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How to Study

Because of the snail's pace that education has developed at, most of us don't really know how to study because we've been told lectures and reading thousands of pages is the best way to go, and no one really wants to do that all day. That's not the only way to study. My first year of medical school... You know when you start the year so committed, then eventually you skip lectures once or twice... then you just binge on skipping? Kinda like breaking a diet "Two weeks in: oh I'll just have a bite of your mac n' cheese... oh is that cake? and doritos? and french fries? Give me all of it all at once." Anyways, when that happened in first year I started panicking after a while; but after studying with friends who had attended lectures, I found they were almost as clueless as I was. I'm not trying to say lectures are useless... What my fellow first years and I just didn't know was how to use the resources we had– whether we were keen beans or lazy pants, or somewhere in between. I still struggle with study habits, but I've formed some theories since and I'm going to share these with you. Reading While reading should not be the entire basis of your studying, it is the best place to start. Best to start with the most basic and detailed sources (ex.Tortora if it's a topic I'm new to, then Kumar and Clark, and Davidson's are where I usually start, but there are tons of good ones out there!). I do not feel the need to read every section of a chapter, it's up to the reader's discretion to decide what to read based on objectives. If you do not have time for detailed reading, there are some wonderful simplified books that will give you enough to get through exams (ICT and crash course do some great ones!). I start with this if exams are a month or less away. Later, it's good to go through books that provide a summarized overview of things, to make sure you've covered all bases (ex. Flesh and Bones, the 'Rapid ______" series, oxford clinical handbook, etc.). These are also good if you have one very specific question about a subject. Video Tutorials**** After all that reading, you want the most laid back studying you can find. This is where Meducation and Youtube become your best friend. (I can post a list of my favourite channels if anyone is interested).I always email these people to thank them. I know from the nice people that run this website that it takes a tremendous amount of effort and a lot of the time and it's just us struggling students who have much to gain. Everyone should use video tutorials. It doesn't matter if you're all Hermione with your books; every single person can benefit from them, especially for osce where no book can fully portray what you're supposed to do/see/hear during examinations. Some youtube channels I like https://www.youtube.com/user/TheAnatomyZone https://www.youtube.com/user/ECGZone https://www.youtube.com/user/MEDCRAMvideos https://www.youtube.com/user/awolfnp https://www.youtube.com/user/harpinmartin https://www.youtube.com/user/RadiologyChannel Lectures We're all thinking it, lectures can be boring. Especially when the speaker has text vomited all over their slides (seriously, If I can't read it from the back of the lecture hall, there's too much!. It's even worse when they're just reading everything to you, and you're frantically trying to write everything down. Here's the thing, you're not supposed to write everything down. If you can print the slides beforehand or access them on your laptop/ipad/whatever you use and follow along, do that. You're meant to listen, nod along thinking (oh yes I remember this or oooh that's what happens? or Oh I never came across that particular fact, interesting!). It's also meant to be a chance for you to discuss interesting cases from the a doctor's experiences. If you're lucky to have really interactive lecturers, interact! Don't be shy! Even if you make a fool of yourself, you're more likely to remember what you learned better. If you happen to be in a lecture you're completely unprepared for (basically 70% of the time?). Think of it as "throwing everything at a wall and hoping something sticks." Pull up the slides on your smart phone if you have one, only take notes on interesting or useful things you hear the speaker say. If all else fails, these lectures where tell you what topics to go home and read about. Tutorials My university has gradually increased its use of tutorials, and I couldn't be happier. Make the most out of these because they are a gift. Having the focused attention of a knowledgeable doctor or professor in a small group for a prolonged period of time is hard to lock down during hospital hours. Ask lots of questions, raise topics you're having trouble understanding, this is your protected time. Discussions In group study activities, this is particularly hard to make the most of when everyone in your group varies in studying progression, but even so, it can be beneficial. Other people's strengths might be your weaknesses and vise versa– and it's always helpful to hear an explanation about something from someone at your level, because they will neither under or over estimate you, and they will not get offended when you tell them "ok I get it that's enough." Myself and 3 of my medic friends would meet once a week the month or two leading up to exams at one of our houses to go through OSCE stations and concepts we didn't understand (food helps too). Besides peer discussions, you should take advantage of discussions with doctors. If the doctor is willing to give you their time, use it well. Practice Questions I am a practice question book hoarder. Practice questions book not only test and reaffirm your knowledge, which is often hard to find if your exams are cumulative and you have little to no quizes/tests. They also have concise, useful explanations at the back and, they tell you where the gaps in your studying are. For my neuro rotation, the doctor giving the first and last lecture gave us a quiz, it was perfect for monitoring our progress, and the same technique can be used in your studies. Practical Clinical Experiences If you freeze up during exams and blank out, and suddenly the only forms of text floating around your brain are Taylor Swift lyrics, these are bound to come to your rescue! "Learn by doing." Take as many histories as you can, do as many clinical exams in hospital, and on your friends to practice, as you can, see and DO as many clinical procedures as you can; these are all easy and usually enjoyable forms of studying. Teaching Have you ever had an experience where one of your peers asks you about something and you give them a fairly good explanation then you think to yourself "Oh wow, I had no idea that was actually in there. High five me." If there is ever an opportunity to teach students in the years below you or fellow students in your year, do it! It will force you to form a simplified/accurate explanation; and once you've taught others, it is sure to stick in your head. Even if it's something you don't really know about, committing yourself to teaching others something forces you to find all the necessary information. Sometimes if there's a bunch of topics that nobody in my study group wants to do, we each choose one, go home and research it, and explain it to each other to save time. If you're doing this for a presentation, make handouts, diagrams or anything else that can be used as an aid.  
Mary
about 6 years ago
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Exam Survival Guide

1. Sleep (I realize I’m posting this at 12:30 am…) (http://www.helpguide.org/life/sleep_tips.htm) I know there’s a popular perception of sleep deprivation going hand in hand with working hard or succeeding academically. However, that is only true if you’re working very last minute, and don’t care about retaining the information–you basically just want to get through your upcoming test/assignment. I would like to clarify that, although learning about 10 months of material in 2 weeks is overwhelming, it is NOT last minute because whatever you’re working on right now, you’ll have to remember in 2 weeks for your exam. Besides the exam, if you’re studying medicine, you need to remember most of these things for the rest of your life. In order to retain that information, you need to stay alert, well rested and motivated. Prolonged sleep deprivation can make you feel very ‘CBA’ very fast. 2. Stay Energized Sleep is only one factor in staying motivated and alert; another is staying energized¬–in a healthy way. Simply put: if you feel well, you’ll work well. Eat well: difficult, I know, when you’ve got so little time to spare; but as much as you can, try to eat more whole foods (aka things that don’t come in wrappers or have their own commercial) and keep a balanced diet (too much of anything is usually not good). Everyone snacks while they’re doing exams, but try to find a vice that won’t put you in a sugar coma (some good examples include berries and other fruits, nuts, carrots with hummus to dip in, granola bars, etc). Note: drinking tea is also an excellent way to stay energized! Stay active: Again, I know something like this is difficult to keep up in normal everyday life, let alone during exam stress. Even if it is just for 15-20 minutes, some cardio (note: the more strenuous the workout in a short period of time, the more benefit you’ll get) is a fantastic ‘eye-opener’ (I learned that phrase while learning how to take an alcohol history and now I really like it)! No one wants to go for a run in the morning, but after you get past the first 2-3 minutes of wanting to collapse, your body starts to feel really grateful. This is the BEST way to stimulate your senses and wake yourself up. I promise it’s better than any energy drink or cup of coffee you could have. Take small breaks: SMALL breaks!!! About 10 minutes. Every once in a while, you need to get up and walk around to give yourself a break, have some fresh air, grab a snack, but try not to get carried away; try to avoid having a short attention span. 3. Make Lists I cannot stress enough how counterproductive it is to overwhelm yourself with the amount of work you have. Whether you think about it or not, that pile is not going anywhere. Thinking about it won’t wish it away. Stop psyching yourself out and just get on with it– step by step. Making a list of objectives you need to accomplish that day or week is a great way to start; then, cross them out as you go along (such a satisfying feeling). Being able to visualize your progress will be a great motivator. Remember: it is important to be systematic with your studying approach; if you jump around between modules because they’re boring you’re just going to confuse yourself and make it hard to remember things when that exam comes Note: I have a white board in my room where I write my objectives for the week. Some days it motivates, some days it I want to throw it out the window (but I can't reach the latch)… 4. Practice Questions Practice questions are excellent for monitoring your progress; they’re also excellent at scaring you. Do not fear! This is a good thing, because now you know what you’re missing, go back and read up on what you forgot to take a look at, and come back and do the questions later. Then give yourself a sticker for getting it right ? Practice questions are also great for last minute studying too because they can help you do what I call “backwards studying”–which is what I just described: figuring out what you need to learn based on what the questions look like. 5. Be realistic Set realistic goals for yourself; most importantly, set realistic daily goals for yourself so that when you get all or most or even some of them done you can go to sleep with a level of satisfaction. Also, you need to pick your battles. Example: if you suck at neuro, then one module’s loss is another’s gain. Don’t spend too much time trying to get through one thing, just keep moving forward, and come back to it later 6. ‘Do not disturb’ Facebook, twitter, instagram, youtube, whatsapp, texting, pinterest, meme websites, so many fantastic ways to kill your time… Do yourself a favor, save them for your breaks. If someone is dying or on fire, they will most likely call you, not text you or write on your wall; you do not need to check your phone that often unless you're expecting something time sensitive. 7.Don’t Compare Everyone studying in your program is going to be stressed about things; do NOT let it rub off on you. You know those moments when you hear a peer or a prof/tutor describing something you have never even heard of, then you start panicking? Yeah, don’t do that. It happens to everyone. Instead of worrying so much, just go read about it! Simple solution right? What else are you going to do? Plus, a lot of the time other students seem to know more than they need to about certain things (which I can tell you right now, doesn’t always mean they’re doing better than you; knowing random, very specific factoids doesn’t mean they can bring it in clinic. Everyone can pull a Hermione and know a book inside out, but this is not necessarily the hallmark of a good doctor), what’s it to you? Worry about yourself, be confident in your abilities, and don’t trouble yourself with comparing to other people 8.Practice for Practicals Everyone is afraid of practical exams, like the OSCE (at any rest station you're likely to find me with my head in my hands trying to stabilize my breathing pattern and trying not to cry). The best way to be ready is to practice and practice and practice and practice. It’s like learning to drive a car. At first you’re too aware of your foot on the gas, the position of your hand on the wheel, etc; but, after driving for a little while, these things become subconscious. In the same way, when you walk into a station, you could be so worried about how you’ll do your introduction and gain consent, and remembering to wash your hands, and getting equipment and and and and and; the anxiety affects your confidence and your competence. If you practice enough, then no matter what they throw at you, you will get most of the points because the process will be second nature to you. Practice on your roommates, friends, family members, patients with a doctor's help...when appropriate... Even your stuffed animals if you're really desperate. DO NOT leave practicing for these practicals to the last minute; and if you do, make sure you go through every thing over and over again until you’re explaining examinations in your sleep. NOTE: When I'm practicing for OSCE alone, I record myself over and over again and play it back to myself and criticize it, and then practice againn. 9.Consistency You don’t necessarily have to study in the same place every day; however, it is always good to have some level of routine. Some examples include: waking up/sleeping at the same time everyday, going for a run at the same time every day, having the same study routine, etc. Repetition is a good way to keep your brain focused on new activities because, like I said before, the more you repeat things, the more they become second nature to you. Hope these tips are of some use to you; if not, feel free to sound off in the comments some alternate ways to get through exams. Remember that while exams are stressful, this is the time where you build your character and find out what you’re truly capable of. When you drop your pen after that final exam, you want to feel satisfied and relieved, not regretful. Happy Studying ?  
Mary
over 6 years ago
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An eye on optic nerve swelling - Diets USA Magazine

Optic neuritis is swelling and inflammation of the optic nerve which may result in dull pain behind the eye, and cause visual impairments such as blurry and distorted vision as well as “blind spots,” and/or “flashing lights, which may become more apparent over the course of several hours, or days.  
diets-usa.com
about 4 years ago
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Diets USA Magazine

14 Reasons why you are always tired and how to deal with it Fatigue was always so obviously on my face and I was the last one who found about it. I was always doing something else but sleep. Sometimes I would even forget to …  
diets-usa.com
about 4 years ago
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Metabolism: Starvation versus Stress

<p>Not feeding an injured or ill patient is not that same as a normal individual who is fasting.&nbsp;&nbsp; A pound of weight loss in the stress patient is significantly different than a pound of weight loss in someone on a diet.&nbsp;&nbsp;A basic understanding of stress metabolism is needed prior to a discussion of nutrition.&nbsp; </p>  
Jeffrey S. Guy, MD, FACS
over 9 years ago
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The (Peninsula) medical student's guide to healthy eating

I am a 4th year medical student, about to go into my final year and I created a healthy eating booklet directed at medical students as part of a Special Study Unit module. In the title of the booklet I included Peninsula medical school in the title to make it more appealing to the medical students in my university. However, all the information provided in the booklet is relevant to all medical students and even to non-medical students. Students are notoriously popular for having unhealthy diets during university life. Some of the reasons for this are the assumptions that healthy meals are more expensive to prepare, take longer to cook and require a greater deal of expertise than the average microwaveable meal Also the transition from living at home where meals are provided to having to fend for themselves especially for freshers can be one of the barriers to adopting a healthy lifestyle for students This booklet provides easy to follow tips on healthy eating and provides practical advice for cooking meals that are both healthy and cheap! The information is also presented in a style that's easy and interesting to read The booklet was created with the help of expert advice from a dietician at the Royal Devon and Exeter hospital, web based resources such as the NHS choices website and food leaflets from reputable organisations.  
Dolapo Thompson
over 7 years ago
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The (Peninsula) medical student's guide to healthy eating

I am a 4th year medical student about to go into my final year and I created a healthy eating booklet directed at medical students as part of a Special Study Unit module. I included Peninsula medical school in the title of the booklet to make it more appealing to the medical students in my university. However, all the information provided in the booklet is relevant to all medical students and even to non-medical students. Students are notoriously popular for having unhealthy diets during university life. Some of the reasons for this are the assumptions that healthy meals are more expensive to prepare, take longer to cook and require a greater deal of expertise than the average microwaveable meal Also the transition from living at home where meals are provided to having to fend for themselves especially for freshers can be one of the barriers to adopting a healthy lifestyle for students This booklet provides easy to follow tips on healthy eating and provides practical advice for cooking meals that are both healthy and cheap! The information is also presented in a style that's easy and interesting to read The booklet was created with the help of expert advice from a dietician at the Royal Devon and Exeter hospital, web based resources such as the NHS choices website and food leaflets from reputable organisations.  
Dolapo Thompson
over 7 years ago
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How Health Evangelism Can Give Us More Out of Life Than We Can See

As more and more knowledge about our health is becoming evident, people everywhere are looking at new and innovative ways like Health Evangelism as a means of treatment. Getting a clean bill of health is a challenge for many people these days. For that reason many people are looking at different types of health care options that may stray a bit from the traditional but still give the patient needed relief from their physical problems. This is where new approaches have come in to help gain control of many of the medical issues that many people have to face. What is Health Evangelism? The expression ‘health evangelism’ is defined as an applying of the principles of healthful living in a way that includes physical laws that have been set forth by God to act in our lives. This is simply recognizing that God, as the provider of life, created us to function in a very specific way. Many of the physical health problems that we face are a direct result of going against those inborn laws that he set forth. Health Evangelism is a means of identifying those laws and not only using them within but passing them on to others in an evangelizing work. Benefits of Health Evangelism Your knowledge of the physical laws that he has set in motion have been instrumental in helping to improve a number of major health concerns of many people. For example, just coming to an understanding of your diet and how certain foods were designed to nourish your body can help to improve blood sugar health, cholesterol levels, cardiovascular conditioning, and your immune system among other things. Higher Spiritual Plane As you see how this understanding has had a major impact on the improvement of your health you will reach a point where, you will develop a personal relationship with your creator and the things he’s provided. Your care for your health and physical well-being will not be just taking care of yourself but you will come to view it as a part of your worship to your spiritual benefactor. By doing this, you will have reached a higher spiritual level that you may not have discovered otherwise. We have all been wonderfully made and our appreciation for our creation is a demonstration that we are part of something that extends far beyond our own personal world. Learning the details of Health Evangelism can open our eyes to many of the things unseen from the world around us. For more information, visit http://www.pambrarmd.com/contact.php.  
Enrica
about 6 years ago
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INFLUENCE OF DIETARY FACTOR IN STUDENT PERFORMANCE

Introduction Nutrition during adolescence is of great importance in the quality of life and in school performance. In our society, eating habits are changing due to socio-cultural and family factors, new ideas about self-image and a global food culture. Data published in the National Health Survey (ENSANUT 2006), suggest that excess weight in adolescents between 12 and 19 years, has a national average of 31.9% in Mexico. One in 3 teens have excessive weight in our country. Several studies suggest that foods high in energy density and large portions of food, increase energy consumption and hence weight gain. Bottled soft drinks currently consumed, contribute to the epidemic of obesity and type II diabetes in Mexico. The intake of energy from these drink, represent 21% of the total energy consumption in Mexican adolescents. This, added to the energy from the diet, both contribute to these epidemics. Therefore, the adoption of patterns of consumption of healthy food and drinks for adolescents should be a priority for the population, since a well-balanced diet positively affects the physical and intellectual development of adolescents.  
katy torres
about 10 years ago
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Obesity Part 1 – Fat Kid in a Fat Society

Introduction to Obesity One of my favourite past-times is to sit in a bar, restaurant, café or coffee shop and people watch. I am sure many of you reading this also enjoying doing this too. People are fascinating and it is intriguing to observe: what they do; how they act; what they wear and what they look like. My family and I have always observed those around us and discussed interesting points about others that we have noticed. When I first came up to visit Birmingham University my family all sat in a coffee shop in the centre of Birmingham and noticed that on average the people walking past us looked much slimmer than what we were used to seeing back in south Wales. Now, when I go home it is more painfully obvious than ever that the people in my home region are much, much heavier than they should be and are noticeably bigger than they used to be even a short number of years ago. This change in the population around me is what first made me seriously think about obesity, as a major problem affecting the world today. Nowadays obesity is all around us! It is noticeable, it is spreading and it should worry us all. Not just for our own individual health but also for the health of our society. Obesity affects everything from the social dynamic of families, to relationships at school or work, to how much the NHS costs to run. Obesity is a massive problem and if we as a society don’t start getting to grips with it, then it will have huge implications for all of us! I am currently in my 5th year at medical school. While I have been here I have taken a keen interest in obesity. The physiology, the psychology, the anatomy, the statistics and the wider affects on society of obesity have all been covered in curriculum lectures and extra curriculum lectures. I have taken part in additional modules on these subjects and sort out many experts in this field while on hospital placements. Obesity is fascinating for some many reasons and I thought that it would be a great topic to write some blogs about and hopefully start some discussions. Warning For my first blog on the topic of obesity I quickly want to write a bit about myself and my battle with weight. Everyone’s favourite topic is themselves, but I like to think that’s not why I have written this and I hope it doesn’t come across as a narcissistic ramble. I don’t intend to try and make myself come off well or suggest that I have all the answers (because I know very well that I don’t) and I hope it doesn’t come across like that. I want to write a bit of an autobiography because I wish to demonstrate how easy it is to go from a chunky kid to a technically obese teenager to a relatively fat adult without really realising what was happening. Chunky Child to Fat adult While planning this blog I realised that my Meducation profile picture was taken when I was at my all time fattest. At the graduation ceremony at the end of my 3rd year at university after completing my intercalation I was over 19 stones. At 6 foot 2” this gave me a BMI of >33 which is clinically obese. I had a neck circumference of >18”, a chest circumference of 48”, a waist of >40”, a seat of >52” and a thigh circumference of >28” per leg. Why do I know all of these rather obscure measurements? Partly because I am quite obsessive but mainly because I had to go to buy a tailor made suit because I could no longer buy a suit from a shop that I could fit into and still be able to move in. The only options left to me where massive black tent-suits or to go to a tailors. After the graduation I sat down at my computer (whilst eating a block of cheese) and compared my face from the graduation photos to pictures I had taken at the start of university and the difference in shape and size was amazingly obvious. I had got fat! I realised that if I had a patient who was my age and looked like me with my measurements then I would tell him to lose weight for the good of his health. So, I decided that finally enough was enough and I that I should do something about it. Before I describe how I got on with the weight management I will quickly tell the back story of how I came to be this size. I have always been a big guy. I come from a big family. I have big bones. I had “puppy fat”. I was surrounded by people who ate too much, ate rubbish and were over weight themselves, so I didn’t always feel that there was anything wrong with carrying a bit of tub around the middle. When I went to comprehensive school at age 12 I had a 36” waist. I thought I carried the weight quite well because I was always tall and had big ribs I could sort of hide the soft belly. Soon after arriving at the new school I had put on more weight and for the first time in my life I started to get bullied for being fat! And I didn’t like it. It made me really self-aware and knocked my confidence. Luckily, we started being taught rugby in PE lessons and I soon found that being bigger, heavier and stronger than everyone else was a massive advantage. I soon got my own back on the bullies… there is nowhere to hide on a rugby field! This helped me gain my confidence and I realised that the only way to stop the bullying was to confront the bullies and to remake myself in such a way as that they would be unable to bully me. I decided to take up rugby and to start getting fit. I joined a local club, starting playing regularly, joined a gym and was soon looking less tubby. Reflecting (good medical jargon, check) on my life now I can see that my PE teachers saved me. By getting me hooked on rugby they helped get me into many other sports and physical activity in general and without their initial support I think my life would have gone very differently. Rugby was my saviour and also later on a bit of a curse. As I grew up I got bigger and bigger but also sportier. I started putting muscle on my shoulders, chest and legs which I was convinced hid how fat I actually was. I developed a body shape that was large but solid. I was convinced that although I was still carrying lots of excess weight I no longer looked tubby-fat. When I was 14 my PE teachers introduced me to athletics. They soon realised that I was built for shot putt and discuss throwing and after some initial success at small school competitions I joined a club and took it up seriously. At this age I had a waist of about 38” but was doing about 3-4 hours of exercise almost everyday, what with rugby, running, gym, swimming and athletics – in and out of school. My weight had by now increased to roughly 15 stones and my BMI was over 30. I was physically fit and succeeding at sport but still carrying quite a lot of fat. I no longer thought of myself as fat but I knew that other people did. Between the ages of 14 and 18 I started to be picked for regional teams in rugby and for international athletic competitions for Wales. My sporting career was going very well but the downside of this was that I was doing sports that benefited from me being heavier. So the better I got the heavier I wanted to become. I got to the stage where I was eating almost every hour and doing my best to put on weight. At the time I thought that I was putting on muscle and being a huge, toned sports machine. It took me a while to realise that actually my muscles weren't getting any bigger but my waist was! By the time I had completed my A-levels I was for the first time over 18 stones and had a waste of nearly 40”. So, at this point I was doing everything that I had been told that would make me more adapted for my sport and I was succeeding but without noticing it I was actually putting on lots of useless excess weight that in the long term was not good for me! During my first year of university I gave up athletics and decided that I no longer needed to be as heavy for my sports. This decision combined with living away from home, cooking for myself and walking over an hour a day to and from Uni soon began to bear fruit. By the summer of my first year at Uni, aged 19, I had for the first time in my life managed to control my weight. When I came to Uni I was 18 stone. After that first year I was down to 14 stone – a weight I had not been since I was 14 years old! I had played rugby for the Medical school during my first year but as a 2nd row/back row substitute. These positions needed me to be fit and not necessarily all that heavy and this helped me lose the weight. During my second year I began to start as a 2nd row and was soon asked to help out in the front row. I enjoyed playing these positions and again realised that I was pretty good at it and that extra weight would make me even better. So between 2nd year and the end of 3rd year I had put on nearly 5 stone in weight and this put me back to where I started at my graduation at the end of 3rd year. The ironic and sad thing is about all this that the fatter, less “good looking” and unhealthier I became, the better I was adapted for the sports I had chosen. It had never occurred to me that being good at competitive sports might actually be bad for my health. The Change and life lessons learnt At the beginning of my 4th year I had realised that I was fatter than I should be and had started to pick up a number of niggly injuries from playing these tough, body destroying positions in rugby. I decided that I would start to take the rugby less seriously and aim to stay fit and healthy rather than be good at a competitive sport. With this new attitude to life I resolved to lose weight. Over the course of the year there were a number of ups and downs. I firstly went back to all the men’s health magazines that I had stock piled over the years and started to work out where I was going wrong with my health. After a little investigation it became apparent that going running and working out in the gym was not enough to become healthy. If you want to be slim and healthy then your diet is far more important than what physical activity you do. My diet used to be almost entirely based on red meat and carbs: steak, mince, bacon, rice and pasta. Over the year I changed my diet to involve far more vegetables, more fibre, more fruit, more salad and way less meat! The result was that by Christmas 2012 I was finally back below 18 stones. The diet had started to have benefits. Then came exams! By the end of exams in April 2013 I had gone back up 19 stones and a waist of >40”. I was still spending nearly 2 hours a day doing weights in the gym and running or cycling 3 times a week. Even with all this exercise and a new self- awareness of my size, a terrible diet over the 3 week exam period had meant that I gained a lot of fat. After exams I went travelling in China for 3 weeks. While I was there I ate only local food and lots of coffee. Did not each lunch and was walking around exploring for over 6 hours a day. When I got back I was 17.5 stone, about 106kg. My waist had shrunk back down to 36” and I could fit into clothes I had not worn in years. This sudden weight loss was not explained by traveller’s diarrhoea or any increased activity above normal. What made me lose weight was eating a fairly healthy diet and eating far less calories than I normally would. I know this sounds like common sense but I had always read and believed that if you exercised enough then you could lose weight without having to decrease your calorie intake too much. I have always hated the sensation of being hungry and have always eaten regular to avoid this awful gnawing sensation. I had almost become hunger-phobic, always eating when given the opportunity just in case I might feel hungry later and not because I actually needed to eat. The time in China made me realise that actually I don’t NEED to eat that regularly and I don’t NEED to eat that much. I can survive perfectly ably without regular sustenance and have more than enough fat stores to live my life fully without needing to each too much. My eating had just become a habit, a WANT and completely unnecessary. After being home for a month I have had some ups and downs trying to put my new plans into action. Not eating works really easily in a foreign country, where it’s hot, you are busy and you don’t have a house full of food or relatives that want to feed you. I have managed to maintain my weight around 17.5 stones and kept my waist within 36” trousers. I am counting that as a success so far. The plan from now on is to get my weight down to under 16.5 stones because I believe that as this weight I will not be carrying too much excess weight and my BMI will be as close to “not obese” as it is likely to get without going on a starvation diet. I intend to achieve this goal by maintain my level of physical activity – at least 6 hours of gym work a week, 2 cardio sessions, tennis, squash, cycling, swimming and golf as the whim takes me. BUT MORE IMPORTANTLY, I intend to survive off far fewer calories with a diet based on bran flakes, salad, fruit, nuts, chicken and milk. I am hoping that this very simple plan will work! Conclusion Writing this short(-ish) autobiography was quite cathartic and I would really recommend it for other people who are trying to remake themselves. Its helped me put my thoughts in order. Over the years I wanted to lose weight because I wanted to look better. This desire has now matured into a drive to be not just slimmer but healthier; I no longer want to be slimmer just for the looks but also to reduce the pressure on my joints, to reduce the pressure on my cardiovascular system, to reduce my risks of being fat when I am older, to hopefully reduce the risk of dying prematurely and to some extent to make life cheaper – eating loads of meat to prevent hunger is expensive! I hope this blog has been mildly interesting, but also informative of just how easy it is for even a health conscious, sporty individual to become fat in our society. I also wanted to document how difficult it is to lose weight and maintain that new lower weight for any prolonged length of time. At some point I would like to do a blog on the best methods for weight loss but that may have to wait until I have found what works for me and if I do actually manage to achieve my goals. Would be a bit hypercritical to write such a blog while still having a BMI yo-yoing around 32 I feel! Thought for the day 1 - Gaining wait is easy, becoming fat is easy, losing fat is also technically easy! The hard part is developing AND then maintaining a healthy mental attitude towards your weight. The human body has evolved to survive starvation. We are almost perfectly made to build up high density fat stores just in case next year’s crops fail and we have to go a few months on broth. I will say it again – We are designed to survive hard conditions! The problem with the modern world and with modern society is that we no longer have to fight to survive. For the first time in human history food is no longer scarce… it is in fact incredibly abundant and cheap (http://www.youtube.com/watch?v=-Z74og9HbTM). It is no surprise that when a human body is allowed to eat want and how much it craves and then do as little activity as possible, that it puts on fat very quickly. This has to be one of the major ironies of our age – When the human race has evolved society enough that we no longer need to have fat stores in case of disaster, that we are now the fattest humans have ever been! 2 – The best bit of advice I was ever given is this: “Diets ALWAYS fail! No matter what the diet or how determined you are, if you diet then within 2 years you will be the same weight or heavier than you are now. The only way to a healthy body is through a healthy LIFESTYLE CHANGE! You have to make changes that you are prepared to keep for a long time.”  
jacob matthews
over 6 years ago
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Imagine a world where procrastination became a productive pastime…

Imagine a world where procrastination became a productive pastime… Procrastination, as it stands, is a core feature of the ‘human condition’ and most would argue that it is here to stay. However, what if we could hijack the time we spend playing Candy Crush saga and trick ourselves into contributing towards something tangible. Today, I wish to explore this possibility with you. The phrase ‘gamification’ is not a new or made up word (I promise) although I agree it does sound jarring and I certainly wouldn’t recommend trying to use it in a game of scrabble (yet). The phrase itself refers to the process of applying game thinking and game mechanics to non-game contexts to engage users in solving problems. For our purposes and for the purposes of this blog ‘problems’ will equate to promoting healthy living for our patients and maintaining our own medical education. For one reason or another, most people show addictive behaviour towards games especially when they incorporate persistent elements of progression, achievement and competition with others. The underlying psychology won’t be discussed here; call it escapism, call it procrastination, call it whatever you will. What I want you to realise is that every day millions of people spend hours tending to virtual farms and cyber families whilst competing vigorously with ‘online’ friends. If we can take the addictive aspects of these popular games and incorporate them in to the non-game contexts I indicated to above, we could potentially trick ourselves, and even perhaps our patients, into a better way of life. The first time I heard the phrase ‘gamification’ was only last year. I was in Paris attending the Doctors 2.0 conference listening to talks on how cutting edge technologies and the Internet had been (or were going to be) incorporated into healthcare. One example that stood out to me was a gaming app that intended to engage people with diabetes to record their blood sugars more regularly and also compete with themselves to achieve better sugar control. People who have the condition of Diabetes Mellitus are continuously reminded of their diet and their blood sugar levels. I am not diabetic myself, but it is not hard to realise that diet and sugar control is going to be an absolute nightmare for people with diabetes both from a practical and psychological standpoint. Cue the mySugr Compainion, an FDA approved mobile application that was created to incorporate the achievement and progression aspects of game design to help encourage people with diabetes to achieve better sugar control. The app was a novel concept that struck a chord with me due to its potential to appeal to the part in everyone’s brain that makes them sit down and play ‘just one more level’ of their favorite game or app. There are several other apps on the market that are games designed to encourage self testing of blood sugar levels in people with diabetes. There is even a paediatric example titled; “Monster Manor,” which was launched by the popular Sanofi UK (who previously released the FDA / CE approved iBGStar iPhone blood glucose monitor). So applying aspects of game design into disease management apps has anecdotally been shown to benefit young people with Diabetes. However, disease management is just one area where game-health apps have emerged. We are taught throughout medical school and beyond that disease prevention is obviously beneficial to both our patients and the health economy. Unsurprisingly, one of the best ways to prevent disease is to maintain health (either through exercise and / or healthy eating). A prominent example of an app that helps to engage users in exercising is ‘RunKeeper,’ a mobile app that enables people to track and publish their latest jog-around-the-park. The elements of game design are a little more subtle in this example but the ability to track your own progress and compete with others via social media share buttons certainly reminds me of similar features seen in most of today’s online games. Other examples of ‘healthy living apps’ are rife amongst the respective ‘app stores,’ and there seems to be ample opportunity for the appliance of gamification in this field. An example might be to incorporate aspects of game design into a smoking cessation app or weight loss helper. Perhaps the addictive quality of a well designed game-app could overpower the urge for confectionary or that ‘last cigarette’… The last area where I think ‘gamification’ could have a huge benefit is in (medical) education. Learning and revising are particularly susceptible to the rot of procrastination, so it goes without saying that many educational vendors have already attempted to incorporate fresh ways in which they can engage their users to put down the TV remote and pick up some knowledge for the exams. Meducation itself already has an area on its website entitled ‘Exam Room,’ where you can test yourself, track your progress and provide feedback on the questions you are given. I have always found this a far more addictive way to revise than sitting down with pen and paper to revise from a book. However, I feel there could be a far greater incorporation of game design in the field of medical education. Perhaps the absolute dream for like-minded gamers out there would be a super-gritty medical simulator that exposes you to common medical emergencies from the comfort of your own computer screen. I mean, my shiny new gaming console lets me pretend to be an elite solider deep behind enemy lines so why not let me pretend and practice to be a doctor too? You could even have feedback functionality to indicate where your management might have deviated from the optimum. Perhaps more sensibly, the potential also exists to build on the existing banks of online medical questions to incorporate further aspects of social media interaction, achievement unlocks and inter-player competition (because in case you hadn’t noticed, medics are a competitive breed). I have given a couple of very basic examples on how aspects of game design have emerged in recent health-related apps. I feel this phenomenon is in its infancy. The technology exists for so much more than the above, we just need to use our imagination… and learn how to code.  
Dr. Luke Farmery
about 6 years ago
Foo20151013 2023 37skir?1444774198
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105

Biohacking - The Brighter Side of Health

2014 is already more than a month old (if you can believe it) and with each passing day, the world we live in is speeding towards breakthroughs in every sphere of life. We're running full tilt, wanting to be bigger and better than we were the day or the hour before. Every passing day reinvents the 'cutting edge' of technology, including medical progress and advancement. Gone are the medieval days when doctors were considered all knowing deities, while medicine consisted of leeches being used to drain 'bad blood'. Nowadays, health isn't just about waiting around until you pick up an infection, then going to your local GP to get treated; in today's world it's all about sustaining your wellbeing. And for that, the new kid on the block is biohacking. Biohacking is the art and science of maximizing your biological potential. As a hacker aims to gain complete control of the system he's trying to infiltrate, be it social or technological; similarly a biohacker aims to obtain full control of his own biology. Simply put, a biohacker looks for techniques to improve himself and his way of life. Before you let your imagination run away with you and start thinking of genetic experiments gone wrong, let me assure you that a biohack is really just about any activity you can do to increase your capabilities or advance your wellbeing. Exercising daily can be a biohack. So can doing the crossword or solving math sums, if it raises your IQ by a few points or improves your general knowledge. What characterizes biohacking is the end goal and the consequent modification of activities to achieve that goal. So what kind of goals would a biohacker have? World domination? Not quite. Adding more productive hours to the day and more productivity to those hours? Check. Eliminating stress and it's causes from their lives? Check. Improving mood, memory and recall, and general happiness? You bet. So the question arises; aren't we all biohackers of sorts? After all, the above mentioned objectives are what everyone aspires to achieve in their lives at one point or the other. unfortunately for all the lazy people out there (including yours truly), biohacking involves being just a tad bit more pro active than just scribbling down a list of such goals as New Year resolutions! There are two main approaches to selecting a biohack that works for you- the biggest aim and the biggest gain. The biggest aim would be targeting those capabilities, an improvement in which would greatly benefit you. This could be as specific as improving your public speaking skills or as general as working upon your diet so you feel more fit and alert. In today's competitive, cut throat world, even the slightest edge can ensure that you reach the finish line first. The biggest gain would be to choose a technique that is low cost- in other words, one that is beneficial yet doesn't burn a hole through your pocket! It isn't possible to give a detailed description of all the methods pioneering biohackers have initiated, but here are some general areas that you can try to upgrade in your life: Hack your diet- They say you are what you eat. Your energy levels are related to what you eat, when you take your meals, the quantity you consume etc. your mood and mental wellbeing is greatly affected by your diet. I could go on and on, but this point is self expanatory. You need to hack your diet! Eat healthier and live longer. Hack your brain- Our minds are capable of incredible things when they're trained to function productively. Had this not been the case, you and I would still be sitting in our respective caves, shivering and waiting for someone to think long enough to discover fire. You don't have to be a neuroscientist to improve your mental performance-studies show that simply knowing you have the power to improve your intelligence is the first step to doing it. Hack your abilities- Your mindset often determines your capacity to rise to a challenge and your ability to achieve. For instance, if you're told that you can't achieve a certain goal because you're a woman, or because you're black or you're too fat or too short, well obviously you're bound to restrict yourself in a mental prison of your own shortcomings. But it's a brave new world so push yourself further. Try something new, be that tacking on an extra lap to your daily exercise routine or squeezing out the extra time to do some volunteer work. Your talents should keep growing right along with you. Hack your age- You might not be able to do much about those birthday candles that just keep adding up...but you can certainly hack how 'old' you feel. Instead of buying in on the notion that you decline as you grow older, look around you. Even simple things such as breathing and stamina building exercises can change the way you age. We have a responsibility to ourselves and to those around us to live our lives to the fullest. So maximise your potential, push against your boundaries, build the learning curve as you go along. After all, health isn't just the absence of disease but complete physical, mental and social wellbeing and biohacking seems to be Yellow Brick Road leading right to it!  
Huda Qadir
almost 6 years ago
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Maternal preconception and gender selection

Maternal preconception and gender selection has long been a controversial topic. Are you more likely to conceive a boy if you eat red meat, and a girl if you make love under a full moon? Oldwives tales and fantasies exploring sexual position, diet, and dominance circulate the Internet however how can we logically distinguish between fact and fiction? The topic has widespread cultural implications. Sex-related abortions are on the increase in China and India where local customs and religious virtues appear to strongly correlate with the systematic elimination of girls. In an effort to challenge the dogma of chance fertilization two main research streams have explored variations in maternal condition and gender conception. The ‘Maternal Dominance’ hypothesis has suggested trait dominance, underpinned by serum testosterone, correlates with increased male conception rates. The second, ‘Maternal condition’ hypothesis relates to pre-conceptual maternal diet, investigating variations in both quantity and quality of diet and effects on sex ratios. However such assumptions have been difficult to replicate and more recent evidence has suggested changes in maternal condition may have a stronger influence Maternal adaptations in behavior appear to closely correlate with biased gender ratios and can have wider connotations on sex-linked disease inheritance. However unless we can identify molecular mechanisms influencing the intrauterine environment and follicular development, hypothesis will remain mere assumptions.  
Langhit Kurar
almost 9 years ago
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WHO: Daily sugar intake 'should be halved' - BBC News

People will be advised to halve the amount of sugar in their diet, under new guidance from the World Health Organization.  
BBC News
almost 6 years ago
Www.bmj
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25

A man with fever, a productive cough, and a striking chest radiograph | The BMJ

A 41 year old man presented to the emergency department with a two week history of worsening shortness of breath. Associated symptoms included a cough productive of green sputum, intermittent fevers, night sweats, and non-pleuritic pain in the right side of the chest wall. He had a history of chronic pancreatitis secondary to alcohol excess, which was complicated by diet controlled type 2 diabetes. He also smoked 40 cigarettes a day. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  
bmj.com
almost 6 years ago
Www.bmj
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22

A man with fever, a productive cough, and a striking chest radiograph

A 41 year old man presented to the emergency department with a two week history of worsening shortness of breath. Associated symptoms included a cough productive of green sputum, intermittent fevers, night sweats, and non-pleuritic pain in the right side of the chest wall. He had a history of chronic pancreatitis secondary to alcohol excess, which was complicated by diet controlled type 2 diabetes. He also smoked 40 cigarettes a day.  
bmj.com
almost 6 years ago
Www.bmj
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46

Drugs for neuropathic pain

The patient is a 63 year old freelance editor with type 2 diabetes diagnosed about five years ago that is relatively well controlled with insulin. He has early signs of retinopathy, with normal kidney function and electrocardiogram. Lipid values are normal with diet and atorvastatin 20 mg/day. He developed autonomic and peripheral neuropathy a few months ago, and now experiences postural hypotension and burning pain and clumsiness in his feet. His pain makes concentration and falling asleep difficult. He asks his general practitioner for painkillers to help him continue working.  
bmj.com
almost 6 years ago
Www.bmj
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Seeing double: the low carb diet

A 38 year old white Scottish man with mild learning difficulties (able to read and write but not to maintain employment) presented with a three day history of diplopia and agitation, after seven days of presumed viral gastroenteritis.  
feeds.bmj.com
almost 6 years ago
Www.bmj
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A man with fever, a productive cough, and a striking chest radiograph

A 41 year old man presented to the emergency department with a two week history of worsening shortness of breath. Associated symptoms included a cough productive of green sputum, intermittent fevers, night sweats, and non-pleuritic pain in the right side of the chest wall. He had a history of chronic pancreatitis secondary to alcohol excess, which was complicated by diet controlled type 2 diabetes. He also smoked 40 cigarettes a day.  
bmj.com
almost 6 years ago
Www.bmj
1
25

The impact of a bodyweight and physical activity intervention (BeWEL) initiated through a national colorectal cancer screening programme: randomised controlled trial

Objective To evaluate the impact of a diet and physical activity intervention (BeWEL) on weight change in people with a body mass index >25 weight (kg)/height (m)2 at increased risk of colorectal cancer and other obesity related comorbidities.  
bmj.com
almost 6 years ago