Albert Einstein College of Medicine, Yeshiva University: Open Journal Systems
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Engaging Healthcare Providers to Help Mothers with Eating Disorders Create Healthy Eating Environments for Their Children
Get PDFEating disorders (EDs), such as anorexia, bulimia, and bingeeating disorder, involve extreme emotions, attitudes, and behaviors surrounding weight, food, and body image, all of which can lead to destructive health consequences. While EDs have innumerable effects on affected individuals, less is known about the consequences for the offspring of childbearing women with past or current EDs. Children of mothers with EDs are at increased risk of various problems during gestation and childhood, including higher rates of miscarriage, cesarean-section deliveries, and stillbirth; greater likelihood of preterm delivery, small- or large-for-gestational-age, low or high birth weight, and growth disturbances; and lower likelihood of being breastfed. These children are also more likely to develop dysfunctional eating habits, behaviors, and attitudes throughout adolescence. Possible effects of maternal EDs on parenting include withholding food from children, using food to reward or punish, a preoccupation with weight interfering with the mother’s responsiveness to her child, failure to express positive attitudes toward eating, and higher tension during mealtimes. These risks are influenced by a variety of factors and the consequences for children are difficult to predict. Complicating matters, the foundations of an ED are established long before diagnosis. The familial setting provides a unique opportunity for integrated and concurrent primary and tertiary ED-prevention strategies for both child and mother. It is imperative for healthcare providers to consider the potential value of educational programs and support for mothers with EDs, as early intervention could interrupt the cycle of risk associated with eating disorders and their effects on the developing child
Communication in the Clinical Encounter: Dealing with the Disparities
Get PDFDespite basing its foundation upon the ideals of Hippocrates, Western medicine, especially in the last century, has shifted from a holistic to a more reductionist approach to understanding and treating patients. These changes are primarily a result of widespread acceptance of the biomedical model in modern medicine. Consequently, there are now significant differences in physician and patient explanatory models for the same ailment. Cancer, for example, is interpreted as primarily a physiological process by the medical community, or more simply, as a disease. The patient, on the other hand, interprets cancer as an illness, a more subjective response, covering all aspects of the patient’s life experience, including emotional, psychological, social, and cultural realms, in addition to physiological aspects. These differences in explanatory models result in disparities between physicians and patients when it comes to defining the condition, managing the condition and even defining successful outcomes. These incongruencies must be addressed through effective communication in the clinical encounter, an aspect of patient care that has proven beneficial effects on patient health outcomes. The shared treatment decision-making model best addresses these communication problems. By providing a framework for both the physician and patient to negotiate their respective explanatory models en route to a mutually agreeable treatment decision, this model is a compromise between the two extremes of patient-physician models of communication: paternalism andinformed decision-making. Ultimately, the shared treatment decision-making model establishes a clinical relationship that is no longer characterized by an inabilityto effectively negotiate and consolidate differing values due to unbalanced informational and power dynamics in a social context. By incorporating this model of communication into medical practice, physicians and patients will better understand each other, bridging the disparities apparent in current practice and allow Western medicine to once again approximate the Hippocratic ideal
Process and Experience of Creating a Student-Run Step 1 Guidance Program
No full textWe developed the Albert Einstein College of Medicine USMLE (United States Medical Licensing Examination) Step 1 Guidance Program in the fall of 2010. The objectives of the program were twofold: to provide reliable, unbiased advice on Step 1 preparation, and to reduce student anxi- ety surrounding the examination. The program aimed to fill a void for the students by focusing on the process of preparing for the test. It was not intended to teach Step 1 content, but instead to help students study effectively and efficiently. In our opinion, the most significant service medi- cal students required was assistance in developing a per- sonalized program of study for this examination.
The Role of Implantable Cardioverter Defibrillators in Ischemic and Non-Ischemic Cardiomyopathy and Effect on Mortality and Sudden Death
Get PDFImplantable Cardioverter Defibrillators (ICDs) have evolved from a treatment of last resort to the current and rapidly growing use as a first line therapeutic option. Early clinical trials captured what had only been apparent in observational studies that subsequently paved the way for the utilization of ICDs as secondary prevention in patients who had survived life-threatening arrhythmias. As a result, these randomized clinical trials exhibited a benefit with ICD only in high-risk patients with ischemic cardiomyopathy. However, recent studies have been able to demonstrate a significant role for primary prevention in selected high-risk patients with non-ischemic cardiomyopathy
Optogenetic Technology and Its In Vivo Applications
Get PDFOptogenetics is a novel technology with the widely acknowledged potential to revolutionize cell biology and neuroscience. Essentially, optogenetic methods integrate optical and genetic tools to control the activity of whole cells or subcellular events. In recent years, optogenetics has been used to activate and to inhibit genetically defined neuronal populations within neural circuits. As such, it has been used to show the sufficiency or the necessity of specific neuronal cell types in generating behaviors across a number of animal species. When employed in rodent models of human neurological and psychiatric disorders, optogenetics has provided clinically relevant insights into the function of pathologic neural circuits. Recent progress in the in vivo applications of this methodology is reviewed in this article, with particular focus on behavioral applications in nematodes, fish, rodents, and nonhuman primates