the interneuron

facts, thoughts, concerns, opinions and inquiries about anything science, music, or technology; especially in the fields of biology, neuroscience, and chemistry brought to you by a relatable college student. Feel free to ask me anything!

[23pairofchromosomes]

Ten core principles necessary for the remodeling of your brain to take place:

1. Change is mostly limited to those situations in which the brain is in the mood for it.

If you are alert, on the ball, engaged, motivated, ready for action, the brain releases the neurochemicals necessary to enable brain change. When disengaged, inattentive, distracted, or doing something without thinking that requires no real effort, your neuroplastic switches are “off.”

2. The harder you try, the more you’re motivated, the more alert you are, and the better (or worse) the potential outcome, the bigger the brain change.

If you’re intensely focused on the task and really trying to master something for an important reason, the change experienced will be greater.

3. What actually changes in the brain are the strengths of the connections of neurons that are engaged together, moment by moment, in time.

The more something is practiced, the more connections are changed and made to include all elements of the experience (sensory info, movement, cognitive patterns). You can think of it like a “master controller” being formed for that particular behavior which allows it to be performed with remarkable facility and reliability over time.

4. Learning-driven changes in connections increase cell-to-cell cooperation which is crucial for increasing reliability.

Merzenich explains this by asking you to imagine the sound of a football stadium full of fans all clapping at random versus the same people clapping in unison. He explains, “The more powerfully coordinated your [nerve cell] teams are, the more powerful and more reliable their behavioral productions.”

5. The brain also strengthens its connections between teams of neurons representing separate moments of successive things that reliably occur in serial time.

This allows your brain to predict what happens next and have a continuous “associative flow.” Without this ability, your stream of consciousness would be reduced to “a series of separate, stagnating puddles,” explains Merzenich.

6. Initial changes are temporary.

Your brain first records the change, then determines whether it should make the change permanent or not. It only becomes permanent if your brain judges the experience to be fascinating or novel enough or if the behavioral outcome is important, good or bad.

7. The brain is changed by internal mental rehearsal in the same ways and involving precisely the same processes that control changes achieved through interactions with the external world.

According to Merzenich, “You don’t have to move an inch to drive positive plastic change in your brain. Your internal representations of things recalled from memory work just fine for progressive brain plasticity-based learning.”

8. Memory guides and controls most learning.

As you learn a new skill, your brain takes note of and remembers the good attempts, while discarding the not-so-good trys. Then, it recalls the last good pass, makes incremental adjustments, and progressively improves.

9. Every movement of learning provides a moment of opportunity for the brain to stabilize – and reduce the disruptive power of – potentially interfering backgrounds or “noise.”

Each time your brain strengthens a connection to advance your mastery of a skill, it also weakens other connections of neurons that weren’t used at that precise moment. This negative plastic brain change erases some of the irrelevant or interfering activity in the brain.

10. Brain plasticity is a two-way street; it is just as easy to generate negative changes as it is positive ones.

You have a “use it or lose it” brain. It’s almost as easy to drive changes that impair memory and physical and mental abilities as it is to improve these things. Merzenich says that older people are absolute masters at encouraging plastic brain change in the wrong direction.

[neurosciencestuff]

Researchers identify specific neurons that distinguish between reality and imagination

New Western University research shows that neurons in the part of the brain found to be abnormal in psychosis are also important in helping people distinguish between reality and imagination.

The researchers, Dr. Julio Martinez-Trujillo, principal investigator and professor at Western University’s Schulich School of Medicine & Dentistry and Dr. Diego Mendoza-Halliday, postdoctoral researcher at M.I.T., investigated how the brain codes visual information in reality versus abstract information in our working memory and how those differences are distributed across neurons in the lateral prefrontal cortex region of the brain. The results were published in Nature Communications.

“You can look at my shirt, and then if I move out of your vision, even with your eyes open you can still see the colour of my shirt in your mind,” explained Martinez-Trujillo, based at the Brain and Mind Institute and Robarts Research Institute at Western University. “That is what we call working memory representations or short-term memory representations – they are abstract, they are imaginary and they don’t exist in reality, but in our minds. Real objects in our visual field, we call perceptual representations. We are trying to determine whether there are neurons in the brain that can signal to a person whether a representation is real or imaginary.”

By having subjects perform two tasks – one where they had to report the direction of movement of a cloud of dots they could see on a computer screen, and one where they had to report the cloud direction a few seconds after it disappeared based on a memory of the image – they found that neurons in the Lateral Prefrontal Cortex encoded perceived and memorized information to various degrees and in different combinations of strength.

“We might have expected that the neurons that are active when we perceive a visual object are the same ones that memorize it; or, on the contrary, that one group of neurons perceives the object and a completely different group memorizes it; but instead, we found that all of the above are true to a certain extent,” said Mendoza-Halliday, first author on the study. “We have perception neurons, memory neurons, and also neurons that do both things.”

The Lateral Prefrontal Cortex has been shown to be dysfunctional in individuals with schizophrenia, who have hallucinations or delusions. However, so far, researchers have not been able to pinpoint the source of this dysfunction.

Using machine-learning, the researchers created a computer algorithm that could read out the pattern of neurons firing in the Prefrontal Cortex and reliably determine whether a subject was perceiving a cloud of dots or remembering one they had seen before. Martinez-Trujillo hopes that by pinpointing the specific neurons responsible for distinguishing between reality and imagination, they might be better able to treat disorders like schizophrenia that cause patients to confuse what’s real and what isn’t.

“I would argue that schizophrenia is not a neurochemical disorder of the whole brain,” said Martinez-Trujillo. “It is only a neurochemical disorder in specific parts of the brain.”

Currently, pharmacological treatments for these disorders change the neurochemistry in the entire brain, often causing unintended side-effects. By targeting only the specific neurons responsible for these disturbances, Martinez-Trujillo hopes they may be able to minimize these side-effects.

[meddaily]

Cardiac Arrhythmia Classifications

There is quite a lot to be said about the medications we use for patients with arrhythmias. It’s easy to get lost as to what drugs do what and how, but thankfully there was a kind enough person by the name of Vaughan Williams, who actually broke them down into separate classes. Each class effects separate parts of the cardiac cycle, ultimately changing the electrical current of the heart.

Cardiac Action Potential

Before looking at the medications, we have to understand the cardiac cycle and how it actually works.

Source: x

The above chart presents the four phases of an action potential in a ventricular myocardial cell and how the electrolytes are used to cause the depolarization and repolarization of myocardial cells.

Phase 0  begins with a slight influx of sodium until it passes the potential threshold. Once past the threshold, more sodium channels will open and flood the cell, causing it the depolarize.

Phase 1 is an efflux of potassium from the cell, causing the cell to reach 0mV.

Phase 2 happens at this point. This is when calcium influx happens, prolonging the repolarization period. This period also goes by the name of an absolute refractory period for the cell, since it cannot depolarize during this time.

Phase 3 Calcium channels close again and potassium continues to efflux from the myocardial cell until the internal cell voltage returns to -90mV. Majority of potassium channels then close and the heart enters phase 4, which potassium is allowed to continue to leak into from the cell.

This process happens anywhere from 60 to 100 times per MINUTE!

Vaughan Williams Classifications

The major purpose of the medications in this class effect they way the cardiac action potential works in the cells of the heart. The drugs usually help to slow down specific phase to the heart and allow the heart to fix itself a bit.

Class I - Sodium Channel Blockers

These medications are designed to disrupt phase 0, causing a prolongation of it. There are 3 subcategories (a,b,c) that are broken down into moderate, weak, and strong.

This article won’t go into great depths, but the major goal of the class is to prolong the QRS complex and prolong or shorten QTi.

Medications include:

Lidocaine

Verapamil

Procainamide

Propafenone

Class II - Beta Blockers (-olol or -alol)

Quite commonly used out of hospital for patients with hypertension, beta blockers are actually a common antidysrhythmic. The basic pharmacology is: by blocking the beta-1 receptor sites, it prevents stimulation of the cardiac muscle to beat faster. The increase of sympathetic tone will decrease the rate the heart will beat.

Medications include:

Propranolol

Metoprolol

Carvedilol

Class III - Potassium Channel Blockers

Similar to the Class Ia medications, potassium channel blockers are used to prolong APD, which can cause a prolongation of ERP. This class of medication is commonly known to treat different ventricular dysrhythmias (Vtach or Vfib). The most common medication for this class is Amiodarone and deserves a post of its own.

It’s most common use is during CPR, when the patient is in pulses Vtach or Vfib rhythm and is then followed by a drip with ROSC is achieved. An important note to make about Amiodarone is it can take 16 weeks to leave the system.

Medications include:

Amiodarone

Sotalol 

Ibutilide

Class IV - Calcium Channel Blockers

Commonly uses for Afib with RVR and PSVT, a calcium channel blocker will prolong phase 2 of the action potion in the cell. The goal is to slow the conduction through the atrioventricular (AV) node, slowing the ventricular tachycardia that is occurring. By prolonging the ERP in the AV node, the heart is able to regulate the rate better.

Calcium channel blockers are commonly prescribed by physicians to assist in the care of such arrhythmias. One side effect of these drugs is it may drop the patient’s BP, so ensure you have an SBP >100 or a MAP >65, prior to administering the medication

Class V - Others

This is the mix bag class. These drugs do not truly fit in any category but are still highly important to mention anyways. Two of these medications are Adenosine and Digoxin.

Adenosine prevents the re-entry of a signal in a sinus rhythm, preventing SVT. A warning though is for patients that have WPW syndrome may cause an increase in heart rate instead, so make sure you’re reading the rhythm correctly.

Digoxin effects vagal tone and is seen less as an emergency drug and more as a maintenance drug for chronic heart issues. A major issue with this drug is it holds a very narrow therapeutic index. Toxicity is quite possible if given too much.

Summary

Each class works in its own way on the action potential in the cardiac conduction system. How they affect the heart greatly determines when and how the medication should be used in different medical scenarios. The point of this article is to help a bit with the pharmacodynamics involved with the medications and to hint at the situations a person in the medical field would use them?

Remember to check out my facebook page. Feel free to send suggestions for possible article ideas, it might pop up some time. Always remember that medicine is an art, just as much as a science.

Sources:

[futureofscience]

Scientists made robotic bees to one day study the ocean

These little robots can fly in and out of water using their insect-inspired wings.

“Researchers led by a team at Harvard University have developed a tiny, 175-milligram (about two feathers) device with insect-inspired wings that can both flap and rotate, allowing it to either fly above the ground or swim in shallow waters and easily transition between the two. Researchers think it will one day be used for environmental monitoring studies, according to Science magazine, which dubbed the device the “robo-bee.””

[252mya]

This holiday season, get to know the family!

Three new evolutionary tree posters from Gabriel Ugueto: Tyrannosauroidea, Ornithomimosauria-Alvarezsauroidea, and Dromaeosauridae are now available through our shop.

—

252MYA.com

[252mya]

Visiting your parents this year? How about you introduce them to your new family members?

[fy-perspectives]

If you really want to live your life to the fullest and realize your greatest potential, you must be willing to run the risk of making some people mad. People may not like what you do, people may not like how you do it, but these people are not living your life. You are!

Iyanla Vanzant (via wnq-anonymous)

[neurosciencestuff]

There’s more to attraction than what meets the eye

Attractiveness isn’t just a matter of good looks, but also the right voice and scent, highlights a mini review in Frontiers in Psychology.

“Recently, most reviews have focused on visual attractiveness–for example, face or body attractiveness,” says Agata Groyecka, lead author of the review and a researcher at the University of Wroclaw in Poland. “However, literature about other senses and their role in social relations has grown rapidly and should not be neglected.”

Whether by an off-putting body odor or a grating voice, it’s easy to understand how the nose and ears are just as important as the eyes in noticing how attractive someone is. It’s not particularly surprising that attractiveness spans more than just physical appearance, but most research has focused on looks, neglecting vocal and olfactory factors.

“Perceiving others through all three channels gives a more reliable and broader variety of information about them,” says Groyecka.

Groyecka and her collaborators recently combed through over 30 years of literature to provide a brief overview of the few studies that have looked into the role of voice and scent. While not extensive, this research field has already given insight into the quantity and variety of information that can be gathered by these other senses–which it turns out can be quite a lot.

Some findings are relatively intuitive, such as people guessing gender and age based on voice alone. But listeners have also proven to be skilled at detecting an unexpected range of characteristics from a voice, including the dominance, cooperativeness, emotional state, and even the body size of the speaker.

Even more surprisingly, other studies have shown that people can correctly deduce very similar types of information based on scent alone. Recent brain imaging studies also suggest that combinations–sight and smell, for example–appear to be synergistic, producing even stronger reactions than would be expected from summing the individual responses.

Perceived attractiveness impacts day-to-day life in a variety of ways, influencing not only romantic relationships, but also friendships and professional interactions. Without incorporating such information, psychological studies of everyday decision making and social communication can’t capture the whole picture. Groyecka’s review also highlights a variety of proposed evolutionary explanations for these multisensory aspects of attraction, such as the utility of having traits that can be detected both from a distance (voice and looks), as well as up close (scent).

“I hope that this review will inspire researchers to further explore the role of audition and olfaction in social relations,” says Groyecka.

[neurosciencestuff]

Region in Brain Found to be Associated with Fear of Uncertain Future

People who struggle to cope with uncertainty or the ambiguity of potential future threats may have an unusually large striatum, an area of the brain already associated with general anxiety disorder, according to research published by the American Psychological Association.

“Uncertainty and ambiguity of potential future threats are central to understanding the generation of anxiety and anxiety disorders,” said lead author Justin Kim, PhD, of Dartmouth College. “Our research suggests a relationship between an individual’s ability to deal with this uncertainty and the volume of gray matter within a specific area of the brain.”

The research was published in the APA journal Emotion®.

In the study, 61 students had MRI scans taken of their brains after filling out a survey designed to measure their ability to tolerate the uncertainty of future negative events. Kim and his colleagues analyzed the MRIs and compared them with the intolerance of uncertainty scores. They found the volume of the striatum was significantly associated with intolerance of uncertainty.

“People who had difficulty tolerating an uncertain future had a relatively enlarged striatum,” said Kim. “What surprised us was that it was only the striatum and not other parts of the brain we examined.”

Previous studies focusing specifically on patients with obsessive compulsive disorder and general anxiety disorder have also found increased gray matter volumes in the striatum, but this is the first time it has been found in association with intolerance of uncertainty in the absence of a confirmed diagnosis, according to Kim.

“Our findings demonstrate that the relationship between increased striatal volumes and intolerance of uncertainty can be observed in healthy individuals,” he said. “Having a relatively enlarged volume of the striatum may be associated with how intolerant you are when facing an uncertain future, but it does not mean you have OCD or generalized anxiety disorder.”

While the striatum has been primarily known for its role in motor function, animal studies have also suggested that it plays a role in how we predict whether or not we will receive a reward for a particular behavior while learning new tasks, according to Kim. “To put it another way, the striatum encodes how predictable and expected a reward is — a higher form of reward processing compared to simply responding to a reward. Given that an important component of intolerance of uncertainty is a desire for predictability, our findings offer a biological marker related to our need for predictability,” he said.

Since the findings came from psychologically healthy individuals, Kim suggested that that the volume of the striatum in young adults could predict those at risk for developing generalized anxiety disorder or OCD later in life, but that remains to be seen. More important, he said, the findings could serve as a starting point for treating symptoms specific to these disorders by monitoring the striatum and tracking its volume over the course of treatment.

[neurosciencestuff]

‘Humanlike’ thought evolved 1.8 million years ago

By using highly advanced brain imaging technology to observe modern humans crafting ancient tools, an Indiana University neuroarchaeologist has found evidence that human-like ways of thinking may have emerged as early as 1.8 million years ago.

The results, reported May 8 in the journal Nature Human Behavior, place the appearance of human-like cognition at the emergence of Homo erectus, an early apelike species of human first found in Africa whose evolution predates Neanderthals by nearly 600,000 years.

“This is a significant result because it’s commonly thought our most modern forms of cognition only appeared very recently in terms of human evolutionary history,” said Shelby S. Putt, a postdoctoral researcher with The Stone Age Institute at Indiana University, who is first author on the study. “But these results suggest the transition from apelike to humanlike ways of thinking and behaving arose surprisingly early.”

The study’s conclusions are based upon brain activity in modern individuals taught to create two types of ancient tools: simple Oldowan-era “flake tools” – little more than broken rocks with a jagged edge – and more complicated Acheulian-era hand axes, which resemble a large arrowhead. Both are formed by smashing rocks together using a process known as “flintknapping.”

Oldowan tools, which first appeared about 2.6 million years ago, are among the earliest used by humanity’s ancestors. Acheulian-era tool use dates from 1.8 million to 100,000 years ago.

Putt said that neuroarchaeologists look to modern humans to understand how pre-human species evolved cognition since the act of thinking – unlike fossilized bones or ancient artifacts – leave no physical trace in the archaeological record.

The methods used to conduct studies on modern humans crafting ancient tools was limited until recently by brain imaging technology. Previous studies depended on placing people within the confines of a functional magnetic resonance imaging machine – essentially a narrow mental tube – to observe their brain activity while watching videos of people crafting tools.

Putt’s study, by contrast, employed more advanced functional near-infrared spectroscopy – a device that resembles a lightweight cap with numerous wires used to shine highly sensitive lasers onto the scalp – to observe brain activity in people as they learned to craft both types of tools with their hands.

In the study, 15 volunteers were taught to craft both types of tools through verbal instruction via videotape. An additional 16 volunteers were shown the same videos without sound to learn toolmaking through nonverbal observation. These experiments were conducted in the lab of John P. Spencer at the University of Iowa, where Putt earned her Ph.D. before joining IU. Spencer is now a faculty member at the University of East Anglia.

The resulting brain scans revealed that visual attention and motor control were required to create the simpler Oldowan tools. A much larger portion of the brain was engaged in the creation of the more complex Acheulian tools, including regions of the brain associated with the integration of visual, auditory and sensorimotor information; the guidance of visual working memory; and higher-order action planning.

“The fact that these more advanced forms of cognition were required to create Acheulean hand axes – but not simpler Oldowan tools – means the date for this more humanlike type of cognition can be pushed back to at least 1.8 million years ago, the earliest these tools are found in the archaeological record,” Putt said. “Strikingly, these parts of the brain are the same areas engaged in modern activities like playing the piano.”

[amnhnyc]

The blue sea slug, or the blue glaucus, is full of surprises. It floats upside down, and its brilliant blue coloring is reserved for its underside, to confuse flying predators from above. It’s also a fierce predator in its own right: it preys on the highly poisonous Portuguese Man-O’-War hydrozoans. And not only is the blue sea slug immune to the Man-O’-War’s terrifying sting, but it actually stores its prey’s poison in the 80+ finger-like appendages on its body. When attacked by a predator, the blue slugs can re-use the Man-o-War’s poison in their own defense. Photo: Greg Schechter

[neurosciencestuff]

When love hurts, a placebo can help

Feeling heartbroken from a recent breakup? Just believing you’re doing something to help yourself get over your ex can influence brain regions associated with emotional regulation and lessen the perception of pain.

That’s the takeaway from a new CU Boulder study that measured the neurological and behavioral impacts the placebo effect had on a group of recently broken-hearted volunteers.

“Breaking up with a partner is one of the most emotionally negative experiences a person can have, and it can be an important trigger for developing psychological problems,” said first author and postdoctoral research associate Leonie Koban, noting that such social pain is associated with a 20-fold higher risk of developing depression in the coming year. “In our study, we found a placebo can have quite strong effects on reducing the intensity of social pain.”

For decades, research has shown that placebos – sham treatments with no active ingredients –  can measurably ease pain, Parkinson’s disease and other physical ailments.

The new study, published in March in the Journal of Neuroscience, is the first to measure placebos’ impact on emotional pain from romantic rejection.

Researchers recruited 40 volunteers who had experienced an “unwanted romantic breakup” in the past six months. They were asked to bring a photo of their ex and a photo of a same-gendered good friend to a brain-imaging lab.

Inside a functional magnetic resonance imaging (fMRI) machine, the participants were shown images of their former partner and asked to recall the breakup. Then they were shown images of their friend. They were also subjected to physical pain (a hot stimulus on their left forearm).

As these stimuli were alternately repeated, the subjects rated how they felt on a scale of 1 (very bad) to 5 (very good). Meanwhile, the fMRI machine tracked their brain activity.

While not identical, the regions that lit up during physical and emotional pain were similar.

This finding alone sends an important message to the heartbroken, said senior author Tor Wager, a professor of psychology and neuroscience at CU Boulder: “Know that your pain is real – neurochemically real.”

The subjects were then taken out of the machine and given a nasal spray. Half were told it was a “powerful analgesic effective in reducing emotional pain.” Half were told it was a simple saline solution.

Back inside the machine, the stimuli repeating, the placebo group not only felt less physical pain and felt better emotionally, but their brain responded differently when shown the ex.

Activity in the brain’s dorsolateral prefrontal cortex – an area involved with modulating emotions – increased sharply. Across the brain, areas associated with rejection quieted.

Notably, after the placebo, when participants felt the best they also showed increased activity in an area of the midbrain called the periaqueductal gray (PAG). The PAG plays a key role in modulating levels of painkilling brain chemicals, or opioids, and feel-good neurotransmitters like dopamine.

While the study did not look specifically at whether the placebo prompted the release of such chemicals, the authors suspect this could be what’s happening.

“The current view is that you have positive expectations and they influence activity in your prefrontal cortex, which in turn influences systems in your midbrain to generate neurochemical opioid or dopamine responses,” said Wager.

Previous studies have shown that the placebo effect alone not only eases depression, but may actually make antidepressants work better.

“Just the fact that you are doing something for yourself and engaging in something that gives you hope may have an impact,” said Wager. “In some cases, the actual chemical in the drug may matter less than we once thought.”

The authors said the latest study not only helps them better understand how emotional pain plays out in the brain, but can also hint at ways people can use the power of expectation to their advantage.

Said Koban: “What is becoming more and more clear is that expectations and predictions have a very strong influence on basic experiences, on how we feel and what we perceive.”

Bottom line, if you’ve been dumped recently: “Doing anything that you believe will help you feel better will probably help you feel better,” she said.

[mosaicrecords]

The Brain and the Language of Jazz

Since my teenage years, I’ve marveled at how quickly and how deeply a musician’s brain can operate and interact during a jazz performance. This article in The Atlantic devolves into research on how the brain responds to music as language.

-Michael Cuscuna

Read the article… Follow: Mosaic Records Facebook Tumblr Twitter

[meddaily]

Patient assessment

For everyone entering or returning to school, welcome back and I am officially back!

What I am about to go over is basic stuff today, but it seems we all get a bit lax with and I feel review for us all is important at this time.

Patient assessment falls on the back steps at times. It is key for our jobs as medical professionals, but quickly forgotten when we use to our tools. We get tunnel vision at times and treat what we hear. This is true of EMTs, Nurses, PAs, NPs, MDs and any others.

Chest pain usually means the following things

Vitals

EKG

Labs

Chest X-ray

IV/IV fluids

Nitro

 ASA

We as providers are trained to think heart attack first. While it is good to put this in your differentials, it’s not always good to jump the gun to it either.

Doorway Impression

A doorway impression is simple that. When you walk in, what do you see?

If you’re in the hospital, how they got to their room, where they sit, how their physical appearance is can all be clues. While we shouldn’t judge, seeing an obese male in his 60’s with a pack of cigarettes in his pockets, you can probably put cardiac related issues in the “possible” pile.

If you see a 20-year-old college student who appears in shape that is curled up with his knees to his chest and taking rapid shallow breaths, your first opinion might not be cardiac, so it should shift in your list possible Dx.

That first impression won’t give tell you what it is most the time, but it might have a few clues.

ABC’s

If these weren’t pounded into your skull in medical school at any level, we need to chat later.

Airway, breathing and circulations are easy tools and tell you a lot. I will throw in their mental stats here as well.

If they are talking with you, their skin is warm dry and pink, and pulses are strong regular-regular radial; It’s safe to assume that they probably aren’t having a major issue at the moment. Their airway is patent, breathing appears unlabored and after some auscultation lungs to be clear to be sure. Strong pulses that are regular-regular is helpful. Skin condition tells you they’re probably not in shock.

You walk in to a patient that is pale, diaphoretic, barely able to get a few words out, before taking gasping breaths. That alone should tell you something is up. Airway may be patent, but breathing obviously isn’t good. Lung sounds might present with wheezing, which will give you the impression of allergic reaction or asthma attack. When do feel a pulse, is it bounding or stringy might give you a bit more information. This is all just from assessing their ABC’s.

Now, if they are not breathing and there is no pulse, for the love of god, start CPR!

Patient history

Time to get the story down. There is a lot to ask the patient, start with why they seek medical attention at this time. What is the chief complaint.

You’ll then go through you OPQRST and SAMPLE. Ask you these questions, you can add things that may assist in leading you toward what is going on with them. Remember not get tunnel vision when you find a single detail, but try having some solid follow up questions.

Tip: try to have the describe things. Don’t give them a lot of “yes” or “no” questions.

Vitals

Vitals can say a lot and pending where you work, they maybe be done early on in your assessment process and that is perfectly fine. They will play a role in determining if your patient is stable or unstable, but this can still determine early without vitals.

Testing

Now you can get their testing, but with it won’t be just chest pain now. You might be looking for an MI, but PE. There maybe be a bruise on that 20-year-old chest from when he got hit with a bat three days ago. You patient that came in with difficulty breathing might have a Hx of COPD and today just got worse.

Test should be done here to assist with further Dx of the pt. This is where you do your EKG, BG, X-rays, and everything else.

Final Notes

Diagnosing a patient is more than a few tests when related to a chief complaint. It is a series of steps that require you as health care provider to look at and break things down. The list above is not a steadfast list either, it is a general outline that we should all look at as the basics.

Ultimately, how you perform these steps pends on how you work and the way you develop your questioning habits. The major point of this is that we need to get past our labs, ekgs, x-rays, TCs and other toys. We need to look at the patient first and ask ourselves what are all the possibilities and then begin looking through out differentials and picking our exams from there.

Written by: MedDaily

[teded]

How the food you eat affects your brain

If you sucked all of the moisture out of your brain and broke it down to its constituent nutritional content, what would it look like? Most of the weight of your dehydrated brain would come from fats, also known as lipids. In the remaining brain matter, you would find proteins and amino acids, traces of micronutrients, and glucose. The brain is, of course, more than just the sum of its nutritional parts, but each component does have a distinct impact on functioning, development, mood, and energy. So that post-lunch apathy, or late-night alertness you might be feeling, well, that could simply be the effects of food on your brain.

Here are four fascinating facts about your brain on food!

Your brain runs on fats! The good kinds, that is. As we mentioned before, your brain is made mostly of fats. Of the fats in your brain, the superstars are omegas 3 and 6. These essential fatty acids, which have been linked to preventing degenerative brain conditions, must come from our diets. So eating omega-rich foods, like nuts, seeds, and fatty fish, is crucial to the creation and maintenance of cell membranes.

Food can make you super sleepy! But, it can also keep you up. Proteins and amino acids, the building block nutrients of growth and development, manipulate how we feel and behave. Amino acids are one of the reasons we might feel calm after eating a large plate of pasta, or more alert after a protein-rich meal. While the human brain only makes up about 2% of our body weight, it uses up to 20% of our energy resources. Most of this energy comes from carbohydrates that our body digests into glucose, or blood sugar. The frontal lobes are so sensitive to drops in glucose, in fact, that a change in mental function is one of the primary signals of nutrient deficiency. Carbs come in three forms: starch, sugar, and fiber. While on most nutrition labels, they are all lumped into one total carb count, the ratio of the sugar and fiber subgroups to the whole amount affect how the body and brain respond. A high glycemic food, like white bread, causes a rapid release of glucose into the blood and then comes the dip. Blood sugar shoots down, and with it, our attention span and mood. On the other hand, oats, grains, and legumes have slower glucose release, enabling a steadier level of attentiveness. For sustained brain power, opting for a varied diet of nutrient-rich foods is critical.

Trans fats are not your friends. While omegas are good fats for your brain, long-term consumption of other fats, like trans and saturated fats, may compromise brain health. Some research shows that trans fats may impair your memory and may actually affect the size of your brain??!?

Food affects your mood. The complex combinations of compounds in food can stimulate brain cells to release mood-altering norepinephrine, dopamine, and serotonin. But getting to your brain cells is tricky, and amino acids have to compete for limited access. A diet with a range of foods helps maintain a balanced combination of brain messengers, and keeps your mood from getting skewed in one direction or the other.

How’s that for ‘food for thought’?

From the TED-Ed Lesson How the food you eat affects your brain - Mia Nacamulli

Animation by Private Island

[abby-studies-art]

When you are balancing classes, homework, extracurriculars, and a full/part time job, it can be hard to find the necessary time to look after yourself. The important thing is to make good use of the small chances you get during the day! I’ve broken it up into time chunks, to make it easier.

Two Minutes

Brush your teeth/hair etc

Wash your face, or splash cold water on it

Drink a glass of water

Stretch! (especially if you've been sitting down for awhile)

Five Minutes

Take the stairs!

Jumping jacks/squats (I do them all the time behind the counter at work!)

Take a break and eat a piece of fruit

Ten Minutes

Walk instead of bussing

Reapply sunscreen if needed

Take a power nap if you need one

Do a short meditation

Twenty Minutes

Find a short yoga routine on youtube

Go for a quick run

Take a longer nap

Write in a journal/ Notebook if that's your thing

Thirty Minutes

Workout

Do a full yoga routine

Run/walk around your block a few times

Take the time to prepare a special, healthy snack for yourself!

One Hour or More

Workout weights or cardio

Tidy your room/ office space

Catch up on other duties (to relieve stress)

Prepare a meal and make enough for a lunch the next day

As its summer in half of the world, I’d like to remind my friends in the northern hemisphere that health in the heat means drinking cold liquids to stay hydrated, wearing sunscreen to prevent burns and skin damage, and spending time in the shade throughout the day! 

Take Care of Yourselves! 

[serotonerdgic]

Not just for students! Works great for anyone!

[serotonerdgic]

As it turns out, if you make a serum from the plasma of a post-feeding snake and inject it into a mouse, the mouse's heart will increase in size. There's still a lot of work to be done to perfect the procedure, but it could be one of the most effective ways to strengthen a heart that's been weakened by cardiovascular disease. With a little more tweaking, it could even lead to an outbreak of reptile-themed supervillains, so that's a win-win. We call dibs on the alter-ego "Spitting Cobra."

Curiosity

SUPER COOL!!!

[serotonerdgic]

You might be a bit more surprised to find that the biggest gap of all exists over GMO safety — I was, it’s stunningly big. But in general, we know this stuff already. We know that people deny a lot of science when they really shouldn’t.

Evolution. Basically, a lot of people are afraid that if they accept the science of evolution, life becomes meaningless, morality collapses, and death becomes just the end. (Yeah, it’s really that big of a deal for them.) To address this fear, scientists need to show how religious believers (like Pope Francis) actually have no problem with the theory of evolution. Some have adopted this wise strategy, but many have instead opted to slam religion, which, obviously, is likely to backfire.

Climate Change. Here, resistance to the science is driven by an ideology and an identity called individualism, which centers on the belief that a fair society is one in which a person succeeds on his or her own merits. What does that have to do with the climate, you ask? Well, nothing obvious — except that libertarian individualists think that the climate issue is a way of clamping down on something they hold in very high regard indeed: the free market. Scientists can try to explain the facts here till they’re blue in the face, but if they don’t disarm the concerns rooted in ideology, they’ll never disarm the resistance.