TGIF Quote of the Week

<span style="font-family: inherit;">This is the last Friday in 2013! Hope everyone is able to make it a great one!</span><br /><span style="font-family: inherit;">Here is the quote if the week:</span><br /><span style="font-family: inherit;"><br /></span><span style="font-family: inherit;"><br /></span><span style="background-color: white; font-size: 15px; line-height: 22px;"><span style="color: purple; font-family: inherit;">"It always seems impossible until it’s done."</span></span><br /><span style="background-color: white; font-size: 15px; line-height: 22px;"><span style="color: purple; font-family: inherit;">                            - Nelson Mandela</span></span><br /><span style="background-color: white; font-size: 15px; line-height: 22px;"><span style="color: purple; font-family: inherit;"><br /></span></span><span style="background-color: white; font-size: 15px; line-height: 22px;"><span style="font-family: inherit;">Think back...what did you do in 2013 that you thought was impossible? Keep on accomplishing the impossible as impossible things are happening everyday! </span></span><br /><span style="background-color: white; font-size: 15px; line-height: 22px;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span><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/AVvXsEiUcNTzPfyVGTAax2KYzqLiFlHvQ_-PCvr6vgbfezXbjd9XMeJBc2c3EYSAnoEFPZNXcBBbnPH4MIbFczdbqlzW5clwdKlhbEUIUFOztl50UpShweslC-cyfpIbPLgGX8HXUgddZDm9_p0/s1600/topOfMountain.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="212" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUcNTzPfyVGTAax2KYzqLiFlHvQ_-PCvr6vgbfezXbjd9XMeJBc2c3EYSAnoEFPZNXcBBbnPH4MIbFczdbqlzW5clwdKlhbEUIUFOztl50UpShweslC-cyfpIbPLgGX8HXUgddZDm9_p0/s320/topOfMountain.jpg" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Have a great weekend! </td></tr></tbody></table><span style="background-color: white; font-size: 15px; line-height: 22px;"><span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></span>

TGIF Quote of the Week

This is the last Friday in 2013! Hope everyone is able to make it a great one! Here is the quote if the week: "It always seems impossib...

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Healthy Holidays!!

While the winter holiday season can be the most magical time of the year, it is also a time when many engage in not-so healthy behaviors. Large amounts of holiday treats, stress over holiday spending and being in large groups as cold and flu season hits can all have a negative effect on your health. The CDC has created a fun holiday song called <a href="http://www.youtube.com/watch?v=hCebthk9b2A#t=15">"The Twelve Ways to Health" </a>, providing a great way to remember all the things we sometimes forget in the rush of the holiday season. On the CDC's page, along with the lyrics, are resources to learn more about every topic are provided. Take some time to sing along and get information about a topic you may want to know more about. When you make the holidays healthy, the happiness come naturally!<div>                 <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6S2C2cHhiLD6UbAXULyMk-0NYFwMmsXPPUr8giImZPYGYamdwUHIvvtt8RkeGU7lbeq3k_aokHY9OAqpewAm5B86RoPzZ8CuIJl0mZLiyT2HgPjkuApCSir1uSBOI_MLvhmqcCx7TIFI/s1600/Candles_and_green.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6S2C2cHhiLD6UbAXULyMk-0NYFwMmsXPPUr8giImZPYGYamdwUHIvvtt8RkeGU7lbeq3k_aokHY9OAqpewAm5B86RoPzZ8CuIJl0mZLiyT2HgPjkuApCSir1uSBOI_MLvhmqcCx7TIFI/s200/Candles_and_green.gif" width="200" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsXaUr4fZ6VYNp6-0p3F3Aqz8xHbSUXQFoeES6JD1Z-tMCcXyZg1z_DhSKBI2V_Td1WtHWUJxLwz0Xbtw6zeSOkaFoj35XHV-Q_ozdkV4yaQD9Jm9dV3V1bz5NG1ktrwdLwARnookbBl4/s1600/Family-Dinner.jpg" imageanchor="1" style="clear: left; display: inline !important; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsXaUr4fZ6VYNp6-0p3F3Aqz8xHbSUXQFoeES6JD1Z-tMCcXyZg1z_DhSKBI2V_Td1WtHWUJxLwz0Xbtw6zeSOkaFoj35XHV-Q_ozdkV4yaQD9Jm9dV3V1bz5NG1ktrwdLwARnookbBl4/s200/Family-Dinner.jpg" width="200" /></a></div><div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><b><span style="color: #0b5394;">ENJOY THE HOLIDAYS!</span></b></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><u><b>Links: </b></u></div><div class="separator" style="clear: both; text-align: left;"><u><b><br /></b></u></div><div class="separator" style="clear: both; text-align: left;"><a href="http://www.cdc.gov/family/holiday/12ways.htm">Twelve Days of Health Lyrics and Resource Page</a></div><div class="separator" style="clear: both; text-align: left;"><a href="http://www.cdc.gov/family/holiday/12waysSong.htm"><br /></a></div><div class="separator" style="clear: both; text-align: left;"><a href="http://www.cdc.gov/family/holiday/12waysSong.htm">Twelve Days of Health song/video</a></div></div></div>

Healthy Holidays!!

While the winter holiday season can be the most magical time of the year, it is also a time when many engage in not-so healthy behaviors. La...

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TGIF Quote of the week!

<span style="font-family: inherit;">Happy Friday everyone! Have a relaxing weekend! hopefully you are or soon will be having a holiday break! Here is our quote of the week, which is especially good for this time of year. While many are looking for holiday cheer; the stress of shopping, cooking and get-togethers can make people the opposite of what you would expect from this time of the year: </span><br /><div><span style="font-family: inherit;"><br /></span></div><div><span style="color: purple;"><span style="font-family: inherit;"><span style="background-color: white; line-height: 20px;">A healthy attitude is contagious but don't wait to catch it from others. Be a carrier.</span></span>-Tom Stoppard </span></div><div><span style="color: purple;"><br /></span></div><div>Choose the healthy attitude....you many be the one to spread it!</div><div><br /></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEive38qwcTIp2FxXjZNYB_M8QD6kGFB_lswjFK6IK8xlrBYEWJRGxg7HexAObtbxK-gkcGJfm5Vz54qNcB_x2l0tK1mnTpzmOg_EyLtpoDCw7PUjEUMfO6nSDJoyNWJiLCpAEV8JcLXvhA/s1600/helping-others-ws3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="197" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEive38qwcTIp2FxXjZNYB_M8QD6kGFB_lswjFK6IK8xlrBYEWJRGxg7HexAObtbxK-gkcGJfm5Vz54qNcB_x2l0tK1mnTpzmOg_EyLtpoDCw7PUjEUMfO6nSDJoyNWJiLCpAEV8JcLXvhA/s320/helping-others-ws3.jpg" width="320" /></a></div><div style="text-align: center;"><br /></div>

TGIF Quote of the week!

Happy Friday everyone! Have a relaxing weekend! hopefully you are or soon will be having a holiday break! Here is our quote of the week, whi...

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Using Advertising to Improve Diet

<span style="font-size: large;">The post for today was written, by me, as an exercise for a class I am taking to improve my writing.  I chose the study for blog relevance and personal interest, but it may seem more formal than my usual, opinion- infused posts.  Now you know why :)</span><br /><br /><div class="MsoNormal"><span style="font-size: large;"> In the United States, obesity rates have risen over the past 40 years <span style="mso-no-proof: yes;">(Ogden & Carroll, 2010)</span>, and many health professionals consider the disease to be epidemic.<span style="mso-spacerun: yes;">  </span>The suggested causes of obesity are numerous, interconnected and multi-level.<span style="mso-spacerun: yes;">  </span>Because individual level prevention programs are expensive and generally ineffective, researchers have begun testing environmental or societal level strategies that can affect whole populations <span style="mso-no-proof: yes;">(Swinburn, Egger, & Raza, 1999)</span>.<span style="mso-spacerun: yes;">  </span>For example, Rusmevichientong, Streletskaya, Amatyakul and Kaiser <span style="mso-no-proof: yes;">(2014)</span>recently conducted a laboratory experiment to compare the effect of 4 types of food advertising on lunch purchases.<span style="mso-spacerun: yes;">  </span>The researchers expected that limiting unhealthy food advertising, increasing healthy food advertising and airing anti-obesity messages would each lead to the purchase of items with less calories, fat, sugar and sodium.</span><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal"><span style="font-size: large;">If advertisement manipulation is effective in reducing over consumption in the short term, public health advocates will have evidence to promote advertising interventions or policies, which may lead to a reduction in obesity rates over the long term.<span style="mso-spacerun: yes;">  </span>Rusmevichientong and colleagues offer some evidence in this regard.</span><br /></div><span style="font-size: large;"></span><br /><div class="MsoNormal"><span style="font-size: large;"><span style="mso-spacerun: yes;"> </span>Rusmevichientong and colleagues randomly assigned 182 adult college students into one of 4 treatment conditions.<span style="mso-spacerun: yes;">  </span>All participants watched TV for about 16 minutes. In all but one group (the control), the participants viewed four, five or six, 30 to 60 second advertisements in one of the following categories: unhealthy food advertisements (unhealthy foods were defined as items high in sugar, fat and sodium), healthy food advertisements (ones promoting the consumption of fruits and vegetables), anti-obesity messages, and a mixture of all three types. Before and after the TV viewing, each participant chose a lunch meal from a computerized menu.<span style="mso-spacerun: yes;">  </span>The researchers provided $10 meal vouchers, but participants had to pay the difference if their order was more than $10.<span style="mso-spacerun: yes;">  </span>The researchers compared the food orders before and after the TV viewing (within participants) and the changes between the groups, including the control. The research design (different in difference) allowed the researchers to compare the magnitude of difference between ad types.</span><br /></div><span style="font-size: large;"></span><br /><div class="MsoNormal"><span style="font-size: large;">In this laboratory experiment; exposure to the healthy food messages, anti-obesity messages and a mixture of unhealthy, healthy, and anti-obesity messages, led to an increase in healthy food purchases and a decrease in number of calories purchased. The healthy food messages produced the greatest decrease in calories purchased (134) compared to anti-obesity messages (93) or mixed messages (90). There was also some reduction in the fat and sodium content in the meals purchased.<span style="mso-spacerun: yes;">  </span>In addition, Rusmevichientong and colleagues found a positive association between these 3 advertisement conditions and ‘becoming healthier,’ which they defined as purchasing a greater number of healthy foods at time 2.<span style="mso-spacerun: yes;">  </span>The researchers suggest using anti-obesity ads judiciously and thoughtfully (i.e., ones that are not stigmatizing or fear producing) and healthy food advertising to reduce the over consumption of calories in the US adult population.</span><br /></div><span style="font-size: large;"></span><div class="MsoNormal"><span style="font-size: large;">Rusmevichientong and colleagues results are important because most research suggesting a relationship between both anti-obesity messages and reduced caloric consumption, and healthy food ads and reduced caloric consumption is based on cross sectional surveys.<span style="mso-spacerun: yes;">  </span>Experimental studies allow researchers to claim causal inference, e.g., healthy food ads change behavior. However, this particular study was small, took place outside of a natural setting and used a homogenous set of participants.<span style="mso-spacerun: yes;">  </span>Policy advocates may present this evidence along with evidence produced from representative, field based, cross-sectional or longitudinal studies to make a case for new advertising polices.</span><br /><span style="font-size: large;"><br /></span><span style="font-size: large;"><span style="font-size: small;">Citations </span></span></div><span style="font-size: large;"><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0in 0.5in; text-indent: -0.5in;"><span style="font-size: small;">Ogden, C. L., & Carroll, M. D. (2010). Prevalence of overweight, obesity, and extreme obesity among adults: United States, trends 1960–1962 through 2007–2008. <i>NCHS Health and Stats</i>. </span></div><span style="font-size: small;"></span><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 0in 0.5in; text-indent: -0.5in;"><span style="font-size: small;"><span style="color: black;">Rusmevichientong, P., Streletskaya, N. A., Amatyakul, W., & Kaiser, H. M. (2014). The impact of food advertisements on changing eating behaviors: An experimental study. <i>Food Policy, 44</i>(0), 59-67. doi: <a href="http://dx.doi.org/10.1016/j.foodpol.2013.10.011">http://dx.doi.org/10.1016/j.foodpol.2013.10.011</a></span></span></div><span style="font-size: small;"></span><div class="MsoNormal" style="line-height: normal; margin-left: 0.5in; text-indent: -0.5in;"><span style="font-size: small;"><span style="color: black;">Swinburn, B., Egger, G., & Raza, F. (1999). Dissecting obesogenic environments: The development and application of a framework for identifying and prioritizing environmental interventions for obesity. <i>Preventive Medicine, 29</i>(6), 563 - 570. doi: 10.1006/pmed.1999.0585</span></span></div><span style="font-size: small;"></span><div class="MsoNormal"><br /></div><span style="font-size: small;">  </span></span>

Using Advertising to Improve Diet

The post for today was written, by me, as an exercise for a class I am taking to improve my writing.  I chose the study for blog relevance a...

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Rheumatoid arthritis

<div class="FreeForm"><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">By Justine Shum, MSIV</span></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;"><br /></span></div><div class="FreeForm"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivVihjnZ4VWfXaPyR7YnDtk0Hm5Q6EhgBK3M0ls88yjjdIblIDbytpg_hAGfCx3ml3yoRqa-4Ji_kduVDFRDDwX6YhCFpge3J7Uy-jqSFn5BJ_NNiPWwo2XqTtt5_kdzYwTQvc6I2VK5E/s1600/knee_pain_man_holding.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEivVihjnZ4VWfXaPyR7YnDtk0Hm5Q6EhgBK3M0ls88yjjdIblIDbytpg_hAGfCx3ml3yoRqa-4Ji_kduVDFRDDwX6YhCFpge3J7Uy-jqSFn5BJ_NNiPWwo2XqTtt5_kdzYwTQvc6I2VK5E/s200/knee_pain_man_holding.jpg" width="133" /></a><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">Rheumatoid arthritis (RA) is an autoimmune disease that most commonly presents as an inflammatory arthritis affecting the joints. Like many other autoimmune diseases, RA affects more women than men -- about 3x as many women have the disease. <o:p></o:p></span></div><div class="FreeForm"><br /></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">RA is a chronic disease that cannot be cured, but there are now many medications that are effective in reducing symptoms and slowing the progression of the disease. These medications are classified as disease-modifying antirheumatic drugs (DMARDs), and can further be separated into conventional DMARDs such as methotrexate and sulfasalazine, and biologic DMARDs such as rituximab and adalimumab. Because of DMARD use, the severe RA that results in crippling joint deformities is fortunately becoming more rare. <o:p></o:p></span></div><div class="FreeForm"><br /></div><div class="FreeForm"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyzksVaZP2gkzl5ThIPuEL2NL6vpgxahAV0fwbnSvfp05udeg3xgPE2ACwpUj-sds6dOfD8-G9aeYC78bPGqAQa7fU3jgNAW-Kbmu7_DseleT-MfsaHSCYo8yYtVFJa2oP8_QexrDjJk4/s1600/woman_and_doctor.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyzksVaZP2gkzl5ThIPuEL2NL6vpgxahAV0fwbnSvfp05udeg3xgPE2ACwpUj-sds6dOfD8-G9aeYC78bPGqAQa7fU3jgNAW-Kbmu7_DseleT-MfsaHSCYo8yYtVFJa2oP8_QexrDjJk4/s200/woman_and_doctor.jpg" width="200" /></a><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">Current recommendations call for treatment with DMARDs to begin once a diagnosis of RA is made. Many patients wish to delay treatment, however, recent studies have shown that early and immediate treatment of RA results in lower disease activity in patients. These studies also show that at 2 years following diagnosis, patients who received immediate treatment were less likely to have joint damage and resultant disability. <o:p></o:p></span></div><div class="FreeForm"><br /></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">Patient education of the disease course of rheumatoid arthritis and the consequences of delaying treatment will likely make the difference in patients who are wavering on initiating DMARDs. See the links below for some basic patient education material provided by the American College of Rheumatology. <o:p></o:p></span></div><div class="FreeForm"><br /></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial Bold","serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;">Links: </span><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;"><o:p></o:p></span></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial Bold","serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;"><span style="color: #000099; font-family: "Arial","sans-serif"; mso-bidi-font-family: "Times New Roman";"><a href="http://www.hss.edu/newsroom_timely-treatment-reduces-ra-disability.asp">http://www.hss.edu/newsroom_timely-treatment-reduces-ra-disability.asp</a></span><o:p></o:p></span></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial Bold","serif"; font-size: 11.0pt; mso-bidi-font-size: 10.0pt;"><br /></span></div><div class="FreeForm"><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">Patient education (English): <span style="color: #000099;"><a href="http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Rheumatoid_Arthritis/">http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Rheumatoid_Arthritis/</a></span></span></div><br /><div class="FreeForm"><span style="color: #191919; font-family: "Arial","sans-serif"; font-size: 11.0pt; mso-bidi-font-family: "Times New Roman"; mso-bidi-font-size: 10.0pt;">Patient education (Espanol): <a href="http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Artritis_Reumatoidea_(Espa%C3%B1ol)/"><span style="color: #000099;">http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Artritis_Reumatoidea_(Espa%C3%B1ol)/</span></a></span><span lang="en-US" style="color: windowtext; font-family: "Times New Roman","serif"; font-size: 10.0pt; mso-ansi-language: #0400; mso-bidi-language: X-NONE; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: #0400;"><o:p></o:p></span></div>

Rheumatoid arthritis

By Justine Shum, MSIV Rheumatoid arthritis (RA) is an autoimmune disease that most commonly presents as an inflammatory arthritis affecting ...

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Will you really burn off those extra calories?

<span style="font-size: large;">In a recent Nutrition Notes Daily, published by the American Society for Nutrition, a professor from UCLA School of Medicine was quoted as saying, "it takes a lot of exercise to make up for a little dietary indiscretion."  </span><br /><span style="font-size: large;">A vast body of research supports his assertion. Even so, many of us believe that an extra 30 minute walk will erase the damage of a 500 calorie donut, piece of cake or holiday cookies.  It is not so.  In this <a href="http://yourhealtheducator.blogspot.com/search?q=METs" target="_blank">past post</a>, I introduced the MET or metabolic equivalent as one way to determine how many calories you might burn doing a certain activity at a certain intensity for a certain amount of time.  For example, I found that I burned less than 500 calories by running at a ten minute per mile pace for just over an hour.</span><br /><span style="font-size: large;">In a more recent post, I talked about the belief we have in the self control of our future self.  For example, the belief that tomorrow you will walk twice as long as usual in order to burn off the extra calories you ate today.  Often tomorrow comes and well, its today, so there you are... pinning your hopes on the next tomorrow. </span><br /><span style="font-size: large;">This is especially important from Thanksgiving to New Years.  One or two days of indulgence can be self corrected, four to six weeks of eating more calories than you need, will lead to weight gain and extra weight is hard to lose. </span><br /><span style="font-size: large;">(And when you start seeing weight loss ads in January remember that the only way to lose weight or to maintain a weight that is healthy for you, is to make a change that you can stick with - forever.  A short term plan will get you a short term fix and whatever trick you try will only work as long as you use it.) </span>

Will you really burn off those extra calories?

In a recent Nutrition Notes Daily, published by the American Society for Nutrition, a professor from UCLA School of Medicine was quoted as s...

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"Good" and "Difficult" Patients

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxnYheyKyxzJxPVzkMt50E7vwRtmYvL-eOeiuQL_QLPb1AuGG7yXcCSGWtY3_FjN2W8BDbidl9yzELqNWAdUTj_ZMsNbhZMdjEayWpU0k7QRlAOkb9vNjOn8QkY-bNbOsLXI9oyw08xRg/s1600/1064973347.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="177" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxnYheyKyxzJxPVzkMt50E7vwRtmYvL-eOeiuQL_QLPb1AuGG7yXcCSGWtY3_FjN2W8BDbidl9yzELqNWAdUTj_ZMsNbhZMdjEayWpU0k7QRlAOkb9vNjOn8QkY-bNbOsLXI9oyw08xRg/s320/1064973347.jpg" width="320" /></a></div><span style="font-family: inherit;">Whether you work in healthcare, have been in the healthcare system or simply watch medical dramas on TV, many are aware of the concept of "good" and "difficult" patients. "Good" patients are simply compliant with what is happening to them, low maintenance and an have an agreeable family. "Difficult" patients may ask too many questions, insist that they need immediate care or suggest things that their providers do not agree with. The article "Good" Patients and "Difficult" Patients - Rethinking our Definitions,</span><span style="background-color: white;"><span style="font-family: inherit;"><span style="line-height: 1.05em;"> by Louise Aronson, M.D. Challenges these images that are bestowed on patients and families by sharing a personal sorry about an </span></span><span style="line-height: 16.796875px;">experience</span><span style="font-family: inherit;"><span style="line-height: 1.05em;"> with her elderly father. This is a great read for physicians and patients alike. Check it out by clicking the link below!</span></span></span><br /><div><span style="background-color: white;"><span style="font-family: inherit;"><span style="line-height: 1.05em;"><br /></span></span></span></div><div><a href="http://www.nejm.org/doi/full/10.1056/NEJMp1303057"> "Good" Patients and "Difficult" Patients - Rethinking our Definitions</a><br /><br /><br /><br />---</div>

"Good" and "Difficult" Patients

Whether you work in healthcare, have been in the healthcare system or simply watch medical dramas on TV, many are aware of the concept of &q...

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Does Cancer Change the Dialogue?

<span style="font-size: large;">Scientists have found that certain genes may place people at risk for disease (e.g., cancer, Alzheimers), but that having the gene does not in and of itself always cause the disease. E</span><span style="font-size: large;">pigenetics is the study of how a gene gets turned on, or is 'expressed'.  The expression of a gene is due to some interaction between biology and environment.  In other words, a person may have a gene that puts them at risk for a certain type of cancer but the gene stays dormant or asleep until some other "thing" or "series of things" occurs.  There is ongoing research into the epigenetics of diet and cancer.  In other words, does the diet of a person turn on a cancer gene?</span><span style="font-size: large;"> </span><br /><br /><span style="font-size: large;">As a researcher, I am interested in how diet (what and how much a person eats) affects health.  Because some research suggests that a diet high in calories, sugar and certain types of fat leads to obesity, heart disease and diabetes, I feel that it is appropriate to use law to help us limit our consumption of certain foods or food ingredients.  This is a very contentious idea.  Americans' believe that food choices are personal (I believe food choices are swayed by industry, the environment, and social norms).  Some people also believe that being overweight or having heart disease is an acceptable outcome for the enjoyment food provides.  Within that person's value system, the risk of heart disease is not considered high or important</span><span style="font-size: large;">.</span><br /><br /><span style="font-size: large;">I wonder if this same global mentality will accompany a finding that too many calories or a diet high in sugar turns on a cancer gene.  People still fear cancer.  Cancer (though seemingly as treatable as heart disease) is not usually considered an acceptable outcome for food indulgences in anyone's value system.</span><br /><br /><span style="font-size: large;">I expect that laws limiting fast food restaurants, taxing sugar sweetened beverages and mandating interpretive, nutrient disclosures (i.e., traffic light labels) will get more support if researchers find a link between the over consumption of certain foods and cancer.</span><br /><br /><span style="font-size: large;">My desire is to test the effect of such laws or strategies, regardless of why they are implemented.  To learn more about my 'new' research interests please click <a href="http://deirdredingman.weebly.com/" target="_blank">here</a> for my professional website.</span>

Does Cancer Change the Dialogue?

Scientists have found that certain genes may place people at risk for disease (e.g., cancer, Alzheimers), but that having the gene does not ...

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Wanna Get Away? - Great Exhibit in D.C.

Going to the D.C. area or wanting to plan a trip there? We have one reason you may want to get there soon! The <a href="http://events.nationalgeographic.com/events/national-geographic-museum/">National Geographic Museum</a> is now hosting the exhibit, <i><a href="http://wovexhibition.org/visit-the-exhibition">Women Of Vision</a>, </i>that features the works of 11 female photojournalists, whose amazing photos capture modern realities and what is means to be a human in the 21st century. <div><br /></div><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPJnoVPWr-EwBnII_EoGBvaM127ELEuLKjebH5j1lQDA3FrYV43t4lVxOSqptKo7Yr_Bc6K4_830XqMe7XQthZ-88JfOGZrFBi9-MScBtAbCWf4Vkd46_UK54mZ6V0BQETSICtJu02GAE/s1600/wv.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="353" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPJnoVPWr-EwBnII_EoGBvaM127ELEuLKjebH5j1lQDA3FrYV43t4lVxOSqptKo7Yr_Bc6K4_830XqMe7XQthZ-88JfOGZrFBi9-MScBtAbCWf4Vkd46_UK54mZ6V0BQETSICtJu02GAE/s640/wv.png" width="640" /></a></div><div class="separator" style="clear: both; text-align: left;"><br /></div><div><br /><div>Visit the <a href="http://wovexhibition.org/visit-the-exhibition">Women of Vision Exhibit webpage </a> to learn more. It will be open until March 9th. Make sure to plan your next trip to D.C. around this great exhibit! </div><div><br /></div><div><br /></div><div><br /></div></div>

Wanna Get Away? - Great Exhibit in D.C.

Going to the D.C. area or wanting to plan a trip there? We have one reason you may want to get there soon! The National Geographic Museum i...

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Labeling Rules ~ The FDA has us all in limbo

<span style="font-size: large;">Any day now, or more likely, sometime in 2014, the FDA will release the final rule for the national nutrition/menu labeling law officially meant to apply to restaurants (sit down and counter chains), vending companies, and <i>similar retail establishments</i>.</span><br /><br /><span style="font-size: large;">As of today, the consumer (you and I),  health advocates (myself,  CSPI, the RUDD Center,  many others), the National Restaurant Association, the National Grocers Association, the Association for Convenience and Fuel Retailing, pizza restaurants and other food selling/entertainment venues (e.g., bowling alleys, cinemas) remain unawares and unprepared for what will be required.</span><br /><br /><span style="font-size: large;">Of those listed above, the consumer interest groups (and thus a majority of the general public), public health folks and the National Restaurant Association supported the menu labeling law, but the others did not nor did they expect to get caught up in it.  My personal belief is that anyone selling ready to eat, unpackaged food has an obligation to share with the buyer of that food, pertinent nutrition information.  I would include food sold from steam tables in grocery stores, hot dogs and the like sold in convenience stores and items sold from concession stands at bowling alleys, sports arenas and movie theaters.</span><br /><br /><span style="font-size: large;">I do think that pizza joints should get some leeway in how they present the information due to the individual, made to order nature of pizza.</span><br /><br /><span style="font-size: large;">Once the FDA makes its announcement, retailers will have 6 mos to 1 year to comply.  Then the next battle begins.  Updating the nutrition facts panels on packaged foods. In this case, the concern </span><br /><span style="font-size: large;">(of food companies) is whether the update is going to mandate  labels that imply a foods goodness, e.g., star ratings or multiple traffic lights. </span>

Labeling Rules ~ The FDA has us all in limbo

Any day now, or more likely, sometime in 2014, the FDA will release the final rule for the national nutrition/menu labeling law officially m...

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IUDs: Myth Busters and Facts

<div class="MsoNormal"><b><u>By: Winnie Natu, MSIV</u></b></div><div class="MsoNormal"><b><u><br /></u></b></div><div class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-size: 12.0pt;">The intrauterine device (IUD) is a small plastic device that is inserted into the uterus and is one of the safest </span><span style="font-size: 11pt; text-align: center;">and most effective forms of reversible birth control for women. Currently there are two major options on the market: </span><i style="font-size: 11pt; text-align: center;"><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;">Mirena</span></i><span style="font-size: 11pt; text-align: center;">, a progestin-releasing IUD and <i>ParaGard, </i>a plastic T-shaped device partially wrapped in copper wire. </span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;">Despite its safety, efficacy, and benefits, the US has one of the lowest rates of IUD use worldwide. The purpose of this blog is to resolve some common misconceptions about IUDs and to answer questions that several women, like you, may have!<o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL4La44Xx0GgqDtsSabULoqTVE7ECXEdPhK9wsb8U1i22Ukw5ryosng-RKpl3Qomdsmt35ljYZjBpVuetMVV2ZZmhcx1NBZboOiBJpxOCpJv5tq3pOqsz590GQSbcgvwGgWcQ11z1WOCM/s1600/download.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="color: blue;"><img border="0" height="132" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjL4La44Xx0GgqDtsSabULoqTVE7ECXEdPhK9wsb8U1i22Ukw5ryosng-RKpl3Qomdsmt35ljYZjBpVuetMVV2ZZmhcx1NBZboOiBJpxOCpJv5tq3pOqsz590GQSbcgvwGgWcQ11z1WOCM/s200/download.jpg" width="200" /></span></a><span style="color: blue;"><b><span style="font-size: 15px;"><u>Case 1</u></span><span style="font-size: 11pt;">: </span></b><i><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;">A 28- year-old female with no past medical history comes in to discuss her options for birth control. She is currently in a monogamous relationship with her boyfriend and uses Loestrin Fe for contraception. She does a lot of travelling for work and is inconvenienced by having to take a daily pill. She does not want to have children in the near future but definitely wants to have a family someday. She has heard about IUDs but is worried that getting one might prevent her from ever having children.</span></i></span><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;"><o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 11pt;">This is a common misconception however an IUD is a completely reversible contraceptive device: it begins working as soon as it is fitted and stops as soon as it is removed with no effect on future fertility. <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVZdLFYu5FFj3TibrfFqfCe5P_eFs8LUojVm9QgPGGdWV3jVL12DUipXgGSMrJ3paORdLOi-m4vmOWZK6-H1l-UxeqzzR-cVfRcR3lK91q78wzchoZ-ZOajQGbmrYYQyRlGIZS0gggPIs/s1600/worried-asian-student.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="132" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVZdLFYu5FFj3TibrfFqfCe5P_eFs8LUojVm9QgPGGdWV3jVL12DUipXgGSMrJ3paORdLOi-m4vmOWZK6-H1l-UxeqzzR-cVfRcR3lK91q78wzchoZ-ZOajQGbmrYYQyRlGIZS0gggPIs/s200/worried-asian-student.jpg" width="200" /></a><span style="color: blue;"><b><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;"><u>Case 2:</u> </span></b><i><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;">A 20-year-old college student comes in for concerns with her current birth control pills. She is experiencing spotting between periods and often forgets to take her daily pill. She has had 3 sexual partners in the past 6 months and uses condoms occasionally. She has never been pregnant or had an STI but is concerned about the possibility of both and wants more information about her contraceptive options. When you mention an IUD she says she doesn’t want that because it increases the risk of something called pelvic inflammatory disease.</span></i></span><span style="font-size: 11.0pt; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt;"><o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-size: 11pt;">The World Health Organization has done multiple studies that all conclude the same thing: </span><span style="font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: "Lucida Sans"; mso-bidi-font-size: 13.0pt; mso-hansi-font-family: Cambria;">overall, women using an IUD have no increased risk of pelvic infection or infertility compared with women who used other types of birth control. </span><span style="font-size: 11pt;">In fact, Mirena acts to thicken cervical mucus and suppress or reduce endometrial bleeding and may offer some protection against an already low risk of PID. However it is important to remember than neither an IUD nor birth control pills protect against STIs! Only barrier contraceptives such as condoms can achieve this. This young woman should be screened for STIs and have a pregnancy test and if negative, she would be a candidate for an IUD.<b><o:p></o:p></b></span></div><div class="MsoNormal"><br /></div><div class="separator" style="clear: both; text-align: center;"></div><div class="MsoNormal"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJ0mgVjSPcO_roJb9yCIMCnqURViIcSmnAhaDZb-KfyyKbn3p35aUBWEWMrmsk_CTDgk8lzTC3CkhVG-YuLimTeJpdTr9Oo36__Gi4LRvNPciT3ecvitrDGhGE4XblUV0VpgiPkz4Xosg/s1600/mom-and-baby-closeup.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJ0mgVjSPcO_roJb9yCIMCnqURViIcSmnAhaDZb-KfyyKbn3p35aUBWEWMrmsk_CTDgk8lzTC3CkhVG-YuLimTeJpdTr9Oo36__Gi4LRvNPciT3ecvitrDGhGE4XblUV0VpgiPkz4Xosg/s200/mom-and-baby-closeup.jpg" width="200" /></a><b><span style="color: blue; font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Cambria;"><u>Case 3:</u></span></b><span style="font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Cambria;"><span style="color: blue;"> <i>A 39-year-old woman that has given birth to her second child 3 months ago is interested in long term but reversible birth control. She has heard about an IUD but is worried that it wont be as effective as the birth control pills she has used in the past.</i></span><b> <o:p></o:p></b></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal" style="margin-bottom: 10.0pt; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none;"><span style="font-size: 11pt;">A new study on perception of birth control has concluded that i</span><span style="font-size: 11pt;">t's not clear whether women have an overly optimistic view of the effectiveness of the birth control pill or an overly pessimistic view of the IUD. However, the fact is that IUDs can be left implanted for years, and are more than 99% effective at preventing pregnancy. In contrast, the birth control pill has been found in real-world practice to be about 95% effective.</span><b><span style="font-family: "Georgia","serif"; font-size: 15.0pt; mso-bidi-font-family: Georgia;"><o:p></o:p></span></b></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><b><span style="font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Cambria;">The Facts: </span></b></div><div class="MsoNormal"><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;">IUDs are an excellent choice of contraception for women who are seeking a long-term and<b> </b></span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;">effective birth control</span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;"> method, particularly those wishing to </span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;">avoid risks</span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;"> and side effects of contraceptive hormones.</span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;"><br /></span></span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;">  </span></span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;">The progestin-releasing <i>Mirena</i> is now considered to be one of the best options for treating heavy menstrual bleeding</span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;"><br /></span></span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;"> </span></span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;">The copper-releasing IUDs do not have hormonal side effects and may help protect against endometrial (uterine) cancer.</span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;"><br /></span></span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;"> </span></span><span style="font-size: 11pt; text-indent: -0.25in;">Certain women may be poor candidates for IUDs including </span><span style="color: #262626; font-size: 11pt; text-indent: -0.25in;">women with current or recent history of pelvic infection, women that may be currently pregnant, have had a recent abnormal Pap smear, have or have a history of untreated cervical or uterine cancer, and women with an anatomically abnormal uterus that is very small or large.</span></div><div class="MsoNormal" style="margin-left: .5in; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; mso-pagination: none; tab-stops: 11.0pt .5in; text-autospace: none; text-indent: -.5in;"><!--[if !supportLists]--><span style="font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Cambria; mso-bidi-font-size: 12.0pt; mso-fareast-font-family: Cambria; mso-hansi-font-family: Cambria;"><span style="font-size: 7pt;">        </span></span><!--[endif]--><span style="color: #262626; font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Georgia; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Cambria;">           </span><span style="font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Cambria;"><o:p></o:p></span></div><div class="MsoNormal"><span style="font-size: 11.0pt; mso-ascii-font-family: Cambria; mso-bidi-font-family: Verdana; mso-bidi-font-size: 12.0pt; mso-hansi-font-family: Cambria;">Please ask your doctor for information about IUD placement and review the following links for learning more about IUDs!</span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -0.25in;"><span style="font-size: 7pt;">  </span></span><span style="font-size: 11pt; text-indent: -0.25in;"><a href="http://www.plannedparenthood.org/health-topics/birth-control/who-can-use-iud-19274.htm" style="text-indent: -0.25in;">http://www.plannedparenthood.org/health-topics/birth-control/who-can-use-iud-19274.htm</a></span></div><div class="MsoNormal"><span style="font-size: 11pt; text-indent: -24px;"><span style="font-size: 7pt;">  </span></span><span style="font-size: 11pt; text-indent: -24px;"><a href="http://health.nytimes.com/health/guides/specialtopic/birth-control-and-family-planning/intrauterine-devices-(iuds).html" style="text-indent: -24px;">http://health.nytimes.com/health/guides/specialtopic/birth-control-and-family-planning/intrauterine-devices-(iuds).html</a></span></div><div class="MsoNormal"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfgTgaYBTzD809W2XqnLcPwy_KRUlojphhQwRa0k6iNkG6E1XFna5xj9ut8jndJX6WlaeIGPsQG-y8q3O40hc2iudDuiVtsMdDebwuh0uwWly8-T-NcFc6079s1mZDEgQH3YKqjjyIanE/s1600/Mirenasmall.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfgTgaYBTzD809W2XqnLcPwy_KRUlojphhQwRa0k6iNkG6E1XFna5xj9ut8jndJX6WlaeIGPsQG-y8q3O40hc2iudDuiVtsMdDebwuh0uwWly8-T-NcFc6079s1mZDEgQH3YKqjjyIanE/s200/Mirenasmall.jpg" width="195" /></a></div><div class="MsoNormal"><br /></div><br /><div class="MsoListParagraphCxSpLast" style="mso-list: l1 level1 lfo3; text-indent: -.25in;"><br /></div>

IUDs: Myth Busters and Facts

By: Winnie Natu, MSIV The intrauterine device (IUD) is a small plastic device that is inserted into the uterus and is one of the safest  and...

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