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<description>This is the aggregated RSS feed for Medlogs.com, a medical news and weblog aggregator</description>
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<item>
<title>
True Tales of Medical School:  The First Stitch
</title> 
<link>
http://politedissent.com/archives/2024
</link>
<pubDate>July 3, 2008, 10:45 am</pubDate>
<description>
<![CDATA[
Third year of medical school was divided into 3 &#8220;minor rotations&#8221; of 2 months each and 2 &#8220;major rotations&#8221; of 3 months each.  The minors were OB/Gyn, Pediatrics, and Psychiatry.  The majors were internal medicine and surgery.  Surgery was then further divided into the A, B, and C courses.  These essentially broke down as follows:  A level was designed for students who knew that they wanted to be surgeons.  It consisted of long hours, but offered the most chance of hands-on work and getting to know the right surgeons.  B level was for students who were considering surgery as career choice, but hadn&#8217;t made up their mind yet.  It still had a lot of hands-on opportunities, but it wasn&#8217;t quite as grueling as the A level courses.  It also had more of the &#8220;romantic&#8221; aspects of surgery (trauma!  transplant!) designed to sweep students off their feet.  Finally, there were the C level courses.  These were for students who were already certain that they weren&#8217;t going into surgery.  Supposedly, it wasn&#8217;t as labor intensive as the A and B levels, and had more general interest rotations.  By this time, I had already decided on Family Practice, and while I found surgery fascinating, I knew it wasn&#8217;t for me, so I went straight for the C level courses.
My three months of surgery consisted of, in no particular order: one month of Pediatric Surgery (rather boring; bland attendings and residents), one month of General Surgery at the VA (easily the worst month of my life, ever.  We were horribly understaffed and the residents were as unhappy to be there as we were, and took it out on us.), two weeks of ENT (fun, but then I already knew all the attending and residents from bartending their Christmas party.  But that&#8217;s another story), and two weeks of Vascular Surgery.  Vascular was probably my favorite rotation.  It consisted of two attendings, one resident, and me.  They were very happy to teach and respected the fact that I was going into Family Practice.  They went out of their way to make sure that I learned the aspects of vascular surgery that would be important in primary care.  

That was a long set up for a very short story&#8230;
It was in a Vascular Surgery case that I was given my first chance to suture a patient all by myself.  We were performing a carotid endarterectomy, and had used part of the saphenous vein for the procedure.  While the surgeon was finishing up in the neck, he looked over to me and said, &#8220;Scott, why don&#8217;t you close up the leg incision?&#8221;
&#8220;Sure!&#8221; I said, almost confidently.  A nurse handed me the proper gear and some suture and I got started.  At the far end of incision, I threw in a stitch, tied a knot, and then worked my way up the incision, one subcuticular stitch at a time.  Subcuticular stitches are done just under the skin and use absorbable suture, so they don’t have to be removed; they dissolve away on their own.  It&#8217;s a zig-zag style of suturing, and the trick is getting the two sides to line up.   
I was being extremely careful, making sure that both sides lined up, and ensuring that I did everything &#8220;by the book.&#8221;  The end result, if I do say so myself, looked pretty good.  Sure, one end was a little dog-eared, but the surgeon didn&#8217;t seem to mind (&ldquo;Just throw a steri-strip on there!&#8221;).  However, when I tied the final knot, I looked up and realized that the main surgery was long over and the entire surgical team had been watching me &#8212; for the past hour.  Yes, it took me well over an hour to sew up what amounted to little more than a 4-inch incision.  I was mortified.  The surgical team were all good sports about it, but I was sure I had just flunked my rotation.
The surgeon gave me another chance to suture the next day, so I probably wasn&#8217;t as bad as I remember &#8212; or maybe I was, and he thought I needed all the experience I could get.  Either way, he gave me a good grade at the end, so I like to think I finished the rotation with some decent suturing skills (though I haven&#8217;t use subcuticular stitches much since).

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<item>
<title>
Kinder, gentler: How to get an innocent person to confess to a crime
</title> 
<link>
http://www.bookofjoe.com/2008/07/kinder-gentler.html
</link>
<pubDate>December 31, 1969, 11:00 pm</pubDate>
<description>
<![CDATA[


Long story short: "Make a kindly suggestion of guilt." 

And: "The more plausible the alleged act... the likelier the false confession."

The May 2008 issue of The Atlantic magazine featured an item about a recent study in the psychology literature about guilt and confession in its "Primary Sources" feature; the piece follows.

Confessions of a Non-Dangerous Mind

The best way to get someone to confess to a crime may be to make a kindly suggestion of guilt — even if the suspect is innocent. Three researchers gathered 219 students and asked them to take a typing test. The subjects sat at computers and typed out letters read aloud by the experimenter. Some of the participants were warned that if they pressed the Alt key, the program would crash and all the data would be lost. The system was rigged so it would shut down after the experimenter asked the participants to type the Z key (which sits just to the left of the Alt key). The experimenter then interviewed the volunteers individually and asked each to sign a statement admitting he or she had ruined the test. “Don’t worry,” the experimenter said. “You didn’t mean to hit the Alt key. Several participants so far have pressed the Alt key during this task. Are you sure you didn’t press it?” Seventy percent of the participants — all innocent — eventually confessed. The professors then repeated the experiment, substituting the Esc key for the Alt key. But since the Esc key sits much farther away from the Z key, only 23 percent of participants admitted to hitting it. The more plausible the alleged act, the authors conclude, the likelier the false confession. The study also found that participants in both tests who were interrogated in a more intimidating manner (“It looks like the entire project may be delayed now. Why did you press the key?”) were less likely to falsely admit to the offense, suggesting that a light hand may be the best way to elicit a false confession.....................

Here's the abstract of the paper, which appeared in the February 2008 issue of Legal and Criminological Psychology.

 Effects of personality, interrogation techniques and plausibility in an experimental false confession paradigm

Purpose: The goal of the present study was to investigate the effects of personality variables, interrogation techniques and the plausibility level of an alleged transgression on the experimental elicitation of false confessions.

Methods: Two hundred and nineteen undergraduate students assessed on measures of compliance, self-esteem, locus of control and interrogative suggestibility participated in the Kassin and Kiechel (1996) paradigm. Experimental manipulations included minimization and maximization interrogation techniques and high and low plausibility of the alleged typing mistake to examine rates of false confession and internalization.

Results: The overall false confession and internalization rates across all conditions were 43 and 10%, respectively. An increased likelihood of false confession behaviour was associated with higher Shift scores on the Gudjonsson Suggestibility Scale, the use of minimization interrogation techniques and an increase in the plausibility of the allegation. Females were more likely to falsely confess than males in the high plausibility condition, whereas Caucasian and Asian participants were equally likely to falsely confess. Personality variables, such as compliance, most influenced the behaviour of males and Asians.

Conclusions: The results of this study offer insight into false confession behaviour, suggesting that individuals who have a tendency to change their responses in the face of negative feedback may be more prone to false confession behaviour. The findings also serve to highlight the dangers of using minimization interrogation techniques and elucidate the limited generalizability of the paradigm to situations in which the alleged transgression is less plausible.
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<item>
<title>
Havard Researchers for Sale: Take 2
</title> 
<link>
http://psychcentral.com/blog/archives/2008/07/03/havard-researchers-for-sale-take-2/
</link>
<pubDate>July 3, 2008, 10:42 am</pubDate>
<description>
<![CDATA[
	Apparently after you&#8217;ve made it as a tenured professor at Harvard University, your first job is to secure some more funding for your research (despite Harvard being the richest school in the world). And what better way to do this than to ask for a little industry support?
	Critics have typically focused on the potential for a conflict of interest when researchers are funded by the pharmaceutical companies whose drugs they study. But there are many deep pockets in the world, and gambling companies have some of the deepest.
	Just ask Howard Shaffer, a world-renown researcher on compulsive gambling and a Harvard professor. Bloomberg pointed out yesterday how he has received over $9 million in industry money since 1996, in support of his research initiatives into gambling and gambling problems.
	Shaffer&#8217;s research, however, is extensive in this field and his reputation is impeccable. The primary difference seems to be that the media (in this case, Bloomberg specifically) is on a bit of a witch hunt now, looking for anyone who gets industry money and does research on that same industry (regardless of whether there has been any failure to disclose the support).
	To be clear, Shaffer is not under any type of investigation for failure to disclose financial support from the industry, a point not clearly made until you&#8217;re nine paragraphs into the article:
	
Shaffer&#8217;s research complies with Harvard&#8217;s guidelines for receiving funding from industry, David Cameron, a spokesman for Harvard Medical School, said in an emailed statement June 25.
	Shaffer, 59, said his funding sources are fully disclosed, his findings are published in peer-reviewed journals and casino companies haven&#8217;t interfered with his research.

	Far before this point is made, the Bloomberg author trots out guilt by association, bringing up the other three Harvard-associated researchers who actually did something wrong &#8212; they failed to disclose industry-received money. 
	That&#8217;s the point. It is perfectly legal and acceptable to receive such money and has been for decades, as long as it is fully disclosed to all &#8212; the university, the journals, and the public. 
	Now, whether it&#8217;s right or not is entirely another question (one the article skirts around and never really frames properly). Whether one&#8217;s research actually does become biased, despite one&#8217;s best efforts to keep it fair and balanced, is a good question for a study or two. 
	Common wisdom suggests that funding sources will eventually exert an influence &#8212; even a subtle influence &#8212; especially when one&#8217;s livelihood is dependent upon it. Alternatively, a researcher&#8217;s reputation is virtually priceless and few researchers would put theirs at stake even to receive virtually unlimited research funding. 
	That&#8217;s why good studies need to be replicated by other researchers. If a bias existed, it should come out in other studies that don&#8217;t find the same results or come to the same conclusions. So eventually, time will tell.
	Read the full article: Harvard Proves Gaming&#8217;s Best Friend With Casino-Funded Research

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</item>
<item>
<title>
In time for the July 4th BBQ
</title> 
<link>
http://www.kevinmd.com/blog/2008/07/in-time-for-july-4th-bbq.html
</link>
<pubDate>July 3, 2008, 10:37 am</pubDate>
<description>
<![CDATA[
How about some Krispy Kreme Bacon Cheeseburgers?Or Grilled Twinkies?Yummy, not.(via Instapundit)

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</item>
<item>
<title>
Mandate metastasis
</title> 
<link>
http://www.kevinmd.com/blog/2008/07/mandate-metastasis.html
</link>
<pubDate>July 3, 2008, 10:37 am</pubDate>
<description>
<![CDATA[
Where you can't find a no-frills policy, even if you tried.

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</description>
</item>
<item>
<title>
Advice on the wards
</title> 
<link>
http://www.kevinmd.com/blog/2008/07/advice-on-wards.html
</link>
<pubDate>July 3, 2008, 10:37 am</pubDate>
<description>
<![CDATA[
Help make the fellow members of your team look good.

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</description>
</item>
<item>
<title>
Best wishes
</title> 
<link>
http://www.kevinmd.com/blog/2008/07/best-wishes.html
</link>
<pubDate>July 3, 2008, 10:37 am</pubDate>
<description>
<![CDATA[
To Lauren, GruntDoc's daughter, who's in the hospital right now.

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</description>
</item>
<item>
<title>
HP intros fault-tolerant blade server
</title> 
<link>
http://bruno.penandscale.com/2008/07/hp-intros-fault-tolerant-blade-server.html
</link>
<pubDate>July 3, 2008, 9:44 am</pubDate>
<description>
<![CDATA[
Hewlett Packard (HP) has introduced its fault-tolerant blade server that supports high transaction volumes and provides real-time response capabilities in a cost-effective design.The new HP Integrity NonStop NB50000c BladeSystem is an ideal replacement platform for mainframe applications in industries such as finance, public sector and telecommunications.Using the same amount of power as existing NonStop server offerings, the NB50000c delivers twice the performance and occupies half the data center space, besides offering 35 per cent lower total cost of ownership than competing offerings and up to a 50 per cent decrease in cost per transaction.“The new Integrity NonStop BladeSystem provides 24/7 business availability and scalability to our customers through the economies of a bladed form factor,” HP’s Technology Solutions Group Executive VP Ann Livermore said.Supporting high volumes of mission-critical transaction processing, the new BladeSystem offers a new way to transition customers’ most-demanding applications onto a highly efficient and modular form factor.The NonStop operating environment offered on a standards-based blade design ensures the highest levels of reliability, while its fault-containment design protects data while error-recovery features eliminate downtime.The new system features double the processing power in half the physical footprint through multi-core technology and HP BladeSystem.It comes with a patented 24/7 fault-tolerant software built on standard components for reduced cost of ownership, HP said in statement.
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</item>
<item>
<title>
Sterilised monkeys in Himachal become pregnant
</title> 
<link>
http://bruno.penandscale.com/2008/07/sterilised-monkeys-in-himachal-become.html
</link>
<pubDate>July 3, 2008, 9:44 am</pubDate>
<description>
<![CDATA[
Everything is possible in love and war. Even monkeys sterilised can reproduce again if they are in love with their mates. The Himachal Pradesh Wildlife Department is ready to prove it.To control the monkey menace in areas like Shimla, Kufri and Rampur, the Wildlife Department sterilised about 1,300 simians last year. The males were sterilised using laser technology while tubectomy was performed on females using the laparoscopic technique.But now the animals are breeding again, reports IANS.“Most of the monkeys sterilised by the wildlife department are pregnant again,” said a wildlife official at the Himalayan Nature Park in Kufri.He said 60 monkeys were caught from Kufri, about 25 km from here, and taken to the Tuti Kandi rescue centre on the outskirts of Shimla. After sterilisation, they were released in the same area.At that time, male and female monkeys were tagged. But now the tags have also disappeared.Conservator of Forests (Wildlife), Lalit Mohan admits that there were some flaws in the sterilisation programme.The drive hit several road blocks due to the shortage of expert monkey catchers. Now the department is training its own staff.“The monkeys might be pregnant again as all animals could not be trapped at that time. Those that had been left out at that time might be breeding now,” he said.The wildlife department had also initiated mass translocation of simians to remote forest areas from cities and towns to control the menace.But this process was not successful as the territory vacated by the animals was occupied by more aggressive troops of monkeys from surrounding areas.According to a census conducted by the Wildlife department, the state has 319,000 monkeys.
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<item>
<title>
Wasabi Ice Cream
</title> 
<link>
http://www.bookofjoe.com/2008/07/wasabi-ice-crea.html
</link>
<pubDate>December 31, 1969, 11:00 pm</pubDate>
<description>
<![CDATA[


Mmmmm.

Falls Church (Virginia) chef Leland Atkinson's super-premium ice cream "... sounds bizarre but is surprisingly delicious," according to an item in yesterday's Washington Post Food section.

$5.99 a pint at at Balducci's, select Whole Foods Markets in Virginia and at Willoughby's Market in Sandy Spring.
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