A few months ago I participated in a "Small group on Small Groups" during an education retreat for the faculty of the medical school. First of all, I was very excited to see that there was a day for faculty to attend lectures, group discussions and information sessions with the goal of improving the way they teach medical students. It was so interesting to watch and listen as some of my teachers and small group facilitators talked about how to lead discussion sessions throughout our curriculum. (Considering we are in small groups for at least 2 hours a day, it's nice to know educators are thinking about how to do it better.) My takeaways were: discussion leaders want to give students what they need, they need students to participate and take charge of their own learning, and they are willing to change the way small groups are run to meet students where they are. I also learned that our faculty small group leaders can be frustrated with med students' attitudes just as much as I was frustrated with 11th graders' attitudes.
The other opportunity that came out of that session was meeting a pediatric geneticist and being invited to his clinic. So yesterday I spent the afternoon with kids... and I loved it. We don't get much time in pediatrics until we are on the wards, so this was my first real experience interviewing a child, doing a physical exam and maybe most importantly, interviewing their parent.
The cases were mostly children with connective tissue disorders, like Ehlers-Danlos Syndrome where patients have extremely loose joints, hyper-elastic skin that bruises easily and easily damaged blood vessels. These patients have a normal life span, but can be at risk for internal organ rupture or joint pain/arthritis.
I learned the most important and telling question that I will now use as the first question to all of my patients, especially the parents of my patients: "What are you most worried about?" Has a doctor ever asked you that? Wow. That one question gets to why the patient is in your office today, gives you insight into what you need to do or say to make that patient feel good about coming, and allows you to evaluate the weight of the problem in the patients life. I like it.
I also learned that the best way to evaluate a 2 year old for a connective tissue, neurological or muscle disorder is to get down on the floor and play with them! See what they can and can't do like standing, running, getting up from the floor without using their hands, or jumping on one foot... keeping in mind their age and milestones that they should be able to meet. Oh, and make sure you have a colorful toy in your pocket to distract them from your poking and prodding.
Saturday, July 23, 2011
Tuesday, July 19, 2011
New Weight Loss Research
Grab your morning cup of coffee or take a 10 minute break from your day to read this article, by Jane Brody published in the New York Times on July 18,2011.
Still Counting Calories? Your Weight-Loss Plan May Be Outdated
The article reports on new research published in the New England Journal of Medicine: "Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men" (Mozaffarian, et al, 2011). Nurses, doctors, dentists and veterinarians were followed for 12-20 years to collect data on their eating and exercise habits and then how their weight changed over those years. Here are some highlights:
1. The average participant gained 3.35 pounds every 4 years: total weight gain of 16.8 pounds in 20 years
2. The kinds of foods people ate had a larger effect over all than changes in physical activity
3. The foods that contributed to the greatest weight gain:
#1: French fries were linked to an average weight gain of 3.4 pounds in each four-year period.
Others:
potato chips (1.7 pounds)
sugar-sweetened drinks (1 pound)
red meats and processed meats (0.95 and 0.93 pound, respectively)
other forms of potatoes (0.57 pound)
sweets and desserts (0.41 pound)
refined grains (0.39 pound)
other fried foods (0.32 pound)
100-percent fruit juice (0.31 pound)
butter (0.3 pound)
4. Foods that resulted in weight loss or no gain when consumed in greater amounts during the study: fruits, vegetables and whole grains.
5. Despite conventional advice to eat less fat, weight loss was greatest among people who ate more yogurt and nuts, including peanut butter, over each four-year period.
6. Yogurt, among all foods, was most strongly linked to weight loss! Participants who ate more yogurt lost an average of 0.82 pound every four years
Still Counting Calories? Your Weight-Loss Plan May Be Outdated
The article reports on new research published in the New England Journal of Medicine: "Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men" (Mozaffarian, et al, 2011). Nurses, doctors, dentists and veterinarians were followed for 12-20 years to collect data on their eating and exercise habits and then how their weight changed over those years. Here are some highlights:
1. The average participant gained 3.35 pounds every 4 years: total weight gain of 16.8 pounds in 20 years
2. The kinds of foods people ate had a larger effect over all than changes in physical activity
3. The foods that contributed to the greatest weight gain:
#1: French fries were linked to an average weight gain of 3.4 pounds in each four-year period.
Others:
potato chips (1.7 pounds)
sugar-sweetened drinks (1 pound)
red meats and processed meats (0.95 and 0.93 pound, respectively)
other forms of potatoes (0.57 pound)
sweets and desserts (0.41 pound)
refined grains (0.39 pound)
other fried foods (0.32 pound)
100-percent fruit juice (0.31 pound)
butter (0.3 pound)
4. Foods that resulted in weight loss or no gain when consumed in greater amounts during the study: fruits, vegetables and whole grains.
5. Despite conventional advice to eat less fat, weight loss was greatest among people who ate more yogurt and nuts, including peanut butter, over each four-year period.
6. Yogurt, among all foods, was most strongly linked to weight loss! Participants who ate more yogurt lost an average of 0.82 pound every four years
Thursday, July 14, 2011
Milestones
A child should be able to stack blocks by age 1.
number of blocks stacked = age in years x 3
My niece Jules should be able to stack 3 blocks. I should be able to
stack 81 blocks.
Wednesday, July 13, 2011
Sex and drugs in popular movies: an analysis of the top 200 films.
Interesting tidbit from the abstract of article 72 of 360 that I'm going through for my research:
Sex and drugs in popular movies: an analysis of the top 200 films.
Gunasekera H. Chapman S. Campbell S.
Journal of the Royal Society of Medicine. 98(10):464-70, 2005 Oct.
We analyse the portrayal of sex and drug use in the most popular movies of the last 20 years using the Internet Movie Database list of the top 200 movies of all time. Films released or set prior to the HIV era (pre 1983), animated, not about humans or G/PG rated, were excluded. Films were reviewed by one of two teams of two observers using a data extraction sheet tested for inter-rater reliability. Sexual activity, sexually transmitted disease (STD) prevention, birth control measures, drug use and any consequences discussed or depicted were recorded. There were 53 sex episodes in 28 (32%) of the 87 movies reviewed. There was only one suggestion of condom use, which was the only reference to any form of birth control. There were no depictions of important consequences of unprotected sex such as unwanted pregnancies, HIV or other STDs. Movies with cannabis (8%) and other non-injected illicit drugs (7%) were less common than those with alcohol intoxication (32%) and tobacco use (68%) but tended to portray their use positively and without negative consequences. There were no episodes of injected drug use. Sex depictions in popular movies of the last two decades lacked safe sex messages. Drug use, though infrequent, tended to be depicted positively. The social norm being presented is concerning given the HIV and illicit drug pandemics.
sidenote: I've never heard of the Journal of the Royal Society of Medicine...
Sex and drugs in popular movies: an analysis of the top 200 films.
Gunasekera H. Chapman S. Campbell S.
Journal of the Royal Society of Medicine. 98(10):464-70, 2005 Oct.
We analyse the portrayal of sex and drug use in the most popular movies of the last 20 years using the Internet Movie Database list of the top 200 movies of all time. Films released or set prior to the HIV era (pre 1983), animated, not about humans or G/PG rated, were excluded. Films were reviewed by one of two teams of two observers using a data extraction sheet tested for inter-rater reliability. Sexual activity, sexually transmitted disease (STD) prevention, birth control measures, drug use and any consequences discussed or depicted were recorded. There were 53 sex episodes in 28 (32%) of the 87 movies reviewed. There was only one suggestion of condom use, which was the only reference to any form of birth control. There were no depictions of important consequences of unprotected sex such as unwanted pregnancies, HIV or other STDs. Movies with cannabis (8%) and other non-injected illicit drugs (7%) were less common than those with alcohol intoxication (32%) and tobacco use (68%) but tended to portray their use positively and without negative consequences. There were no episodes of injected drug use. Sex depictions in popular movies of the last two decades lacked safe sex messages. Drug use, though infrequent, tended to be depicted positively. The social norm being presented is concerning given the HIV and illicit drug pandemics.
sidenote: I've never heard of the Journal of the Royal Society of Medicine...
Tuesday, July 12, 2011
Getting caught up?
"There comes a time when for every addition of knowledge you forget something that you knew before. It is of the highest importance, therefore, not to have useless facts elbowing out the useful ones." (like directions) - Sir Arthur Conan Doyle
"Never regard study as a duty, but as the enviable opportunity to learn." - Albert Einstein
"Live as if you were to die tomorrow. Learn as if you were to live forever." - Gandhi
In an effort to solidify a few of the approximately 1 million facts, processes, diseases, concepts and terms that I learned during year 1, I'm breaking out "First Aid for the USMLE Step 1." After spending my first 2 weeks of summer beginning a research project at the Center for Addiction and Pregnancy and the 3rd week relaxing at the Outer Banks with Matt and his family... I figure I can hit the books for the last 6 weeks. Here we go.
"Never regard study as a duty, but as the enviable opportunity to learn." - Albert Einstein
"Live as if you were to die tomorrow. Learn as if you were to live forever." - Gandhi
In an effort to solidify a few of the approximately 1 million facts, processes, diseases, concepts and terms that I learned during year 1, I'm breaking out "First Aid for the USMLE Step 1." After spending my first 2 weeks of summer beginning a research project at the Center for Addiction and Pregnancy and the 3rd week relaxing at the Outer Banks with Matt and his family... I figure I can hit the books for the last 6 weeks. Here we go.
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