I believe that within 50 years the vast majority of all physical doctor’s surgeries will have disappeared.

Why’s that?

Simply because people will be using their mobile phones to connect with their doctors.

Now I can see a lot of people that come up with instant arguments such as:

• but what about something that needs physical examination like a knee problem OR
• but people prefer to see their doctor’s in person

I’m not even going to attempt to try and answer these. My view is that there will be answers to these questions. I don’t necessarily know what they are but some people out there do know these answers (if you’re one of these please leave a comment!).

We’re roughly in the pre-mass-market car era. I guess that would be somewhere in the 1920s?

According to this article (http://answers.google.com/answers/threadview?id=144565) in the USA in 1915 there were 20 million horses. By the 1950s and 1960s this had dropped to between 1 and 3 million. Note that now this has increased to around 7 million (I’ll come back to that).

Back then, if you talked to someone and said that in 50 years time between 85% and 95%  of all horses would have disappeared to be replaced by cars people would have looked at you as if you were mad. There would be questions like:

• what if you got a puncture?
• why would anyone want to drive to a distant gas station and spend a huge amount of money on gas when you can simply put your horse out to graze on your land?

It seems easy to answer these now. But back then, trying to answer them clearly and successfully would have been really difficult. For example, if you answered, you would get a mechanic to drive out to fix a puncture, they would answer but there aren’t any local mechanics. If you answered that you would have to fix it yourself, they would say but that would require some complex skills. Fixing a horseshoe is very simple. And there are loads of horse vets in every town. And loads of spare horses if you need a new one.

Back to the 7 million current horses. Why has this gone up? For various reasons:

1. there was a correction. In the 1950s it would have seemed obvious that horses should completely disappear. However, horses have found a niche. For example, they’re a great way for police to establish a presence in a not-too threatening way. They are also being used for racing rather than as a source of power (i.e. a work horse).
2. the GDP of the USA has increased tremendously since 1915 (https://ourworldindata.org/gdp-growth-over-the-last-centuries/). Hence why horses have an increasingly large role in the leisure sector as race horses.

So, my belief is that the vast majority of doctor’s surgeries will have disappeared in 30 to 50 years time. There may be a correction but it will be for a particular niche.

Disclosure: whilst this doesn’t change anything about this post and my beliefs, I have equity in a telemedicine startup called Dr Medy.

Many people already know that exercise is good for you.

Studies show it changes the structure and function of the brain. E.g. studies in animals and people have shown that physical activity generally increases brain volume and can reduce the number and size of age-related holes in the brain’s white and gray matter.

It also augments adult neurogenesis (i.e. the creation of new brain cells in an already mature brain). Exercise doubles or even triples the number of new neurons that appear after exercise in the animals’ hippocampus, a key area of the brain for learning and memory, compared to the brains of animals that remain sedentary.

Scientists believe that exercise has similar impacts on the human hippocampus.

A recent study however compares exercise types – distance running, weight training and high-intensity interval. You can read more about it here

http://mobile.nytimes.com/blogs/well/2016/02/17/which-type-of-exercise-is-best-for-the-brain/

but, in a nutshell, distance training does the magic. And the greater the distance an animal runner covered during the experiment, the more new cells its brain now contained. From the study, sustained aerobic exercise might be most beneficial for brain health also in humans.

A few organizations I’d like to highlight that work with Youth on social issues (referred by a colleague at the United Nations):

• https://www.ushahidi.com/

Technology leader in Africa with a handful of products that serve people with limited access in hard-to-reach places. HQ Nairobi.

• http://spatialcollective.com/

Data collection and visualization experts. Based in Nairobi.

• http://www.sisiniamani.org/

Innovative approaches to communication to increase civic engagement & prevent violence in Kenyan communities. Also based in Nairobi.

• https://www.ureport.in/

Social messaging tool allowing people to respond to polls, report issues, support child rights and work as positive agents of change. India.

http://www.zambiaureport.org/home/

An example of the platform in use. The Zambia U-Report platform provides confidential, free of charge, individualized and interactive counseling services on HIV and STIs to adolescents and youth.

• http://unhabitat.org/books/ict-urban-governance-and-youth/

The ICT, Urban Governance and Youth report is the fourth report in the Global Youth-Led Development series.

I had a chat with some friends last weekend about how people get into web programming. They were hardly newbies but probably had 3 or 4 industry years under their belts.

Having worked in the web industry for over 20 years I’ve accumulated a ton of knowledge along the way. I said I thought it must be hard for newbies to get into web programming.

Their response was that there were more facilities available now – e.g. coding courses are online and that I had had to learn from a book.

This was partly true. I had learned some stuff from books. However, there were other tools about in my time such as IRC and, believe it or not, websites! The whole web thing was being invented as I got into programming.

However, this doesn’t answer the problem.

It’s not just about learning to program. The issue is you’re going to run into a ton of issues en route. For example, say you develop on a Mac. Here are a very few issues you’ll encounter:

• setting up your web development environment (e.g. Unix file permissions, Apache conf files, error logs, mod_rewrite, .htaccess files)
• problems upgrading software – e.g. look at the thousands of questions and posts about this simple MySQL problem – https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=RROR+1045+(28000)%3A+Access+denied+for+user+’root’%40’localhost’+(using+password%3A+YES)
• using all the tools you’ll encounter – e.g. vi
• managing your environment – e.g. killing a process with -9

It’s just one reason why StackOverflow is so wildly successful.

But I don’t think StackOverflow necessarily answers questions with any depth. It promotes copy and paste fixes with little to no understanding. Not to say I don’t use SO or Google’ing – I do.

But it takes a lot of time to develop the filters that help you realize which answers are useful and which aren’t – there’s an awful amount of rubbish out there!

I recently had to go back to the UK and found I had a pile of paper correspondence.

Among them were various statements from one of my investment accounts.

I converted my accounts with the same bank (via a deliver-all online toggle switch) to online-only so I was surprised to still be receiving them.

I called and was told that due to legislation/regulations they have to deliver paper versions. I was shocked. Email has existed since 1971 although it would be fairer to say that it has existed as a mass medium since the mid nineties. To not be able to offer an online-only version means the legislation is around 20 years out of date. I asked them if they could change the address to an HSBC branch (e.g. 1, The Bin, HSBC, Tottenham Court Road) however they said it has to go to a personal residential address.

I was curious whether there were older forms of communication and it is certainly not the oldest – the papal message is delivered via coloured smoke up a chimney – however that’s due to tradition. Legislation that’s out of date is not down to tradition. I refuse to believe that the law-makers won’t change the law because they believe sending out the statements on paper is more “traditional”. The more plausible  answer is security. Either the law-makers believe that paper is more secure (it isn’t as various humans handle the paper envelopes on their physical route whereas email/web can be encrypted) or a critical part in the the bank delivery chain hasn’t been updated due to fear of a lack of security.

The more feasible is the latter. However the person on the call was adamant – paper delivery was because  legislation demanded it. I’d be interested to know of similarly ridiculous cases – where, due to archaic legislation, there is similar waste and expense.

What causes ageing?

It's attractive to think of ageing as the accumulation of damage (like a car or washing machine) at a cellular level (e.g. reactive oxygen species damage). However, there has been a turn away from the idea of death through the accumulation of cell damage due to the lack of experimental evidence that shows any benefits when changes are made to reduce this damage.

Recently, there has been a trend of thought that says simply turning down those pathways associated with growth may make the body work better for longer.

When doing research its useful to look at exceptions to the rule.

For ageing, the Marine Hydra is very interesting as it seems to be immortal (this paper did a statistical analysis of mortality over a 4 year period of a population of marine hydra: http://www.biochem.uci.edu/steele/PDFs/Hydra_senescence_paper.pdf).

However, a problem with studying them for the purposes of tackling human-related ageing is that you can't make a change to make them live longer.

Studies in comparative ageing (i.e. animals of the same species) on the other hand are very interesting. E.g. worker ants have a lifespan of several weeks but the queen ant can live for years. And there are clams that have similar properties.

One factor in ageing seems to be telomere shortening (ends of chromosomes – the idea is that they get so short that you can't function) however this varies in animals. But flies don't have telomere shortening and still age. Also mice have ridiculously long telomeres and age. More on telomere shortening in this TED talk: http://m.youtube.com/#/watch?v=pbqi-v-mKts

Another factor is diet. Calorie restriction (e.g. a reduced daily calorie intake of 2/3 your normal calories such as around 1600 to 2000 calories for male adults – http://www.webmd.com/diet/features/estimated-calorie-requirement or a 5:2 diet (i.e. intermittent fasting (aka IF)) where you have 600 calories (or 500 calories for women) for 2 days of the week) can have an impact on life duration and cognitive ability. The NHS has a page on the diet, originally written in Jan 2013 but updated in May 2013, here: http://www.nhs.uk/news/2013/01January/Pages/Does-the-5-2-intermittent-fasting-diet-work.aspx. Briefly:

Does IF increase life span? This study, whilst a small sample, would indicate it does: http://eresveratrol.com/content/00/01/43/84/95/userimages/ADCR_JBJ_MH.pdf

Does IF improve cognitive ability? This study, whilst limited to mice, is also affirmative: http://matsuokalab.georgetown.edu/pubs/2007%20Neurobiol%20Dis%20Caloric%20restriction.pdf

Does IF prevent diseases? This 2007 clinical review on IF (specifically alternate day fasting) indicates it does have a preventative effect on heart disease, type 2 diabetes and cancer in animals but says further studies are necessary for humans: http://ajcn.nutrition.org/content/86/1/7.full.pdf

Aubrey de Grey claims that someone may already be alive today that could live to 1000 due to the bridge to a bridge effect of solving sufficient age-related diseases now to get to the stage where the really difficult age-related diseases are solved. More on him here: http://en.wikipedia.org/wiki/Aubrey_de_Grey

And a Royal Society discussion on “Is Growing Old An Illness” here:

http://royalsociety.org/events/2013/ageing-cafe/

In 1981, Ellen Langer and her Harvard colleagues took two groups of men in their seventies and eighties to an old monastery which was set up to appear as in 1959 with 1950s issues of Life magazine and the Saturday Evening Post, a black-and-white television and a vintage radio.

The first group were asked to pretend they were young men, once again living in the 1950s. The second group, who arrived the next week, were told to stay in the present and simply reminisce about that era.

In studies with colleagues at Yale, Langer had already shown that memory loss—a problem often blamed on aging—could be reversed by giving elderly people more reasons to remember facts; when success was rewarded with small gifts, or when researchers made efforts to create personal relationships with their subjects, elderly memory performance improved.

In another study, she and Yale colleague Judith Rodin found that simply giving nursing-home residents plants to take care of, as well as control over certain decisions—where they would meet guests, what activities to do—not only improved their subjects’ psychological and physical health, but also their longevity: a year and a half later, fewer of those residents had died.

Before and after the experiment, both groups of men took a battery of cognitive and physical tests, and after just one week, there were dramatic positive changes across the board. Both groups were stronger and more flexible. Height, weight, gait, posture, hearing, vision—even their performance on intelligence tests had improved. Their joints were more flexible, their shoulders wider, their fingers not only more agile, but longer and less gnarled by arthritis.

But the men who had acted as if they were actually back in 1959 showed significantly more improvement. Those who had impersonated younger men seemed to have bodies that actually were younger.

More here:

http://harvardmagazine.com/2010/09/the-mindfulness-chronicles

Another amazing story of old age is that of Dr Charles Eugster, a 93 year old bodybuilder.

http://www.examiner.com/article/93-year-old-bodybuilder-dr-charles-eugster-may-be-coolest-man-alive-video

Tim O’Reilly puts the point eloquently in his talk on why Idealism is the Best Marketing.

With Delacroix’s painting of Jacob wrestling with the Angel in the background he reads Rilke’s poem:

What we fight with is so small, and when we win, it makes us small. What we want is to be defeated, decisively, by successively greater things.

The point being that even if we lose we make the world a better place. So, go out there and find hard problems.

http://ecorner.stanford.edu/authorMaterialInfo.html?mid=3109

Really interesting point about Defaults and Path of Least Resistance in the Behavioural Economics course from Duke.

People were given a course of branded medication. During the course they were offered generics – the same drug but substantially cheaper. The take up rate was practically 0%. So, it appears people prefer branded medication.

However, if people were told they would not receive any further medication until they made a choice then there is a drastic change. Now, 82% chose generics.

People generally avoid changes, even if they are minor and even when another path is clearly better.

Another case run in a shop selling jams.
One day, it had 6 jams on display and another day it had 24 jams on display. People were given coupons with money-saving offers on the jam.

Unsurprisingly, 60% went to the 24 jam booth – it’s more exciting. And more people were willing to try from this booth.

However, from which booth were people more likely to purchase jam?

The answer? 30% bought from the 6 jam booth, 3% bought from the 24 jam booth.

Why? Some people had jam as their default – it was on their shopping list. So, you see many, you see few, you will buy some jam. However, for many people jam is not on their shopping list. So, it’s not part of the default.

So, what’s the percentage of people having jam on their shopping list (i.e. the Default)? It’s around 3%.

So, how did the 6 jam booth get so much action on jam? People are overwhelmed by choice. The complexity of the 24 jam booth overwhelmed their desire to buy jam.

https://class.coursera.org/behavioralecon-001/lecture/65