Strategic Learning – Do You Have a PD Plan?

I recall in my early days of practicing, I pretty much did every PD course available. Which was not difficult and probably only took three or four weekends per year. My how times have changed, you could fill every weekend now if you set your mind to it.

We are spoiled for choice with a huge range of professional development opportunities advertised every month. So how do we select what is most appropriate for each of us?

Do you go for new topics? Or base your selection on the presenter? Are some topics fashionable (think dry needling or fascial planes)? Each course involves significant outlay in terms of cash, time and energy so it makes sense to select wisely.

Your workmates or employers can offer guidance based on your current role or aspirations, but it is based on their opinion of what you need or what you can bring to the workplace. But is it the right fit for you?

Strategic Learning is a practice of aligning your professional development with a longer term strategy of where you want your career to go. Or at least to give you the tools to respond to career opportunities that may arise.

To be strategic, you must first have a strategy. To have a strategy you must have some overarching idea of where you and your career are going. The old ‘where do you see yourself in five years’ type of exercise. Or ten years. This is a difficult exercise to do on your own without input and challenging from a trusted mentor or panel of advisers.

I like the option of reverse engineering a strategy by starting with the end in mind, asking ‘What would be my ideal job at the time of my retirerement?’ and back track a strategic course from that end point. Like any good strategy it can be modified and adapted as the career landscape changes.

Once you have developed your strategy you can then evaluate PD opportunities based on how they align with your path. Do they add knowledge, skills, networks, contacts or connections to advance your strategy? When you see an event advertised ask yourself these three questions:

  1.     Will this event contribute toward my long term professional pathway?
  2.     Will this event deliver skills to improve my understanding or performance in my current role?
  3.     Will this event enrich me as a person?

The event should get at least one tick, if it gets more than one it is starting to look like a good investment. Three ticks and it is a ‘must do’. If you are not certain from the advertisement you should contact the provider and seek further specific information to make a considered choice.

Still going ahead? Great, now there are two more questions –

  1.     Can I afford to attend?
  2.     Can I afford NOT to attend?

The first one relates to resources (money, time, logistics) and is a totally practical decision. The second is a more important consideration in terms of the cost of not pursuing your strategy. If you have a strategy and the event is well aligned you are retarding your plans if you don’t attend.

As a provider of professional development I have a vested interest in you as a potential client. In my experience the best teaching happens when the learner is truly engaged in the topic, the process and the long term outcomes of the knowledge exchange.

Think carefully when evaluating PD options. Understand your long term strategy not just short term needs. Plan your learning to align with where you want to arrive rather than where you starting from and you won’t go far wrong.

A Fast Way to Manage Body Weight, Hunger and Energy

This plan has been around for hundreds if not thousands of years. In fact it is probably the way our evolutionary ancestors were obliged to eat and perhaps our DNA is molded toward it. More recently it has received some mainstream publicity on TV and in the press under different guises: it is Intermittent Fasting.

Our prehistoric forebears would hunt for protein in the form of animals. It might take days for the group to make a kill and upon returning it would be devoured promptly due to the lack of refrigerators. Meat had to be stripped from the carcass, prepared and eaten before it became bad. It might then take several more days (at least) to make another kill, so the diet between kills was collected from nature in the form of berries, roots, leaves, stems, flowers and so on. There were energy dense days (after a kill) interspersed with energy lean days (vegetarian).

Intermittent fasting is similar – days of full on eating and days of very light eating.  Like all eating plans it has its fans and its detractors, currently I am a big fan and let me tell you why before I tell you how.

Firstly, forget all the guff about fasting being a ‘detox’ for the body. The body does a very good job of detoxing every day, there are complex systems to prevent toxins getting in, for neutralizing them once they are identified and for eliminating them as quickly as possible. Ever had a dose of food poisoning? See how effective your body is at detox?

The benefits of Intermittent Fasting include:

  • Learning to manage hunger – most of us are unlikely to starve to death or even sustain any damage from not eating for a day. Learning to ride the hunger waves and become comfortable rather than immediately seek food (usually high in sugar and/or fat) is mastery of your body and mind.
  • You can eat what you want, but not on fasting days. After a day of denial, you have one or more days of no restrictions at all so this program is sustainable and low maintenance – no daily counting of kilojoules or calories, no portion control, no denial of what you enjoy.
  • It is a flexible program, you choose which days are fasting to fit your social or activity calendar. It doesn’t even have to be a full day without food, you can fast from 4pm to 4pm the next day, for example, meaning no day is totally without eating.

There are a range of fasting plans but the one I have found most compatible with my lifestyle (I love food) and my goals (losing the 5, maybe 7, OK 8 kilograms I have gained in the last 10 years) is the 5:2 Fasting Plan.

This involves five days of normal eating per week and two days of fasting or near fasting per week. I like the option of near fasting in the early weeks of starting the plan, but moving on to the full fasting is even more powerful. The partial fasting recommendations are – five days unrestricted and two days of limiting intake to 2500 kilojoules (around 600 calories) or less for a man and 2100 kJ (around 500 calories) for a woman.

Warning: complying with this limit puts you in the zone of ‘very low energy diet’ and should not be undertaken by pregnant women, diabetics or others with metabolic disorders. Check with your doctor beforehand.

For blokes, 2500kj will be consumed with:

Breakfast:

  • Small bowl of fruit salad
  • 1 slice of multigrain toast (no butter)
  • 1 teaspoon of yeast spread (who needs a full tsp?)

Lunch

  • Undressed salad – cup of lettuce, slice of tomato, 1/4 of a capsicum, 1/2 cup grated carrot, 4 olives, slice of ham, small can of tuna in water

Dinner

  • 1 grilled fish fillet
  • 1/3 cup of beans
  • 3 florets of broccoli
  • 1 small mashed potato (no butter or milk)

Snacks through the day

  • 1 banana
  • 1 green apple
  • 10 glasses of water (alcohol free on fasting days)

Tomorrow – Anything you want! Just wait until tomorrow. So you can see you are most unlikely to starve. Yet you will start to see weight and girth loss within the first three weeks, but only if you stick to the plan.

How does this plan work? As usual, lots of theories but I think the critical ones are:

  • Breaking the habit of  ‘I am hungry, I will eat’
  • Resetting your metabolism twice per week from growing to repairing (there is some evidence for this one). Repair mode includes resolving inflammation in the body, which is perhaps the single highest health risk for all of us. After driving in China.

And if you still remain to be convinced, imagine the impact on your weekly food shopping bill if you (and everyone else in the house) fasted for two days per week! A reduction of around 25% is possible. What a bonus.

As always, be careful when making changes and be prepared to trial it for at least a month to see if it is right for you and those who live with you.

 UPDATE

  • My starting weight – 98.5 kg.
  • Weight four weeks later – 93.2 kg (5.4% of my body weight).
  • This was on the 5:2 fasting plan with limited intake on the two fasting days of around 2000kj (500cal).
  • The initial hunger pangs of weeks one and two are now much less intense.
  • Sweet food (eg. breakfast cereal or jam) is starting to taste too sweet for my palate and leaves a furry mouth feel afterwards.
  • Energy levels are good, still able to do everything I need – yard work, writing, cycling, weight training.
  • Sleep is good – going to bed hungry is no effort if you know you can eat what you want tomorrow.
  • Mood – no complaints from my wife.
  • Productivity – excellent – I have lots more time on the fasting days to get stuff done with no food prep or eating time eating into it (sorry).
  • Savings – probably around 15% on weekly grocery expenses.

‘All Day’ fasting actually results far more than a 24 hour fast. There is the additional 8 hours from 10pm the previous night (more if you don’t snack after dinner) making a fast time of 32 hours twice per week for a total of 64 hours not eating. Out of a possible 168 hours in a week!  This is 38% of the week in a fasting state. No wonder my body is resetting it’s metabolic priorities and energy metabolism.

This is only one story. Keep an open mind.

 

How do Clients Judge You?

One of the best feelings in our work is when a new patient answers the question, ‘Why have you come to see me?’ with ‘Because I was told you are the best’. This has two great benefits, firstly my ego gets a stroke (although my wife may suggest this is neither a benefit nor necessary), secondly it indicates the patient is more likely do well with my treatment because they already expect to do well.

However it begs a second question of the patient: ‘Best at what?’  A question I was never brave enough to ask for quite some time (or subconsciously avoided to preserve the ego stroke), and when I started to ask the answers were sometimes unexpected.

It appears I was ‘best’ at each of the following for various patients who then found it useful to tell others:

  • attractive staff
  • running on time
  • privacy of treatment room
  • worked at the Olympics
  • warming the ultrasound gel
  • variety of gym gadgets
  • getting a result
  • interesting memorabilia display
  • no stairs
  • explaining the treatment program
  • availability of parking
  • excellent coffee shop next door

Shock and horror!  Many of my ‘recommendations’ had absolutely nothing to do with my professional expertise or competence and everything to do with the ambience, convenience, consideration, accessibility and neighbours of the business.

It appears that patients use a different yardstick to judge (and thus recommend or pillory) health practitioners than we use to judge each other. I am impressed with colleagues who have mastery of theory, knowledge and techniques whereas patients judge us on their experience rather than ours.

Of course they do. How could they do otherwise? Our clients rarely have an understanding of the treatment evidence base or current trends in health care for specific conditions. So they judge us on what they do understand: customer service, respect, honesty, integrity, fairness, cleanliness, hygiene, eye contact, manual contact, tolerance, value and coffee.

A quick search of the literature  shows a vast array of complex assessment tools to evaluate ‘quality’ of patient care. Almost all give a strong weighting to the outcome of care – was the goal achieved? Yet patient satisfaction is not the same as patient outcome. Nor is it the same as the patient experience. It appears clients can be very satisfied despite a poor outcome provided the experience was positive, supportive and client centred.

The sensory environment has also been studied with factors such as music, aroma, air quality, furnishings and layout being assessed in relation to hospital patient outcomes. As yet the quality of studies lacks rigor (link to Cochrane Library).

The American Medical Association states that ‘patient-centered communication is key to quality care’ and not only reduces errors but also can ‘achieve better health outcomes’ (link).

In another article, Dr Oliver Kharraz identifies the relationship (likeableness) of the practitioner as a significant factor in whether the client will follow the advice provided (program adherence).

I think this is more critical for practitioners who provide a process as opposed to providing an event. Let me explain, the concept of selling goods versus services is well understood. However I believe in medical care the service can be further divided into those that are events and those that are processes.

Events include vaccinations, surgery, provision of an appliance (orthosis, plaster cast, etc), completing a procedure (dental filling or extraction, blood test, endoscopy, etc). Each of these has a clear end point and a yes or no outcome.  Did it happen or did it not?

Processes include weight loss programs, blood glucose management, neurological rehabilitation, soft tissue recovery, fitness programs, aged care and so on. These tend not to have a clear start/finish cycle but are more elastic and depend on patient adherence for desired outcomes.

Physiotherapists are process therapists. Most of our clients require more than one session as we build their programs and progress them through the recovery. Spinal manipulation for mechanical displacements (wry neck, facet subluxations) are the exception and practitioners who work solely in this area are (I suspect) judged on immediate outcomes as a result of the manipulative event.

So what is the take home message here?  Simply this, as we are a process profession, we need to make sure the process is very, very good. We cannot rely on them feeling ‘cured’ each time they attend (a great event when it happens). Our science based treatments take time and adherence to have their therapeutic effect and it is the elements of process that enable sufficient exposure to the therapist for the treatment to make a difference.

Patients will recommend you based on the process of you delivering the treatment. So take some time to evaluate the patient experience in your business – from referral to discharge. Every single, seemingly insignificant element of the patient journey is important to the patient experience. Ask them what you are doing well and what you could improve on. Put aside your professional ego and listen closely.

Is it Possible to Overservice a Private Client?

This was a question posed to me by a participant at a business workshop and my immediate response was, ‘Good Question’. This is a time honoured strategy to gain time to formulate a considered answer thus avoiding saying something like, ‘You wish,’ or ‘How do you mean?’

If a considered answer still remains elusive, the second strategy is to ask the questioner to clarify the question. Eventually however I had to respond.

Who decides if a client has been over-serviced?  The health professional or the client?  In the case where a third party is paying for the treatments, it is often that party making the call of ‘enough already’. But what about when the client is paying for their own treatment? Who decides when enough treatment is enough?

I am sure we have all had clients that proved difficult to discharge. Everytime we got close there was a relapse or new problem that necessitated extending the treatment plan. Then there are those patients with chronic, degenerative conditions that are never going to be cured. How many sessions are sufficient for a condition that is always going to need management?

And what is overservicing? Too many sessions over a short period of time? Or too many over a long period? When (if ever) do you say to a client, ‘That’s all. No more treatment for you’, even though they are prepared to pay for further sessions?

What if it wasn’t a medical service, let’s say I really love a particular restaurant or cafe and frequent it several times per week. Are they over-servicing me? Or am I simplyl meeting a need, paying a price and receiving what I consider to be fair value?

Does a cinema refuse admission if you have already seen the movie twice? Does your butcher say ‘No more, you have eaten enough meat already this week’? I don’t think so.

Are these purchases that meet needs such has hunger and relief of boredom any more or less valid than purchasing a service that fills a different need and does so at a price that represents good value?

The evidence-base theory of treatment would place this decision on the practitioner, who has the knowledge of what further benefits are likely with ongoing treatment. When the benefits dwindle, according to the evidence, we must then discontinue treatment lest we be operating fraudulently.

The customer focused practitioner would have access to the same evidence base, and upon reaching a point of diminishing returns would ask the client if they were receiving sufficient ongoing benefit to justify the ongoing cost. Perhaps the evidence isn’t measuring all the benefits that the client is perceiving, and even though the condition is no longer improving the process of treatment is meeting some other as yet unmeasured need.

Ah, if only it was that simple: if the client believes it is helping then it can’t be over servicing. Now into play comes the gray areas of fully informed consent, unequal power relationships, the concept of ‘the expert’, and self interest.

Continuing to offer treatment based on authority, fear, dependence, self-interest or mis-information is unethical and unprofessional.

Continuing to deliver treatment at the request of a fee paying client where clear professional boundaries are respected, full information about the limits of treatment are explained and acknowledged and where the client has the power to regulate and/or cease at any time can, in my mind, be optimal servicing.

At all times the benefit equation must fall on the side of the client. Repeated questioning regarding the perceived benefits of ongoing treatment, benefits that can be described in a logical, rational manner rather than emotional (I just like coming here), should ensure the level of service represents a value proposition for the client.

Alongside that process should be regular reviews where the practitioner and client document the treatment plan for the upcoming period and identify where the benefits are likely to appear.

The final test: if you can’t explain to a professional colleague why the client is attending, they probably shouldn’t be.

Active Surveillance for Prostate Cancer: is it for you?

The decision facing many blokes upon diagnosis of prostate cancer is difficult. Should you opt for surgery, some other treatment or simply monitor the numbers and hope it stays stable or slow growing. The research reported below may help you in your decision. At least it gives you some background when discussing your best options with your urologist and GP.

STOCKHOLM—Active surveillance (AS) for patients with favorable risk prostate cancer (PCa) is safe long-term, with patients much more likely to die from causes other than PCa, according to study findings presented at the European Association of Urology 29th annual congress.

The study, led by Laurence Klotz, MD, of Sunnybrook Health Sciences Centre, University of Toronto, included 993 men (median age 67.8 years) with favorable or intermediate PCa who underwent AS for a median of 8.1 years. A total of 206 men were followed for more than 10 years and 50 were followed for more than 15 years.

Of the 993 men, 149 died (15%), 15 (1.5%) from PCa. The 10- and 15-year actuarial cancer-specific survival rates were 98.1% and 94.3%, respectively. Patients were 9.2 times more likely to die from other causes than from PCa.

In addition, at 5, 10, 15, and 20 years, 75.7%, 63.5%, 55.0%, and 55.0%, respectively, remain untreated and on AS. Metastatic disease developed in an additional 7, who either died of other causes (5) or are alive with disease (2). Post-treatment failure occurred in 6.3% of the total cohort.

“Active surveillance for favorable risk prostate cancer is feasible and appears safe in the 15-20 year time frame,” the authors concluded in their poster presentation.

At entry into AS, patients had a Gleason score of 6 (or 7 for men aged 70 and older), clinical stage T1b-T2b N0 M0, and a PSA level of 10 ng/mL (15 or less in men aged 70 or older). All had elected to be managed with AS. Clinicians offered intervention to patients if they had  Gleason score progression, a PSA doubling time of less than 3 years, or unequivocal clinical progression.

Although AS may be a safe option, a study published recently in the New England Journal of Medicine (2014;370:932-942) found that men with localized PCa are less likely die from the disease if they undergo radical prostatectomy (RP) instead of watchful waiting, especially if they are younger than 65 years. At 18 years of follow-up, RP was associated with an overall significant 44% decreased risk of death from PCa compared with watchful waiting. Men younger than 65 years had a significant 55% risk reduction, whereas older men had a non-significant 25% decreased risk.

Dr. Klotz told Renal & Urology News that the patients on the watchful waiting arm of this study did not have serial biopsies or the opportunity for delayed definitive therapy upon risk reclassification. In addition, most of the patients who died from PCa had intermediate- or high-risk disease at diagnosis.

Value In Practice – new workshop for health professionals

Your business is based on value. The giving of value to clients, referrers and other stakeholders, and the receiving of fair value in return.

Value In Practice is a three hour workshop looking at three aspects of Value In Practice, they are:

Valuing your service and putting an appropriate price on it.  What do you charge and why? How do you calculate your fair value and are you prepared to ask for it? You will use your data to determine what you should be charging in return for the value you provide.

Valuing your business. I am often asked to help value a physiotherapy business with a view to selling all or part of it. It is much easier for me, as I have no emotional attachment to the staff, patients, referrers or the business itself. Without the ‘baggage’ it becomes a simple mathematical exercise. We will look at a few options.

Adding value to stakeholders is vital to grow your business. Not just for clients but also for employees, referrers your community and profession. We will workshop value adding strategies to give you practical, low cost, take-home ideas to implement in your practice. Including the secret of what every new client must understand in order to guide their decision to continue with you or not.

This workshop is scheduled in Australia and overseas – Cities, dates, fees and registration links are listed below. Click through if you want to attend.

You will receive not only the three hour session, but also a course workbook, spreadsheets for ongoing business analysis and maybe a coffee.

Melbourne, May 1, 2014.  $330 course fee, starts in Greensborough at 6,30pm, finished by 9.30pm.  Click for more

Sydney, May 13, 2014. $330 course fee, starts in Camperdown at 7pm, finished by 10pm. Click for more

Marlborough, Wiltshire, UK, June 3, 2014. £50 course fee, starts at 6.30pm, finished by 9.30pm. Click for more

Dublin, Ireland, June 13, 2014. €130 course fee. Starts at 2pm, finished by 5pm (Friday). Click for more

Perth, June 21 2014. $330 course fee. Starts at 9am, finished by noon (Saturday). Click for more

Slides: what happens when they don’t work….

It was an absolute catastrophe. I was on a weekend road trip doing a shoulder workshops for a group of physiotherapists in Wollongong (south of Sydney) on the Saturday, and in Newcastle (north of Sydney) on the Sunday. The venues were about 4 hours drive from each other.

My workshop was structured around (wait for this, it will date me) a slide presentation spanning three carousels. Remember them? The circular slide cartridges that dropped 35mm slides into a projector. These are in the days way before data projectors and PowerPoint.

Anyway, Saturday went very well, finished up and drove to Newcastle that evening. Got to the venue ready to set up for the Sunday event and the venue had done a great job, the projector and screen were ready, the whiteboard, chairs, coffee station all good. So I started to unpack…. only to find my slide carousels were missing. Well not missing as it turned out, just sitting back down in Wollongong. And 15 minutes to showtime for 50 participants.

I had no back-up plan. I couldn’t cancel the event as people had flown in or driven some distance. I went through the Kubler-Ross stages of loss: denial (they must be in here somewhere), anger (who forgot to pack them? what a disaster), bargaining (asking my assistant to retrieve them somehow for the after lunch session at least), acceptance (well, they are really missing) and finally onto resolution – I will do the whole day without them. I got through the five stages in about five minutes because I had to.

I never used those slides again. Never. Not because I didn’t recover them, but because it was the best day of teaching I had ever done. Robbed of my slides, all I had was me. So I told my stories, showed my techniques, discussed with the audience, jumped all over the usual program sequence to meet the demands of the group and received the best feedback ever.

Now, some fifteen years later, I still do a similar (updated) workshop for physiotherapists and I still don’t use any slides. Instead, I teach. I talk, demonstrate, joke,  listen, review, monitor, correct and encourage.

This teaching sure beats giving a great slide show.

 

 

 

Why do they leave? This is a good place to work.

I was chatting with a respected, long term physio colleague recently and he pinned me with the question, ‘How long do you expect physios to stay?’ Meaning, what is a realistic expectation for professional staff turnover? I asked him some further questions and it seemed a more common problem with recent graduates (one, two or three years out of uni) and he told me he does exit interviews.

‘What do they reveal?, I asked. He indicated some move onto formal post-graduate study which necessitates leaving the area but the others seem to feel they have exhausted their learning opportunities at the current practice. One departing employee said, ‘I feel like I have learned all I can here, and need to move on.’  One reason she can move on easily is she had no ties to bind her geographically: no partner with a job nearby, no children in school or other family nearby.

We observed that recruiting staff a little further along their life journey provides some of these anchoring factors that aid retention, perhaps up to around 5 years as opposed to the 1-2 year expectation for the more recent graduates. I guess I felt that the curiosity and mobility of youth was a fact of life, probably not limited to physiotherapy and resiled myself to it being an unalterable tenet.

However, on further reflection this may not be the case, at least in all cases. Over the first year or so of being employed by an experienced colleague there is a steady knowledge transfer from senior to junior. This tends to be intense at first and gradually tapers as the lessons are passed on. There may reach a point of equilibrium where the teacher runs out of new material and the learner has the skills and knowledge close to that of the teacher; and being hungry for more, starts to look elsewhere.

What can be done to encourage a longer tenure in such a situation? Perhaps we need to be counter-intuitive and reverse the roles somewhat, helping the learner become the teacher and the teacher open their mind to the learner.

Lovely words – what does it mean?  I distinctly recall having talented employees who could have taught me much but my ego and inflexibility blinded me to this opportunity. They were ready and able to teach, but I was unready or unwilling to learn.

Developing talent is a wasted process if 0nce developed it is not deployed where it can make the greatest contribution. In our mini-case-study, what may have eventuated if the physiotherapist who had filled her learning quota had been asked to take over the development of staff for a year or so? Including the principal. Not by re-teaching the same stuff, but by adding from her unique knowledge and experience base, by bringing in new information to the organisation, by developing leadership and development skills in her role and by being rewarded for this contribution.

Sure, she may still leave even after this extension of her role (and tenure), but she would be leaving a more enriched organisation behind and leave as a more accomplished practitioner and employee. She would also have contributed to the training of those who followed her.

As employers we often see how much we give to our teams and resent any feelings of not being repaid by output, loyalty or even simple thanks. Step back, stop giving for a while, and ask what you might receive if you realised everyone has something to teach. Have you ever asked your reception staff how they ‘read’ clients?  Asked them to explain how they manage to multitask with phones, computers, people, money, files, letters, reports and the rest? Or asked your cleaning staff how they know when they have done a good job? Or your professional staff what skills and knowledge they may have that can be adding value to the organisational goals or client outcomes? In order, these represent customer service skills, time/task management skills, self-managing team skills and self-knowledge/development skills.

The answers to such questions may surprise you (as much as being asked may surprise them!) and potentially restless staff may even stick around to see if you have learned anything from them and are prepared to put it into practice. Who knows, you may discover your eventual replacement and they may discover a career path.

 

It Changed Our Thinking

It must be at least fifteen or twenty years ago when I first heard the term ‘under-recovery’. Until then we had labelled chronic, repetitive microtrauma injuries as ‘over-use’ injuries. Believing that the tissues were damaged due to repeated, frequent overloading.

Under-recovery suggested that the loading may have been quite appropriate, provided the tissue (tendon, fascia, muscle, bone, sheath, etc) had sufficient time since the last loading cycle to recover.

The ability to absorb more loading was reframed from one of being too hard on the body, to instead being too impatient and not allowing the normal cycle of post-training stress recovery reach completion.

So we started managing the recovery cycle with the same diligence and vigilance as we did the work cycle of training. Not only did we reduce the injury stress, but it turns out the level of performance would often go up as well. Whether this was due to the change of cycles directly or due to the longer period of training possible because it was not being interrupted by injury is difficult to say, and possibly irrelevant.

However this was a short won victory for common sense. Once the coaches realised sports science could improve the quality of the recovery cycle they increased the frequency and intensity of the loading cycles to maximise training adaptations. Active recovery strategies led to increased loading cycles and the injury and burn-out complications reasserted themselves.

I find the same thing happens in a busy life of work, family, recreation and chores. When I raise the efficiency of managing my tasks I then see gaps into which I can add more tasks…

So, how are YOU doing? How is your RESILIENCE?

Resilience: the current buzzword in business training and life management is RESILIENCE. It is not new, just a rebadging of the ability to bounce back, to roll with the punches to pull yourself up by the boot-straps, and other meaningless babble.

But actually it is not so much overload as it is under-recovery in terms of not quite regaining your equilibrium between the challenges that life will inevitably throw your way.

Each of us will handle this in their own way. Maybe not a rational or appropriate way, but the way we have always used (habit) probably learned when our minds were most plastic (childhood and adolescence).

Recognising your resilience is compromised is the first stage of avoiding burnout, depression, anxiety or other such failures of your coping mechanisms. Taking action and seeking assistance is the next step. Action and time to allow your recovery cycle to prepare you to step back into life’s fray.

Looking on from outside, you may not fully appreciate the range or depth of others’ overloading and risk judging them harshly for what you perceive as failings. Really, really try not to do that. It is not helpful for either of you. Ask how you might help (not fix, just help) them share the load. And if you are part of the problem, get out of the way without taking it personally (tough ask).

Finally, keep an eye on each other – your loved ones, your family, your team mates and employees. Your professional colleagues, teachers, students and most importantly yourself. Be mindful of how others are coping and dealing with their loads before you dump some of yours.

Bedroom TV & Body Weight Gain

A recent study suggests having a TV in a child’s bedroom significantly increases their likelihood of weight gain in the subsequent four years. Perhaps setting them up for a lifetime of battling excess weight.

The study published in JAMA Pediatrics confirmed previous studies linking a bedroom TV to increased risk of being overweight.

Read the study abstract here: http://archpedi.jamanetwork.com/article.aspx?articleid=1838347

The lead author, Diane Gilbert-Diamond, spoke with Reuters Health and pointed out the TV saturation rate in adolescent bedrooms (71%) and and suggested a responsible parent should remove it to help children get a healthier start in life.

The mechanism of action is not clear with possibilities including disrupted sleep patterns (correlates with weight gain), increased exposure to convenience food advertising and prolonged inactivity periods.

Good luck removing the TV from your teenagers bedroom I say. In fact, the best strategy may be to lead by example and remove any TV from your own bedroom first. Who knows what other benefits might accrue when you have to make your own entertainment…..