Wednesday, August 31, 2016

Sequels in August 2016

August 27, 2016
Burkini bans in France beach

French Supreme Court seems to be against banning of burkini.

International Business Times: France's highest court overturns burkini ban

I think this decision is rational. And I respect the human rights group to have continued the legal battle for Muslims.

August 17, 2016

Unfortunately, Japan was struck by another typhoon. This one had a unique move. It had stayed on the Pacific Ocean for several days, to grow up. And it turned to the contrary direction, to land Iwate prefecture in Japan. I hope no people were victimized by this disaster.

August 9, 2016
Several way of stress reduction in the hottest time

Recently, it became relatively cool in Japan. It is fortunate for me. I hate the heat.

August 3, 2016
Kindle Unlimited launched in Japan

I am still enjoying Kindle Unlimited. I have already several books and comic books. In Japan, many magazines are available in Kindle Unlimited. In addition, I can read over one million of English e-books.

I think Kindle Unlimited is friendly to authors of minor titles. Books written by a not so famous person is hardly bought even if someone is interested in the book. But you may download it via Kindle Unlimited because it is completely free. And if you read it partially, the author will get some money.

In contrast, popular authors want their book bought regardless if the buyer completes to read it. Indeed, the majority of best seller books are not read completely. In this case, Kindle Unlimited is unfriendly for the author because he cannot earn money if it is not read at all.

Tuesday, August 30, 2016

Erroneous and troublesome Microsoft Office Update

Previously, I had a tough time because of Microsoft Windows Update. It occurred when I was connecting my laptop PC to the internet using tethering of my smartphone. All at sudden, Windows began to download files with mega volume reaching some gigabytes for updating itself. Hense, the amount of data transaction exceeded a monthly limit within some minutes. I was forced to abandon data connection services with my smartphone until the end of that month.

My past entry: Terrible update of Windows 10

Actually, it was one of the reasons I replaced my main laptop PC to MacBook.

My past entry: MacBook early 2016 has come

And today, I was struck by another tragedy.

It was 30th August. As a contract with the mobile service provider, approximately 1 GB had remained I could use for data transfer in this month. Therefore, I started to connect my MacBook with tethering.

As soon as connecting the internet, MS Office asked me to update its programs.

I had a bad feeling about this, to be honest, but I gave the permission. And the nightmare became real.

Just some minutes after, the volume of data transfer jumped into the red zone. I had to stop data transaction immediately.

I do not know why MS Office update requires so much data transfer. Or, is there any running programs accountable for this phenomenon?

Anyway, I was betrayed by Microsoft again. I am willing to seek a solution for preventing such sudden and massive transfer.

Monday, August 29, 2016

X-MEN: Apocalypse, the finale of the new X-MEN movie series

I saw X-MEN: Apocalypse on cinema yesterday. In Japan, this film was just started to be broadcasted last week.

X-MEN: Apocalypse is the sequel to the past X-MEN movies, “The First Class” and “Days of Future Past.” The story begins at the 1980s, several years after Mystique saved the life of President Nixon. Mutants are partially accepted to the human society thanks to the contribution of Mystique. Charles Xavier (Professor X) is teaching mutant students for improving their performance and control upon their uncanny power.

On the other hand, Mystique is concealing herself from the society because she feels annoyed to see some people hating mutants. As well, she dislikes being approved as a hero by other mutants. And, Eric Lehnsherr (Magneto) is living as a factory employee, disguising his past. Only his wife and daughter know his mutant power. He tries to keep an ordinary life without any troubles.

Meanwhile, Apocalypse, the origin of all mutants, revives from the long sleep for thousands of years. He was the king in the ancient Egypt, continuing to move his soul to another powerful mutant’s body repeatedly, but finally had been betrayed by his subordinates, to be buried in the deep of a pyramid alive.

Apocalypse makes some mutants belong to him, showing his extraordinary power and even making their mutant power stronger. Angel, Psylocke, and Storm are aside of Apocalypse.

An earthquake occurs relevant to the resurrection of Apocalypse. Then, one worker is near to be killed by accident. Magneto saves him with his mutant power to control metals. He is afraid someone reports him to the authority and attempts to run away with his family. But he is too late so that his daughter is caught by police. The police try to arrest Magneto as a terrorist. Magneto accepts to be detained, but his daughter cries so seriously that she awakes her mutant power. Seeing her daughter and wife killed by the police accidentally, Magneto fails to suppress himself from his rage, and he kills the police all. He feels desperate to know he is not free from bloody life, and human never accepts him. Then, Apocalypse appears to invite him to destroy the current civilization together.

I understand Magneto’s agony well. But, I think he cannot justify his behavior. He attempted to kill President Nixon. His had not been judged officially, neither compensated the crime. I never say criminals should not become happy. But he had to do something before making another life.

In real, many offenders insist that their behavior is justified, without being empathetic to the victims of their crimes.

Apocalypse has a unique character as a ruler. He has overcome the challenges of mortals. He destroys all nuclear weapons possessed by all nations. It is not for eliminating the threats for himself, but thinking that there is no need for weapons for humans to be guided by him. Apocalypse is almost invincible, but worrying about human conflicting each other.

However, it seems not Apocalypse is perfect. He was betrayed in the ancient era. The traitors shouted, “False God!” It means that Apocalypse was not trusted completely by some citizens. But he is arrogant so that he never recognizes his fault. In a later part, he calls his subordinates “useless” after he was interrupted by X-MEN. It is not a behavior of a good leader. He should be shameful to have failed the skills of friends and foes.

For these reasons, I did not feel Apocalypse as a great villain. Magneto in the first X-MEN film and Striker in X-2 seems more powerful and consistent in their ideology.

In the last battle, Jean Grey unleashed her mutant power to save Xavier from Apocalypse’s mind attack. She has potentially strongest ability among X-MEN. But in The Last Stand, she failed to control her power, to become Dark Phoenix and killed Cyclopes and Xavier. The last scene of The Last Stand is quite tragic. X-MEN: Apocalypse describes another history of X-MEN, and it is very contrastive to the past trilogy.

X-MEN: Apocalypse is a great movie. But I was not satisfied to the acts of Apocalypse. Also, it is sorry that the conflict between human and mutants, the main theme of X-MEN stories, is not focused at all on this film.

Personal Rating: 4 (Good)

Sunday, August 28, 2016

Fukuoka and Saga trip

I visited Fukuoka and Saga last week.

I climbed up the Fukuoka Tower. It was 234m tall, and the third tallest building in Japan.

In the middle of the tower, I saw Shin-Godzilla which was over 100m tall. Wow!

The next day, I visited Nokonoshina which is a small island located in Fukuoka prefecture.

In the island park, I could see a sunflower garden.

Some other beautiful flowers flourished.

As well, there were some goats and rabbits.

In the ship to Nokonoshima, I could see Fukuoka tower and Yafuoku! Dome (a baseball studium belonging to Fukuoka Softbank Hawks) over there.

At night, I stayed at Takeo city. An even was held in the garden nearby the inn. I saw many candles fired in a banboo lantern. It was a fantastic night. But picturing was prohibited in the main stage.

Another day, I saw a couple of big camphorwoods. This is Takeo-no-okusu (the great camphorwood at Takeo). It is considered to be 3,000 year old.

And this is Kawako-no-okusu (the great camphorwood at Kawato). It was as great as Takeo's one.

I enjoyed many events and foods as wekk in Fukuoka and Saga. It was hot, but comfortablly sunny. It was a nice journey.

Saturday, August 27, 2016

Burkini bans in France beach

Recently, a series of pictures of French police ignited a global argument regarding women’s right. In these photos, a Muslim woman was demanded by armed police officers to strip off the burkini on a Nice beach.

Independent: Burkini ban: Armed police force woman to remove swimwear on Nice beach

Burkini is a type of swimwear for women which covers almost all skin of the wearer. Islamic women are prohibited to expose their skin on public space. Therefore, they have to wear burkini or other similar clothing when they want to enjoy swimming. On the public road, they usually wear burqa or niqab, to adhere to their religious rule.

In France, however, burqa and niqab have been prohibited in public spaces since 2011. In addition, burkini, which is worn by Islamic women as swimwear, was also subjected to be regulation.

Why are they prohibited from wearing a particular clothes? Manuel Valls, the French Prime Minister, said that banning of full-bodied Islamic suits was justified because such religious regulations were a symbol of enslavement of women. In another opinion, it is afraid that Islamic women are abused if wearing the burkini. Some other politicians, needless to say about Sadiq Kahn, Mayor of London who is a Muslim, are against this policy, claiming that what women wear should not be forced at all.

Sydney Morning Herald: French PM Manuel Valls defends burkini ban as global backlash grows

Interestingly, the ban of burkini from the public beaches seems to have multiple effects. For example, it provided a business opportunity for retailers of swimwear for Muslims. Their sales of full-bodied swimsuits have been doubled. In addition, the argument of banning burkini will be a subject of the next election of French President.

USA Today: 5 things to know about French burkini bans

In my opinion, the banning of burkini wearing is inappropriate for the reason of protecting Islamic women. Full-bodied clothing suggests enslavement of women, perhaps, for my sense of an Asian man. Nonetheless, coercing women not to wear such clothing is another way of enslavement. Every men and women have a right to choose what to do, unless they invade other person’s right. Binding themselves with a religious rule is an option, as far as it is spontaneously decided.

On the other hand, asking to put off their clothes is unavoidable in some particular situations. In the security checkpoint in the airport, the investigator has to watch the face of passengers in detail. In Japan, most convenience stores request users to put off their helmet. These rules should be accepted without exceptions for security reasons.


Friday, August 26, 2016

The three way to avoid gloomy Monday morning

You may be moaning on every Monday morning due to massive annoying tasks. You have to look through e-mails sent till the morning, some of which are quite troublesome. You want to keep indulged in leisure you enjoyed on Sunday. Waking up at 7:00 is also challenging. You imagine the agony coming soon, making you depressed on Sunday evening.

Also in Japan, there is a slung, "Sazaesan syndrome." Sazaesan is a famous animation program broadcasted nationwide on Sunday evening. People feel sad while watching Sazaesan because they realize that this weekend is over.

So, how can you overcome this annoying time? Among several ideas, I suggest three solutions which must be useful.

1. Distinguish Saturday and Sunday
Perhaps you spend the weekend with the constant mood. It is an error typically conducted by young businesspersons. Enjoying the holiday is good, but too much excited on whole Sunday would make you tired at the end of the weekend. It is smart to make the difference between Saturday and Sunday. You shall go out and make some pleasures on Saturday. On the contrary, if you go out on Sunday, you should go home at early afternoon. After dinner, you prepare for tomorrow's work, and go to bed as usual as other working days. It recovers your body clock to the normal mode.

2. Kill silly tasks on Sunday as many as possible
If you see some boring tasks on Monday morning, it must reduce your motivation for work. The beginning of the week is the most frequent opportunity for you to encounter new tasks. Some of them are easy to treat, but other are not. You have to deal all of them in the morning. It gets rid of your power. Rather, you may treat some tasks on Sunday evening. Responding e-mail, sending some documents, and making an appointment on the internet are not such complicated tasks. If you achieve them in advance, you can concentrate other more important works on Monday morning. It looks absurd to work on Sunday evening. And the performance of this solution depends on your workstyle. If you belong to the so-called white-collar employee, or you are self-employed, it would be beneficial.

3. Modify the timetable on Monday according to your favor
Finally, whether you can get up in the early morning depends on your body structure. Some people are good at morning work, but others hardly make themselves motivated. If you are the latter type, I recommend you not to adhere to "power breakfast." You can deal with some quite simple tasks on the morning. After the lunch, you face the dominant tasks. Be aware of your own circadian rhythm.

Thursday, August 25, 2016

Gender difference in circadian rhythm?

Which is the better learner in school, men or women has been discussed for many years, mostly to lead to a dysfunctional argument.

In real, it seems that girls are more adaptive and good students. They have better marks in school than boys. Nowadays, women are more likely to go to university than men in some developed countries.

These facts do not mean that women are better at school learning. In elementary school ages, girls grow up faster than boys. Therefore, they become more serious to commit the class, and can learn more things at the class. On the other hand, the higher rate of entering university in women may suggest the difficulty to get a job. Perhaps, women need a higher grade of education to earn the same money as men.

Recently, another hypothesis was suggested. According to economists at the University of California, women are productive than men on the morning. They conducted an experiment in which students began a class on the afternoon instead of the morning. Then, boys showed higher performance, whereas girls had no changes. It means that boys cannot adapt the early morning class. The researchers concluded that men's circadian rhythm is longer than women's, and therefore women are resistant to sleep deprivation.

Independent: Girls do better than boys at school because they’re morning people, study suggests

This is an interesting experiment. The result is consistent with my personal experience. Boys are likely to be late for school despite some girls are suffering from hypotension. And women seems less likely to get a jet rug.

However, it is not sure that women are proven to be morning people. It is possible that women have a better ability to adapt a new environment than men. It may be difficult to be accustomed to the class whose opening time is altered every month. To testify the difference in circadian rhythm, "alone in the cave" experiment is preferable, besides the ethical issue.

Finally, gender difference is not so eminent compared with the interpersonal difference, in my opinion. The personalized curriculum is profitable rather than gender specific programs.

Wednesday, August 24, 2016

Melbourne and food allergy

An allergic reaction is one of the concerns for parents and physicians in the modern world. There has been much-increased patients suffering from allergy, although it was already reported in the previous era.

In Japan, it was only a couple of decades ago the government mandated food providers to show the information regarding some types of allergen such as milk and flour. I sometimes hear the news in which a child died from allergic reaction in a nursing house. I am not sure how the degree to extent allergic disease has increased in recent years, but it is undoubtedly much closer to us than the past.

Among the world, Melbourne is said to the place where food allergy is the most frequently reported. Melbourne is located in Australia. Its natural environment is a little unique.

There are some hypotheses to explain such high rate of food allergy of people in Melbourne. They can be a key to reducing the risk of emerging allergy.

The Age: Why Melbourne is the food allergy capital of the world

Desensitization is one of protecting methods for a person against an allergic reaction. Children gradually exposed to allergens are unlikely to make an allergic reaction. It means that dirty environment is beneficial for children, sound strangely.

Meanwhile, the cleaner our environment becomes, the more likely we have allergies. It is an irony considering keeping the environment clean is protecting us from infectious disease.

Also, people in developed countries have more risk of allergy. And it is expected that patients suffering from an allergy will be increased as the world is developing.

Tuesday, August 23, 2016

Password will survive if biometrics become popular

You may be annoyed to remember enormous kinds of passwords for internet services. It is not easy to manage several passwords secure. Also, in some websites, you are requested to change the password regularly. If you fail to input the correct password, you have to reset it, to be replaced with a new one. It makes you harder to remember the current password.

There are some ways to release you from this troublesome issue. Some applications let you administer many passwords through only one password. Nowadays, several web services are connectable to Google, Yahoo, Facebook, or other popular internet services. It also helps you to reduce the number of passwords to be remembered. However, they share a shortcoming: if this one integrated service allows an intruder, everything will be lost.

You may imagine another solution. Biometrics. Newest iPhone and some other smartphone equip fingerprint sensor. You have only to touch the panel to log in.

As well as fingerprint, face recognition seems desirable as a method of identification. Different from a fingerprint, it does not require additional devices than a CCD camera, which is equipped with almost all laptop PCs and smartphones. I used it with my smartphone a couple of years ago.

However, face recognition is a relatively weak method of identification. Computer analysis sometimes causes an error. Recently, Google image search engine misidentified a black woman as a gorilla. From my experience, a person with the same skin color and a similar length of hair of the original one had a chance to open the lock. On the contrary, if you cut hair, you would be rejected by the computer.

Furthermore, there is a possibility of fooling the security with a 3D image of a face. It has become not so difficult for a hacker to create a 3D image from some picture of the targeted person. And its quality may reach high enough to deceive the secure system.

Engadget: 3D faces based on Facebook photos can fool security systems

Facial recognition is a first ability for human, and has been used to keep security for many centuries. Now, this incredible skill is almost mimicked by the computer.

As a result, biometrics are no more secure than the passwords, although it has not been spread. Duplicating a face, or even a fingerprint, to break the security, is now feasible. And of course, they are much more easily stolen than passwords. Your fingerprint can be collected immediately after you leave a café.

ITProPortal: Why biometrics are less secure than passwords

It is ironic that biometrics is more vulnerable than traditional passwords. You will not be free from administering several meaningless chains of characters.

Monday, August 22, 2016

Internet porn and sexual dysfunction

In recent year, the internet has been much closer to our daily lives. Following the spread of the internet services, several maladies of it are argued.

Among them, internet porn is an issue to be treated carefully. Child porn and other sex crimes emerged through a contact on the internet are typical, and often the most serious, problems. On the other hand, personal use of porn sites is no more innocent. There are many people suffering from its adverse effects.

International Business Times: How the proliferation of porn is ruining men’s love lives

Some researchers suggest the relationship between the internet use and sexual dysfunction. They claim that excessive exposure to porn movies can cause bluntness to sexual stimuli with the partner in real. This tendency is frequently seen in young men. They get accustomed to sensational pictures too much and tend to masturbate to be satisfied while watching them. Therefore, they feel difficult to erect their penis only with seeing the partner’s nude.

In Japan, some couples are said to be influenced too much by porn movies. They believe some abnormal sexual behaviors, such as oral sex and facial ejaculation. Indeed, there is a wide range of pleasure among people. Some like these play very much, but others hate them. Some men misunderstand extreme acts of porn stars as usual. It is nothing other than troubles for most women.

Sexual addiction is reported as one of the modern categories of mental disorder. Patients hardly stop their desire to make a sexual relationship with others regardless of their mutual relationship. Most of them are thirsty for a secure and reliable relationship with their partner. Thus, it is not an issue of sexual function, but a subtype of dependency.

Sexual dysfunction in a narrow definition, or impotence, is another problem. It can be catastrophic for some men. Impotence occurs for several reasons. Vascular diseases are typical causes. There are several medicines potentially harming the user’s erection. Apart from them, many men have functional impotence. Excessive sensitization can be a cause, as written above. Complicated relationship with the partner is also influential. Other illnesses, such as depression, ban be behind impotence or loss of sexual interest. Psychiatrists can identify them. But unfortunately, few patients visit psychiatrists to talk about their sexual function.

It is inevitable for the internet porn to become popular, as sexual desire is human’s instinct. It is difficult to regulate them officially. Using them with temperance is preferable.

Sunday, August 21, 2016

"Shin-Godzilla" made the era of post-Kaiju movies

I saw “Shin-Godzilla (Godzilla Resurgence)” on cinema. It was an amazing and truly suggestive work.

By the way, “Shin” seems deliberately expressed in Katakana character. It has several meanings such as “true,” “new,” and “God.”

Godzilla is a traditional Japanese Kaiju character created by Toei Company. It is a gigantic beast with a figure like a tyrannosaurus. Originally, it was born under the influence of a nuclear experiment, and so it can take a nuclear fire breath. Thus, the original Godzilla had a message of anti-nuclear weapon. “Shin-Godzilla” succeeds these profiles from the original one.

However, “Shin-Godzilla” is clearly different from other Godzilla movies.

In this film, persons are never described as heroic. Even Yaguchi, a politician as the main personnel, loses his temper and is scolded by his colleague at the middle of the story. The Prime Minister is a weak and timid and indirective person. Experiencing the catastrophe, he becomes a little brave. But in the middle of the story, he is attacked by Godzilla, to be lost. Another person replaces the seat of the Prime Minister, but he is also coward and irresponsible until the last battle.

Several politicians, officials, and researchers struggle to find the way to defeat Godzilla. However, their personality is hardly described in this film. Even family members of them do not appear at all, despite familial relationship and conflict of the heroes are frequently described for making them impressive and humane in many Hollywood movies.

Compared to the US as the nation of the President, Japan is often recognized as a nation of organizations. Many unnamed officials and labors collaboratively make efforts for the great performance. In other films, a well-organized team whose components are ordinal persons often overcomes the tough challenge. In this term, Shin-Godzilla is a typical Japanese movie. It is a good contrast of "Independence Day," a typical American movie in which President fights bravely against an external threat.

In this film, a Japanese team plans to freeze Godzilla with a medical component. In contrast, the US army and the multinational alliance of the United Nations do not hesitate to use nuclear weapons to destroy Godzilla. The US government has a rational but arrogant attitude to Japan, concealing the responsibility on Godzilla's reborn, requesting Japan to give the whole data of Godzilla, and finally demand to Japan accepting the bombing. I wonder how do American people feel about such descriptions.

Anyway, Shin-Godzilla is an amazing movie. It has completely redefined the Kaiju movie or panic films. In recent years, victims of heroes' activities are sometimes described, for example in "Captain America: Civil War," and "Batman v. Superman: The Dawn of Justice." Shin-Godzilla achieved to shed light to the agony of citizens forced to evacuate and the endeavor of many people with no particular superpower. These descriptions made the story realistic. After Shin-Godzilla, films without such perspectives will no more survive.

Personal Rating: 5 (excellent)

Saturday, August 20, 2016

Julian Assange to be interviewed by prosecutor

Julian Assange is going to be interviewed by the prosecutor soon.

Julian Assange is the founder of WikiLeaks, a web service for whistleblowers. The documents he had published on WikiLeaks contained several secret issues conducted by the US and other major nations. The US authorities have been willing to arrest Assange as a serious security risk. But he refused to appear.

Instead, he was prosecuted for rape committed in Sweden. He was blamed for having intercourse without equipping a condom. Sweden has the strictest regulation regarding sex crimes in the world. It is uncertain why the partners sued him on time. It is suspected that there was a deal between the plaintiff and the persons who wanted to detain Assange.

Assange called for help to Ecuador, which is unfriendly to the US. Ecuador’s London embassy accepted him. Therefore, he has stayed there since 2012.

However, recently, Ecuador allowed Swedish prosecutors to contact Assange. The interview is planned to be held at the Embassy. It is uncertain whether he will be sent to Sweden for the trial afterwards.

It is easily imaginable that the UK, the US, and Ecuador have been experiencing tough negotiation about the treatment of Assange. If he were sent to the US, the US government would never release him.

Whistleblowers such as Assange and Snowden are getting popular in the era of the internet. Meanwhile, many people feel it necessary for the government to control the personal information of potentially dangerous people. We face a difficult situation between public safety and human right.

Friday, August 19, 2016

How generation conflict is generated

Conflict among generation seems a global trend.

In the UK, a couple of cinemas describing middle-aged people struggling toward the best were launched, to be popular recently. But, the intergenerational relationship is not good in the UK. It is well known that most young people voted for remain in the EU, while elder people desired to choose Brexit.

The Guardian: Young people are wrongly targeting their anger against the older generation

The author of this article is against the idea that young generation is exploited by the elderly. I agree with it. It is not a simple issue.

Chikirin, a famous Japanese blogger, commented that: many older people have much estate than younger ones. Some young people are jealous about it. Nonetheless, nobody would desire to get old immediately even for gaining enough estates. It is a suggestive anecdote.

Each generation has experienced their own life. Many old English people respect Margaret Thatcher, and they believe the Great Britain can stand alone again. This idea is understandable, even unfeasible. Thatcher restored the UK economy and wanted to introduce poll tax as being English is a privilege.

Japan is a super-aged society. I am 41 years old, but still, belong to younger half of the population. Elder Japanese have experienced the great resuscitation from the agony of the WWII. Japan was reborn from a burnt field to the nation with the world second largest economy. They believe they have accomplished this dramatic reform by themselves. After all, elder people in Japan have much higher self-esteem than younger people. On the other hand, younger people feel such attitude of elder people as arrogant.

My past entry: Troublesome elders

There are other factors to form generation gap. Previously, people unhealthily born could hardly survive. Thus, elder people alive are superior on their physical ability to younger ones potentially. In addition, we are not free from recall bias. We remember our past challenges in detail. Therefore, we tend to speak as if we have overcome more many troubles in youth than those in real.

Therefore, conflict among generation is unavoidable. But it is not wise for us to be indulged in the idea we are discriminated. The only thing to consider is the way for the better future regardless of generations.

Thursday, August 18, 2016

Terrorism and mental disorder

Recently, some cases of the terror attack were reported again and again. In some cases, it is suspected that the offender had some mental disorders. If the media reports as so, discussion about forensic mental health is often ignited.

This tendency is the same regardless of nations. In Japan, immediately after a mass murder case at Sagamihara was reported, the government was requested to reconsider official involuntary hospitalization scheme in Japan, despite this case is neither a typical terror attack.

My past entry: Mass murder case of challenged people in Sagamihara, Japan

Indeed, most of the terrorism is unlikely to be relevant to mental disorders. Therefore, preventing terror attack with enhanced mental health care is unfeasible.

International Business Times: Terrorism is not a symptom of mental illness

To begin with, the terrorist organization includes few members with mental disorders, according to this article. Thus, most of the terror attacks conducted by an organization are not relevant to mental disorders.

In this article above, it is said that terrorist groups are likely to reject people with mental disorders for some reasons. I was a little surprised to know this fact. I had guessed some cult groups were willing to recruit patients as a group member because they are likely to be controlled by a charismatic leader. Actually, I heard from some patients to have been invited to such a group.

On the other hand, there are many cases committed by a lone-wolf culprit who had some mental disorders. Some of them have delusions regarding political issue. Hinckley in the US and Breivik in Norway were suspected to have mental illnesses. There is a case series in which attempted attacks of a prominent person of public status by a person in the US were investigated. The result suggests that 43% of the attackers were at delusional mental state at the time of the principal incident. This proportion is far higher than that of mentally disordered offenders in all crimes, not to mention about the prevalence rate of mental disorders.

Pubmed: Assassination in the United States: an operational study of recent assassins, attackers, and near-lethal approachers.

Considering the wide range of definition of mental disorders, the issue becomes more complex. Most of the offenders may be diagnosed with antisocial personality disorder (ASPD). This diagnosis is defined mainly from explicit behavioral tendencies. If provocation, attitudes against authorities, deceiving others, and reckless acts are frequently observed, you can be diagnosed as ASPD. I think Han-Solo, in Star Wars, meets the criteria of ASPD. But what does it means? Many criminals have ASPD, but there is no standard treatment strategy established for ASPD.

In some cases by mentally disordered offenders, the incident is attributed to his psychiatric symptoms. In most of such cases, the victims are family members, at least in Japan. Thus, supporting family bond and adequate care for the patients in advance, as well as collaboration with police, can prevent many tragedies. It is certain that terrorism should be considered as different from public mental health care.

My past entry: Mental health and public safety

Wednesday, August 17, 2016


Typhoon Chanthu (No. 7 in this year) is threatening Japan.

It is approaching to Eastern and Northern Japan. It had rained heavily in some regions. Last night, I encountered rainy clouds early in the afternoon. Then I got home as soon as possible. Immediately after I reached home, it began to rain, and it continued all night.

However, now, it is sunny. I am not sure it is temporal or the typhoon has changed the course. Japan Meteorological Agency canceled the warning for heavy rain in Chiba prefecture. North-eastern regions are still subjected to the warning. I decided to go to work today as usual.

Japan is often struck by Typhoon in summer and early autumn. It is very annoying and even dangerous. Some people are killed by heavy rain and flood. You shall not walk near to the river when it rains seriously.


Tuesday, August 16, 2016

London all-night tube launching

On August 19, night tube in London will be launched. Initially, Central and Victoria lines, followed by Piccadilly, Jubilee, and Northern lines, will be working at midnight as well as in the noon.

This new scheme was initially planned to be started in September in 2015. However, strikes by the worker had been making it delayed.

My past entry: 24 hours Tube coming in London

My past entry: Tube strike again to delay night tube in London

Sadiq Khan, The Mayor of London, succeed the planning from Boris Johnson. He looks eager to ensure the passengers’ safety. A total of 100 additional police officers will be sent to some key stations for preventing crimes at night.

International Business Times: London's new Night Tube will get 100 extra police with £3.4m funding boost from Sadiq Khan

From my experience, London is relatively safe. Nonetheless, I dare not to walk alone there at midnight. It is essential for populalization of the night tube to make the road secure.

If it is realized, Londoners will receive the fruit of 24-hours tube entirely. London is the center of England, as well as the capital city. Many commuters and travelers are passing London at night. They will not have to be stuck when moving in London at midnight. As I wrote, some industries will be energized.

On the other hand, I am doubtful the government will be able to keep an adequate number of officials working for midnight tube. London’s financial status is not good, and the government has minimized the cost of hiring workers. I saw an empty police office frequently. It is uncertain that the cost of ensuring the city at night will be rewarded.

Monday, August 15, 2016

Pakistan Electronic Cybercrime Bill

The freedom of speech and expression is a basis of modern democracy. Guaranteeing anyone to talk their honest opinions is essential for the development of the society. On the other hand, there are many words potentially hurting others. If you violate other person’s life or dignity with your words, your speech will no more be respected.

Thus, freedom of speech and social security are often conflicting. Many developed countries have established some legislation restricting the right of free expression. Child porn is prohibited in most countries. Hate speech is explicitly forbidden and often deserves to punishment in some countries.

Regarding in the cyber space, this issue is still under-constructing. The governments are eager to prevent any cyber-crimes, including agitating others on the internet and encouraging other people to commit violence. To track risky pathway to crimes, regular censorship is necessary. In the US, the FBI made efforts to read the data encrypted in an iPhone possessed by a terror suspect. But, Apple refused to collaborate with FBI for restoring the data on the iPhone, because it would threaten other users’ privacy.

My past entry: Apple reject the order of FBI to unlock an iPhone

In Pakistan, new legislation was established recently. Pakistan Electronic Cybercrime Bill was approved in the diet, to be planned to be enforced.

According to the writer of this article below, this new law is potentially dangerous. The government will be able to arrest many citizens who had only used the internet. The author seems to worry that contents on the internet are subjected to censorship. And the subject of regulation is quite vaguely defined in the law.

International Business Times: Pakistan’s new cyber-security law could make bloggers, writers, and even readers criminals

The expression on this article is a little provocative. I understand the concern of the author. But I am not sure if the Pakistani government has an attention to supervising the behaviors of citizens using this law. It is not because I have not read the whole articles of the law, but because I am not familiar with the current situation of Pakistan. What to the extent some legislation is arbitrarily utilized by the authority highly depends on the policy of the government.

In Japan, State Secrecy Law was enforced in 2014. Some people criticized it for the possibility of abusing the regulation by the government. However, there has been nobody arrested for violating the law so far, for my best knowledge. If the government had certainly intended to eliminate persons against the government with this law, as some people were afraid, some journalists and activists would have been subjected to the legislation soon after the enforcement, despite I never say there is no risk in the future.

It is difficult to balance the freedom of speech and keep the society secure. We should be aware that privacy is easily sacrificed in the name of public safety. On the other hand, minimal regulation against extreme and risky ideas may be unavoidable. I hope Pakistan will not be biased between these two values.

Sunday, August 14, 2016

Visiting Los Angeles for academic conference

This week, I visited Los Angeles in the US for attending an academic conference.

The theme of this conference was medical law and ethics. It included the vast variety of regions. Speakers talked about several things such as informed consent, clinical trials, artificial abortion, chronic brain injury, and eponymous recognition of war crimes. Some lawyers, as well as medical doctors, made an atractive presentation.

Some Japanese researchers also appeared in the conference, to present newly judgment of Supreme Court of Japan regarding the liability of family members of an incompetent patient.

Los Angeles is one of the representative cities in the US. I had visited Chicago and New York. But LA was far different from other cities in its atmosphere. LA is similar rather to Hawaii, I think. The sun was brightly shining, but as it was not so moist that I enjoyed the hot noon. Citizens looked friendly. One passenger commended for my tie.

I also met my friends living in LA. They are engaged in psychiatric research. They said LA is comfortable to live, but the price is high. We discussed several things from our current research to the comparison between the American and Japanese culture. The conversation was very impressive for me.

LA is a big city. I used the metro bus for moving in the city. Transportation cost was not high.

I ate Kampachi grill in a restaurant. It tasted good, but a little salty.

It was for the first time for me to enjoy the Western Coast of the US. I hope to visit there again.

Saturday, August 13, 2016

Mental state of Trump and Clinton mentioned

The US president election campaign came to the climax. Usually, in the election, each nominee attacks in the speech the opponent with very severe tone. Voters judge through arguing which is more reliable and deserve to give the seat of the leader of the US.

Donald Trump, the GOP presidential nominee, questioned the mental health of Hillary Clinton, his opponent in the Democratic Party, repeatedly. He claims that Clinton is unstable and incompetent, and she would destroy America if she wins. Trump also mocked Clinton as she had achieved nothing during her long carrier as a politician.

The Washington Post: Trump, in series of scathing personal attacks, questions Clinton’s mental health

Blaming one’s personality is the last thing for a gentleman to do. I have sometimes heard the nominees railing at the opponent in the US presidential election. Thus, Trump is not an only person to behave impolitely. But, the matter to be judged for the nominees is the vision as a politician. I wonder Trump has anything else to mention Clinton’s flaw and his superiority as the leader.

On the other hand, some people are afraid of Trump’s psychopathology. Karen Bass, a Democratic congresswoman, said it is suspected that Trump has Narcissistic Personality Disorder (NPD). Her statement is supported by not a few people.

Independent: Tens of thousands of people want Trump examined for narcissism

However, American Psychiatric Association made a warning referring the Goldwater rule in which medical practitioners are prohibited from commenting on individuals who they have not examined themselves.

This rule is absolutely rational. The facts in media reports are often exaggerated. Especially in cases the reporter is not familiar with the region issued in the news, the report frequently contains inaccurate and/or misleading elements.

Considering this, I should be deliberate about mentioning the nominees’ mental status. In general, many politicians have a tendency of narcissism. It is not matter. Thus, narcissism itself is neither a pathological symptom nor a subject to treatment. Of course, expanded narcissism would be a risk for dictatorship. It is not limited to Trump, obviously.

I support Clinton. Apart from this, I expect creative debates will be performed by the two nominees.

Friday, August 12, 2016

Fewer time and prolonged term of work in future

How many hours should we work in a week? It is an issue being discussed for a long time.

It has been proven that excessive work increases a risk of sudden death. In Japan, a total of 100 hours of extra work in a month is a standard in which a worker’s sudden death should be relevant to the excessive work, or “karoshi.”

On the other hand, how much can we reduce the working hours? Previously, we worked on Saturday, but now we usually work for five days in a week. In the future, will this work style change?

Carlos Slim, an investor famous as the richest man in Mexico, said that people would be working only three days in a week in the future, at least in the sector where productivity is prioritized. Instead, people will continue to work for more years in the old age. According to him, such work style will be suitable for the aged society. In this policy, elder people can share working with younger people. And they can gain enough experience to be skilled in a particular work because of long-term engagement.

Independent: Mexico's richest man Carlos Slim says we may soon have a three-day work week

His hypothesis seems feasible. Actually, elder people seldom change the job, and they often know broad things around their work.

Life expectation is prolonging in most countries. It will cause an issue of sustainability of pension for elders. Governments are eager to encourage elder people to continue to work as long as possible.

Also, shared working is a topic in the modern society. Diversity in work style has been expanded. Some people would like to devote his life to other things than work. They are glad if more vacation is provided even if it means reduced income.

Some people indicate a more radical form of work. Timothy Ferriss, an American investor, proposes to work only four hours in a week. He calls this lifestyle “new rich.” The 4-hour workweek

Tim’s style requires some extent of capital and talent. Noe everyone can work like him. Nonetheless, his words deserve to hear. We are not living for work. Except some entrepreneurs who are sincerely fond of working, work is not an end of life, but a means for living. In the modern computerized society, we have to do fewer things for daily living than in the past. How to spend vacant time should be examined seriously.

Thursday, August 11, 2016

Half of US food is abandoned

In the US, a half of whole food is abandoned before consumed, according to the latest research. Multiple interviews for food suppliers as well as official data were utilized in this research.

I had heard that a third of food was dropped in the world. But, in addition to this wasted food, many vegetables and fruits are left in the field without harvested. In addition, products with minor blemishes are kept in a warehouse, to be rotten.

The Guardian: Half of all US food produce is thrown away, new research suggests

Previously, there has been a big issue about transportation of food, and it is one of the main causes why some people in the world are eager to lose their body weight while others are suffering from fatal starvation. However, considering the facts described in the article above, to be adjusted is not limited to the matter of distribution but also perfectionism. Cosmetic damage is the main cause of rejection by the market.

This report was issued in the US. In general, Japanese consumers are more eager to gain products with good proportion. I think retailers in Japan set a stricter standard for food in shape. Freshness and safety are matters of importance for foods. But sticking to high cosmetic standard results in an excessive waste of food and burdening farmers.

Recently, stores dealing with flawed foods were opened in some countries. This attempt has effects not only on saving food but also let people being aware of the reality of wasting foods.

My past entry: Market for old and ugly foods in Denmark

Food expiration is considered as one of the biggest problems in this century. However, if we were a little more tolerant to the shape of vegetables, this issue would be automatically solved.

Wednesday, August 10, 2016

A trap of resilience

Some people say that having difficulties makes you stronger. By contrast, many people are suffering from various stressors.

On reading an autobiography of a remarkable person, you see a certain phrase very frequently. It is that “what made me strong.” Some people are keen to say an experience in which he or she had very tough time. They believe that overcoming such challenges cause them stronger, wiser, motivated, and energized.

But is it true? In real, most people would like to avoid tough time. And actually, some people get broken their body and mind due to tragic events. What distinguish the outcome?

Recently, the term “resilience” is often referred in the context of traumatic stress. Resilience means an ability to cope with the challenge. People with high resilience tend to consider the event as a gift rather than misfortune. They are eager to learn something from it. They are open-minded to seek help and get along with the stressors. As a result, they gain something useful, such as reframing ideas, good friends, compassion for others, and so on.

The Conversation: Is it true that what doesn’t kill us makes us stronger?

Resilience is indeed an important factor in growing us up. However, I do not think that this concept applies to all traumatic situations.

In many cases, victims are even not given a chance to get resilience. Children who had been abused by the parents often distrust others for a long time. They hardly understand the meaning of being abused. Otherwise, they misunderstand their experience as they are bad enough to be punished. This idea is over-adapting, and completely of dysfunction.

On the other hand, resilience is often exaggerated by remarkable people. People who write an autobiography are not average persons. Many of them are blessed inherently and have lots of chance to succeed. Recall bias is also serious. People who have been successful tend to remember difficult situations they had overcome. By contrast, failures are not remembered by them. Furthermore, losers never write an autobiography.

I do not think resilience is meaningless. It is useful for some people. But they are ready to believe the value of resilience. If your friend is suffering from some challenges, you should be empathetic, not tell him about resilience unless he is willing to accept this concept.

Tuesday, August 9, 2016

Several way of stress reduction in the hottest time

Are you OK at work in the hot summer? I am not.

This August, Japan is struck by the heat. It is as usual as every summer. Nonetheless, the hot and moist weather gets rid of our energy.

In addition, we quickly feel irritated in an annoying atmosphere. In summer, many people are exhausted by not only the heat but also mental dysregulation.

When you feel tired, there are some options you can choose to restore your health. Taking a nap, having frozen drink, using the shower, and receiving massage are representative we frequently try for stress reduction.

The author of the article below suggested five options, in which running is favorite for the author.

The Conversation: Five ways to reboot your brain this summer

Indeed, computer gaming is not a good solution when you feel exhausted, I think. Gaming is fun, but it causes your tiredness instead of restoration. Gazing a TV monitor for a long time needs concentration. And your eyeballs become dry. When you quit the game, you may feel more tired than before starting the game.

I like gaming very much. But gaming is tiring and time consuming as well as other hobbies. Considering these facts, the game should be used for fun exclusively, not for restoring act.

The author ranked the TV watching as the same as reading a book. I cannot agree with this opinion. TV watching is rather a passive behavior. Even if you are not keen to listen to the TV casters, the program will go ahead. You will feel satisfied as if you gain much information from the content, regardless of the degree of understanding. In contrast, when reading a book, you have to read and absorb the content of a page before you proceed. Otherwise, you will lose the way of reading; you will merely trace the words on a page. It will make you suffering.

You can watch the TV while doing other tasks such as sewing a button or washing dishes. When reading a book, you cannot do other things at the same time. Thus, the TV is much less burdening than the book.

However, it does not mean that TV watching relieves you from stress. It depends on the content. After watching a TV comedy, you may feel relaxed. An action movie may make you excited. A news report offers you an opportunity to consider the world. However, you may get depressed if you watch a program not fitting your current emotion. There is no golden rule what kind of program is suitable for you. The choice is yours. In other words, you should not watch the TV when you are so exhausted that you cannot decide which program you would like to watch.

Running is one of the best choices for stress reduction. Exercise makes your body activated. And you have no room to worry about anything during running with your full strength. Before reaching the maximum speed, your blood flow moves to external muscles. It means your concern will shift to your body from ideological fear. In short, activating your body is preferable when your mind is broken down. Resetting your concern in your brain brings you new ideas which have never appeared. Many people believe the effectiveness of physical exercise for creative work.

Of course, running is not the only way to refresh your brain. And excessive exercise adversely affects your mind. If you dislike running, you can ride a bicycle, swim, or take a series of weight training, alternately.

Previously, I wrote about some ways of stress reduction. In this method, you can categorize solutions based on two axes. I recommend you to take a balanced combination of some solutions. However, if you have one favorite way, it is acceptable to rely on the solution, unless you are tired to continue it.

My past entry: Stress reducing activities, 2 axis and 3 principles

Make fun and resist the hottest summer!


Monday, August 8, 2016

Mental health and public safety

Criminal justice and mental health are strangely associated with each other. A shortcoming of each service will lead to deteriorating the quality of the other.

In this article below, some examples are shown. Some people with mental disorders are arrested because of their odd behaviors. The police are willing to send them to a psychiatric hospital. But, in the case there are no available beds, the patients are detained in jail, without receiving adequate treatment. The longer untreated duration is, the more difficult for the patients to be cured.

The Meridian Star: Budget cuts may swell county jails with mentally ill

Public safety is one of the most important issues for citizens. However, divisions for achieving it are suffering from lack of budget, because we would hardly recognize the improved safety in spite of the effort of conventional force. This tendency is shared by many countries.

Just recently, Sagamihara mass murder case occurred in Japan. This tragedy has shaken many people’s mind. Not a few people claim the necessity of enhanced supervision for mentally disordered offenders. I agree with this idea partially. But if realized, we would not feel the community safer than in the past at all.

My past entry: Mass murder case of challenged people in Sagamihara, Japan

People working in a division for protecting safety are unconsciously involved to community mental health. In Japan, a survey to family members of patients with mental disorders was conducted. The result suggested that they truly wanted help for bringing the patients to the hospital when needed. Since many patients with mental disorders resist to visit the hospital, it is difficult for the families alone to escort them to the hospital. However, most medical practitioners cannot visit the home of patients. They say they can do nothing to do unless the patient comes to the hospital. After all, the police catch the patient to bring them to the hospital. Families have no one than the police to rely on when there is a risk of the patient for harming others.

On the other hand, many practitioners in Japan are hesitating to keep in touch with the police in the treatment of patients with mental disorders. It looks a little strange. Community mental health cannot be achieved by medical practitioners in Japan. Police officers should also be engaged in the act for improved community mental health.

In England, budget cut resulted in the reduced number of official workers in prison. The outcome of this radical change was increased suicides of prisoners. They had not been treated with specialized care. Indeed, mere supervision and the daily connection did prevent them from killing themselves.

In my sense, English police are more familiar with community mental health than the Japanese one. Nonetheless, it seems not adequate collaboration is kept between mental health workers and police. The cost is always the core of concern. In England, the cost of treating offenders with personality disorders was analyzed. As a result, they should be treated in prison rather than in a hospital, at least regarding the cost-effectiveness. Although it attracts some criticism, I think this conclusion is acceptable.

The relationship between mental health and public safety is not simple. Stereotypical idea that patients with mental disorders are dangerous should be expelled. But we have to consider how to gain the society in which everyone can live without worrying about safety matters.

Sunday, August 7, 2016

AI medicine realized

Medical treatment by Artificial Intelligence (AI) is being realized.

Just recently, Tokyo University Hospital reported that Watson, an AI program powered by IBM, had successfully diagnosed a woman suffering from leukemia. Doctors previously considered her as a typical type of leukemia, but the pharmacotherapy for her was not successful. Watson examined her status, to identify her illness as a rare form of leukemia. The medical team altered the treatment strategy based on the recommendation by Watson and was able to offer her better treatment.

SiliconAngle: Watson correctly diagnoses woman after doctors were stumped

One of the strengths of AI is the range of information utilized for choosing the correct answer. An AI doctor can find an answer, if exists, in a short time. Watson can refer 20 million oncological studies to examine a patient’s medical status. Instead, we rely on our experience and instinct, and there are limited amount of experience for a human. It is impossible for a human to learn as many things as an AI does, regardless of your industriousness.

On the April fool last year, I wrote a joke article about Google psychiatrist. But it will be no more fantasy. Since there is limited evidence in psychiatric treatment, it will take a while for AI to replace human decision making, but the time will certainly come.

My past entry: Google Psychiatrist launched: loosing my job

This article above suggested two issues to be concerned regarding utilization of medical AI. One is privacy, and the other is the fact that AI would not work in the region reliable data is lacking.

However, I think these issues are not serious in considering the utilization of medical AI. The importance of protecting the privacy of the patients is not limited to this situation. And deep learning method will be a solution for detecting a preferable answer in underdeveloped regions. To begin with, these two issues are also challengeable for human doctors.

I believe medical AI will be spread soon. The issue most likely to be discussed will be who is responsible for mistaken treatment. The decision of the doctor in charge has been respected so far. But, in the near future, we will not be able to understand the process of thinking by the AI. We should decide whether we trust, human or AI, in a critical situation.

Saturday, August 6, 2016

The Lion King, excellent direction and mediocre storyline

I saw the Lion King the Musical for the first time in Tokyo.

The Lion King is originally an animation film published by Disney in 1994. It was revised into a musical play by Disney in 1997. In Japan, Shiki Theatre Company, a famous theatrical group produces the work. Shiki also plays "The Phantom of the Opera" and "Cats." The Lion King by Shiki has overcome the longrun record of Cats in Japan.

In the Lion King, Simba, a son of Mufasa, the lion king, takes a role of the main hero. He was brave, but reckless and rather egoistic child. One day, he was deceived by Scar, the brother of Mufasa, leading to the death of Mufasa. Simba was encouraged to leave the lion kingdom. Scar successfully replaced the Mufasa’s throne. But he failed to manage the power balance between lions and hyenas, making the kingdom dilapidated. Simba heard the situation of the kingdom, and after hesitation, he came back to the kingdom to defeat Scar.

In this musical, several animals such as lions, hyenas, birds, giraffes and so on, appear. All of them are played by a human. Many gimmicks are utilized to describe various animals in the jungle. In a key scene, a trampling group of gnus is dynamically expressed. I was fascinated to this direction.

In some music numbers, the Swahili language is used. Several African instruments are adopted to compose the music. You can feel the mystic atmosphere as if you are standing in the field in Africa through the scenes.

On the other hand, I felt the storyline not so attractive. It is said that the writer referred Hamlet by Shakespeare in considering the story of Lion King. It is not surprising itself. However, the plot is too mimicking traditional fairytales.

I was rather sympathetic to Scar. He seems to be always compared to Mufasa by his father. In the musical, he was described as having a disability in his waist. It may be a cause of being discriminated. Scar was willing to make a treaty with hyenas, different from Mufasa deeming hyenas as degrading creatures. Despite his intention to utilize hyena for usurping the King’s seat, Scar looked having a liberal ideology. But he failed to integrated the hyenas' culture into lions'. Simba finally exiled hyena family from the kingdom. I am afraid that such an exclusive idea of Mufasa will be realized in the real world, to be honest.

In the climax, Scar disclosed that he was responsible for the death of Mufasa. Knowing this fact, Simba got raged, to revenge Scar. It looked a little strange. Scar was so deliberate that he had never told the truth for several years since killing Mufasa. I hardly understand why he was so imprudent at the scene.

In spite of these flaws, I enjoyed the Lion King completely. Someday, I would like to the original film, and see the musical again.

Friday, August 5, 2016

When people inclined to cults

Recently, we hear the news of terror attacks very frequently. The members of ISIS conduct some of them. Other extremists are also eager to take a chance of showing their power. Despite the cold war ended, we still seem to face a dangerous world.

Western countries were surprised to know that not a few domestic people having joined to ISIS. They are keen to prevent citizens from being influenced by radical and destructive ideology. In King’s College London, I saw many flyers describing the caution about the invitation from cults and terror groups. Also in Japan, authorities strictly prohibit cults from inviting students without disclosing their name and purpose. These facts suggest that many young people are easily inclined to extraordinary ideologies.

In this article below, several factors which are keys of recruitment for cults were pointed out. People experiencing alienation, drug abuse, loneliness, sadness, rejection, search for alternative parental authority, identity crises, a higher need for order, and trauma are likely to listen to the cult speech. Recruiters must recognize such factors and utilize them for successful recruitment.

The Conversation: What kind of person joins a cult or joins a terror group?

I agree with the view of the author. People who experienced a loss of things they had relied on are very vulnerable to external stimuli. Drug and alcohol dependence is likely to be started after devotion or social exclusion.

However, it is a problem that people hardly recognize that they are at risk state. In deep sadness or dissatisfaction, most people would like to change their situation as soon as possible. The irritation makes them difficult to examine the malicious invitation they encounter. Recruiters also inflict their agitation to get rid of their ability of neutral assessment.

The author emphasizes that the core concept of every cults and terror is “all-encompassing ideology.” It means that an absolute entity exists in their idea. Like the God, an ultimate leader, or an idea such as the real world is completely rotten, they present a simple and easy-to-understand ideology. The human brain has an ability to save energy. The more tired we are, the more we tend to simplify the current situation. This character had been crucial in the ancient era for human to get food and avoid risks. But in the modern age, both rewards and risks are often hidden and connected with each other.

Therefore, being aware of the current complicated situation is quite important not to be involved in cults. As well, accepting diversity in our society will be a resistance against extreme ideologies. Not only for young people but also elders, it is essential to face many ideas they hardly accept and taste them as they are.

Thursday, August 4, 2016

Behavioral Activation is equally effective to Cognitive Behavioral Therapy

It is needless to say that depression is a dreadful disorder in terms of threatening human life. Therefore, clinicians are eager to develop new treatment strategies for depression. Nowadays, many options are available.

So far, cognitive behavioral therapy (CBT) has been deemed as the most effective psychotherapy for depression. Modifying cognitive distortions seen in patients is a core concept of CBT. The effectiveness of CBT has been proven to be almost equal to antidepressant treatment.

Recently, there are some attempts to enhance the cost-effectiveness of CBT with some modifications. Mindful-based cognitive therapy (MBCT) can be one solution. For example, MBCT has a similar effect as medication regarding the relapse rate. MBCT represents “the third wave of psychotherapy” in the 21st century.

My past entry: Mindfulness-based cognitive therapy, a new way to protect you from depression

On the other hand, the number of therapists who can perform CBT is limited in many countries including the UK, one of the nations in which maximum numbers of the therapist are ready to offer CBT in the world. It suggests that a therapy protocol which is easily learned and offered by relatively less specialized clinicians is needed to be established.

Behavior activation (BA) methods may be a solution. In BA, we think that some specific behaviors exist in depressive people. Such behaviors repeatedly appear, often unconsciously, to work for maintaining the depressive mood in patients. We encourage the patients to change their behaviors to those potentially elevate their mood. Monitoring and scheduling activities are concrete keys for behavior modification in BA.

BA was considered as a part of full series of CBT. Thus, it is easier to conduct in shorter term compared to CBT. If BA has the same effect as CBT, the cost-effectiveness of BA is superior to that of CBT.

Therefore, researchers conducted a randomized trial for comparing BA to CBT regarding the effect of reducing depression. Participants were randomly assigned to either BA or CBT and took each treatment. PHQ-9, a popular self-rating scale of depression was adopted as the primary outcome measure. Therapists were qualified to take each therapy in advance. But, the therapists offering BA had an inferior specialty in psychotherapy.

LANCET: Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomized, controlled, non-inferiority trial

As a result, BA could improve the symptoms of depression in the participants. The effect size seems not inferior to CBT. These facts indicate that we can treat many depressive patients with BA for a lower cost than CBT.

This study is amazing. However, there are some concerns about the interpretation of the result. First, patients with recent suicidal attempts, patients with alcohol abuse, and patients with bipolar disorder were excluded from this study. We are always annoyed in treating such patients. It is uncertain whether seriously ill patients can be treated in BA protocol.

By contrast, patients with mild depression sometimes overcome their difficulty on their own. It is possible that some of the subjects of this study recovered without the effect of psychotherapy. If so, it is not guaranteed that BA is equally effective as CBT.

Even not so qualified as CBT therapists, BA therapists in this study had passed the assessment by Quality of Behavioral Activation Scale. The result of this study never indicates an immature therapist can cure depression.

In my opinion, some patients with depression need cognitive reconstruction session to improve the symptoms. Others do not need it. And it is not easy to distinguish them, or identify the component of the therapy necessary for each patient.

To begin with, only seriously ill patients visit our clinic in Japan. They need both psychotherapy and medication. Considering this fact, primary BA sessions should be offered in non-clinical situations, such as school or industrial setting in Japan. It will lead to improved community mental health, and maybe contributes to reduced prevalence rate of depression.