Wednesday, November 29, 2017

Should you call an ambulance or drive a gunshot victim to the hospital?


Let’s start off with a theoretical problem: 

You come out of a restaurant just as a man you do not know gets shot right in front of you. The gunman runs off and the gunshot victim and you lock eyes.
The victim is bleeding from the center of his body, you find yourself taking your shirt off, putting it to the man’s abdomen, and applying pressure. You can’t believe what is happening, as you yell, “Call a doctor! Call a doctor!”
Your thoughts are racing. “What if he bleeds out before the ambulance arrives?”
You think to yourself, “My car is right there, should I drive him to the hospital? It’s not far, but I’m not an ambulance driver. I have no idea what to do! I have no emergency medical training.” 

Should you transport a gunshot victim, or should you wait on emergency medical services?
Before you read on, take a minute to play the thought game. You desperately want to save this person’s life, what should you do? Wait for help, or get your patient to the ER?

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A study in JAMA Surgery found…
Do whatever gets the patient to the Emergency Room the fastest. For most injuries, the prehospital support of an ambulance was often best. But when it came to gunshot or knife wounds, the evidence showed that time was the most important factor. The faster the victim got to the hospital the better. 
The senior researcher, Elliott Haut, at Johns Hopkins University School of Medicine says:
Typically, protocols for prehospital interventions are established at a regional or statewide level, which allows first responders to determine what, if any, medical procedures should be performed prior to and during transport to the hospital, Haut says. But research studies have rarely, if ever, evaluated or compared all of the effects of system-driven pre-hospitalization policies, leaving ideal prehospital care strategies undefined, he adds.



Friday, November 24, 2017

I’m too bored to do this for another second!


I am often asked by patients, “How can I get myself to do stuff I don’t want to do?”
To this, I give the simple answer, “Switch up the stuff you’re doing, so that you aren’t totally bored.”
I am not a big believer in willpower. At best, people can only bully their way through a task for so long. Willpower may work for short bursts, mainly when you are newly motivated, but it doesn’t work in the long run.
In the real world, we often have to do stuff that needs to be done, but we get no direct reward for doing it. We like the idea of getting the boring project done, but we really don’t want to do it.
The project could be laundry, exercise, or a big report—we want it done, but we really don’t want to do it.
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Break it up into small chunks
The old question is: How do you eat an elephant? The answer: One bite at a time.
For example, if I am working on a large writing project I take regular breaks, usually every hour and fifteen minutes. Then, for the next 15 minutes, I do something else that needs to be done, such as move laundry from the washer or clean the bathroom. Yep, it’s true. I don’t want to do the laundry or clean the bathroom, but I do want it done.
After 15 minutes, I go back to my writing project. (I have a load in the dryer as we speak.)
By changing activities, I have found that I can get more done and stay motivated to complete tasks.

Research from the University of Toronto backs up my actions
University of Toronto (U of T) News reports, “…according to new University of Toronto research, there may be no noticeable dip in our motivation and ability to do something as long as we switch up tasks throughout the day.”

Dan Randles, is a postdoctoral fellow in the lab of Michael Inzlicht, a professor of psychology at U of T Scarborough. He says, “While people get tired doing one specific task over a period of time, we found no evidence that they had less motivation or ability to complete tasks throughout the day.”

Friday, October 6, 2017

Wiggle Balls recalled by Toys "R" Us: choking hazard to infants



The U.S. Consumer Product Safety Commission reported today, October 5, 2017, a recall involving Bruin Infant Wiggle Ball toys also called a giggle ball. They were sold exclusively at Babies “R” Us or Toys “R” Us.

"The firm has received six reports of rubber knobs breaking off, including four reports of pieces of the product found in children's mouths." the report said.

From the news release:

Description:
This recall involves Bruin Infant Wiggle Ball toys also called a giggle ball. The blue ball has textured bumps for gripping and has orange, green and yellow rubber knobs around the ball. The ball wiggles, vibrates and plays three different musical tunes. It has an on/off switch and requires 3 AA batteries to operate. The recalled wiggle balls have model number 5F6342E and Toys “R” Us printed on the product.


Remedy: 
Consumers should immediately stop using the recalled balls, take them away from babies and return them to Babies “R” Us or Toys “R” Us for a full refund.
Incidents/Injuries: 
The firm has received six reports of rubber knobs breaking off, including four reports of pieces of the product found in children's mouths.
Sold Exclusively At:
Babies “R” Us and Toys “R” Us stores nationwide from June 2016 through January 2017 for about $13.
Importer(s): 
Toys “R” Us Inc., of Wayne, N.J.
Distributor(s): 
Toys “R” Us Inc., of Wayne, N.J.

Toys “R” Us at 800-869-7787 from 9 a.m. to 5 p.m. ET Monday through Friday, or online at www.toysrus.com and click on Product Recalls for more information.
Manufactured In: 
China 
Units: 
About 29,700 (about 3,000 were sold in Canada)


Wednesday, September 13, 2017

Does your dog vote “lets go” or “stay” by sneezing?



When it comes to domesticated dogs, there is no evidence that sneezing is used to communicate, but in the African Wild Dog population of Botswana, sneezing seems to be used to vote: “Let’s go on a hunt” or “lets not”. 


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Saturday, September 9, 2017

Research: Specialized talk therapy and antidepressants help children and teens


A specialized mental health treatment called, cognitive behavioral therapy (CBT) has been clinically shown, many times over the last few years, to help patients deal with common diagnoses such as depression, anxiety disorders, and panic disorders.
CBT is a form of talk therapy that teaches patients how to challenge negative patterns of thought, about themselves and their world; thoughts that often lead them to self-destructive decisions and behaviors.
This research looked at how CBT worked by itself, and with mental health medication, for childhood anxiety disorders.
The medications were:
Selective Serotonin Reuptake Inhibitors (SSRIs), are a class of antidepressants that work by increasing levels of serotonin (a neurotransmitter) in the brain. SSRIs slow how quickly the brain picks up serotonin from between the nerve synapsis, thus leaving more available for the nerves to use.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), is a class of antidepressants that work by increasing levels of serotonin and norepinephrine (neurotransmitters) in the brain. SNRIs slow how quickly the brain picks up serotonin and norepinephrine from between the nerve synapsis, thus leaving more available for the nerves to use. SNRIs affect a wider range of neurotransmitters and are often used with multiple types of mood disorders.
Size of the study and its findings
•This meta-analysis looked at data from 7,719 patients in 115 studies. 4290 (55.6%) were female, and the mean (range) age was 9.2 (5.4-16.1) years. A meta-analysis statistically analyzes data from multiple studies.
•When SSRIs were compared to placebo pills, this study found that SSRIs significantly reduced anxiety in patients.
•Patients in this study taking Benzodiazepines and tricyclics (Older forms of anti-anxiety medication, tranquilizers.)
•Concerning CBT the researchers wrote:
When CBT was compared with wait-listing/no treatment, CBT significantly improved primary anxiety symptoms, remission, and response. Cognitive behavioral therapy reduced primary anxiety symptoms more than fluoxetine and improved remission more than sertraline. The combination of sertraline and CBT significantly reduced clinician-reported primary anxiety symptoms and response more than either treatment alone.
•It was noted that medication had some negative side effects while CBT did not:
Adverse events were common with medications, but not with CBT, and were not severe. Studies were too small or too short to assess suicidality with SSRIs or SNRIs. One trial showed a statistically nonsignificant increase in suicidal ideation with venlafaxine [antidepressant brand name Effexor XR].
• Cognitive behavioral therapy had fewer patient dropouts than placebo pills or medications.


Read the research paper
Citation: Wang Z, Whiteside SPH, Sim L, Farah W, Morrow AS, Alsawas M, Barrionuevo P, Tello M, Asi N, Beuschel B, Daraz L, Almasri J, Zaiem F, Larrea-Mantilla L, Ponce OJ, LeBlanc A, Prokop LJ, Murad MH. Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety DisordersA Systematic Review and Meta-analysis. JAMA Pediatr. Published online August 31, 2017. doi:10.1001/jamapediatrics.2017.3036

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Monday, July 3, 2017

Humans, monkeys, and rats laugh, but why?

I am asked this question often, "Why do we laugh?" My common answer is, "As social animals it helps us deal with the stress of being social animals."

In this 17 minute TED Talk, Dr. Sophie Scott, talks about her own and other's research into the subject.

Most of this TED talk is information based and quite interesting, but by the end I was gasping for air in full laughter. Then she explained why. Educational and fun... not a bad way to learn.




Sophie Scott, Ph.D is the deputy director of the University College London’s Institute of Cognitive Neuroscience.