Grand Rounds: 5.9

Welcome to Grand Round 5.9 - a weekly rotation of blogposts in the medical and health fields. I am delighted to be your host again, and present to you the following for your listening pleasure.














"A Sudden Jolt of Sadness" by The Sterile Eye
"Annual ACAAI Meeting" by Allergy Notes
"Crestor and other CRP" by Covert Rationing
"Diagnostic Acumen" by In My Humble Opinion
"Doctors Empowering Parents" by Dr. Nancy Brown
"Flu Vaccine Recommendations for Children" by Dr. Paul Auerbach
"I Am Not Special" by Bongi
"Interview with Dr. David Newman" by Detroit Receiving
"It's Elementary" by The D-Log Cabin
"Medicine in Media" by Medical Pastiche
"My Favorite VBAC" by Rural Doctoring
"Ritual" by Dr. Bruce Campbell
"Sciatica and the Saline Story" by Back Pain Blog
"Selenium/Vitamin E Don't Prevent Prostate Cancer" by Laika
"Should Doctor Sex Scandals Be Made Public" by Canadian Medicine
"Sometimes Death is a Good Thing" by You Just Gotta Keep Livin'
"Teratoma: One Patient One Disease" by Dr. Am Ang Zhang
"Tips for New Medical Bloggers" by Clinical Cases & Images
"Which Stretch Stops Back Pain" by Dr. Jolie Bookspan

"1,000 Cranes" by Dethmama Chronicles
"Bariatric Surgery: Psychological Considerations" Suture for a Living
"Borderline Personality" by Clinically Clueless
"Can We Pick Your Brain" by Dr. Joshua Steinerman
"Freezing and Unfreezing" by In Sickness & In Health
"Kudos for the General" by Doc Gurley
"Marx" by CBTISH
"New DSM Diagnosis" by Tiny Shrink
"Obsession with Internal Medicine" by ACP Internist
"Resilience" by Health Psych
"Studing Sin" by Neuroanthropology
"The Future of the Aging Society" by Dr. Alvaro Fernandez
"Understanding Social Anxiety" by Psych Central
"Virtual Reality Therapy for PTSD" by Dr. Shock

"Gluten Free Eating" by A Chronic Dose
"Rules of Engagement" by Diabetes Mine
"The Diving Bell & The Butterfly" by How to Cope With Pain
"The Things I Carried" by Duncan Cross
"Understanding Stress" by Mother of Shrek
"Walking From The Heart" by Own Your Health
"What I've Learned from Being One Armed" by ChronicBabe
"When a Doctor is a Patient" by e-Patient Dave















"Coordination of Care Fractures Medical System" by Dare to Dream
"Dear President-Elect Obama" by Repairing the Healthcare System
"DNV David Harlow & Hospital Accreditation" by HealthBlawg
"Heart Failure Hospitalizations Rates Surge" by Dr. Mercola
"Live from the Operating Room" by Change:Healthcare
"One in Five Hospital Stays Involve Mental Illness" by MHA Society
"The Implications for Live Tweeting Surgery" by Healthcare Law Blog
"Was It a Very Good Year" by InsureBlog
"World Diabetes Day" by International Diabetes Foundation

Many thanks to "Executive Producers" Colin Son and Dr. Val Jones, as well as "Grandmaster" Dr. Nick Genes. For without them, none of this would be possible. Grand Rounds drops again at Canadian Medicine on Tuesday, November 25th. But before you go, check out my playlist of music inspired by your Grand Round submissions.

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Just Do It

Talking while doing something non-verbal can throw you off. In fact, many athletes believe that being in their head too much can disrupt performance - so they focus on the action of the moment.

Researchers from the University of Michigan Psychology Department and the University of St. Andrews in Scotland agree. They found that, for some, trying to verbalize a performance distracted the brain by putting the focus on language. This is called verbal overshadowing and has been shown to interfere with the non-verbal aspects of a memory, resulting in a decreased performance on tasks. For more, read here

I can relate to this phenomenon. I can cook a great meal, sink a golf putt or drive the quickest way to a destination, but ask me to explain what I'm doing as I'm doing it and my performance will suffer. So, verbal overshadowing when performing can be a good thing or it can throw a monkey wrench into your world. See how this works for you and adjust accordingly.

Me? I'll be the quiet one on the Just-Do-It bench.

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Genetic Indicators for Gender Identity

From an early age, we develop an inner sense of being a boy or a girl - male or female. This is called gender identity.

Individuals who have a gender disorder identify with the sex opposite of their assigned biological sex. They feel as if they are not in the right body, and yearn to be someone other than who they are.

These feelings begin in early childhood and have been considered "disordered" thinking in the past. A psychological problem, like homosexuality was perceived years ago. Not too long ago, such gender issues were seen as "choices", not biologically bound within one's DNA. And as a result, many children, teens and adults would hide in shame. Some even choosing suicide.

More research, like this recent one from Australia, show that there is a genetic link for gender identity. "There is a social stigma that transsexualism is simply a lifestyle choice, however our findings support a biological basis of how gender identity develops, " reports Dr. Vincent Harley, Head of Molecular Genetics at Prince Henry's Institute.

This research will be published in the January 2009 journal Biological Psychiatry and suggest that pathologizing "Gender Identity Disorder" will be a thing of the past.

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Inkblot Fun

There are many kinds of psychological tests that are used to understand the human psyche.

Some are very formal and standardized, while others are not.

Tests like the Rorschach Inkblot analyze perception and the inner life experience of a person. There are no wrong answers in these kinds of tests.

So, if you are so inclined, find out what you see in the inkblot above.

By the way, it is NOT an authentic Rorschach Inkblot, but rather a made up one. It's important to keep tests secure.

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Mental Health Coverage in US is Law!

It took a long time, well over a decade, but those of us who live in the US will now have mandatory mental health coverage.

The Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act of 2008, also known as Mental Health Parity, states that no insurance company can discriminate against mental health coverage or susbstance abuse treatment.

This means:

* No person can be "cut off" from mental health care with an arbitrary number of visits.

* No person can be forced to pay out-of-pocket for mental health care.

* Any person who has been "locked out" from mental health insurance will now have the opportunity to access such care.

The Mental Health Parity Act will be in full effect by January 1, 2010, but many states are already rolling this law into their books. So, as the new year approaches, find out if you live in a state that has its parity laws up and operating.

Now all we need is universal care for every person. No one should be without medical or mental healthcare.

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Parental Alienation Syndrome

Actor Alec Baldwin has written an interesting book on a controversial subject called Parental Alienation Syndrome. I thought it was a very balanced take on what can happen when issues of child custody go very wrong.

The reason PAS is so controversial stems from the fact that it is recognized in our legal system as a form of child abuse, but not, as yet, listed as a formal diagnosis in the clinical world. PAS is a psychological dynamic brought about by one parent in a divorced family whose aim is to alienate the other parent from his or her child.

I have seen Parental Alienation Syndrome in my work. Sometimes the alienation is not an intentional set of behaviors. While other times, it is conscious and intentional. And, don't get me wrong, there are many divorced families where this alienation does not come into play at all!

The most important thing with PAS is to help everyone see that divorce of a marriage does not mean that the child must divorce one's parents. Psychotherapy with a specialist can help the parent who is unconsciously or consciously alienating. Divorce is hard on everyone, especially children. Trying to help your child have a healthy connection with his or her "other" parent can be a lifelong gift.

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Writing Backward or Upside Down: It Doesn't Really Matter To Your Mind

Can you read the phrase above?

It is presented backwards as well as upside down.

A few years back there was a meme about an university research study showing how misspelled words and scrambled word order don't impinge reading comprehension. Well, the example above falls along those lines. Sadly, the research regarding the university study seems to be an urban myth .

BUT the mind DOES have a fantastic way of taking indistinct stimuli and morphing them into something that makes sense to us. Whatever the reason this word-order-thingy occurs, research based or not, it's totally cool.

Here's an upside down/backward writing generator for you to enjoy.

¡unɟ ǝɯos ǝʌɐɥ oƃ puɐ ǝɹǝɥʇ ɹǝʌo uo pɐǝɥ ʍou

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