The prevalence of body dissatisfaction and disordered eating amongst males is on the rise. Early figures that men accounted for 1 in 10 diagnoses of anorexia and bulimia nervosa are now considered underestimates, and researchers have increasingly focused on new disorders, such as muscle dysmorphia, that capture the “male experience” of wanting a more muscular body. I review the nature and prevalence of male body dissatisfaction and disordered eating, and explore their relationship with traditional notions of masculinity. I further review the stigmatisation of males with body image and eating disorders, and discuss the challenge that stigma represents to treatment seekers and to health professionals. In addition, I explore the concept of muscularity-oriented disordered eating and some of its major components, including nutritional supplements, steroid use, and compulsive exercise. Finally, the role of the general practitioner in recognising and addressing male body dissatisfaction and disordered eating is addressed, and guidelines for working with males are suggested.
A crash-course ED 101 for dietitians not familiar with eating disorders
- What does "normal eating" mean and when does it become "disordered eating?"
- What are the spectrum of eating disorders?
- What are the causes of eating disorders and what does treatment involve?
- What is the dietitian's role in eating disorders?
- What are some ways to screen eating disorders and obsessive/compulsive exercise?
- Why are "Health at Every Size" and "Intuitive Eating" effective approaches in preventing clinical eating disorders?
A crash-course ED 101 for dietitians not familiar with eating disorders
- What does "normal eating" mean and when does it become "disordered eating?"
- What are the spectrum of eating disorders?
- What are the causes of eating disorders and what does treatment involve?
- What is the dietitian's role in eating disorders?
- What are some ways to screen eating disorders and obsessive/compulsive exercise?
- Why are "Health at Every Size" and "Intuitive Eating" effective approaches in preventing clinical eating disorders?
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
"Eating Disorders" is presented by Dr. Carl Christensen, MD, Ph.D.; Addictionologist; and Lori Perpich, LLP, MS Clinical Behavioral Psychology; cognitive behavioral therapist and EDEN program facilitator. This program examines the evidence that eating disorders are true biopsychosocial diseases, similar to chemical dependency. It defines various eating disorders and their consequences, explores neurobiological theories of addiction, discusses screening tools used for eating disorders, and provides information on treatment options and resources for eating disorders. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.
ICED 2014 Workshop on Males with Eating DisordersScoti Riff
Eating disorders in males are understudied, underrecognised and misunderstood. Despite evidence that males constitute 25-33% of diagnoses of anorexia and bulimia nervosa, and up to 50% of diagnoses of binge eating disorder, limited research has focused on the “male experience” of eating and body image concerns. In addition, researchers and clinicians have only recently begun to focus on the role that muscularity plays in males with eating and body image psychopathology. We present evidence that disordered eating behaviours are increasing more rapidly in men than in women, particularly with regard to binge eating. We further present a clinical comparison of men with anorexia nervosa and muscle dysmorphia (“reverse anorexia”) and review community-held attitudes and beliefs about people with these conditions. We conclude with a discussion of clinical treatment guidelines for males with eating disorders. This workshop will (1) present an overview of the evidence base pertinent to males with eating disorders, (2) evaluate evidence for the prevalence of disordered eating amongst males, compare the phenomenology of muscle dysmorphia and anorexia nervosa, and review the stigmatization of males with anorexia nervosa and muscle dysmorphia. Finally, this workshop 3) details treatment guidelines for clinicians working with males.
this presentioation will help individuals learn about the most popular eating disorders known around the world, and how these disorders are spreading in the arab countries.
"Eating Disorders" is presented by Dr. Carl Christensen, MD, Ph.D.; Addictionologist; and Lori Perpich, LLP, MS Clinical Behavioral Psychology; cognitive behavioral therapist and EDEN program facilitator. This program examines the evidence that eating disorders are true biopsychosocial diseases, similar to chemical dependency. It defines various eating disorders and their consequences, explores neurobiological theories of addiction, discusses screening tools used for eating disorders, and provides information on treatment options and resources for eating disorders. This program is part of the Dawn Farm Education Series, a FREE, annual workshop series developed to provide accurate, helpful, hopeful, practical, current information about chemical dependency, recovery, family and related issues. The Education Series is organized by Dawn Farm, a non-profit community of programs providing a continuum of chemical dependency services. For information, please see http://www.dawnfarm.org/programs/education-series.
ICED 2014 Workshop on Males with Eating DisordersScoti Riff
Eating disorders in males are understudied, underrecognised and misunderstood. Despite evidence that males constitute 25-33% of diagnoses of anorexia and bulimia nervosa, and up to 50% of diagnoses of binge eating disorder, limited research has focused on the “male experience” of eating and body image concerns. In addition, researchers and clinicians have only recently begun to focus on the role that muscularity plays in males with eating and body image psychopathology. We present evidence that disordered eating behaviours are increasing more rapidly in men than in women, particularly with regard to binge eating. We further present a clinical comparison of men with anorexia nervosa and muscle dysmorphia (“reverse anorexia”) and review community-held attitudes and beliefs about people with these conditions. We conclude with a discussion of clinical treatment guidelines for males with eating disorders. This workshop will (1) present an overview of the evidence base pertinent to males with eating disorders, (2) evaluate evidence for the prevalence of disordered eating amongst males, compare the phenomenology of muscle dysmorphia and anorexia nervosa, and review the stigmatization of males with anorexia nervosa and muscle dysmorphia. Finally, this workshop 3) details treatment guidelines for clinicians working with males.
Sex differences in the links between disordered eating and admiration for peo...Scoti Riff
Background: Disordered eating in young women is positively associated with their admiration for women with anorexia nervosa. However, little is known about sex differences in this association, or whether the association extends to muscle dysmorphia.
Aims: The present study aimed to investigate sex differences in the associations between young peoples’ disordered eating and their admiration for people with anorexia nervosa and muscle dysmorphia.
Method: Male (n = 174) and female (n = 325) undergraduates read one of four descriptions of a male or female character with anorexia nervosa or muscle dysmorphia. Participants then answered questions about their admiration for the characters and completed a measure of disordered eating.
Results: Averaged across character diagnosis and character sex, female participants expressed greater desire to be like the characters than males. For females, moderate to large positive correlations were observed between disordered eating and admiration for characters with both anorexia nervosa and muscle dysmorphia. For males, moderate positive correlations emerged between disordered eating and admiration for muscle dysmorphia, and a single small positive correlation was observed for anorexia nervosa.
Conclusions: The results indicate important sex differences in the associations between young peoples’ disordered eating and their admiration for anorexia nervosa and muscle dysmorphia.
Muscle Dysmorphia: What Happens when Body Image Collides with Exercise, Nutri...Nutrition in Recovery
Learn about the growing problem of Muscle Dysmorphic Disorder and how it relates to eating disorders. This presentation will focus on the male population who is in relentless pursuit of muscularity. For more information about the author David A. Wiss, MS, RDN, CPT visit his website at www.NutritionInRecovery.com
Running Head INDIVIDUAL PROGRAMMATIC ASSESSMENT1INDIVIDUAL PR.docxcharisellington63520
Running Head: INDIVIDUAL PROGRAMMATIC ASSESSMENT 1
INDIVIDUAL PROGRAMMATIC ASSESSMENT 11
Individual Programmatic Assessment
Mary Oliver
PSYCH / 630
Mr. Adam Castleberry
January 12, 1015
Individual Programmatic Assessment:
Bulimia Nervosa
Psychological disorders occur frequently. A common psychological disorder selected for the purpose of this paper is bulimia nervosa. Bulimia nervosa has several therapeutic interventions that can help when treating the disorder. Therapeutic interventions can be helpful, but have different measures of effectiveness. The measures of effectiveness consist of validity, efficacy, symptom, behavior management, and recidivism. These measures should be identified, prior to deciding which therapeutic interventions can be most helpful to the individuals diagnosed with the psychological disorder. Many common symptoms are associated with bulimia nervosa. Rates of symptom reduction or management have been reported with the three treatments. Furthermore, the neurophysiological underpinnings of diseases and disorders have to be identified, along with the contemporary attitudes towards the three treatments chosen.
Psychological Disorder: Bulimia Nervosa
Bulimia nervosa is known as an eating disorder. This disorder typically affects females and is most often done by binge-and-purge eating patterns. This eating disorder brings about the effects of bingeing and purging, and using laxative. People, suffering from bulimia nervosa, frequently eat a lot of food at one time. A short period after eating the food, the person, then, attempts to remove the food from his or her system by vomiting, through medication that creates bowl movements, or by working out. Excess working out has been known to lead one to throw up. People diagnosed with bulimia nervosa, often lack self-esteem. Many are self-conscious about their body image and preoccupied by food. Majority of individuals, suffering from bulimia nervosa, have normal weight or believe that they have weight problems. Bulimia is associated with other illnesses, as well. For example, some suffer from depression. Bulimia nervosa shares many characteristics of anorexia nervosa. Anorexia nervosa is a psychological eating disorder that impacts many people, as well. However, instead of purging or bingeing, people with anorexia nervosa, simply, do not eat. People, diagnosed with bulimia nervosa, have a difficult time maintaining a set weight like other individuals. Furthermore, more critically, they are able to hide the fact that they have bulimia nervosa. If bulimia nervosa goes untreated, it can create critical issues, along with a nutritional downfall. “Bulimia nervosa can be extremely harmful to the body. The recurrent binge-and-purge cycles can damage the entire digestive system and purging behaviors can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions” (NEDA, 2012).
The cause of bulimia nervosa has not .
Eating Disorders
Eating Disorder Statistics
• 30 million Americans suffer from an eating disorder
• The rate of development of new cases of eating
disorders has been increasing since 1950 (Hudson et
al., 2007; Streigel-Moore & Franko, 2003; Wade et al.,
2011).
• There has been a rise in incidence of anorexia in
young women 15-19 in each decade since 1930
(Hoek& van Hoeken, 2003).
• The incidence of bulimia in 10-39 year old women
TRIPLED between 1988 and 1993 (Hoek& van
Hoeken, 2003).
Risk factors for Eating Disorders
• they often occur with one or more other psychiatric
disorders, which can complicate treatment and
make recovery more difficult.
• Among those who suffer from eating disorders:
– Alcohol and other substance abuse disorders are 4 times
more common than in the general populations (Harrop
& Marlatt, 2010).
– Depression and other mood disorders co-occur quite
frequently (Mangweth et al., 2003; McElroy, Kotwal, &
Keck, 2006).
– There is a markedly elevated risk for obsessive-
compulsive disorder (Altman & Shankman, 2009).
Biological risk factors
• Scientists are still researching possible
biochemical or biological causes of eating
disorders. Current research indicates that there
are significant genetic contributions to eating
disorders. (NEDA, 2017)
– In some individuals with eating disorders, certain
chemicals in the brain that control hunger,
appetite, and digestion have been found to be
unbalanced. The exact meaning and implications of
these imbalances remain under investigation.
– Eating disorders often run in families.
Diagnosing Anorexia Nervosa
(APA, 2013)
• Anorexia nervosa is a mental health disorder
characterized by distorted body image and
excessive dieting that leads to severe weight
loss with a pathological fear of becoming fat.
– Females- more likely to focus on weight loss
– Males- more likely to focus on muscle mass
• Diagnostic criteria
– restriction of calorie intake resulting in a below normal body
weight level for age and height
Diagnosing Anorexia Nervosa
(APA, 2013)
• There are Two subtypes of AN:
1. Restricting type: a reduction in total food intake without binge-
eating or purging behavior
2. Binging eating/purging type: regularly engaging in self-induced
vomiting or the misuse of laxatives, diuretics, or enemas
3. Can also be characterized by a combination of the 2:
• An individual with anorexia has an appetite; he/she just tries to control it.
It is very difficult when a person is starving not to want to eat. What
happens to many individuals is that they lose control
• Other characteristics
– significant disturbance in the perception of the shape or size of his or
her body
– exercising compulsively
– developing unusual habits such as refusing to eat in front of others
Diagnosing Bulimia Nervosa
(APA, 2013)
• A serious, potentially life-threatening mental
health disorder characterized by:
1. frequent episodes of binge eat ...
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Sex differences in the relationships between body dissatisfaction, quality of...Scoti Riff
Background: Body dissatisfaction is associated with impairment in women's quality of life (QoL). To date, research has not examined the relationship between body dissatisfaction and men's QoL, or sex differences in this relationship.
Methods: A community sample of 966 males and 1,031 females living in Australia provided information about their body dissatisfaction, mental health and physical health-related QoL, and eating disorder symptoms. Data were analysed using three hierarchical multiple regressions and interactions between body dissatisfaction and sex were examined.
Results: For both sexes, increasing levels of body dissatisfaction were associated with poorer mental and physical health-related QoL and greater psychological distress. The adverse associations between body dissatisfaction and mental health-related QoL, and between body dissatisfaction and psychological distress, were more pronounced for males.
Conclusion: High levels of body dissatisfaction may threaten the psychological and physical wellbeing of both men and women. Body dissatisfaction appears to be a public health problem, distinct from the eating disorders and other adverse psychological phenomena for which body dissatisfaction is commonly discussed as a risk factor. Males, historically understudied and underrepresented in body image research, warrant increased empirical attention.
Self-stigma of Seeking Help and Being Male Predict an Increased Likelihood of...Scoti Riff
To examine whether self-stigma of seeking psychological help and being male would be associated with an increased likelihood of having an undiagnosed eating disorder. A multi-national sample of 360 individuals with diagnosed eating disorders and 125 individuals with undiagnosed eating disorders were recruited. Logistic regression was used to identify variables affecting the likelihood of having an undiagnosed eating disorder, including sex, self-stigma of seeking psychological help, and perceived stigma of having a mental illness, controlling for a broad range of covariates. Being male and reporting greater self-stigma of seeking psychological help were independently associated with an increased likelihood of being undiagnosed. Further, the association between self-stigma of seeking psychological help and increased likelihood of being undiagnosed was significantly stronger for males than for females. Perceived stigma associated with help-seeking may be a salient barrier to treatment for eating disorders – particularly among male sufferers.
Stigma resistance, described as the capacity to counteract or remain unaffected by the stigma of mental illness, may play a crucial role in the fight against stigma. Little is known, however, about stigma resistance and its correlates in people with eating disorders. This study investigated stigma resistance in people currently diagnosed (n = 325) and recovered (n = 127) from anorexia nervosa, bulimia nervosa, and EDNOS. Participants completed an Internet survey that included the Stigma Resistance subscale of the Internalized Stigma of Mental Illness Scale together with a battery of psychosocial and psychiatric measures. Greater stigma resistance among the currently diagnosed was associated with less marked eating disorder and depression symptoms, higher self-esteem, more positive attitudes about seeking psychological treatment, and lower internalized stigma. Stigma resistance was significantly greater among the recovered than the currently diagnosed (Cohen’s d = 0.25), even after controlling for differences in eating disorder and depression symptoms, attitudes about seeking psychological help, self-esteem, years between symptom onset and diagnosis, and years since diagnosis. A minimal-to-low level of stigma resistance was exhibited by 26.5% of currently diagnosed participants compared to just 5.5% of recovered participants. Stigma resistance is a promising concept that warrants further study. Researchers should consider designing interventions that specifically cultivate stigma resistance in people with eating disorders as a complement to current interventions that target public perceptions of eating disorders. Clinicians may consider incorporating the concept into their practice to help patients rebuff the adverse effects of mental illness stigmatization.
The Prevalence and Adverse Associations of Stigmatization in People with Eati...Scoti Riff
To date, studies of stigma relating to eating disorders have been largely confined to surveys of the public. We sought to examine the prevalence and correlates of stigma as reported by individuals with eating disorders. An online survey designed to assess frequency of exposure to potentially stigmatizing attitudes and beliefs as well as the perceived impact of this on health and well-being was completed by a cross-national sample of 317 individuals with anorexia nervosa (n = 165), bulimia nervosa (n = 66), or Eating Disorder Not Otherwise Specified (EDNOS; n = 86). Participants rated two beliefs as both particularly common and particularly damaging, namely “I should be able to just pull myself together” and “I am personally responsible for my condition”. Participants with bulimia nervosa more commonly experienced the belief that they had "no self-control" and male participants more commonly experienced the belief that they were “less of a man". More frequent stigmatization was associated with higher levels of eating disorder psychopathology, a longer duration of disorder, lower self-esteem, and more self-stigma of seeking psychological help. Stigma towards individuals with eating disorders, as experienced by sufferers, is common and associated with numerous adverse outcomes. The perceptions that eating disorders are trivial and self-inflicted should be a focus of destigmatization interventions. Efforts to reduce stigma towards individuals with bulimia nervosa may need to focus on perceptions of self-control, whereas efforts to reduce stigma towards males with eating disorders may need to focus on perceptions of masculinity/manhood.
Breakfast of champions: Steroids and the men who use themScoti Riff
Muscularity is the single word that best distinguishes the male and female experience of eating disorders and body dissatisfaction. We are increasingly confronted by the facts that a) men and women pursue different body shapes, b) overvaluation of different body shapes leads to different forms of disordered eating and exercise, c) the current framework of disordered eating is thinness- and fat-centric, and d) muscularity-oriented disordered eating and body dissatisfaction are becoming increasingly prevalent. Anabolic steroids, described as the “breakfast of champions” by former bodybuilder, movie star, and Governor of the US state of California Arnold Schwarzenegger, are perhaps the most clear-cut example of an eating disorder behaviour that is motivated by the overvaluation of a muscular body rather than a skinny body. For decades, steroids have attracted fascination from the general public, politicians, and the scientific and sporting communities, often becoming embroiled in heated discussions about cheating, “roid rage,” and violence. However, despite all this attention, most of the discourse surrounding steroids is wildly misinformed, politicised, or sensationalised. We, the community of eating disorder researchers, clinicians, and nutritionists, are particularly well-suited to discuss and contribute to issues surrounding body image, eating and exercise. If local and population-level efforts to encourage body dissatisfied men to access the resources our community have to offer are to succeed, it is imperative that we arm ourselves with the truth about steroids. This workshop discusses what steroids are, their history, their legal status, the short- and long-term positives and negatives of their use, what a typical “steroid cycle” is, and the recent phenomena of steroid dependence and muscle dysmorphia. I also provide a mock-demonstration of “pinning”, the process by which steroids are injected into the body, so that participants may foster an appreciation of what taking steroids actually entails.
Stigmatization of anorexia nervosa and muscle dysmorphiaScoti Riff
The nature and extent of stigma towards individuals with anorexia nervosa and muscle dysmorphia remains underexplored. This study investigated attitudes and beliefs likely to be conducive to stigmatisation of individuals with these conditions. Male and female undergraduate students (N = 361) read one of four vignettes describing a fictional male or female character with anorexia nervosa or muscle dysmorphia, after which they responded to a series of questions addressing potentially stigmatising attitudes and beliefs towards each character. Characters with anorexia nervosa were more stigmatised than characters with muscle dysmorphia, female characters were more stigmatised than male characters, and male participants were more stigmatising than female participants. A very large effect of character diagnosis on masculinity was observed, such that characters with anorexia nervosa were perceived as less masculine than characters with muscle dysmorphia, and this effect was more pronounced amongst male participants. However, no significant corresponding effects were observed for femininity. Females with anorexia nervosa may be particularly susceptible to stigmatisation, especially by males. Anorexia nervosa and muscle dysmorphia are perceived as “female” and “male” disorders respectively, in line with societal gender role expectations, and this stigmatisation is tied more strongly to perceptions of sufferers’ masculinity than femininity.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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Men, muscles and masculinity: The general practitioner and the male experience of body dissatisfaction
1. MEN, MUSCLES & MASCULINITY: THE
GENERAL PRACTITIONER AND THE MALE
EXPERIENCE OF BODY DISSATISFACTION
Scott Griffiths | Prof. Stephen Touyz | Dr. Stuart Murray | A/Prof Jonathan Mond
2. DSM V – “feeding and eating disorders”
› Anorexia nervosa
- Restriction of energy
intake relative to
requirements leading to
significantly low weight
› Bulimia nervosa
- Recurrent episodes of
binge eating
› Binge eating disorders
- Recurrent episodes of
binge eating
- Recurrent inappropriate - The binge eating is not
compensatory
associated with
- Intense fear of gaining
behaviours to preent
recurrent inappropriate
weight or persistent
weight gain, e.g. purging
compensatory
behaviour that interferes
behaviours as in bulimia
- Self-evaluation unduly
with weight gain
nervosa
influenced by body
- Self-evaluation unduly
shape and weight
influenced by body
shape and weight
2
3. Prevalence of eating disorders in males
› Men are no longer "immune" to eating disorders
- 15-33% of anorexia and bulimia diagnoses (Hoek & Hueken, 2003; Hudson et al.
2007)
- 30-40% of binge eating disorders (Muise et al. 2003)
- 25% of early onset eating disorders (Madden et al. 2009)
- 100% increase in binge eating, purging and strict dieting amongst males from
1995 to 2005 (Hay et al. 2008)
- Rates of disordered eating amongst males are increasing faster than for females
(Hay et al. in press)
- Young Australian males rate body image as their most significant concern
(Mission Australia, 2007, 2010)
3
4. But what about men trying to become more muscular?
› Like women, men desire a body
low in body fat
› Unlike women, men rarely
describe their ideal body as
"skinny" or "thin"
› The ideal male body combines
low body fat with well-developed
muscles
› Both components are equally
important to male body image
(Bergeron & Tylka, 2007)
› Men describe their ideal body as
"toned," "cut," "athletic", "ripped,"
or "jacked"
4
5. Muscle dysmorphia
› "Discovered" in 1993 and named "reverse anorexia" (Pope, Katz &
Hudson, 1993)
› Renamed "muscle dysmorphia" in 2001 and classified as a subtype of
body dysmorphic disorder
› Criteria
- Preoccupation with being lean and muscular
- At least 2 of the following:
- Giving up important activities due to a compulsive need to work out and diet
- Avoiding body exposure/enduring body exposure with intense anxiety and
distress
- The preoccupation with body size/musculature causes impairments in
important activities
- Continuing to work out, diet or use steroids/PEDs despite knowledge of
adverse physical or psychological outcomes
5
6. Muscularity-oriented disordered eating
Definition of muscularity-oriented
disordered eating:
“Problematic eating attitudes and
behaviours motivated by the desire
to become more muscular”
What makes an eating attitude or behaviour
disordered/problematic?
The attitude or behaviour must be
1. Rule-driven, or
2. Compensatory
6
7. Associations with muscularity-oriented disordered
eating
Emotion
regulation deficits
Attentional biases
Cognitive deficits
(Griffiths, Angus, Murray, &Touyz, unde
r review in Body Image)
(Griffiths, Angus, Murray, &Touyz, unde
r review in Body Image)
(Griffiths, Murray, & Touyz, in press in
Body Image)
MUSCULARITY MUSCULARITY
-ORIENTED
ORIENTED
DISORDERED
DISORDERED
EATING
EATING
Masculinity
Admiration of muscle
dysmorphia
(Griffiths, Murray, &Touyz, under review
in Psychology of Men & Masculinity)
(Griffiths, Mond, Murray &Touyz, under review
in International Journal of Eating Disorders)
Thinness-oriented
disordered eating
8. Body dissatisfaction in young men
Body fat dissatisfaction
(mean scores)
Muscle dissatisfaction
(mean scores)
N = 286
Mean = 2.87
Often to Always =
18%
N = 286
Mean = 3.14
Often to Always =
20%
9
9. Why are men so bothered by their appearance?
› Men are being exposed to increasingly muscular bodies
11
10. Why are men so bothered by their appearance?
› Video games feature hypermuscular male bodies (Barlett& Harris, 2008)
12
11. Why are men so bothered by their appearance?
› Advertising on campus at the University of Sydney
13
12. Why are men so bothered by their appearance?
› Messages communicated to young boys
14
13. Why are so few males in treatment?
› Men with eating disorders tell us that society believes eating disorders are a
"female issue/girl's problem" (Robinson et al. 2012)
› Health professionals may believe that eating disorders are a "female issue"
and may not ask the right questions
› Many psychologists will tell you that men with eating disorders are stigmatised
more than women with eating disorders, but evidence for this is lacking
› Eating disorders and mental health in general are stigmatised already
› What additional elements of stigmatisation apply to men?
› Studying anorexia nervosa and muscle dysmorphia together is useful
› Anorexia nervosa may be perceived as a “female problem”
› Muscle dysmorphia may be perceived as a “male problem”
15
15. Stigmatisation and societal gender role
expectations
Perceived masculinity (mean)
5
***
4
3
Male
participants
Female
participants
= no less or more
masculine
› Exhibiting thiness-focused
versus muscularity-focused
psychopathology has a
significant effect on how
masculine one is perceived
› Size of this effect size is very
large (η2 = .23)
2
- The effect is even stronger
amongst male participants
1
- 3 times larger than the effect of
participant sex on masculinity
(η2 = .07)
Anorexia
Muscle
nervosa dysmorphia
Characterdiagnosis
16. Conformity to masculine role (mean)
Masculinity and femininity in men with anorexia
and muscle dysmorphia
Healthy
controls
150
Anorexia
nervosa
Muscle
dysmorphia
100
50
0
› Men with muscle dysmorphia
exhibit greater masculinity than
healthy control men
› However, men with anorexia
nervosa are just as masculine as
healthy controls
17. Knowledge of anorexia vs. muscle dysmorphia
100%
much did
you know
about
_________
_ before
taking this
survey?”
Percentage of responses
“How
Never heard
of it
75%
50%
Heard of
it, but don’t
know much
about it
25%
I know a lot
about it
0%
Anorexia
Nervosa
Muscle
Dysmorphia
Character Diagnosis
18. Prevalence of thinness- vs. muscularity-focused
psychopathology
“Do you
n.s. p>.05
know
anyone
who has
had a
problem
like
________
”
N = 343
Error bars =
95% CIs
19. What can I do?
Challenge your stereotypes
Eating disorders are not a "female" problem
Males account for 25-33% of anorexia nervosa diagnoses
Males account for ~25% of bulimia nervosa diagnoses
Males account for 40-50% of binge eating disorder diagnoses
Males probably account for >85% of muscle dysmorphia diagnoses
Men with eating disorders are no less masculine than other men
-
Even for anorexia nervosa, which may be perceived as the most
"female/girlish" of the eating disorders
21
20. What can I do?
Ask questions
How important is it to you that you get your ideal physique?
Some guys (particularly young guys and masculine guys) baulk at discussing
"body image"
Concept of body image is viewed as feminine, girlish, effeminate
"Physique" is interpreted as more gender-neutral
Do you have definite rules about eating? E.g., the types of food you can
eat, when you can eat it, how much you have to eat?
What happens if you break those rules?
How do you feel when you meet your physique or diet goals? Do you feel
content? Do you immediately re-set your goals?
How would you feel if you had a setback? For example, you badly sprained
your wrist during a workout and could not train for two months?
22
21. What can I do?
"Ye shall not judge"
- Anorexia and muscle dysmorphia are ego-syntonic
- Good chance they are in your office because of a co-morbid issue that has
developed because of / in conjuntion with the eating disorder
- Depression and anxiety are common, but also substance abuse, bipolar
disorder, obsessive-compulsive disorder
- If disclosed to you, do not pass strong negative judgements about steroid use
- Steroid use in samples of men with muscle dysmorphia has ranged from 33%
to 90%
- Men with muscle dysmorphia who use steroids are not "junkies," they extend
the same metitcioulsness over their diet and training to their steroid use
- Attacking the steroids might win you the battle but will cost you the war
23
22. What can I do?
› Breaking down the masculinity / ego-syntonic barrier in that first meeting
- Frame your collaboration as trying to relieve negative emotions, not change
behaviour
- "My goal here is not to try and change your diet or your workouts. I hear you
when you say that watching what you eat and excerising regularly are positives
in your life. What I want for you is to be able to diet and train without the
negatives; the guilt you feel when you eat something you shouldn't, the
embarassment you feel when you examine your physique in the mirror... Does
that sound like something worth working towards?"
- Use whatever terms they use to describe their emotions and be prepared for
little emotional insight and intolerance of emotional vulnerability
- Male with muscle dysmorphia, age 27: "It's like I'm working a dumbell 24/7. It's
physically right there. Gear [steroids] make it go away, training hard make it go
away, but if I stuff up my eating or skip the gym the dumbell is right back there
sitting on my head or in my chest and I have to train it away again. I get so
frustrated that it's even there. Fucking feelings are wrecking my life."
24
Editor's Notes
Hi, I’m Scott Griffiths, I’m a PhD student at the University of Sydney. I’m studying eating and body image disorders in males under the supervision of Stephen Touyz.
This is a modified version of the EDE-Q completed by a young male diagnosed with muscle dysmorphia.
Lots of males, especially young males, suffer from body dissatisfaction. In fact, we might be approaching a point at which body dissatisfaction in young men is normative. The blue and red graphs are frequency histograms depicting the mean scores of 286 male psychology undergraduates who completed the Male Body Attitudes Scale for a related but separate study to the one I am presenting today. The blue graph is the frequency histogram for mean scores on the Muscle Dissatisfaction subscale of the Male Body Attitudes Scale, which measures males’ dissatisfaction with their muscularity. Similarly, the body fat dissatisfaction subscale measures dissatisfaction with body fatBoth scales ask participants to rate their level of agreement with statements about the body, such as “I think my arms should be more muscular” or “I think I have too much fat on my body”. Both measures use the 6-point Likert scales at the bottom of each histogram. The mean level of muscle dissatisfaction in these 286 males is 3.14, which corresponds to someone agreeing “sometimes” to “often” with questions such as “I wish my chest was broader” and “I think I have too little muscle mass on my body.” Worryingly, almost 1 in 5 or 20% are, on average, agreeing “often” to “always” with these statements.Body fat concerns appear less marked overall than muscle concerns, but high nonetheless.Thus, amongst University of Sydney psychology graduates at least, muscle dissatisfaction is almost the norm.
I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
I had 343 male and female undergraduates read a vignette describing a character with anorexia nervosa or muscle dysmorphia named Michael or Kelly. The muscle dysmorphia vignette described a male with an intense fear of losing his muscle mass, and who redoubled his efforts in the gym and with his diet if he found it difficult to control his eating and workouts, and who thought he was scrawny and underweight despite being very muscular with little body fat. Without telling them the diagnosis, I asked them to indicate if they knew anyone who has had a problem like Michael/Kelly.? 343 undergraduates answered this question, meaning there was plenty of power to detect a significant difference in the pattern of responses. However, the differences were not significant, suggesting that people are as familiar with muscularity-focused psychopathology as they are thinness-oriented psychopathology.
When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
When we discuss disordered eating we rarely refer to just eating behaviours and body image. We often talk about, or measure, laxative use, diuretic use, vomiting, purging and excessive exercise under the umbrella of disordered eating. Similarly, a framework of muscularity-oriented disordered eating
