My OFB is the city's FOG

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">It is a pretty well known fact that I do not cook with any oil, fat or butter and that when I go to restaurants, I order my grilled seafood and steamed veggies without any oil, fat or butter - or as I like to say no OFB.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I do use monounsaturated oils - especially olive oil - I just don't cook with it.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I am admittedly saturated fat phobic. However, more of us should be afraid of that artery clogging fat.  Saturated fat is what you find in red meats, fried foods, and many baked goods.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I do want to keep my blood lipids (blood fats) low as to prevent plaque build up and hardening of my arteries - things which can lead to a heart attack oh and if your a man - erectile dysfunction (i.e. blood flow to the penis:)). </span></span>(of course, saturated fat is very high in calories too!)<br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">FOG is something similar.  I got a little postcard in my mailbox yesterday from the city - it told me that FOG - fats, oils and grease - can clog the sewer system and I needed to NOT pour them down my sink or into my toilet.  The city suggested that if I put FOG in the trash my pipes would not clog.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Thus - FOG or OFB - whatever you call it - it is best to trash it.</span></span>

My OFB is the city's FOG

It is a pretty well known fact that I do not cook with any oil, fat or butter and that when I go to restaurants, I order my grilled seafood ...

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Toddlers to Twenty Somethings

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I see the children outside by the swing sets sometimes, but on one of the routes, I run (on the sidewalk) right by the fence where the children are playing.<span style="mso-spacerun: yes;">  </span>I always smile and wave if they are looking.<span style="mso-spacerun: yes;">  </span>I have to show them the grown up having fun exercising </span><span style="font-family: Wingdings; font-size: 14.0pt; mso-ascii-font-family: Garamond; mso-char-type: symbol; mso-hansi-font-family: Garamond; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;">J</span></span><span style="font-size: 14.0pt;"></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 14.0pt;">Last week, I ran by that particular pre school, and the kids were out again.<span style="mso-spacerun: yes;">  </span>It had been a couple of weeks since I had seen them – the weather I suppose.<span style="mso-spacerun: yes;">  </span>The children – boys and girls – are most certainly age 3 and 4.<span style="mso-spacerun: yes;">  </span>This last time, I saw one or two digging, a couple running and a whole group of them walking down hill backwards, falling, rolling, laughing. It was divine.</span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 14.0pt;">Today, I did some studying outside on campus, because it was warm.<span style="mso-spacerun: yes;">  </span>I am quite lucky to have 1) an office (cubby) space at all and 2) to have this space on the floor that ‘houses’ the athletic team training and rehab rooms.<span style="mso-spacerun: yes;">  </span>I am always walking by runners, softball and base ball players, students who play volleyball, basketball, and soccer, etc.<span style="mso-spacerun: yes;">  </span>While I was outside today, the women’s softball team was practicing.<span style="mso-spacerun: yes;">  </span>I saw some good catches, throws and dives.<span style="mso-spacerun: yes;">  </span>A group of male runners congregated near the building entrance, and a trainer worked with a few women.<span style="mso-spacerun: yes;">  </span>One of them was on a stationary bike – outside (how cool).<span style="mso-spacerun: yes;">  </span>But the best thing I saw – a young woman who was small framed (so I would guess her a runner), had a cinch around her waist – like a horse might be tethered to an aerator or plow.<span style="mso-spacerun: yes;">  </span>The strap around her waist went down her right and left side, again, think of a horse being hitched to a hand plow. She was attached to a round piece of steel, iron or something – which really could have been some kind of grounds keeping tool – but on closer inspection, it seemed to have a free weight<span style="mso-spacerun: yes;">  </span>- or weight plates on it. The heavy round disc (oh let’s see, hold your arms in front of you with your fingertips touching, palms facing you – it was at least twice that round and a few inches in diameter) was flat on the ground. <span style="mso-spacerun: yes;"> </span>She turned around and was pulling that thing across the field and back. The disc did not leave the ground – she drug it. <span style="mso-spacerun: yes;">  </span>Mostly I expect she was working her legs – quads probably.<span style="mso-spacerun: yes;">  </span></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 14.0pt;">But anyway – YAY for spring and physical activity and our youth – 3 or 4 or 24 </span><span style="font-family: Wingdings; font-size: 14.0pt; mso-ascii-font-family: Garamond; mso-char-type: symbol; mso-hansi-font-family: Garamond; mso-symbol-font-family: Wingdings;"><span style="mso-char-type: symbol; mso-symbol-font-family: Wingdings;"></span></span><span style="font-size: 14.0pt;"></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 14.0pt;">As NC Says – Eat Smart and Move More</span></div><div class="MsoNormal"><br /></div>

Toddlers to Twenty Somethings

On one of my running routes, actually two of them – I pass by preschool play grounds. I see the children outside by the swing sets sometim...

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To Sleep

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I have written several posts that mention sleep.  <a href="http://yourhealtheducator.blogspot.com/2010/02/another-eight-myth.html" target="_blank">This one</a> talks about sleep needs as we age and <a href="http://yourhealtheducator.blogspot.com/2011/09/pills-are-for-illnesses.html" target="_blank">this one</a> refers to over use of medication for treatment of sleep irregularities. (if you want to see more of my past posts on sleep, use the search box on the Health Educator blogsite - on the right)</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"></span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I bring the posts up because this <a href="http://news.yahoo.com/common-sleeping-pills-linked-higher-death-risk-233312713.html" target="_blank">popular press article</a> discusses some recent research that identifies the high risk of mortality (death) related to the use of some of the popular sleep medications.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">One of the things I consider myself blessed to have is good sleep.  I only have trouble falling or staying asleep</span></span><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"> on the rarest of occasion</span></span><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">.  I attribute my sleep consistency to sleep hygiene - same time to bed and wake each day- daily exercise and good nutrition (every day).  </span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">When I was completing my first semester of the doctorate program I did have a real sleep scare.  I NEVER thought of treating it with a pill, but I can promise you, a doctor would have offered me one in about two seconds.  It was hard - but I worked through it - I knew it was stress. I did a lot of self talk - trying not to give into it.  I was very fearful of letting an acute 'crisis'  become a chronic condition.  Again - I do not take my good sleep for granted.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">There are true sleep disorders that require medical treatment - the thing is - most people getting that treatment don't have those disorders! </span></span>

To Sleep

I have written several posts that mention sleep.  This one talks about sleep needs as we age and this one refers to over use of medication...

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Working with WOAR to Educate Teens on Safety in Sexual Health

<div style="text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBlnQCAUHpUOrC08PLY5-BlX06dSNGH5bMAVEEPkCBTxgKNz0426W481OaTD6mTSa6kKTLMSOVrIF75wwvvKtQZf1Gb8ZHGHDUnttCaW3S7VsKoN2nlIOiifBlVpBYQyrcY_TtuU_c-EPy/s1600/JenLee2012.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBlnQCAUHpUOrC08PLY5-BlX06dSNGH5bMAVEEPkCBTxgKNz0426W481OaTD6mTSa6kKTLMSOVrIF75wwvvKtQZf1Gb8ZHGHDUnttCaW3S7VsKoN2nlIOiifBlVpBYQyrcY_TtuU_c-EPy/s200/JenLee2012.jpg" width="160" /></a></div><span style="font-family: Arial, Helvetica, sans-serif;"><strong><em>WHEP ELECTIVE: Women’s Health in the Community </em></strong></span></div><div style="text-align: left;"><span style="font-family: Arial, Helvetica, sans-serif;">For my Women’s Health in the Community elective, I reached out to the organization Women Organized Against Rape (WOAR). WOAR provides counseling services, advocacy for victims of sexual violence, and educational programs to stop sexual and domestic violence and bullying. As a future gynecologist, I am aware of the dangers of intimate partner violence and sexual assault, and I wanted to better educate myself on the topic. </span></div><div style="text-align: left;"><br /></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; text-align: left;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhukodsAE32ehoph_5zeaiFi3LJWkwQN1G0dYIAEIlZIQKABeonnxqCY8HsspjkNNn6BcbZqOaLz50R4ac7cRcpToxbfrolyk6djC4qFtZveyaP4DTtmaHmkqR4YJi-f8bsbevPaMhhUyl7/s1600/teresawhitewoarteaching.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhukodsAE32ehoph_5zeaiFi3LJWkwQN1G0dYIAEIlZIQKABeonnxqCY8HsspjkNNn6BcbZqOaLz50R4ac7cRcpToxbfrolyk6djC4qFtZveyaP4DTtmaHmkqR4YJi-f8bsbevPaMhhUyl7/s1600/teresawhitewoarteaching.jpg" /></a><span style="font-family: Arial, Helvetica, sans-serif;">Once I got in touch with Teresa White-Walston, Director of Educational Services, we discussed WOAR’s educational programs and how I could contribute. Teresa works closely with local schools, teaching teens about bullying, self-esteem and character building. She saw the need for sexual health education for her students, as many of them become involved in sexual activity before they are ready and, often, are misinformed by their peers on the topic. </span></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><span style="font-family: Arial, Helvetica, sans-serif;">I developed a lecture geared toward middle school girls where I covered basic female reproductive anatomy, facts about teen sexual activity, sexually transmitted illnesses (STI) risks and the realities of teen pregnancy. Researching, alone, for this presentation was an eye-opening experience! Here are some interesting facts that stood out to me (AND my students):</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">-43% of teenage girls and 42% of teenage boy have had sexual intercourse, but only 33% are currently sexually active <span style="font-size: x-small;"><strong>(CDC Youth Risk Behavior Survey)</strong></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">-15-24 year olds account for only 25% of the sexually active population in US, but are nearly 50% of all new STI’s diagnosed annually <strong><span style="font-size: x-small;"><em>(CDC)</em></span></strong></span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">-In 2009, more than 400,000 girls aged 15-19 years old gave birth <strong><span style="font-size: x-small;"><em>(CDC)</em></span></strong></span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">-50% of teen moms have a high school diploma by age 22, compared to 90% of teenage girls who don’t give birth <strong><span style="font-size: x-small;"><em>(CDC)</em></span></strong></span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">As I gave my lecture to classrooms of curious 6th, 7th, and 8th graders, I could see that many of the things I taught were completely new to them. First of all, most of the girls had no idea what body parts they had or what their proper names are. Secondly, my students were surprised to see that only 33% of teens are sexually active. Based on the media and schoolyard gossip, they thought the number was closer to 80 or 90-percent! I’m glad I could show them otherwise. The information I gave the students about STI’s seemed to hit the kids from left field. Sure, they’ve heard of HIV and how bad it is. But they didn’t know about all of the other STI’s or how many people have them. I shocked many when I informed them that some sexually-transmitted infections are life-long and could have serious consequences like cancer and infertility. As for the pregnancy part of the lecture, it seemed like each of the students knew someone who got pregnant and gave birth before she was ready. I ended each lecture with a discussion on the magnitude of engaging in sexual activity, the importance of waiting until one is ready, and what a responsible teenager should do when she is. </span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1_80UigkmSW_xh35ixONlhn6poHW93dvJxHhZA8gbWSZa7PVFFuu-fDNhoiTYw5uNm2q1Mt6IQ67IvlP-uaRVJawSiiinYwpEV1QYF2p_FP7mxpCuyW-J3ykbJAjKNGG53KQy2T2DsE6x/s1600/morehopehealtheduc.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" height="240" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1_80UigkmSW_xh35ixONlhn6poHW93dvJxHhZA8gbWSZa7PVFFuu-fDNhoiTYw5uNm2q1Mt6IQ67IvlP-uaRVJawSiiinYwpEV1QYF2p_FP7mxpCuyW-J3ykbJAjKNGG53KQy2T2DsE6x/s320/morehopehealtheduc.jpg" width="320" /></span></a></div><span style="font-family: Arial, Helvetica, sans-serif;">I hope the information I gave these girls empowered them to stand up against peer pressure and wait until they are truly ready and fully educated to be sexually active, as there are many consequences to consider and protect against. I hope I prepared them with a good foundation on reproductive health and safety. In the end, it is each girl’s responsibility to protect herself, and I hope these girls rise to the challenge to take care of her health and future. </span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Teresa was terrific. In addition to teaching, she took the time to give me some training for crisis counseling. We discussed the issues surrounding sexual and domestic violence and how to empower victims. She even took me to the Philadelphia Sexual Assault Response Center, so that I could see where a rape victim is treated and what she must go through. </span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Unfortunately, my time with WOAR has come to an end. However, Teresa and the schools I visited would love to have more Drexel students come through and do similar work to what I had been doing. As medical students, we offer more medical information than Teresa and her volunteers can give to their students, and there is a great need for strong role models at these schools. Please consider working with WOAR either through a Women’s Health elective or as a volunteer. You will be able to reach out to many young girls who need your expertise, and you will probably learn a few things along the way as well. If you are interested, email WHEP at mnickens@drexelmed.edu. To learn more about WOAR, check out their website: </span><a href="http://www.woar.org/"><span style="font-family: Arial, Helvetica, sans-serif;">www.woar.org</span></a><span style="font-family: Arial, Helvetica, sans-serif;">. </span><br /><br /><div style="text-align: center;"><span style="font-family: Arial, Helvetica, sans-serif;">Submitted by Jennifer Lee, Class of 2012</span></div></div>

Working with WOAR to Educate Teens on Safety in Sexual Health

WHEP ELECTIVE: Women’s Health in the Community For my Women’s Health in the Community elective, I reached out to the organization Women Orga...

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Odds and Ends

<div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">This week's version is going to have to be a literal one liner - it is mid term project and exam week and my brain is literally about to implode... oh, ok - obviously - not literally... but I may be gone for a few days....</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><u>Prescribing Exercise</u> -  I am really delegating this one.  One of my newsletters had an intriguing headline - doctors are telling patients to exercise!  That is great news.  I kept the article in my queue all week but never had the time to read it.  I will pass it on to you. <a href="https://www.webmdhealth.com/nl/nlv.aspx?id=gbd7mxQhlSc=&s=11970" target="_blank">Read Me</a>.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><u>Weight Watchers Gains Another</u> - One of my professors told me <i>he</i> joined Weight Watchers - and I bet you know what I said...... "THAT is AWESOME!"  Followed by, WW is the only program that I have ever endorsed and that is because it teaches lifetime habits - not 'diets.'</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><u>Heart Attack</u> - Women - We die from heart attacks more than men.  It may be related to the symptoms that both women and physicians miss.  Watch the CBS news video <a href="http://www.cbsnews.com/8301-505269_162-57382498/women-and-heart-attacks-what-you-need-to-know/" target="_blank">here.</a></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><u>My Ice Cream </u>- Earlier this year, oh wait - late last year, I told you about a Blue Bunny ice cream that was sugar free with half the fat of regular ice cream.  Not all Blue Bunny but some types of it meet this criteria.  This week I noticed a change in the package.  It now says Sweet Freedom AND comes with some FOP labeling.  Listed on the front are calories, total fat grams and carbs.  Well - one out of 4 ain't bad.  The recommendations from the IOM were saturated fat grams, total calories or calories per RACC (i.e. 1/2 cup), sodium and sugar.  The IOM also said not to add the % DV.  This label had that as well.  It did not tell how many grams per serving or the household serving size that this info pertained to.  Still - I find the ice cream yummy.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><u>Store Labels </u>- On another shopping trip, I noticed that the grocer had put some FOP labeling on its packages of shredded cheese - store brand.  Again, they are not using the standard or the info that has been recommended by the IOM.  I truly hope the FDA gets on top of this.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><u>Database updated</u> - The USDA nutrient database that I have referred you to in the past, has been upgraded.  You can visit it <a href="http://ndb.nal.usda.gov/" target="_blank">here</a>.  First click on the start your search here line and then put in the name of a food, like I just did - KALE  - It will come back with some options, like - cooked, raw, frozen, salt, no salt...etc and it will tell you the nutrient info, including calories.  SO the kale I made today - oh my goodness it was yummy.  I simmered it with garlic powder and a bouillon cube.  It isn't always yummy, but this batch was the best - it was only this good once before and I didn't make it that time.  My sister says that it has to do with when it was picked.  When I bought it - today - the tag said, fresh - local.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"><br /></span></div><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">HA HA HA _ I said these would be one liners..... I am going to fail my classes......</span></span>

Odds and Ends

This week's version is going to have to be a literal one liner - it is mid term project and exam week and my brain is literally about to...

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Choices determined by Chances

<div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">Cockerham, W. C., Rütten, A., & Abel, T. (1997). CONCEPTUALIZING CONTEMPORARY HEALTH LIFESTYLES. <i>Sociological Quarterly, 38</i>(2), 321-342.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><br /></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">Older article - important words... all taken directly from the text as follows:  </span></div><blockquote class="tr_bq" style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"> We would therefore suggest the following definition of health lifestyles: collective patterns<br />of health-related behavior based on choices from options available to people according to<br />their life chances. These life chances include age, gender, race, ethnicity, and other relevant<br />variables that impact on lifestyle choices. The behaviors generated from these choices can<br />have either positive or negative consequences on body and mind but nonetheless form an<br />overall pattern of health practices that constitute a lifestyle. We further suggest that this definition<br />provides an initial theoretical statement of a health lifestyle. It incorporates the interplay<br />of choice and chance along Weberian lines but omits the requirement that choices are voluntary. We would add that adoption of a health lifestyle gives the individual a strategy that serves as an anchor in coping with health risks in an evolving postmodem environment. Contrary to Weber, we assign priority to chance over choice, although choice remains a central factor in lifestyle selection. Bourdieu’s assertion that structure determines the perceptual<br />boundaries underlying choice is persuasive.</span></blockquote><span style="font-size: large;"> <span style="font-family: "Trebuchet MS",sans-serif;">Noting in my words, we do not have equal chances and therefore we do not have the same choices.. </span></span>

Choices determined by Chances

Cockerham, W. C., Rütten, A., & Abel, T. (1997). CONCEPTUALIZING CONTEMPORARY HEALTH LIFESTYLES. Sociological Quarterly, 38 (2), 321-342...

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Not the juice, not the pill - it is the FRUIT

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Let me get ahead of the marketing blitz and save you from making a wrong decision.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">A study that was reported in the news yesterday and published in the American Heart and Stroke Associations' Journal - <i>Stroke</i>- found that those who ate more oranges and grapefruits - or citrus - had lower incidence/risk of</span></span><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"> clot related strokes.  (the study summary can be read <a href="http://stroke.ahajournals.org/content/early/2012/02/23/STROKEAHA.111.637835.abstract?sid=d4b373d7-3016-406f-861e-f8ebf0910477" target="_blank">here</a>)</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">This positive outcomes are related to consumption of the fruit itself.  </span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">This is not an affirmation of any type of supplementation.  If you see an advertisement for a vitamin or food product which states that 'studies show flavanoids reduce stroke risk' - it does NOT mean that the product they are trying to sell you will do anything for your health.  The study was NOT about pills or extracted chemicals.  </span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Also - the scientists suggest that we avoid juices because of the high sugar content and the risk of diabetes associated with them.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The point is that something about the chemical properties of vitamin C in the actual fruits is health promoting.  No other association should be made.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Good news -  oranges are far cheaper than juices or supplements - especially if you have an orange or grapefruit tree in your backyard!</span></span><br /><br />(note about strokes - there are two types, one occurs when a clot forms and stops oxygen flow the other is when there is bleeding or hemorrhaging - from a blood vessel.  The results of this study were about clot related strokes)

Not the juice, not the pill - it is the FRUIT

Let me get ahead of the marketing blitz and save you from making a wrong decision. A study that was reported in the news yesterday and publi...

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NO HITTING!! February is Teen Dating and Violence Awareness and Prevention Month

<span style="font-family: Arial, Helvetica, sans-serif;">A number of our terrific seniors are engaged in teen health activities this month, Sonia on teen attitudes on sources of sexual health information, Jen and Rita on interactive strategies to raise awareness and knowledge about core health education important for youth, Patti Jo on college health issues.</span><br /><br /><div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBgttIH7DQ3DHqY3fiU8DEo_zcYgJnOxbxo2d6qGIWmEFEj8QgS0rk0JwqznrhstMpmdxcYjeCJNyAwK69J8siJ9T6wpPTqlyHMrhih91P4r3LhyphenhyphenSaxhMjkMs79boYz1NxQ-O1df-l5NRA/s1600/no_hitting.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBgttIH7DQ3DHqY3fiU8DEo_zcYgJnOxbxo2d6qGIWmEFEj8QgS0rk0JwqznrhstMpmdxcYjeCJNyAwK69J8siJ9T6wpPTqlyHMrhih91P4r3LhyphenhyphenSaxhMjkMs79boYz1NxQ-O1df-l5NRA/s200/no_hitting.jpg" width="200" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="font-family: Arial;">During our group discussion, Rita mentioned the unhealthy trend of Date Fighting and it's association with relationship violence. (e.g. a young man grabbing a girl's wrist and punching her in the arm). Many of you may have seen youth 'horsing around' - punching each other or grabbing someone. This may seem innocuous, but the rates of interpersonal violence tell us another story. The inability to address anger and frustration or have role models who show how to do so in a healthy fashion;  the role of trauma as an layer that confounds health all contribute </span><span style="font-family: Arial, Helvetica, sans-serif;">to interpersonal violence. Clinicians play a pivotal role in talking with youth and highlighting that they have different options. </span></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br /></div><span style="font-family: Arial, Helvetica, sans-serif;">Here's the AAP's policy statement about the role of the Pediatrician in Youth Violence </span><br /><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="font-family: Arial, Helvetica, sans-serif;">Prevention </span><a href="http://www.clemson.edu/olweus/aap.pdf"><span style="font-family: Arial, Helvetica, sans-serif;">http://www.clemson.edu/olweus/aap.pdf</span></a><span style="font-family: Arial, Helvetica, sans-serif;"> and here's ACOG's Tool Kit for Teen Care </span><a href="http://www.acog.org/~/media/Departments/Adolescent%20Health%20Care/Teen%20Care%20Tool%20Kit/AdolQuestREVISED-2009.pdf?dmc=1&ts=20120224T1420412782"><span style="font-family: Arial, Helvetica, sans-serif;">Tool Kit for Teen Care ACOG 2009</span></a><span style="font-family: Arial, Helvetica, sans-serif;"> </span></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br /></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><span style="font-family: Arial, Helvetica, sans-serif;">There was another article of interest that I came across - <em>Attitudes Affecting Physical Dating Violence Perpetration and Victimization: Findings From Adolescents in a High-Risk Urban Community  </em> Ali, Bina; Swahn, Monica; Hamburger, Merle. Violence and Victims26. 5 (2011): 669-83.  This article discussed factors in adolescent hitting and dating violence behavior across gender difference lines. Boys and girls hit, maybe for different reasons. The support of their friends associated with behavior, among other items was associated with interpersonal / dating violence. There are number of interesting risk factors they found. One that I found interesting was that they found the lack of self-efficacy and illicit drug use were unique important factors associated with physical dating violence perpetration for girls only.</span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" height="134" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjiX_Wpmj7rEFOS1Hvoixy1fj63pFJI495jO-e3_MrDMJni_1l4Dl1N07-khDkFTDOU5VuS89QWbTJWUkHM1bC8I6_hv4uiNjfKNwE4OJFOv1U9AoQTCXudabHLhICdLQrW1qXCdMpw3D-6/s320/jinterpersonalviolence.png" width="320" /></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: Arial, Helvetica, sans-serif;">Violence prevention is a health issue - as clinician's we need to develop our antennaes and help young women and men to heal from trauma and to be able to lead healthier lives.</span></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_uEapC5fmQno8iAjtA9mbzF2RXJPRpWPs_6lxQWi_mMFyeau2Y0JKhtM2axwdYeX3ydIIqY276su_Cer9ey-e2_uRC5OUrEP1vmcD2enJVV_oFFCY40iZ0UKLRs32OrchB3e5CvYQZGt-/s1600/thatsnotcool.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="180" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj_uEapC5fmQno8iAjtA9mbzF2RXJPRpWPs_6lxQWi_mMFyeau2Y0JKhtM2axwdYeX3ydIIqY276su_Cer9ey-e2_uRC5OUrEP1vmcD2enJVV_oFFCY40iZ0UKLRs32OrchB3e5CvYQZGt-/s320/thatsnotcool.png" width="320" /></a></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: Arial, Helvetica, sans-serif;">That’s Not Cool.com, is a national public education campaign that uses digital examples of controlling, pressuring, and threatening behavior to raise awareness about and prevent teen dating abuse. OVW also funds the National Dating Abuse Helpline at 1-866-331-9474. Teens can also text “loveis” to 77054 to reach an advocate or chat on line by clicking on the icon found on </span><a href="http://loveisrespect.org/"><span style="font-family: Arial, Helvetica, sans-serif;">loveisrespect.org</span></a><span style="font-family: Arial, Helvetica, sans-serif;">.</span></div>

NO HITTING!! February is Teen Dating and Violence Awareness and Prevention Month

A number of our terrific seniors are engaged in teen health activities this month, Sonia on teen attitudes on sources of sexual health infor...

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Invisibility and Lesbian Health

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTr5j2Cf-A4frE2kG1thtGmkYMGCYaNxiEoriuAyOTtmIP8c_XcnIhxp3-dB69I2EX5bTHXlgJwEEMeo_KR8lFWVYOu4iiuKKRvgV7o0FPB-wUU3GSHAwPYJXpMuQdTVRCrz5NvoSbxWry/s1600/fitall1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="150" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTr5j2Cf-A4frE2kG1thtGmkYMGCYaNxiEoriuAyOTtmIP8c_XcnIhxp3-dB69I2EX5bTHXlgJwEEMeo_KR8lFWVYOu4iiuKKRvgV7o0FPB-wUU3GSHAwPYJXpMuQdTVRCrz5NvoSbxWry/s320/fitall1.jpg" width="320" /></a></div><span style="font-family: Arial, Helvetica, sans-serif;">One size does not fit all. Even when we evaluate trends within a given group, we need to deduce what are the individual traits of the person in front of us and what are the population trends that we need to be aware of when assessing support structures, risk and treatment options.</span><br /> <br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRz1QUBBXN76ktSAaL_ZZrt5kOGyadYOJfYyuQh7InzfRFCMjcI4w6sLgUqDdOeSZnGVJ0P8kH5FT7bG_N1NDslJBIOC_NgOYNGv6rj7A72t3nSXc_71YBAjwNmzmupgrtiNK29P_UPTu-/s1600/jfosterpride.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="200" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRz1QUBBXN76ktSAaL_ZZrt5kOGyadYOJfYyuQh7InzfRFCMjcI4w6sLgUqDdOeSZnGVJ0P8kH5FT7bG_N1NDslJBIOC_NgOYNGv6rj7A72t3nSXc_71YBAjwNmzmupgrtiNK29P_UPTu-/s200/jfosterpride.jpg" width="132" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Littlest Pride J.Foster 2008</td></tr></tbody></table> <span style="font-family: Arial, Helvetica, sans-serif;">Lesbian women, similarly do not fit any one socioeconomic class, ethnicity or educational status. They are young and old; majority and minority; affluent and poor. Although media images of Lesbians may portray stereotypic images of androgenous women (and some are), others are not. So, you can't just 'tell by looking at her.' Rather you need to create a safe clinical space to enable her to tell you about herself and who is important to her and her life.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Lesbian's health risks can differ from heterosexual women. </span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Would you ever ask a heterosexual woman when she 'came out' as heterosexual? </span><br /><span style="font-family: Arial, Helvetica, sans-serif;">Sexual minorities have barriers to health. </span><span style="font-family: Arial, Helvetica, sans-serif;">These include: discrimination, presumed heterosexism, lack of inclusivity in environment/language/forms. </span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhum4Qz74Ii0GqZOsctF16gDfDi_NUYz4xyzCckpkR7bnIWvTQfVXb2aiUJI9vswm7MnBLf7AQ7W6_5AqnqJDSRjeO9qaN2RdgI4ch5oQQEGtHmCWCz5arQShQIA7SaivzB6tbQhefTtRbK/s1600/stethoscope1.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="100" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhum4Qz74Ii0GqZOsctF16gDfDi_NUYz4xyzCckpkR7bnIWvTQfVXb2aiUJI9vswm7MnBLf7AQ7W6_5AqnqJDSRjeO9qaN2RdgI4ch5oQQEGtHmCWCz5arQShQIA7SaivzB6tbQhefTtRbK/s200/stethoscope1.jpg" width="200" /></a></div><span style="font-family: Arial, Helvetica, sans-serif;"><strong>ENVIRONMENT</strong> </span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><em>FORMS</em> When a Lesbian woman sits in a waiting room, surrounded by images of happy (heterosexual) couples, the visual impact is not inclusive. When her first visit form gives her the option of "Single"; "Married"; "Divorced" "Widowed."What are her choices? She can leave it blank (and be treated as single, even if this is not accurate.) She can check off married as she has been in a monogamous relationship for 20 years. More likely than not, if she opts for the latter, the health care provider in their perusal of the form will say: <em>"So what does your husband do?"</em> So now - she comes out and risks a distancing response by the clinician or she is forced to create a story that colludes with presumed heterosexuality. Creating a condition that forces lack of authenticate communication is not the best start to a clinical relationship.</span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjixmcEuOH137n1bB_xJQ0nXXc0nv7hJOyK5LgH2JJHxiNO_sJ3zN5icPcSHHffGELCKtznwXX9_DGGzWvywbxuY7UH6w886-iu8ALY5vdP6ggcyITnA8g9-DxHNAByrafH9wCXNN8F8Ehc/s1600/barrier.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="181" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjixmcEuOH137n1bB_xJQ0nXXc0nv7hJOyK5LgH2JJHxiNO_sJ3zN5icPcSHHffGELCKtznwXX9_DGGzWvywbxuY7UH6w886-iu8ALY5vdP6ggcyITnA8g9-DxHNAByrafH9wCXNN8F8Ehc/s200/barrier.jpg" width="200" /></a></div><span style="font-family: Arial, Helvetica, sans-serif;">MORE THAN YOU So you may be saying that you are hip to inclusive language (<em>who helps you? who all lives at home with you? Who do I need to include in your care and what connection are they to you?)</em> But it is more than you. You may terrific, warm, sensitive and inclusive - but they have to get to you. So part of being a responsible clinician is being responsible for oversight of your environment. Snickers or disrespectful treatment of patients by staff have to be addressed and potentially in-service/staff trainings on quality care delivery need to include LGBT issues.</span><br /><strong><span style="font-family: Arial, Helvetica, sans-serif;">MISPERCEPTION OF RISKS BY PATIENTS AND CLINICIANS</span></strong><br /><span style="font-family: Arial, Helvetica, sans-serif;"><em>PATIENT CENTERED</em> Lesbian women may not be accurate in assessing their health risks. For example, despite statistics that most lesbian women (2/3-3/4) have had sexual intercourse with men (and therefore have similar risks to heterosexual women.) Many Lesbians feel that they have minimal risk for STIs and for screening studies. Thus, they don't come into care for regular preventive visits.</span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYPmXTnHJ45Fj7H1DHwOGyW16hX1emnjhmGrzVnb3XNjaPg1u0f7jV-z1ksPMKEQL4tTmmkOfJ2zBMgBP77AL19Npl5SNS5uqJEr1XU4ZvhL2eIWZEzZ8S-CVbCuYsG8h3hlrw51hKqc6V/s1600/trainstationperspectivejfwinter2011.JPG" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="149" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYPmXTnHJ45Fj7H1DHwOGyW16hX1emnjhmGrzVnb3XNjaPg1u0f7jV-z1ksPMKEQL4tTmmkOfJ2zBMgBP77AL19Npl5SNS5uqJEr1XU4ZvhL2eIWZEzZ8S-CVbCuYsG8h3hlrw51hKqc6V/s200/trainstationperspectivejfwinter2011.JPG" width="200" /></a></div><span style="font-family: Arial, Helvetica, sans-serif;"><em>INVISIBILITY </em>Clinicians might 'miss' risks if they don't know that the woman is a Lesbian. Unclear many other minorities with whom the visual at least generates a question, Lesbian women look like heterosexual women. Additionally, they may feel that it is none of our business (their sexuality) and not include it in their health information. Assessing a support structure is essential when dealing with health issues (who will take to the test? who else should be in the room to hear this in order to reinforce/ decode/support you?)  Thus understanding the context of a patient's world and who they are and identify as is important if our goal is excellent care for all.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><em>SPECIFIC HEALTH CONDITIONS AT HIGHER RISK</em> Health specific conditions of note include cancer, cardiovascular disease (as a result of suboptimal weight and smoking), delay in health screening, <span style="mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Breast cancer (both from higher risk factors and fewer screenings), depression, anxiety, smoking, heart disease, uterine cancer, obesity (and therefore obesity related cardiovascular disease), alcohol abuse  </span>They may be at higher risk of unabated estrogen related cancers if they are nulliparous (uterine, breast, etc.)</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><em>SEXUAL HEALTH PRINCIPLES</em> Remember that there are three important domains to consider when understanding sexual health: orientation, identity and behavior. Orientation: to whom do I gravitate to/ sexual attracted to; Identity: who do I say I identify as; Behavior: what exactly do I do and with whom. We've discussed how these three elements are not concordant (a patient - can have an orientation but not identify as such;can have an identity but not have concordant behavior; can have a behavior but not feel that this relates to identity) There is an arcane term of sexual preference which many people in the non-health arena inaccurately use interchangebly or substitute for orientation. Orientation of sexuality for all people (and creatures) has an neural basis, so it is the preferred medical description. Preference implies that behavior is rather capricious (e.g. <em>I'd like strawberry ice cream, no, vanilla.) </em>We are all socialized in a heterosexual environment. I have yet to meet a person who wants to have discrimination or barriers. </span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjVvA4KhW_8WFSwVsXs1HcCPedFQP8Q28ltpoPaimWGjjsw5iSw6tQtgefCNXBTOnWqit-AF9R3Ri4egiWVani85WaSRiMKTDxdzQv8OnnMdSFbzhx3KEAsu8ELLg1bHZlfmE9cb6icuKG/s1600/washhand.bmp" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="185" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjVvA4KhW_8WFSwVsXs1HcCPedFQP8Q28ltpoPaimWGjjsw5iSw6tQtgefCNXBTOnWqit-AF9R3Ri4egiWVani85WaSRiMKTDxdzQv8OnnMdSFbzhx3KEAsu8ELLg1bHZlfmE9cb6icuKG/s200/washhand.bmp" width="200" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEib3ZEUlyn7m-DdVLRPyMsFljnOSmBo3aUwgKvRdVrP7lfpzGdiyTe5CTBNGeLUATwPPL4Tg7w0xBGhktEKZG3TAcBt7gRHA_vfuPtDni91UDjPBWFA4kkPT-AM5lSX2Pw-LenwW27U9BP7/s1600/dirtyhand.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="101" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEib3ZEUlyn7m-DdVLRPyMsFljnOSmBo3aUwgKvRdVrP7lfpzGdiyTe5CTBNGeLUATwPPL4Tg7w0xBGhktEKZG3TAcBt7gRHA_vfuPtDni91UDjPBWFA4kkPT-AM5lSX2Pw-LenwW27U9BP7/s200/dirtyhand.jpg" width="200" /></a></div><span style="font-family: Arial, Helvetica, sans-serif;"><em>QUICK SAFE SEX TIPS:</em> HPV is a STI (as well as Chlamydia) that is found among women who have sex with women. So first, we need to advise women to wash up (as is true actually with everyone!). Hand washing is important in safe sex. Cleaning sex toys or using condoms and/or dental dams is also important. Lastly, getting regular health maintanence visits to be promote wellness is important. There are a number of resources for Lesbians to identify high quality respectful clinicians. Some cities have Rainbow Health Pages; resources can also be found on the Internet. There are national groups that promote Lesbian Health like our friends at </span><a href="http://www.lesbianhealthinfo.org/index.html"><span style="font-family: Arial, Helvetica, sans-serif;">UCSF Lesbian Health & Research Center</span></a><br /><br /><span style="font-family: Arial, Helvetica, sans-serif;">Updating our discussion on health issues for women who are lesbians, here's some additional resources.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;">JAMA September article mentioned - across the U.S. in med schools the coverage is low and variable in nature. </span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnMV-IdzpTdLLbAIk4BWq3jWbhHIMP9hXb6tlLw_pOpYlKt73-Q5h4kuRFUzmgSgD_BdkXwrP_oN2W0BoJ2AIP4bxa6gzX9f8dEXp6l3fv85zZdcePsg_8V1aOZ6P4h4SGzbdp_l3dQFSI/s1600/lgbtmededucjamasep2011.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" dda="true" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnMV-IdzpTdLLbAIk4BWq3jWbhHIMP9hXb6tlLw_pOpYlKt73-Q5h4kuRFUzmgSgD_BdkXwrP_oN2W0BoJ2AIP4bxa6gzX9f8dEXp6l3fv85zZdcePsg_8V1aOZ6P4h4SGzbdp_l3dQFSI/s640/lgbtmededucjamasep2011.jpg" width="579" /></span></a></div><div align="left" class="separator" style="clear: both; text-align: center;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhyphenhyphenBQZbZWlP3KTRBE6Z1QR6fdIyv69tFlDsAkpk2E9ubmQ2C34rjqbIqLPgs2-6N-y2J-WtWq0l9BErJoXEssij61AK_XaIme9N-_Z1W_00sAN_15leUfNzsD1-vK3qYc_ioQadn4LX4TJ/s1600/lgbtiom2011.gif" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" dda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhyphenhyphenBQZbZWlP3KTRBE6Z1QR6fdIyv69tFlDsAkpk2E9ubmQ2C34rjqbIqLPgs2-6N-y2J-WtWq0l9BErJoXEssij61AK_XaIme9N-_Z1W_00sAN_15leUfNzsD1-vK3qYc_ioQadn4LX4TJ/s1600/lgbtiom2011.gif" /></span></a><span style="font-family: Arial, Helvetica, sans-serif;">The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding Institute of Medicine 2011 Report available </span><a href="http://www.iom.edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx"><span style="font-family: Arial, Helvetica, sans-serif;">here</span></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3lFKumZP4x3AbLZYpsKYdCj6yhEuDaVfB48e5bAeO2zB4VwD3jc8OGuM_PAWlOIDNSNIdEliCZpxbr0u5fDjbP3f3DqPcA3iLCyvFt5FZQPOL5ydzUw-CkHkijz5rffLLtOU3RejJ2C_3/s1600/lesbianhealthiom2003.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><span style="font-family: Arial, Helvetica, sans-serif;"><img border="0" dda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3lFKumZP4x3AbLZYpsKYdCj6yhEuDaVfB48e5bAeO2zB4VwD3jc8OGuM_PAWlOIDNSNIdEliCZpxbr0u5fDjbP3f3DqPcA3iLCyvFt5FZQPOL5ydzUw-CkHkijz5rffLLtOU3RejJ2C_3/s1600/lesbianhealthiom2003.gif" /></span></a></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: Arial, Helvetica, sans-serif;">and the previous Lesbian Health IOM Report available </span><a href="http://www.iom.edu/Reports/2003/Lesbian-Health-Current-Assessment-and-Directions-for-the-Future.aspx"><span style="font-family: Arial, Helvetica, sans-serif;">here</span></a><span style="font-family: Arial, Helvetica, sans-serif;">  </span><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: x-small;"><span style="color: #cc00cc; language: en-US; mso-ascii-font-family: Georgia; mso-bidi-font-family: +mj-cs; mso-fareast-font-family: +mj-ea;"><span style="color: black;">Is Body Image Protected in Lesbian Relationships?  Romantic Relationships and Body Image - Lesbian women are not 'protected' by body image issues by being in a relationship and are influenced by their self-perception; their perception of their partner and their partner's actual opinion of their body (image) </span></span><span style="color: black; language: en-US; mso-ascii-font-family: Arial; mso-bidi-font-family: +mj-cs; mso-color-index: 3; mso-fareast-font-family: +mj-ea;">(Markey, Markey, & Birch, 2004; Markey & Markey, 2006) </span></span><span style="font-size: x-small;"><span style="color: black; language: en-US; mso-ascii-font-family: Arial; mso-bidi-font-family: +mj-cs; mso-color-index: 3; mso-fareast-font-family: +mj-ea;">and Markey, P. M. & Markey, C. N. (2011). The complementarity of behavioral styles among lesbian couples. Manuscript under review</span></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span><br /><span style="color: black; font-family: Arial, Helvetica, sans-serif; font-size: x-small; language: en-US; mso-ascii-font-family: Arial; mso-bidi-font-family: +mj-cs; mso-color-index: 3; mso-fareast-font-family: +mj-ea;"><strong><em>Other web resources:</em></strong></span><br /><span style="color: black; language: en-US; mso-ascii-font-family: Arial; mso-bidi-font-family: +mj-cs; mso-color-index: 3; mso-fareast-font-family: +mj-ea;"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Gay and Lesbian Medical Association: </span><a href="http://www.glma.org/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.glma.org/</span></a></span><br /><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Gay Mens Health Crisis (GMHC): </span><a href="http://www.gmhc.org/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.gmhc.org/</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">CDC Gay and Bisexual Mens Health: </span><a href="http://www.cdc.gov/msmhealth/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.cdc.gov/msmhealth/</span></a><a href="http://www.cdc.gov/msmhealth/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.cdc.gov/msmhealth/</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Lesbian Health and Research Center (UCSF): </span><a href="http://www.lesbianhealthinfo.org/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.lesbianhealthinfo.org/</span></a><a href="http://www.lesbianhealthinfo.org/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.lesbianhealthinfo.org/</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">LGBT Aging Project </span><a href="http://www.lgbtagingproject.org/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.lgbtagingproject.org/</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Lesbian and Bisexual Women’s Health Fact sheets (DHHS): </span><a href="http://www.womenshealth.gov/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.womenshealth.gov/</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">American Public Health Association LGBT Initiatives (APHA): </span><a href="http://www.apha.org/about/Public+Health+Links/LinksGayandLesbianHealth.htm"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.apha.org/about/Public+Health+Links/LinksGayandLesbianHealth.htm</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Gay and Lesbian Advocates and Defenders  </span><a href="http://www.glad.org/"><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">http://www.glad.org/</span></a><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">  New England Legal Advocates (lists laws and topics by state)</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Makadon H. Improving health care for the lesbian and gay communities. New England Journal of Medicine 2006, Vol. 354 (No. 9), pp. 895-7. </span><br /><span style="font-family: Arial, Helvetica, sans-serif;"> </span><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Coker TR, Austin SB, Schuster MA. The health and health care of lesbian, gay, and bisexual adolescents. Annual Review of Public Health 2010. Vol. 31. pp 457-77.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Coren JS, Coren CM, Pagliaro N, Weiss LB. Assessing your office for care of lesbian, gay, bisexual, and transgender patients. Health Care Manager 2011. Vol 30 (No. 1), pp 66-70.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Dowshen N, Garafalo R. Optimizing primary care for LGBTQ youth. Contemporary Pediatrics, October 2009, pp. 58-65.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Kann L, Olsen EO, McManus T et al. Sexual Identity, Sex of Sexual Contact, Health-Risk Behaviors Among Students Grades 9-12 – Youth Risk Behavior Surveillance, Selected Sites, United States, 2001-2009. MMWR, June 10, 2011, Vol 60, No. 7.</span><br /><span style="font-family: Arial, Helvetica, sans-serif;"><br /><span style="font-size: x-small;"></span></span><br /><span style="font-family: Arial, Helvetica, sans-serif; font-size: x-small;">Katz K. Health Hazards of “Don’t Ask, Don’t Tell”. New England Journal of Medicine 2010. Vol 363 (No. 12), pp 2380-1.</span>

Invisibility and Lesbian Health

One size does not fit all. Even when we evaluate trends within a given group, we need to deduce what are the individual traits of the person...

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Placebo Effect is NOT Harmless

<div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">A placebo, by its very nature, is supposed to be a non substance, a non issue, a non treatment.  It is something given to people so they think they are getting a special program or medication.  This is not necessarily to trick them into being well, but for scientists to trick themselves.  One group gets the real thing and the other gets 'no thing' and researchers collect information on the two groups sometime later.  Next, a person who has no idea which person got the real thing analyzes the data to see if the two groups have the same outcome - i.e score on a test, weight or change in health condition.  The best studies are double blind - no one(participant or scientist) knows who got the real thing until the end.  </span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">The placebo effect is when someone gets better without the treatment.  It should be harmless right?  Even a good thing - you got nothing and yet you are well - YIPPEE.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><br /></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">That is not the case with the story aired on 60 Minutes this past Sunday.  It regards the lack of effectiveness of antidepressant medications.  The people may be improving but NOT because of the pills.  Sort of a reverse placebo effect, except the pills are, in many instances, toxic.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><br /></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">Nearly 11% of Americans age 12 and up take antidepressant medication and maybe half of them take them without just cause.  See the National Center for Health Statistics report <a href="http://www.cdc.gov/nchs/data/databriefs/db76.htm" target="_blank">here</a>.  Some antidepressant medications have the potential to cause metabolic dysfunction and increase the risk for diabetes.  AND - the pills cost a lot of money in copays and for insurance companies as well as Medicaid and Medicare.   They are not harmless or free.</span></div><div style="font-family: "Trebuchet MS",sans-serif;"><br /></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;"></span></div><div style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: large;">Watch the story below or on <a href="http://www.cbsnews.com/video/watch/?id=7399362n&tag=mncol;lst;3" target="_blank">CBS</a>, or <a href="http://www.cbsnews.com/8301-18560_162-57380893/treating-depression-is-there-a-placebo-effect/" target="_blank">read it</a> here..  You decide, is the antidepressant placebo effect something to address?  Is there a reason to take some people off the pills?  Whatever your thoughts, remember that medications should always be discussed with a physician - before starting and or stopping.</span></div><br /><embed allowfullscreen="true" allowscriptaccess="always" background="#333333" flashvars="si=254&&contentValue=50120238&shareUrl=http://www.cbsnews.com/video/watch/?id=7399362n&tag=mncol;lst;3" height="279" salign="lt" scale="noscale" src="http://cnettv.cnet.com/av/video/cbsnews/atlantis2/cbsnews_player_embed.swf" type="application/x-shockwave-flash" width="425"></embed>

Placebo Effect is NOT Harmless

A placebo, by its very nature, is supposed to be a non substance, a non issue, a non treatment.  It is something given to people so they thi...

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WHERE TO BEGIN? Figuring Out What You Don't Even Know That You Don't Know?

<div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEic63Jni_huFm4P0c2NXWSlEl4JGyig8t_yHuxJ_E-EIKYLeIuiuNtN4z5OMmalX378KjFilHL_wwE9Is72oaIUeqSP8r95C_KmD4bzDilXomC06a9LgIoAcoqBwXDhh6tiKneaisWWi5kq/s1600/knowdontknow.gif" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEic63Jni_huFm4P0c2NXWSlEl4JGyig8t_yHuxJ_E-EIKYLeIuiuNtN4z5OMmalX378KjFilHL_wwE9Is72oaIUeqSP8r95C_KmD4bzDilXomC06a9LgIoAcoqBwXDhh6tiKneaisWWi5kq/s320/knowdontknow.gif" width="320" /></a></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">It is pretty easy to feel comfortable with what we know. It is equally comfortable (especially in an insatiably curious person) to be comfortable asking lots of questions about a topic that we are aware we don't know enough or have enough knowledge (aka a 'Wiki dip' to answer a question).</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">But how do we get an inroad to asking a question when we haven't yet thought about it? When we don't even know that we need to know about it?  It is a huge challenge. The only approach I have come up with thus far, is to intentionally expose yourself to diverse experiences - stream a video on a topic or area you know little about; read a book (or even a blog!) on a topic that you stumble upon; go visit an art exhibit on a style that doesn't grab you; visit countries and work on gaining a different perspective. </span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaz8LmRdB8W9qstGLuaKnfkBmgGfjenB0o4mrZ17_F1MIJz4ca6D612282HCcBFO1epNKdzwy-Uxw9_1CzaSGleY7D1lmxMD_S1Wns4O9TG65dohVW2AaBIduGVKuyhBSdyXu_ByKKRSTF/s1600/Ujimacardapril2011.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="150" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaz8LmRdB8W9qstGLuaKnfkBmgGfjenB0o4mrZ17_F1MIJz4ca6D612282HCcBFO1epNKdzwy-Uxw9_1CzaSGleY7D1lmxMD_S1Wns4O9TG65dohVW2AaBIduGVKuyhBSdyXu_ByKKRSTF/s200/Ujimacardapril2011.jpg" width="200" /></a></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">So here'a health literacy example, I came upon while delivery a community engagement workshop that highlights 'knowing.' In our Philadelphia Ujima Network, we have the honor of training lay health ambassadors. These women and men are the informal opinion leaders and experts on health in their community based groups(faith based, social service, educational, etc.) Our training sessions happen on Saturday mornings and we have highly interactive sessions to learn things like "Know Your Numbers and Your Health." In one of these sessions, we were </span><span style="font-family: Calibri;">discussing heart health risks and hypertension. As I spoke to the group, I became aware that 1) they knew many people with hypertension; 2) they had heard 'a lot' about it; 3) they were aware that it was a very prevalent condition (HTN). But here is where they didn't know what they didn't know.</span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYelJ86WRykgtDySZ_QpuBHG_D0FV3wp2DmUt4NsJfA-PlCG5vCzYeaL9j6wyP74mZhjFbBPiVmCOIvG1gylCRBzHzCuYvlVLKI9Qjcy_WIuOB_XS4RrrVSlosJ3aH6_Xc8rnMMu9bLhPt/s1600/reasons-for-high-blood-pressure.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYelJ86WRykgtDySZ_QpuBHG_D0FV3wp2DmUt4NsJfA-PlCG5vCzYeaL9j6wyP74mZhjFbBPiVmCOIvG1gylCRBzHzCuYvlVLKI9Qjcy_WIuOB_XS4RrrVSlosJ3aH6_Xc8rnMMu9bLhPt/s200/reasons-for-high-blood-pressure.jpg" width="200" /></a></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Because of health outreach successes of others, almost every knew that high blood pressure was associated with the reading of 140/90. But here was the gap. What hadn't been conveyed effectively was that this number represented the 'admissions ticket' to a diagnosis of hypertension,  instead of the audiences' interpretation on this number. Most of the group believed that controlled blood pressure MEANT a bp of 140/90 (or 'near that, 150/100'!). When I clarified that the target BP control range (at least) was 120-134/70-84, many were shocked. "How can you have that blood pressure if you have High Blood Pressure?" one asked.  "By taking medications," I responded. It was new news to the group - something they didn't know (that they needed to know), that good control of BP had readings that were the same as someone who didn't have High Blood Pressure. We didn't even get to the lower numbers needed if you also had Diabetes. </span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEio5bM983LE2xv1Ov6z000M55BUjv9ErBwB1qcimZYIfXcu753tBRbgmlgZTKvTazdSElYQUFT-YTpV558V3FWFCQfQh6Kmp72AkXgPYg14BHPaT1Jo_i-Xl3gxSEfOTXfk7pxLnOASRJB9/s1600/gift-wrapped.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="199" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEio5bM983LE2xv1Ov6z000M55BUjv9ErBwB1qcimZYIfXcu753tBRbgmlgZTKvTazdSElYQUFT-YTpV558V3FWFCQfQh6Kmp72AkXgPYg14BHPaT1Jo_i-Xl3gxSEfOTXfk7pxLnOASRJB9/s200/gift-wrapped.jpg" width="200" /></a></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">It made me wonder, from a literacy perspective - do we confuse people by accepting the common phrase of High Blood Pressure instead of Hypertension? (e.g. If you have High Pressure (this condition), how can it be low  or normal?) </span></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Every opportunity to teach, we open ourselves up to the gift of learning. </span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgS5dwdXlHQiVel8c2lBXJuyy0IdCAlcX9h9lmhqj1YbYyjapedjHlkqxtB2MgbEb5SgrYEO-DHM4wC2E2kU2K8p3H2ZZqgNHrFNT8lmxOXfTQCrlSh78g83jX2WVht_tiysXBUdzjvqV8U/s1600/lit_match.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" lda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgS5dwdXlHQiVel8c2lBXJuyy0IdCAlcX9h9lmhqj1YbYyjapedjHlkqxtB2MgbEb5SgrYEO-DHM4wC2E2kU2K8p3H2ZZqgNHrFNT8lmxOXfTQCrlSh78g83jX2WVht_tiysXBUdzjvqV8U/s200/lit_match.jpg" width="133" /></a></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Stimulating questions of the unknown, reminds me of the saying that when you learn a little about a topic, it is not too dissimilar to lighting a match in a huge auditorium - you become aware how little you know and how much more you need to know. </span></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Gaining experiences that engage us in the uncovering of what we don't know and haven't yet thought of asking about, increases the number of matches we hold!</span></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><br /></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><br /></div><div class="MsoNormal" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; margin: 0in 0in 10pt;"><span style="font-size: x-small;"><span style="font-family: Calibri;"><strong>RESOURCES:<br />Health Literacy </strong></span>•Ask Me Three </span><a href="http://www.npsf.org/askme3/"><span style="font-size: x-small;">click here</span></a><br /><span style="font-size: x-small;">•Teach Back Technique in Removing barriers to safer care. Health literacy and patient safety. Help patients understand. Manual for clinicians. Weiss, B. AMA Foundation </span><br /><span style="font-size: x-small;">•Institute of Medicine (2010) Safe Use Initiative and Health Literacy: A Workshop. National Academy Press. Washington, DC.</span></div><span style="font-size: x-small;"><span style="font-family: Arial, Helvetica, sans-serif;"><strong><span style="font-size: xx-small;">READ MORE:</span></strong> A very interesting blog to read more on Knowing and Not Knowing:   </span></span><br /><span style="font-size: x-small;">Atherton J S (2011) Doceo; Knowing and not knowing [On-line: UK] retrieved 23 February 2012 from </span><a href="http://www.doceo.co.uk/tools/knowing.htm"><span style="font-size: x-small;">http://www.doceo.co.uk/tools/knowing.htm</span></a><span style="font-size: x-small;"> #ixzz1nFFYq2B6  Under Creative Commons License: Attribution Non-Commercial No Derivatives </span>

WHERE TO BEGIN? Figuring Out What You Don't Even Know That You Don't Know?

It is pretty easy to feel comfortable with what we know. It is equally comfortable (especially in an insatiably curious person) to be comfor...

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What is the diet myth?

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">If you check back to these <a href="http://yourhealtheducator.blogspot.com/2011/12/metabolic-fuel.html" target="_blank">past</a> <a href="http://yourhealtheducator.blogspot.com/2011/12/odds-and-ends_11.html" target="_blank">posts</a>, you will see that we began this discussion some time ago - before the popular press started picking out pieces of the research for its headlines.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The original intent for this blog had been and still is to keep a  watch on those headlines and provide better interpretations of research - for your personal consideration.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">To paraphrase the work of both Kevin Hall and Boyd Swinburn - the diet advice is misleading and incorrect because it does not consider the implication of weight LOSS.  People are hearing that diets don't work because metabolism changes when people diet - but do you know WHY it changes?  It changes because you burn less calories when you weigh less.  It is a good thing. </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">People who have weight loss goals <span style="font-size: small;"> </span>should keep this in mind</span></span><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><span style="font-size: small;"> (note: I do believe in weight loss - but, I don't endorse "diets" the way people usually refer to them)</span></span></span><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">. </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The recent studies suggest that our expectations be tempered by these three things:</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">1) time frame</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">2) amount of the change(lifestyle)</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">3) new steady state weight</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><br /></span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Dr. Hall explains that half ones goal weight may be lost in the first year but it takes two more years to lose the other half.  It is not a fast process, it is a myth to think so.  Accepting this is important if you don't want to sabotage yourself.  In regards to the second factor, it might be helpful to cut 200 calories instead of 100 or to cut 100 for one year and than an additional 100 the next (individual advice cannot be provided here).  It is wise to add some exercise into the equation for a gazillion reasons.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">When you reach your goal - understand that this new body has a new metabolism - you didn't damage your metabolism - you do not have some predetermined set weight that you are destined to return to - you have a NEW body - treat it right and don't give it more food than it needs!</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><br /></span></span>

What is the diet myth?

If you check back to these past posts , you will see that we began this discussion some time ago - before the popular press started picking...

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Sink or Swim

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I want to share with you something I read in an article by Nancy Krieger titled, <i>Theories for Social Epidemiology in the 21st century: an eco-social perspective.</i>  It is published in the International Journal of Epidemiology. </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">(2002: 30:668-667)</span></span>.<br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I will just quote from the article and leave you to your own thoughts:</span></span><br /><blockquote class="tr_bq"><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">...the study of why some people swim well and others drown when tossed into a river displaces study of who is tossing whom into the current - and what else might be in the water. </span></span>(p670)</blockquote>

Sink or Swim

I want to share with you something I read in an article by Nancy Krieger titled, Theories for Social Epidemiology in the 21st century: an ec...

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Is Weight Training Supposed to Get Easier?

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">One of the professors in my department (Public Health) works out in the Student Rec Center like I do.  It should just be called the Rec Center because it is there for all of us.  Anyways, his research and work regards work site wellness programs.  Individual level factors that can improve health or increase risk of disease are his focus. </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I have run into him in the gym the last couple of Mondays.  Today as he was coming back into the academic building, he said, "I thought these workouts were supposed to get easier." To which I replied, "No, they aren't.  If they get easy it means you're doing it wrong."  He laughed and said, "That's exactly right."  Because it was - but I knew what he really meant and he knew what I meant(gym rats think alike). </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I did follow up my comment by mentioning some friends or relatives that I have who don't understand (or choose to ignore)that the weight training piece of their workout needs to be periodically revised.  </span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">But put that aside a minute. I want to break this 'easier' concept into two parts.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">There is a physical and a psychological component to weight training.  I make this distinction because I don't want anyone who is considering starting to exercise or who is new to exercise to abandon all hope and run back to the couch.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Psychologically it DOES get easier.  It becomes a routine with benefits.  Emotional well being, strength, conditioning and better metabolism are a few of the pay offs.</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">As people who are new to exercise and many older exercisers are uncomfortable with the progressive nature of weight training - i.e. adding reps, weights and new routines, I offer <a href="http://www.cdc.gov/physicalactivity/growingstronger/progression/index.html" target="_blank">this link</a> to a CDC page which offers suggestions on how to keep those workouts <i>working</i> for you.</span></span>

Is Weight Training Supposed to Get Easier?

One of the professors in my department (Public Health) works out in the Student Rec Center like I do.  It should just be called the Rec Cent...

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ASSESSING RISK AND STILL PROMOTING HOPE FOR THE FUTURE

<div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidRXvl9d9GF8P0Ed4jFmVvthli-DWGGiznniv7xs3OfaRlg3ULqTmg6kyoaQ2ydZXxSVOJzUsdjT6KvKLKTYPHA_bUfQW8o3w71Itp0V3r8lEAoEAl2zboFPuE9gYwG_OzUrd_4IjaPLgX/s1600/abstractdetective.GIF" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidRXvl9d9GF8P0Ed4jFmVvthli-DWGGiznniv7xs3OfaRlg3ULqTmg6kyoaQ2ydZXxSVOJzUsdjT6KvKLKTYPHA_bUfQW8o3w71Itp0V3r8lEAoEAl2zboFPuE9gYwG_OzUrd_4IjaPLgX/s1600/abstractdetective.GIF" yda="true" /></a>In Medicine, we are taught to assess risk. To identify factors that make a condition more or less likely. It is akin to a detective novel. Uncovering and eliciting information to put together a high, medium or low risk for conditions. It enables us to generate our differential diagnosis - the list of most to lesser likely items associated with a symptom. </div><br /><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Risk assessment is not an emotional charged process for the assessor. </div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br /></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Pulling out the Framingham risk factors for heart disease and assessing becomes a memorized habit. Switch seats and it becomes an entirely different experience. </div><div class="separator" style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none; clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUjyW_CSdrg5VT90EFsQysU97Q7sInB1FP6yKsHvPicz_b6lN6gdEKc_bjq4bbuLuicf47jK0dInl_gfJMviO20JFSq6W_EqxrV3lbq4YOXfg5EFQ5_rbvluLVLW1AhcZ_v5lyuQkmzQVo/s1600/cadrfwomen.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUjyW_CSdrg5VT90EFsQysU97Q7sInB1FP6yKsHvPicz_b6lN6gdEKc_bjq4bbuLuicf47jK0dInl_gfJMviO20JFSq6W_EqxrV3lbq4YOXfg5EFQ5_rbvluLVLW1AhcZ_v5lyuQkmzQVo/s200/cadrfwomen.jpg" width="200" yda="true" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br /></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">Patients often say that they'd rather not visit their clinicians office because we will 'find something' (wrong) with them. </div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi9WDQ4G0lt8NoYgTvpWWPIydbafpldSE1SVj4_WBxaZIrRuSB5gSnh7q04QrioDx7-1FTsuF0pnTSvk13ZLfOyP6yLfduCruKPtqZPVAN2AbzvK_ztHU7qVflxDN-snHRuP-zMzs322tBm/s1600/interogationguys.jpg" imageanchor="1" style="clear: right; cssfloat: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="169" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi9WDQ4G0lt8NoYgTvpWWPIydbafpldSE1SVj4_WBxaZIrRuSB5gSnh7q04QrioDx7-1FTsuF0pnTSvk13ZLfOyP6yLfduCruKPtqZPVAN2AbzvK_ztHU7qVflxDN-snHRuP-zMzs322tBm/s200/interogationguys.jpg" width="200" yda="true" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">In fact, in lifestyle and disease prevention, in history and laboratory screening - we do just that. But it is important for the assessment to not stop there. We have a role in assessing what is right as much as what is not. The twice weekly exercise (in contrast to none) needs to be identified and lauded, for example. <a href="http://www.sanctuaryweb.com/">Dr Bloom's Trauma model</a> talks about SELF - safety, emotions, loss and future. Without future, there is no healing from trauma. As we 'do our jobs' and identify health risks, patients can feel traumatized. So we need to intentionally include optimism in the process.</div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpvIgLM3B3FpCa7UYqTLW9MLwr3hl0WeWTzs1g3Le3VP3i434Sabl61EbvbZ4jrLdZR-wHBB45DbkXhwqE0oOizxT-yIgCDhVGIc7MgwAtXF-E3v0yWygv06yUCOdYvWfArpZ7SBdf6wmG/s1600/trainwheels.JPG" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="132" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgpvIgLM3B3FpCa7UYqTLW9MLwr3hl0WeWTzs1g3Le3VP3i434Sabl61EbvbZ4jrLdZR-wHBB45DbkXhwqE0oOizxT-yIgCDhVGIc7MgwAtXF-E3v0yWygv06yUCOdYvWfArpZ7SBdf6wmG/s200/trainwheels.JPG" width="200" yda="true" /></a></div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;">During a <a href="http://www.philadelphiaujima.com/about/default.aspx">Ujima </a>Lay Health Ambassador training session, the participants brought this point home to me. We talked about risks associated with heart disease. As I went through the components (DM, HTN, premature heart disease, elevated lipid levels, smoking, etc.), the vibe from the group back to me was of being sad or overwhelmed. This made me mentally pause and reconsider how I was presenting the information. I paused in the laundry listing of 'bad stuff' to then start to highlight the impact of intervening in each factor. Inside of the runaway railroad train of bad stuff down to Heart Attack land, I covered one area at time and then talked about how, for example, quitting smoking, can decrease your risk. </div><div style="border-bottom: medium none; border-left: medium none; border-right: medium none; border-top: medium none;"><br /></div>Every time you have the privilege to teach, you can also have the opportunity to learn - another way of thinking, a question not yet considered, the impact of your information.  The group enabled me to truly appreciate how the automatic nature and the speed of risk assessment can adversely affect hope for the future. And if hope for the future is annihilated, the likelihood of intentional action for behavior change is too.<br /> <br /><div class="separator" style="clear: both; text-align: center;"></div><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM5GKTXpy_q3DUocn-zDF8jyu6-6JhvdKftne9bxN6T7bxPaixQIVUFQ5HsYL5RvAdJMbKz9fRe2gcHojku5ciswf0S8xmYFhNUs1zR4ozxs5f6KAJWKiYFaonVf6_VKkHbMtW_V_twI2j/s1600/yinyang.jpg" imageanchor="1" style="clear: left; cssfloat: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiM5GKTXpy_q3DUocn-zDF8jyu6-6JhvdKftne9bxN6T7bxPaixQIVUFQ5HsYL5RvAdJMbKz9fRe2gcHojku5ciswf0S8xmYFhNUs1zR4ozxs5f6KAJWKiYFaonVf6_VKkHbMtW_V_twI2j/s200/yinyang.jpg" width="200" yda="true" /></a>So my take home with this is that despite time constraints to quickly deduce and figure out risks, it is even more important in imparting hope for positive change when relaying this information to a patient. From risks to findings it important to put the data in a context that promotes understanding and change. For example - <em>What lab value is abnormal? What does it / can it mean? What can I do about it?</em><br /><br />Perhaps risk and hope are a yin/yang type of thing - highlight the change I need and support me to be optimistically ready to take action (and coach me to make the hard changes.) Either way, we need to have one script inside our heads and a different language of delivery to patients if we hope to have them a) come back and see us again :> and,  b) take action to promote healthier lives.

ASSESSING RISK AND STILL PROMOTING HOPE FOR THE FUTURE

In Medicine, we are taught to assess risk. To identify factors that make a condition more or less likely. It is akin to a detective novel. U...

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Odds and Ends - outsourced?

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The title is in reference to my taking some shortcuts this week by linking a couple of the blurbs to outside sources - instead of summarizing the content myself....</span></span><br /><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><u>Starch is Starch</u> - There is a commercial for the non-butter spread, "I can't believe it's not butter," that shows a pat of the spread melting or being spread over different food items.  I believe they are; in order, potatoes, corn, peas and bread.  I shake my head every time I see this commercial.  You may be saving some calories with the spread, but the foods that are shown are the starchy ones that the Dietary Guidelines for Americans suggest we limit.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><u>Ease into Changes </u>- I came across <a href="http://www.usatoday.com/money/perfi/retirement/story/2012-02-18/cnbc-retire-home/53123264/1" target="_blank">this article</a> last night. A very good point is made by the writer and it regards the mistake of living one way all your life and then suddenly trying to live a completely different way in retirement.  Instead, he suggests, we start changing our lives now so that how we live will work for us no matter our age or income. It is a great read. He also talks about families living together again!</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><u>Sugar</u> - Several public health experts and organizations have made a case for regulating sugar.  This regulation could be through taxes, price differentials, bans on soda (not selling it in schools, worksites or with food stamps, for example).  I think that sugar is causing damage similar to that of tobacco and using taxes to reduce consumption makes sense.  The issue was discussed on Science Friday this week.  The scientist who is interviewed on this program, Dr. Lustig, was mentioned in a <a href="http://yourhealtheducator.blogspot.com/2012/02/odds-and-ends.html" target="_blank">recent Odds and Ends post</a>.  Hearing him speak about the research, and how sugar causes us problems is quite informative.  Here is the <a href="http://www.npr.org/2012/02/17/147047545/should-sugar-be-regulated-like-alcohol" target="_blank">link</a>.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><u>It's always about what you eat</u> - The Harvard School of Public Health released its latest newsletter this week.  One of the articles regards diet and surgery outcomes.  IF you are or someone you love is going to be operated on anytime soon you may be interested in this article.  You also may just be curious.  You can read it <a href="http://www.hsph.harvard.edu/news/press-releases/2012-releases/protein-surgical-complications.html" target="_blank">here</a>.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><u>Dietary Supplements</u> - Lastly, for my favorite subject - dietary supplements, aka vitamins and minerals from a bottle.  The folks at MedScape recently included several articles and commentaries regarding supplements and health.  The bottom line was that physicians need to talk to their patients about NOT taking most of the pills that people think they should take.  I hope <a href="http://www.medscape.com/viewarticle/756190?src=emailthis" target="_blank">this article</a> is accessible to you because it is another must read (I didn't log out of my account, so give it a try).  Remember, supplements more often than not, give you no benefit at all (beyond high dollar urine) and sometimes cause you harm.  </span></span>

Odds and Ends - outsourced?

The title is in reference to my taking some shortcuts this week by linking a couple of the blurbs to outside sources - instead of summarizin...

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The Misleading Skinny Cocktail

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I went to a small get together at a classmate's home this evening.  She wanted to gather us together outside of the university to enjoy each other and to see the first season of the PBS show Downton Abbey.  She enticed us with healthy foods and Skinny Margaritas.  Some interesting things about this cocktail brand.  1)I think there is a lawsuit out because of false advertising - but it isn't really false.  It says All Natural on the label and as you know by now, that really means nothing.  So, I am not concerned with that. </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">2) I am concerned with the hype about the drink mix being low calorie. You see - it is a mix - a cocktail in a bottle. The label serving size is 1.5 ounces.  That amount of drink (basically a shot glass full) contains just under 40 calories.  Okay - YES - 40 is much less than the 100 calories in 1.5 ounces of liquor - however, it is not pure liquor.  A 4 ounce serving of the cocktail would have a 100 calories.  I noticed my friends' glasses had 6- 8 ounces each.  They may have had 12 to 16 (ounces) total.  A 4 ounce glass of wine also has 100 calories.  A 12 ounce light beer has 100 calories.  A shot of whisky/liquor adds 100 calories to a calorie free 12 ounce soda  - now THAT is a skinny drink.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><br /></span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">But I did bring along a snack tray - happy to have a chance to use my beautiful tulip platter.  A gift from my sister. </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><br /></span></span><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiw-EfzJB5jct0Rsi9k4yPHBdYJb8xB1jf9uTuIa__iIyT2BB2j7SMgaoJqvbYWyMIuQQSR8-5plrV2tXDpAWoVwZ5v6JO5uRaGNWS7GC4uBZg2FW0WY7cfr319h8XtYtT5zqyGo8iCAVwY/s1600/snack+tray.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="321" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiw-EfzJB5jct0Rsi9k4yPHBdYJb8xB1jf9uTuIa__iIyT2BB2j7SMgaoJqvbYWyMIuQQSR8-5plrV2tXDpAWoVwZ5v6JO5uRaGNWS7GC4uBZg2FW0WY7cfr319h8XtYtT5zqyGo8iCAVwY/s640/snack+tray.jpg" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">chocolate cake squares, vegetarian egg rolls, hummus and pepper slices</td></tr></tbody></table><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><br /></span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;"><br /></span></span>

The Misleading Skinny Cocktail

I went to a small get together at a classmate's home this evening.  She wanted to gather us together outside of the university to enjoy ...

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Manual Standard Car

<div style="text-align: justify;">There have been many books published over the years aimed both at car maintenance and DIY, however few books have quite reached the level of acclaim and respect Haynes manuals have. After publishing his first book in 1956 which explained with great ease how to build a 'special', based on the Austin 7, John Haynes wrote two more books before setting up a publishing company in 1960. Since then they have published hundreds of instruction booklets. These have included 300 models of car as well as 130 models of motorcycle.<br> <br> But what is the secret of success? Having sold over 150 million books worldwide there is defiantly something about these books that people value over others on the market. Prior to the beloved Haynes Manuals entering the market there were other books available. However it was at the frustration of these books that originally stirred the idea. At the time intrusion books were not helpful enough. The problem was they were written by the car manufacturers at the time and as the authors had an in-depth knowledge of the cars they were writing about the manuals seemed to assume a certain level of knowledge. So although they did help they didn't quite allow for accessibility to people with less knowledge of car maintenance.<br> <br> This is essentially the key; accessibility. The way Haynes Manuals are displayed allows almost anyone to pick one up and understand what it's trying to tell them. Through a combination of step by step guides and an amazing level of detail in the technical drawings the books are incredibly easy to follow.<br> <br> What this did was allow anyone to become an expert in the maintenance of their own car. So suddenly people were able to teach themselves the basics. This expanded the market dramatically as it allowed young people, who would otherwise have to learn from someone else, to teach themselves.</div>

Manual Standard Car

There have been many books published over the years aimed both at car maintenance and DIY, however few books have quite reached the level of...

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Growth

<span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I attended a meeting today - a colloquium - where health science researchers came together to share what they are currently studying in an effort to pool resources (experience, expertise, funding, etc).  </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">One of the guests was a PhD psychologist who works on individual level programs or research.  One of her grant funded projects gave me a "-huh-" moment.  </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">It does make sense for someone to look into this matter and several of the women in my own family would be great people to study.  Okay - I am going to tell you....</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The researcher is looking into Post Traumatic Growth.  Yes you caught that correctly.  Not the disorder that sometimes occurs after people experience extreme duress (e.g, battle, life threatening conditions and loss)- not PTSD - post traumatic stress disorder - but PT - GROWTH.  </span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">Some people experience a trauma and come out of it with better emotional stability, sense of purpose, relationships, engagement, health, quality of life etc.  IF researchers knew what it was about THOSE people, maybe they could use the knowledge to help more people come out on the positive side of a negative experience.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The woman I met today (from WFU - SOM)  is working specifically with breast cancer patients/survivors. When she said this, I had NO doubt that she was on to something because my sister emerged from a breast cancer crisis and absolutely re-embraced life and made positive changes.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">I, having some trauma related to relationships, also turned my life around for the positive and my mother, widowed suddenly in her late years, found independence, health and an active lifestyle that had in many ways eluded her before her great loss.</span></span><br /><span style="font-size: large;"><span style="font-family: "Trebuchet MS",sans-serif;">The field of post traumatic growth research is definitely something to keep an eye on.</span></span>

Growth

I attended a meeting today - a colloquium - where health science researchers came together to share what they are currently studying in an e...

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