Enclothed Cognition

I remember a world before the internet and mobile tablets. I remember the age of pagers and typewriters. I remember the AOL dialup tones and the extraordinary phone bills . . . and, no, I'm not that old - though anyone too young to remember life before the digital revolution of the 90s might disagree.

There's currently an E-Trade ad on TV featuring a talking baby with a Smartphone. It makes me laugh every time I see it, but today, it does almost seem as though children are born with an innate understanding of technology. An annual survey from Parenting Group, the publisher of Parenting, Babytalk and Parenting.com and the BlogHer network, found that 25% of toddlers have used a Smartphone by age 2. I read an article recently about an 11-year-old boy who developed a successful iPhone/iPad app called iSketch. The boy, Cameron Cohen, donated $20,000 of the proceeds to the Chase Child Life program at Mattel Children’s Hospital UCLA.

There is a plethora of mobile apps for children, from teaching apps to apps that assist Autism. When there are such examples of children doing and learning amazing things with Smartphone and tablets, it's easy to overlook an important question: Is it safe for young children to use iPhones and iPads?

The American Academy of Pediatrics (AAP) has advised parents to limit screen time for toddlers and babies, most recently suggesting that kids younger than 2 avoid televisions altogether. The AAP notes that children do best when interacting with other humans. However, the AAP’s new policy doesn’t address iPhones or iPads.

According to a NPR interview with Dr. Ari Brown, the lead author of the AAP’s revised guidelines on toddlers and TV, “There might be a real educational use for those items on these screens,” she says. “We just don’t have any data to say one way or the other.”

What's your opinion? Are we helping or hindering the development of our next generation?

I'm proud to announce that we were recently honored by Uniform Market with the 2012 Univator Awards for Product Innovation. As Uniform Market News states, the Univator Awards recognize innovation within the uniform industry and serve as a reminder that, even in times of economic upheaval, companies both large and small can still improve. We were awarded this honor in recognition of our line of dental-specific lab coats. The newly developed line of gender-specific dental lab coats - featuring the Elsie G. and Lucy H.T. lab coats for women and the Fauchard lab coat for men - offer snap closure to the neck and knit cuff sleeves, consistent with OSHA recommendations. In addition, our dental coats are ergonomically designed to accommodate motion from a seated, arms extended position, a requirement of dental professionals. As with all Medelita lab coats, the lightweight, 100% pre-shrunk cotton fabric of the dental coats resists wrinkling and is distinctly more breathable and comfortable than polyester blend fabrics. Certified performance fabric by DuPont repels fluid, soil and stains - including blood and the impression material used extensively within the dental industry - maintaining a bright white lab coat that signifies prestige and professionalism. Our dental coats are the direct result of feedback from colleagues like you. We're so grateful for your support, and as a company, we're actively committed to involving our customers as we grow, maintaining a consumer-centric approach to both customer service and product development.

I went to a tanning salon once . . . only once. I was about 16, and my mother had convinced me to go with her. I have the sort of English skin that burns within seconds - as though the sun and I are simply sworn enemies. My mother (who somehow doesn't burn even when she covers herself in oil) thought I was too pale, and so we headed to the tanning salon. At the salon, I declined the option of donning a heart-shaped sticker (for a heart-shaped tan line), and I stepped into the impossibly small circular box and closed the door. Naked and surrounded by lights, I read the instructions - hold the strap above my head . . . don't touch the lights less than an inch away on all sides . . . stand in the most uncomfortable position possible. Regretting the decision already, I pushed the button and an industrial fan assaulted me with a hurricane of air while I essentially microwaved myself with lights capable of both blinding and burning me. I never went back, but millions of teenagers today are practically addicted to tanning. California teenagers, however, are now going to have to spend more time outside, on our beautiful beaches, if they want to maintain their tan. As of January 1st of this year, minors cannot legally use tanning beds in the State of California. While 31 other states have tanning restrictions for minors, California is the first state to completely ban the use of tanning beds for anyone under the age of 18. According to the American Academy of Pediatrics, “the incidence of melanoma is on the rise”, increasing by 3% a year. Caucasian women aged 15 - 39 are the most affected demographic, and melanoma is the second most common cancer of women in their 20s. The American Academy of Pediatrics, the World Health Organization, the American Medical Association, and the American Academy of Dermatology all condemn the use of artificial tanning devices for minors. Could California be the first of many states to follow? What are your thoughts?

Every day we proudly add exquisite finishing touches to our lab coats and scrubs in the form of name & title embroidery. We've noticed over the years that the order in which degrees are listed often changes from one person to the next, and in my ever-curious quest for knowledge I recently wondered, "Is there an official system for determining the order of degrees in a title?" The answer isn't simple. I can neither say yes nor no, because it seems to be based largely upon opinion. In an effort to shed some light on the subject, let's go over some of the unofficial rules regarding post-nominal titles. Opinion #1: Chronological Order According to the Gregg Reference Manual, 10th edition, post-nominal titles should be listed in the order in which they were awarded. Honorary degrees should follow earned degrees, and when both academic degrees and professional designations follow a person's name, the academic degrees should be listed first. Opinion #2: Order of Importance - Highest to Lowest More than one source stated that degrees should be listed in order of general importance, i.e. Sam Brown, Ph.D., MS, RN, FAAN. However, this way seems very contextual - the importance of a degree being based upon the current work of the professional. For instance, if a medical doctor is writing a book about history, a subject for which he also has a Ph.D, he ought to list the relevant Ph.D. first. Similarly, if a medical doctor is working as a pharmacist, then the MPH should be listed before M.D. Opinion #3: Order of Credentials - Lowest to Highest On the opposite end of the scale, the University of Oxford states that degrees should be listed in ascending order from the degree with the lowest credentials to the degree with the highest. I should note as well that academic degrees outrank professional degrees. In the end, the rules on this subject are a matter of opinion and personal preference. What's your opinion? How do you list your post-nominal titles and why?

Imagine being a wounded soldier on a battlefield. Through the pain you watch as the war continues around you - comrades fall, gunfire plays an incessant and deafening melody, and the ground seeps a chill through your skin. Prior to the 19th century, you would have had a long wait before help arrived. The wounded were not collected until the battle was over, and millions of casualties occurred simply because the wounded were left too long without medical care. Luckily in the modern world, our brave soldiers are moved quickly to medical stations, but it was not until 1792 that emergency ambulances were developed to transport the wounded during battle. As Napolean Bonaparte's chief physician, Dominique-Jean Larrey noticed the speed with which soldiers moved the wheeled artillery and applied the concept to the development of the "flying ambulance." Larrey's ambulance was a lightweight horse-drawn wagon that collected the wounded during battle and delivered them to tents or field hospitals. The new ambulance system not only increased soldier survival, but also boosted morale. Continuing a trend of military to civilian development in the medical industry, the ambulance was introduced to American civilians in 1869 by a US army surgeon, Edward Dalton. Dalton founded an ambulance service in Bellevue, Washington, and medicine throughout the public sector was forever changed.

My pants fell down today. I was listening to the lungs of a patient, and she had a toddler, about waist high, who tugged on the drawstring of my scrub pants to tell me something. They puddled on the floor, leaving me to examine my patient in my pink polka-dot panties. How professional. Nobody wants to be caught with their pants down. Particularly not in an audition rotation where you are trying to prove competence and professionalism to possible future colleagues. Given that I look young to begin with, a look exacerbated by no makeup and a daily ponytail, I try to make sure that I give a professional presentation in both a tailored dress and manner. Pink polka-dots were not the look I was going for. I dropped my stethescope and snatched up my pants, silently cursing the bastard that invented "unisex" scrubs. They are the suggested uniform of the wards, and required to enter any surgical procedure. They are an ugly green two-piece set freely dispensed from the ScrubX machine in the hall. They say "unisex" but are clearly designed by a man for a man. First of all, no woman would pick that atomic booger color. Secondly, they don't fit. I have the option of scanning my badge and pressing "10" for a size small uniform, and "12" for a medium. I can press "10" and get pants that are huge on the waist, yet hug my hips so tight that it brings the rise and hem of the pants four inches above my socks. I can press "10" and recieve a shirt that is so big that when I bend over, you can see my belly button through the v-neck. Or, I can press "12" and get a pair of pants that easily slides over my hips but has twenty extra inches around the drawstring waist and a rise halfway down to my knees. You can see my toes through the v-neck in that shirt. Usually I opt for the "12" since I don't like things tight on my hips nor unintended capri pants, but this choice leaves me vulnerable to rogue toddler pantsings. Men do not have these problems. They walk around confident, broad-shouldered and tall, scrubs draped gently over their physician physiques. They look like doctors, not girls wearing their father's scrubs. I do have some Medelita scrubs that fit me. I spent about $100 a pair, and they were worth it. Designed for a female doctor, they look like clinician scrubs, not nursing scrubs, and fit every curve and height. I look like a well-polished version of myself; the tailored female equivalent to the uniforms my male colleagues wear so easily and for free. But I can't wear them in outside of ambulatory care. Any procedure requires a hospital-issued uniform where its sterility can be verified. With almost half of new doctors being female, this "unisex" policy is dysfunctional for nearly a majority of physicians. In ob/gyn, there were only 7% female physicians in 1970; today females make up 80% of incoming obstetricians. Yet most women look like I do, uncomfortably sandwiched or swimming in an ill-fitting professional uniform. Medicine is still a man's world. Scrubs designed for a man's form are issued to women. I've sat in many doctors lounges filled with only males, making women driver/shopper/insert your stereotype here jokes over lunch, seemingly oblivious to the fact that I was there. Ugly, fat men that I have done hernia assessments on pull down the underwear and tell me to be careful, don't get turned on during your exam down there. Surgical instruments fit in a man's hand, not my small fingers. If a toddler pulled on a man's drawstring, their pants would stay up. Aside from offensive jokes and patients with too much self-esteem, I genuinely think that our male counterparts are oblivious to the day-to-day difficulties that face a female physician. I'm sure they don't think how uncomfortable it is for pants to pull around your widest part all day, or for a male patient to leer down a gaping top. The tide of medicine is still changing; since older physicians are still in practice, females make up only 30% of doctors despite nearly equivalent numbers of males to females in medical school. And perhaps some of these challenges will change when the gender of the work force evens out. In the meantime, I think of James Brown's 1966 song... This is a man's world This is a man's world But it wouldn't be nothing, nothing Without a woman or a girl Medelita Guest Blogger: Dr. Anne Kennard. Anne is an OB/GYN resident in Phoenix. She has kept a collection of writings about medicine/becoming a doctor since her second year of medical school, and we're honored to welcome her as a guest blogger for Medelita.

There are many reasons why cat owners dread taking their favorite feline to the vet. It is actually difficult to safely get a cat to the clinic. All cat people will agree on that. Cats are smart and they will try to sabotage the operation in any way they can. Placing your cat in a carrier is not a simple task. First, you have to find the carrier, and since you use it once a year, chances are you forgot where you hid it last time. By the time, you locate it, your cat is gone, alerted by the not so discreet search through the house. Now you have to find your cat. He will most likely be hiding in a dusty, dark spot. Do not worry, the vet will not judge you when you show up at the clinic, your clothes covered with cat hair and dust, a strong smell of cat urine (and/or vomit) coming out of the carrier. We understand. We are just happy you were able to bring your cat in! You would not believe the numbers of phone calls we get saying "I have to reschedule my appointment for tomorrow, I can't find Tuna Breath! I have been looking all over the house!" So back to the cat hunt, you will probably have to extract him from underneath the bed, by crawling or using a broom to gently push him to the other side of the bed. Now you have the cat. Run to the carrier that you left downstairs off course. Go fast. Use gravity to actually dump your kitty head first in the standing carrier (well known technique used by 99% of cat owners). Close the carrier. Oops, the other side of the carrier is not secured. Your cat just escaped. Repeat. This is just the typical experience cat owners go through about once a year. However, over the years, my clients have come up with some variants to make the experience even more memorable. Here is are some different approaches to the classic plastic carrier... Place your cat in a covered (preferably empty) litter box. Duct tape the front opening, several times, all around the box. Great technique. Usually followed by a 30 min session to unwrap the box and get the cat out. Don't forget to bring duct tape with you. Redo the whole thing for the trip back. Don't forget to free the cat when you get home. Place your cat in a pillow case. Actually very effective. Place your cat in a Victoria secret pink bag. Dress him with a baby outfit to match the said bag. Place your cat in bread basket, complete with soft napkin. Only available for very young kittens! Place your cat in a covered baby stroller. The nice kind, the Jogging stroller kind. Place your cat in your bright yellow Mustang automobile. Drive to clinic. Park close to the entrance. Get your cat out of your yellow Mustang into the waiting room. Travel in style. Place your cat in a rusty metal cat trap that you borrowed from the local shelter. Pretend he is a stray you found in your backyard. Try to get the "feral cat sterilization" discount. It may fail if your "stray cat" comes out of the trap purring and loving on everybody. Place "something that smells like home" in the carrier to soothe your feline. Blanket, checked. Stuffed animal, checked. Cat toy, checked. Sweater, checked. Female underwear... Checked. That's right. Size 8, blue thong. Note to our vet staff, do not forget to put gloves on Before digging through a carrier. Because you never know... To this day, I do not know if the cat dragged it in to sabotage the exam, or if the owner intentionally placed it in there. I like to think the cat is to blame. Medelita Guest Blogger: Julie Pearson, DVM. Julie is currently working on the East Coast as a small animal veterinarian. She was born and raised in France, where she got her degree before getting licensed in the USA. She enjoys being a general practitioner, and feels privileged to be there for her patients, whether it is for a wellness visit or a serious medical issue. Julie has been wearing Medelita since August 2010, and is seen here wearing her scrubs.

How "health literate" do you believe your patients to be? You often send your patients home with prescriptions, pamphlets, and detailed instructions - but do they often follow your guidelines? Do they even understand what they're reading? In 2003, the National Assessment of Adult Literacy (NAAL) introduced the first large-scale national assessment in the United States to measure health literacy - the ability to use literacy skills to read and understand written health-related information encountered in everyday life. Unfortunately, they found that the health literacy rate in the US is only 12%. Approximately one out of ten Americans are "health literate", according to the U.S. Department of Health and Human Services. Health literacy is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” What this means is that roughly ten percent of the population is proficient with measuring medications, understanding nutrition labels, choosing healthcare and prescription plans, and generally understanding their own health and wellness. Most Americans, therefore, struggle to make appropriate decisions in regards to their own health. The American Medical Association further claims that poor health literacy is “a stronger predictor of a person’s health than age, income, employment status, education level and race.” As a healthcare provider, what do you think can be done to increase health literacy?

I'm still a little surprised that my name badge says Doctor. I've seen prescriptions filled that I've written, pausing momentarily to look with surprise and marvel that my name- Dr. A. Kennard- is on the label. And not as the patient. It's in the top corner; the doctor's spot on the label. I'm always surprised in the operating room when I say "knife, please" and they hand it over. My mother laughs, and tells me I have Imposter Syndrome. She says its common in young professionals, and probably most so with a very important job, as I have. So, I looked it up. I thought she was making it up, but apparently it is actually a described and studied entity. Imposter Syndrome is described as " is a psychological phenomenon in which people are unable to internalize their accomplishments. Despite external evidence of their competence [ie, my name badge], those with the syndrome remain convinced that they are frauds and do not deserve the success they have achieved. Proof of success is dismissed as luck, timing, or as a result of deceiving others into thinking they are more intelligent and competent than they believe themselves to be. It is commonly associated with academics and is widely found among graduate students and especially in high-achieving women" (Clance, et al, 1978 and Lucas, 2008). Huh. I wasn't aware I had given consent for researchers to observe me and exactly describe my thoughts and behavior. I think part of my reluctance to realize my success is that I am in a group in which I am very, very average. I am definitely not the smartest. I am not the prettiest. I am not the most athletic, the thinnest, the tallest, the shortest, the hardest-studying. I am probably not the most insecure. And I'm quite sure I am not the only imposter. I watch in awe (and jealousy) as these residents give presentations at world-class perinatal conferences. They run marathons. They have beautiful, highlighted hair, smart clothes, designer shoes and bags, toned arms, tight abs. They are mothers. They seem to effortlessly go through working twenty-four hours with a plan to go for a run afterwards, as I am blindly grabbing for my coffee, planning a workout I won't do, and stumbling towards bed. They spend hours pumping breastmilk so their babies can have the best nutrition possible while they are away at work. My dog is lucky to get his scoop of dry kibble. What normal person wouldn't be an imposter, wouldn't be intimidated, by this group and this job? But my mother points out, I am not a normal person either. I belong here too. It would have been impossible to fool enough people for me to be here just on luck, so I must be here on my own merit, despite my veil of inadequacy. And the fact that it took a prestigious residency- one of the top in the country- to make me average is pretty un-average. I'm back in the operating room, after reading this research. "Knife, please." They hand it over. I look at them suspiciously and with surprise. Are you really sure you want to do that? I'll keep working on it. Medelita Guest Blogger: Dr. Anne Kennard. Anne is an OB/GYN resident in Phoenix. She has kept a collection of writings about medicine/becoming a doctor since her second year of medical school, and we're honored to welcome her as a guest blogger for Medelita.

Emma Willits is known as the first woman to head a surgery department in the United States. Born in 1869 in Macedon, New York, Emma was educated at Quaker schools and in 1892, she moved to Chicago to enroll at the Women's Medical College of Chicago. At that time, female surgeons were essentially unheard of, and Emma Willits was only the third woman in the United States to specialize in surgery. When she received her medical degree in 1896, Dr. Willits served her internship at the Women's Hospital of Chicago before moving to San Francisco. After completing her residency at the Children's Hospital in 1900, she opened her own private practice but maintained close ties to the hospital. Initially a member of the surgical staff of the Department of Pediatrics, Emma Willits later became the chief of the Department of Surgical Diseases of Children. Dr. Willits served as the head of the Department of General Surgery at the Children's Hospital from 1921 to 1934. We've chosen to honor Dr. Willits in our own Medelita way, and we'll soon be unveiling the Emma W., an exciting new addition to our line of Women's lab coats.