to over a billion by 2022.

Facebook has already been tweaking its algorithms to recommend more groups to users. Those changes have increased the number of people in meaningful groups by 50 percent over the past six months, Zuckerberg said a testament to the power of algorithms on human behavior.

Of course, anything that keeps people coming back to Facebook also gives it more opportunities to learn about their interests and other personal details that help it sell advertising, according to analysts.

Its really simple economics: If users are spending time on Facebook, theyre seeing more ads, said eMarketer analyst Debra Williamson. Increasing user engagement is a necessity for Facebook.

COMMUNITY COLLAGE

Virtual communities can fill a fundamental need we have for a sense of belonging, much like eating or sleeping, said Anita Blanchard, a psychologist at the University of North Carolina at Charlotte who has studied them for 20 years. Facebooks plan to connect people with like-minded fellows sounds like a fine idea, she said.

Blanchards research has also shown online communities can make people less intolerant of opposing viewpoints. They get you out of your own clothes and make connections across the U.S., making you realize you can get along with people with different beliefs, she said.

For Sarah Giberman, an artist and parent who lives in Arlington, Texas, a meaningful group is one that serves a need in your life, that fills some space that would otherwise feel vacant.

I spend a lot more time on Facebook because of the groups than I would otherwise, she said. Especially with the current sociopolitical climate, Im not comfortable being very open in my regular newsfeed.

More:
Facebook wants to nudge you into 'meaningful' online groups - Online Athens

What is the psychology of living in a densely populated place? If you think of New York or Los Angeles, you might be inclined to imagine the fast life, unrestricted sexuality, street gangs, and hordes of uncaring people rushing toward a dystopian future. But a recent series of studies conducted by Oliver Sng, a post-doctoral researcher at the University of Michigan, suggests a different picturepopulation density is associated with a slow lifestyle.

Fast versus slow life histories

As an undergraduate, Sng developed an interest in studying human behavior in evolutionary perspective. Before going to graduate school to study social psychology, in fact, he spent two years observing a group of long-tailed macaques at the Bukit Timah Nature Reserve. Biologists studying animal behavior have distinguished between a slow as opposed to a fast life history strategy. A slow life history means reaching sexual maturity at a later age, having fewer offspring, and investing heavily in each of those offspring (elephants, for example, dont begin having calves until well into their teens, and they nurse each one for several years). This compares to a fast life history, which, conversely means producing a large number of offspring as quickly as possible, and investing relatively little in each one (some small mammals in Madagascar, called tenrecs, start having offspring a few months after birth, for example).

Source: Oliver Sng, used with permission

Among animals other than humans, high population density is associated with a slow life history strategy. This makes sense because if there are a lot of ones own species around vying for resources, offspring are especially likely to need their parents to help them out.

What about humans?

When I was a young assistant professor, I taught a class in environmental psychology, which included a section on density and behavior. In those days, psychologists were convinced that nothing good could come of crowding. Environmental psychology textbooks would typically describe research on what ethologist John B. Calhoun called the behavioral sinka dystopic state of social pathology that resulted from crowding. Calhoun placed a large group of rats in a 10 by14 foot four-room enclosure, and provided them sufficient food and water to allow them to reproduce to their hearts content. The prolific little creatures reproduced quite freely, and were soon as crowded as New Yorkers on a subway at rush hour. The animals began exhibiting numerous forms of pathology, ranging from extreme social withdrawal to violence, rape, and cannibalism.

Calhouns research was widely publicized, fueled by the implication that the behavioral sink applied to human beings as well.

But not all the research supported this picture of density doom and gloom. After reviewing the findings in this area, psychologist Jonathan Freedman concluded that research with human beings has not supported earlier belief about the negative consequences of high density, and that, in fact, psychologists had misinterpreted and over-interpreted a few dramatic and non-representative studies of animals (such as Calhouns behavioral sink study).

After Freedmans review, research on the psychology of density became less popular. But Sng, working with Steve Neuberg, Michael Varnum, and I, decided to revisit the phenomenon in light of later developments in life history theory. The results were reported recently published in the Journal of Personality and Social Psychology.

The first study in the series was an analysis of archival data from different societies around the world. In Sngs native Singapore, every square kilometer is filled up with 7,987 people. That is 30 times more people than youd bump into if you took a stroll around the United Kingdom (at 261 people per sq. km.)and 249 times the density of the United States (at 32 folks per square kilometer). Despite its extremely dense population, Singaporeans hardly live the hard-paced sexually unrestricted lifestyle, though.They are generally well-behaved and hard-working, and they invest a lot in their small families (20 percent of the national budget goes to education). And Singapore isnt alone in this regard. In general, countries with higher density were found to have lower fertility rates, lower rates of teen pregnancy, longer lifespans, more emphasis on planning for the future, less promiscuous behavior, and more children enrolled in pre-school (indicative of more investment in children). These relationships held even after taking into account a variety of alternative factors, such as economic development, urbanization, and population size. This is consistent with the prediction that density would be associated with a slower life history in human beings, as it is in other species.

A second study compared different states in the United States, and found that states with higher density had lower fertility, less teen pregnancy, later age at first marriage, more children enrolled in preschool, more young people obtaining college degrees, longer lifespans, and more participation in retirement plans. Again, all this is evidence for a slower life history in places with higher density.

The paper also reports two experimental studies in which people were presented with various cues to crowding, such as a news article (purportedly from the New York Times) titled The Crowded Life: Too Many Too Much. The article stated that:

Throughout the United States, people are becoming increasingly familiar with long lines, big crowds, and giant traffic jams. Theres a good reason for all this overcrowding. According to statistics released by the U.S. census this year, population densities are growing at an unprecedented rate. In almost every U.S. state, population densities are increasing rapidly

Participants were then given a series of choices, such as:

Would you prefer 1) to have $100 today, OR 2) $140 ninety days from now?

and:

Would you prefer to: 1) have ONE child and invest all your resources in that one child OR 2) have MULTIPLE children and split your time and resources across all of them.

The results indicated that people who had been primed to think about crowding made more choices associated with a slower strategychoosing fewer children and long-term rather than short-term payoffs, for example.

To summarize, these results suggest that human beings, like other animal species, adopt a slower life history when they are living in high density conditions. Does this mean that everyone living in New York and Los Angeles starts having children later, has small families, and focuses on long term rather than short-term payoffs? Obviously not. But on average, there are relatively more slow strategists in places with high populations as compared to low populations. It remains an interesting question why some people living in big cities still adopt a faster life history strategy.

Douglas T. Kenrick is author of:

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Why Are Crowded City Dwellers Living the Slow Life? - Psychology Today (blog)

Colin Murphey/The Daily Astorian

A new state law requires hospitals to have a protocol when releasing mentally ill patients from emergency rooms.

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Gov. Kate Brown held a ceremonial signing ceremony Friday for new laws to help the mentally ill.

Hospitals in Oregon will no longer be able to release patients who come into the emergency room in mental health crisis without taking steps to prevent suicide and find treatment.

The new state law is another thread in the patchwork of care for the mentally ill, who often fail to get proper treatment even when their behavior escalates into an emergency.

The state requires hospitals that admit patients for mental health treatment to have a protocol at discharge to assess suicide risk, the capacity for self-care, the need for outpatient treatment, a transition plan, and a timetable for follow-up appointments.

Erasing an exemption

But hospitals that do not provide mental health treatment, like Columbia Memorial Hospital in Astoria and Providence Seaside Hospital in Seaside, were exempt in a compromise to get the mandate through the state Legislature in 2015.

Hospital administrators had argued that doctors and nurses were not equipped to counsel the mentally ill on top of the stressful, around-the-clock demands of an emergency room.

Basically, we didnt buy that, said state Rep. Alissa Keny-Guyer, D-Portland, one of the chief sponsors of the new law. Thats not an acceptable answer to say, We cant do it. You dont send somebody home who had a heart attack and say, Sorry, we dont have any help for you.

The new law, signed by Gov. Kate Brown in early June, takes effect this fall.

Hospitals will have to provide copies of emergency room release policies for patients in mental health crisis to the Oregon Health Authority. The Health Authority will compile the information in a report to the Legislature in January on the progress and potential barriers in carrying out the law.

Another new law signed by Brown requires public and private health insurers to cover behavioral health assessments and medically necessary treatment for people in mental health crisis, a mechanism to help finance care.

These bills ensure that when Oregonians reach out for help in a behavioral health crisis, they can access a broad range of mental health professionals, emergency services and critical support systems, Brown said in a statement Friday after a ceremonial signing with advocates for the mentally ill. Now, Oregonians in their most vulnerable moments will have the tools they need to recover, without undue financial burden.

Crisis response

Columbia Memorial and Providence Seaside work with Clatsop Behavioral Healthcare Clatsop Countys mental health contractor on crisis response to the mentally ill. A crisis respite center that opened last summer in Warrenton is also intended as an alternative to emergency rooms or, in more severe circumstances, the county jail. The hospitals are a partner in the crisis respite center.

CMH has been following this practice already and we are glad to have the state make this the standard policy for everyone. Trece Gurrad, the vice president of patient care services at Columbia Memorial, said of the emergency room protocol in an email.

Janiece Zauner, the chief operating officer and chief nursing officer at Providence Seaside, said in an email that we are working on developing innovative, sustainable solutions that actively engage community resources to meet the needs developed in these policies. We are beginning the work in each ministry this summer, and hope to have community-based solutions identified later this fall, before the legislation takes effect.

Caring for patients with behavioral health needs is a priority, and we will be working on how best to implement targeted strategies in support of people in need.

Tragedies

Social workers, police officers and prosecutors who regularly encounter the mentally ill recognize the challenge for emergency room doctors and nurses. But some have observed that hospitals at times seem unprepared to handle people in a behavioral health crisis and unable to link patients to treatment.

Tragedies, like the suicide of Carrie Barnhart, who jumped from the Astoria Bridge in 2015 after several interactions with police, Clatsop Behavioral Healthcare and Columbia Memorial involving her schizophrenia and depression, have drawn attention to treatment gaps. Barnharts family has filed a $950,000 lawsuit against Clatsop Behavioral Healthcare and Columbia Memorial alleging negligence.

Another suicide Susanna Gabays Vicodin overdose in 2010 inspired state action. The 21-year-old University of Oregon student from Mosier, who struggled with depression, had a psychotic breakdown and was placed in a hospital psychiatric unit on suicide watch. She killed herself just before a counseling appointment a month after her discharge.

Her parents, Jerry and Susan Gabay, said the hospital did not disclose their daughter was on suicide watch and told them she may or may not have another psychotic episode, not enough information to alert them of suicide risk.

The 2015 law that set a protocol for hospitals when discharging mentally ill patients also clarified medical privacy to help avoid leaving loved ones in the dark. Patients are encouraged to authorize hospitals to disclose information to caregivers, such as prescribed medications and behavioral warning signs that demand immediate medical help.

Follow-up appointments must be scheduled within seven days after discharge, or hospitals must document why the seven-day goal is not possible.

The law was named the Susanna Blake Gabay Act.

Jerry Gabay, who now serves on the board of the National Alliance on Mental Illness-Oregon, said he and his wife learned that medical providers are reluctant to talk with families about mental health in a way that would be shocking if you came in with a broken hip.

Research

New research released in April found that suicide risk among emergency room patients in mental health crisis is reduced if they receive suicide screening from an emergency room doctor, guidance at discharge and follow-up phone calls. The study, led by Ivan Miller, a professor of psychiatry and human behavior at Brown University in Rhode Island, showed a 30 percent decline in suicide attempts among patients who received interventions over a 52-week follow-up period.

Its very important, particularly with people in a fragile mental state, and super important if they may be suicidal, to want to have done an adequate assessment of their mental health condition, which is not always done. And in my personal experience, with my daughter, it was not done, when I was there anyway, Gabay said.

So you need to have an adequate assessment of what is the problem here. And then dont just release them and say, Hey, good luck. Give them a little bit of a transition. Have some plan about what youre going to do. Make an appointment for them to see somebody.

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The rest is here:
New laws help screen mentally ill for suicide - Daily Astorian