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The Patients Per Doctor Map of the World
Remarkably, Cuba leads the world (or at least those countries shown on this map) in the patients per doctor ratio.
This map comes from Dutch advertising agency EuroRSCG. Using data culled from Doctors of the World, they mapped out the number of doctors per patient in every country of the world. On their site, they explain:
“This poster (published in September 2007) hangs on the wall of waiting rooms at the doctor. This way we let Dutch people know how privileged they are when it comes to medical care, and thus how appropriate it would be for them to help Doctors of the World help the less privileged.”
Remarkably, Cuba leads the world (or at least those countries shown on this map) in the patients per doctor ratio. Other countries doing very well include the successor states to the communist bloc nations, which generally had good (and cheap) health care, and the developed (capitalist) nations in Europe and beyond – although the Netherlands is quite far down, and behind neighbouring countries such as Denmark, Belgium, France and Germany, if ever so slightly.
Here’s the complete list (bigger map below):
This map was found here at adsoftheworld.com.
This post is 185 in the Strange Maps series.
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A 62-year old Russian mystery (and conspiracy theory) has been solved
Some mysteries take generations to unfold.
05 February, 2021
Winter in the Ural Mountains
Credit: Hикита Чертков / Adobe Stock
Surprising Science
- In 1959, a group of nine Russian hikers was killed in an overnight incident in the Ural Mountains.
- Conspiracies about their deaths have flourished ever since, including alien invasion, an irate Yeti, and angry tribesmen.
- Researchers have finally confirmed that their deaths were due to a slab avalanche caused by intense winds.
<p>In February 1959, a group of nine hikers crossed through Russia's Ural Mountains as part of a skiing expedition. The experienced trekkers, all employed at the Ural Polytechnical Institute, were led by Igor Dyatlov. On the evening of February 1, all nine appear to have fled their tents into the Arctic temperatures, for which they were unprepared. None survived.</p><p>Six of the members died of hypothermia; three suffered from physical trauma. Some members were missing body parts—a tongue here, a few eyes there, a pair of eyebrows for good measure. According to reports, no hiker appears to have struggled or panicked. They were likely too quickly overtaken by the hostile environment in Western Russia. </p><p>All the members were young, mostly in their early twenties; one member, Semyon Zolotaryov, was 38. Good health didn't matter. Given the uncertain circumstances—<em>what made them flee into the bitter cold?</em>—the incident known as Dyatlov Pass has long been the type of Area 51-conspiracy theory that some people love to speculate about. A vicious animal attack? Infrasound-induced panic? Was the Soviet military involved? Maybe it was the <a href="https://en.wikipedia.org/wiki/Katabatic_wind" target="_blank">katabatic winds</a> that did them in. Local tribesmen might not have liked the intrusion. </p><p>Or perhaps it was aliens. Or a Yeti. Have we talked about Yeti aliens yet? </p><p>These theories and more have been floated for decades.</p>
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYwMjM0Ny9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYzNjA0ODIyNn0.nZJr0UCDRh_jFyd2H13ztrndPbwa_i3lz0LrXK5cLBE/img.png?width=980" id="682de" class="rm-shortcode" data-rm-shortcode-id="6ca242158cc1289329d9a1054929e047" data-rm-shortcode-name="rebelmouse-image" data-width="2430" data-height="856" />
a: Last picture of the Dyatlov group taken before sunset, while making a cut in the slope to install the tent. b: Broken tent covered with snow as it was found during the search 26 days after the event.
Photographs courtesy of the Dyatlov Memorial Foundation.
<p>Finally, a <a href="https://www.nature.com/articles/s43247-020-00081-8" target="_blank">new study</a>, published in the Nature journal Communications Earth & Environment, has put the case to rest: it was a slab avalanche.</p><p>This theory isn't exactly new either. Researchers have long been skeptical about the avalanche notion, however, due to the grade of the hill. Slab avalanches don't need a steep slope to get started. Crown or flank fractures can quickly release as little as a few centimeters of earth (or snow) sliding down a hill (or mountain). </p><p>As researchers Johan Gaume (Switzerland's WSL Institute for Snow and Avalanche Research SLF) and Alexander Puzrin (Switzerland's Institute for Geotechnical Engineering) write, it was "a combination of irregular topography, a cut made in the slope to install the tent and the subsequent deposition of snow induced by strong katabatic winds contributed after a suitable time to the slab release, which caused severe non-fatal injuries, in agreement with the autopsy results."</p><p>Conspiracy theories abound when evidence is lacking. Twenty-six days after the incident, a team showed up to investigate. They didn't find any obvious sounds of an avalanche; the slope angle was below 30 degrees, ruling out (to them) the possibility of a landslide. Plus, the head injuries suffered were not typical of avalanche victims. Inject doubt and crazy theories will flourish.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYwMjM1NC9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYyOTIyNDk4M30.b7fG0Cl4MapfWtFi2k0G3Q38gLm8nNqvQEfOBVnG5oE/img.png?width=980" id="3d33d" class="rm-shortcode" data-rm-shortcode-id="c6afa25007fe4e3851973b98a0436b3c" data-rm-shortcode-name="rebelmouse-image" data-width="2306" data-height="1682" />
Configuration of the Dyatlov tent installed on a flat surface after making a cut in the slope below a small shoulder. Snow deposition above the tent is due to wind transport of snow (with deposition flux Q).
Photo courtesy of Communications Earth & Environment.
<p>Add to this Russian leadership's longstanding battle with (or against) the truth. In 2015 the Investigative Committee of the Russian Federation decided to reopen this case. Four years later the agency concluded it was indeed a snow avalanche—an assertion immediately challenged within the Russian Federation. The oppositional agency eventually agreed as well. The problem was neither really provided conclusive scientific evidence.</p><p>Gaume and Puzrin went to work. They provided four critical factors that confirmed the avalanche: </p><ul><li>The location of the tent under a shoulder in a locally steeper slope to protect them from the wind </li><li>A buried weak snow layer parallel to the locally steeper terrain, which resulted in an upward-thinning snow slab</li><li>The cut in the snow slab made by the group to install the tent </li><li>Strong katabatic winds that led to progressive snow accumulation due to the local topography (shoulder above the tent) causing a delayed failure</li></ul><p>Case closed? It appears so, though don't expect conspiracy theories to abate. Good research takes time—sometimes generations. We're constantly learning about our environment and then applying those lessons to the past. While we can't expect every skeptic to accept the findings, from the looks of this study, a 62-year-old case is now closed.</p><p> --</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a> and <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a>. His most recent book is</em> "<em><a href="https://www.amazon.com/gp/product/B08KRVMP2M?pf_rd_r=MDJW43337675SZ0X00FH&pf_rd_p=edaba0ee-c2fe-4124-9f5d-b31d6b1bfbee" target="_blank" rel="noopener noreferrer">Hero's Dose: The Case For Psychedelics in Ritual and Therapy</a>."</em></p>
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As we approach death, our dreams offer comfort and reconciliation
As patients approached death, many had dreams and visions of deceased loved ones.
08 March, 2021
Credit: Amisha Nakhwa on Unsplash
Mind & Brain
One of the most devastating elements of the coronavirus pandemic has been the inability to personally care for loved ones who have fallen ill.
<p><a href="https://khn.org/news/bereaved-families-are-the-secondary-victims-of-covid-19/" target="_blank">Again and again</a>, grieving relatives <a href="https://www.cnn.com/2020/04/24/us/coronavirus-victim-family-note-trnd/index.html?sr=twCNN042420coronavirus-victim-family-note-trnd0853PMStory" target="_blank">have testified</a> to how much more devastating their loved one's death was <a href="https://www.charlotteobserver.com/news/coronavirus/article241678926.html" target="_blank">because they were unable to hold their family member's hand</a>—to provide a familiar and comforting presence in their final days and hours. </p><p>Some had to say their final goodbyes <a href="https://www.marketwatch.com/story/its-230-am-in-north-dakota-youre-holding-a-smartphone-to-let-a-husband-say-goodbye-to-his-wife-via-facetime-after-60-years-of-marriage-2020-11-23" target="_blank">through smartphone screens</a> held by a medical provider. Others resorted to <a href="https://www.charlotteobserver.com/news/coronavirus/article241678926.html" target="_blank">using walkie-talkies or waving through windows</a>.</p><p>How does one come to terms with the overwhelming grief and guilt over the thought of a loved one dying alone? </p><p>I don't have an answer to this question. But the work of a hospice doctor named Christopher Kerr—with whom I co-authored the book “<a href="https://books.google.com/books/about/Death_Is_But_a_Dream.html?id=KX6cDwAAQBAJ&source=kp_book_description" target="_blank">Death Is But a Dream: Finding Hope and Meaning at Life's End</a>"—might offer some consolation.</p>
<h2>Unexpected visitors</h2><p>At the start of his career, Dr. Kerr was tasked—like any and all physicians—with attending to the physical care of his patients. But he soon noticed a phenomenon that seasoned nurses were already accustomed to. As patients approached death, many had dreams and visions of deceased loved ones who came back to comfort them in their final days.</p><p>Doctors <a href="https://www.nursingtimes.net/clinical-archive/end-of-life-and-palliative-care/the-significance-of-end-of-life-dreams-and-visions-04-07-2014/" target="_blank" rel="noopener noreferrer">are typically trained</a> to interpret these occurrences as drug-induced or delusional hallucinations that might warrant more medication or downright sedation.</p><p>But after seeing the peace and comfort these end-of-life experiences seemed to bring his patients, Dr. Kerr decided to pause and listen. One day, in 2005, a dying patient named Mary had one such vision: She began moving her arms as if rocking a baby, cooing at her child who had died in infancy decades prior.</p><p>To Dr. Kerr, this didn't seem like cognitive decline. What if, he wondered, patients' own perceptions at life's end mattered to their well-being in ways that should not concern just nurses, chaplains, and social workers?</p><p>What would medical care look like if all physicians stopped and listened, too?</p>
<h2>The project begins</h2><p>So at the sight of dying patients reaching and calling out to their loved ones—many of whom they had not seen, touched, or heard for decades—he began collecting and recording testimonies given directly by those who were dying. Over the course of 10 years, he and his research team recorded the end-of-life experiences of 1,400 patients and families.</p><p>What he discovered astounded him. Over 80% of his patients—no matter what walk of life, background, or age group they came from—had end-of-life experiences that seemed to entail more than just strange dreams. These were vivid, meaningful, and transformative. And they always increased in frequency near death.</p><p>They included visions of long-lost mothers, fathers, and relatives, as well as dead pets come back to comfort their former owners. They were about relationships resurrected, love revived, and forgiveness achieved. They often brought reassurance and support, peace and acceptance.</p>
<h2>Becoming a dream weaver</h2><p>I first heard of Dr. Kerr's research in a barn.</p><p>I was busy mucking my horse's stall. The stables were on Dr. Kerr's property, so we often discussed his work on the dreams and visions of his dying patients. He told me about his <a href="https://www.youtube.com/watch?v=rbnBe-vXGQM" target="_blank" rel="noopener noreferrer">TEDx Talk on the topic</a>, as well as the book project he was working on.</p><p>I couldn't help but be moved by the work of this doctor and scientist. When he disclosed that he was not getting far with the writing, I offered to help. He hesitated at first. I was an English professor who was an expert in taking apart the stories others wrote, not in writing them myself. His agent was concerned that I wouldn't be able to write in ways that were accessible to the public – something academics are not exactly known for. I persisted, and the rest is history.</p><p>It was this collaboration that turned me into a writer.</p><p>I was tasked with instilling more humanity into the remarkable medical intervention this scientific research represented, to put a human face on the statistical data that <a href="https://doi.org/10.1177/1049909113517291" target="_blank" rel="noopener noreferrer">had already been published in medical journals</a>.</p><p>The moving stories of Dr. Kerr's encounters with his patients and their families confirmed how, <a href="https://www.brainpickings.org/2012/12/12/montaigne-on-death-and-the-art-of-living/" target="_blank" rel="noopener noreferrer">in the words of the French Renaissance writer Michel de Montaigne</a>, "he who should teach men to die would at the same time teach them to live."</p><p>I learned about Robert, who was losing Barbara, his wife of 60 years, and was assailed by conflicting feelings of guilt, despair, and faith. One day, he inexplicably saw her reaching for the baby son they had lost decades ago, in a brief span of lucid dreaming that echoed Mary's experience years earlier. Robert was struck by his wife's calm demeanor and blissful smile. It was a moment of pure wholeness, one that transformed their experience of the dying process. Barbara was living her passing as a time of love regained, and seeing her comforted brought Robert some peace in the midst of his irredeemable loss.</p><p>For the elderly couples Dr. Kerr cared for, being separated by death after decades of togetherness was simply unfathomable. Joan's recurring dreams and visions helped mend the deep wound left by her husband's passing months earlier. She would call out to him at night and point to his presence during the day, including in moments of full and articulate lucidity. For her daughter Lisa, these occurrences grounded her in the knowledge that her parents' bond was unbreakable. Her mother's pre-death dreams and visions assisted Lisa in her own journey toward acceptance—<a href="https://books.google.com/books?hl=en&lr=&id=0TltiT8Y9CYC&oi=fnd&pg=PR11&dq=losing+a+parent+acceptance+grief&ots=S1b_VEJ6YR&sig=fQ0IX4ZJ1ri80S1GlhwlYsmY648#v=onepage&q&f=false" target="_blank" rel="noopener noreferrer">a key element of processing loss</a>.</p><p>When children are dying, it is often their beloved, deceased pets that make appearances. Thirteen-year-old Jessica, dying of a malignant form of bone-based cancer, started having visions of her former dog, Shadow. His presence reassured her. "I will be fine," she told Dr. Kerr on one of his last visits.</p><p>For Jessica's mom, Kristen, these visions—and Jessica's resulting tranquility—helped initiate the process she had been resisting: that of letting go.</p>
<h2>Isolated but not alone</h2><p>The health care system is difficult to change. Nevertheless, Dr. Kerr still hopes to help patients and their loved ones reclaim the dying process from a clinical approach to one that is appreciated as a rich and unique human experience.</p><p>Pre-death dreams and visions help fill the void that may otherwise be created by the doubt and fear that death evokes. They help the dying reunite with those they have loved and lost, those who secured them, affirmed them, and brought them peace. They heal old wounds, restore dignity, and reclaim love. Knowing about this paradoxical reality helps the bereaved cope with grief as well.</p><p>As hospitals and nursing homes continue to remain closed to visitors because of the coronavirus pandemic, it may help to know that the dying rarely speak of being alone. They speak of being loved and put back together.</p><p>There is no substitute for being able to hold our loved ones in their last moments, but there may be solace in knowing that they were being held.<img src="https://counter.theconversation.com/content/154133/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/carine-mardorossian-1202094" target="_blank">Carine Mardorossian</a>, Professor of English, <em><a href="https://theconversation.com/institutions/university-at-buffalo-925" target="_blank">University at Buffalo</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/as-death-approaches-our-dreams-offer-comfort-reconciliation-154133" target="_blank" rel="noopener noreferrer">original article</a>.</p>
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Surprising new feature of human evolution discovered
Research reveals a new evolutionary feature that separates humans from other primates.
07 March, 2021
Human evolution.
Credit: Adobe Stock
Surprising Science
- Researchers find a new feature of human evolution.
- Humans have evolved to use less water per day than other primates.
- The nose is one of the factors that allows humans to be water efficient.
<p>Scientists discovered a new feature that makes humans distinct from other primates like chimpanzees. The research shows that the human body uses 30% to 50% less water per day than our closest animal relatives.</p><p>Certainly, our brain power, and the ability to walk upright are key in making us special but the efficiency with which the human body uses up water is another major difference. This characteristic likely came about as an evolutionary adaptation in ancient hunter-gatherers, who had to venture out further and further from water sources in search of food, thinks the study's lead author Herman Pontzer, associate professor of evolutionary anthropology at Duke University.</p>
<p style="margin-left: 20px;">"Even just being able to go a little bit longer without water would have been a big advantage as early humans started making a living in dry, savannah landscapes," Pontzer <a href="https://phys.org/news/2021-03-humans-evolved-closest-primate-relatives.html" target="_blank">said</a>.</p><p>As our body constantly gets rid of water through processes like urinating or sweating, it is necessary for the water levels to be restored. "To sustain life, humans and other terrestrial animals must maintain a tight balance of water gain and water loss each day," as the paper's authors <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00289-X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS096098222100289X%3Fshowall%3Dtrue" target="_blank">write</a>. </p><p>For the study, the researchers looked at this cycle of water consumption and loss in 309 people from a variety of backgrounds. These included farmers, hunter-gatherers, and office workers, who were compared to 72 apes spread around zoos and sanctuaries.</p>
<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTc5Mzg4NS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2Mjc5NDIxNX0.twc5eqzbcvstjN1fXX-egPqyRhL5ob1oxbmE7Vm_M4g/img.jpg?width=980" id="5b260" class="rm-shortcode" data-rm-shortcode-id="0410ac6c503e7f6c52ff043c1ffaa533" data-rm-shortcode-name="rebelmouse-image" data-width="2250" data-height="2250" />
A model of water turnover for humans and chimpanzees who have similar fat free mass and body water pools.
Credit: Current Biology
<p>The scientists calculated the water intake of each person in the study, whether it came from drinks or food. They also tracked how much water was lost through urine, sweat or the GI tract. With all the numbers added up, it became clear that an average person's body goes through about 3 liters of water every day. That's about 12 cups. A chimp or a gorilla goes through twice as much.</p><p>The results were surprising because humans tend to sweat more than other primates. In one square inch of skin, "humans have 10 times as many sweat glands as chimpanzees do," <a href="https://phys.org/news/2021-03-humans-evolved-closest-primate-relatives.html" target="_blank">explained</a> Pontzer. We can sweat out about a half gallon in a 30-minute workout. We also lead much more active lives than the apes at the zoo, with most apes only moving a couple of hours a day, according to the scientists. So how is it that we use up so much less water?</p>
<p>The researchers believe that the very real difference in water processing they observed in humans compared to other primates is related to evolutionary mechanisms. Our bodies had to adjust to need less water to stay healthy.</p><p>The scientists are now focused on figuring out how exactly this change occurred. The data suggests that our sense of thirst diverged from other ape relatives. We just don't want so much water. Notably, the ratio of water-to-calories is 25% less in human breast milk than in ape milk.</p><p>It is also possible that our nose has a lot to do with this. Fossils point to the fact that humans started to get more protruding noses than its evolutionary cousins about 1.6 million years ago, with the dawn of Homo erectus. In contrast, gorillas and chimp have flatter noses. </p>
<p>What's good about our noses? Since we tend to breathe out water vapor, the nasal passages actually cool and condense it, turning it back into liquid. This liquid gathers inside the nose and get reappropriated back into the body. Essentially, having a nose that juts out likely helped ancient humans keep more moisture when breathing.</p><p>Read the study published in <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00289-X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS096098222100289X%3Fshowall%3Dtrue" target="_blank">Current Biology. </a></p>
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Skepticism: Why critical thinking makes you smarter
Being skeptical isn't just about being contrarian. It's about asking the right questions of ourselves and others to gain understanding.
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