A confluence of topics dealing with mental health, substance abuse, health, public health, Social Work, education, politics, the humanities, and spirituality at the micro, mezzo, and macro levels. In short, this blog is devoted to the improvment of the quality of life of human beings in the universe.
Stephen Murdoch, the author of the book IQ: A Smart History of A Failed Idea, talks about the misuse of IQ tests by the Nazis and Americans to use IQ scores to forcibly sexually sterlize women and in Nazi Germany kill people. The video only lasts 3:29 minutes and is worth watching to remind us of the misuse of psychological and psychiatric diagnostic information for political purposes which is both unethical, immoral, and sometimes criminal.
It is validating to read research findings that confirm what good clinicians already know. On November 28, 2007, Reuters reported on a study in the November, 2007 issue of the Journal of Pediatrics which found that teenagers with a history of sexual abuse have a highter rate of suicidal ideas and attempts than teens without this history, but that the risk factor of sexual abuse is offset if the teen has the protective factor of "family connectedness" that is, a loving and caring family that is supportive in a nonjudgmental way. Here is part of what is written in the Reuters article:
However, having positive relationships with adults seemed to reduce some of this risk, the study found. Abused teens who said they had teachers or other adults in their lives who cared about them were less likely to report suicidal behavior.
The most important protective factor was a sense of family connectedness -- which the study measured by asking teens the extent to which they felt their families cared about and understood them, and whether they could discuss their problems with their parents.
"If connections with family members, teachers or other school personnel, or other adults in the community were strong, young people had a much lower risk of suicide, even if they were particularly vulnerable due to sexual abuse," Eisenberg said.
The implication, she and her colleagues write, is that strengthening these connections for abused teenagers could help lower their suicide risk.
AP reported today, 11/07/07, on a report that abstinence only programs do not curb teen sex.
Programs that focus exclusively on abstinence have not been shown to affect teenager sexual behavior, although they are eligible for tens of millions of dollars in federal grants, according to a study released by a nonpartisan group that seeks to reduce teen pregnancies.
"At present there does not exist any strong evidence that any abstinence program delays the initiation of sex, hastens the return to abstinence or reduces the number of sexual partners" among teenagers, the study concluded.
The report, which was based on a review of research into teenager sexual behavior, was being released Wednesday by the nonpartisan National Campaign to Prevent Teen and Unplanned Pregnancy.
The study found that while abstinence-only efforts appear to have little positive impact, more comprehensive sex education programs were having "positive outcomes" including teenagers "delaying the initiation of sex, reducing the frequency of sex, reducing the number of sexual partners and increasing condom or contraceptive use."
"Two-thirds of the 48 comprehensive programs that supported both abstinence and the use of condoms and contraceptives for sexually active teens had positive behavior effect," said the report.
A spending bill before Congress for the Department of Health and Human Services would provide $141 million in assistance for community-based, abstinence-only sex education programs, $4 million more than what President Bush had requested.
This is another example of how ideology and religious agendas have trumped sound public health science during the Bush Administration. Perhaps as we move to a new administration we can once again renew our belief in the constitutional principle of the separation of church and state. Bush's "faith based" initiatives, while they may have attracted right wing evangelical support, are not founded on sound social policy values.
Reuters reported on February 7, 2007 on a survey reported in the Febuary 8, 2007 issue of the New England Journal of Medicine which found that a sizable minority of physicians would not inform patients or refer patients to other physicians for legal treatment options to which they object on moral grounds.
A substantial minority of doctors do not feel obligated to inform their patients about medical procedures that they themselves object to on moral or religious grounds, or to refer patients to another doctor for the treatment, according to a survey of U.S. physicians.
I professionally believe that these are sins of omission and that ethical practice should require physicians and other health care providers to provide information to patients so that can make informed health care decisions.
The findings of this survey seem to indicate that patients should inquire about their health care providers moral beliefs to that they can determine whether their provider's advice and information is trustworthy and unbiased.
Curlin and colleagues say patients who want information about legal but morally controversial treatments may need to inquire proactively to determine whether their doctor would accommodate such requests.
"I hope this paper fosters frank, respectful conversations between doctors and patients," Curlin told Reuters Health, in an effort to anticipate areas of moral disagreement and to negotiate acceptable accommodations before crises develop.
Reuters reported on June 1, 2006 on an study published in the June 1, 2006 issue of The New England Journal of Medicine which found that people with capped drug benefits died at 22% higher rates than people with uncapped benefits and in the long run having capped drug benefits does not save HMOs any more money.
People with limited drug coverage skip their medicines, make more trips to the hospital, and die sooner than patients with unlimited benefits, according to a study in The New England Journal of Medicine.
The study compared the medical records of 157,275 people in a plan that only covered the first $1,000 worth of drugs, with 41,904 who had unlimited drug coverage.
Those with limited drug coverage spent 31 percent less on drugs, but their total medical costs were not significantly lower as they had a 9 percent greater chance of going to the emergency room and a 13 percent greater chance of landing in hospital.
"The savings in drug costs from the cap were offset by increases in the costs of hospitalization and emergency department care," concluded the researchers, who were led by John Hsu of Kaiser Permanente in Oakland, California.
The annual death rate of people whose drug benefits were capped was 22 percent higher than those with unlimited benefits.
These are the cockimamie things that happen when health care gets turned into a business and is run for economic benefit of shareholders and CEOs and not for the good of the patients and for the community. People needlessly die because they do not have access to available health care strictly for economic reasons.
"Students who attend college in states with strong alcohol control laws are less likely to be binge drinkers, according to a study released Tuesday.
The report, conducted by researchers at the Harvard School of Public Health and the Centers for Disease Control and Prevention (CDC), found that campus binge drinking rates were one-third lower in states that had four or more laws targeting high volumes of alcohol sales than states that did not.
"The good news is that if more states and communities take relatively straightforward actions -- such as enacting laws that discourage high-volume sales -- they could see fewer drinking problems on college campuses and in their broader populations as well," said Toben Nelson, the studies author.
"Environmental factors such as low prices, special promotions of alcohol, and high density of alcohol outlets near college campuses support heavier drinking by college students," Nelson said.
Binge drinking -- often defined as five or more drinks in a row on a single occasion -- has been linked to 1,400 college student deaths every year, as well as injuries, rapes, assaults, unsafe sex and poor student performance.
According to the study, college students spend more than $5.5 billion a year on alcohol -- more than they spend on textbooks, soft drinks, tea, milk, juice and coffee combined."
I learned this stuff from Michael Klitzner. Using the public health model is a way to conceptualize what it will take to save lives in a three pronged approach: change community norms, decrease access, and enhance regulatory enforcement. Holy smokes, here is more evidence that it works.
In 2002, over 1,000 teens in the U.S. killed themselves with guns.
A study reported in the February 9, 2005 issue of the Journal of the American Medical Association stated that many of these deaths could have been prevented had the guns used in these suicides been locked away, separated from ammunition, or any one of many things done to make the access and use of guns more difficult thereby overcoming the moment of impulsivity.
Americans love their guns. Unfortunately, they most often are used to kill the ones they love or themselves. Americans don't need guns to defend themselves from strangers. The biggest risk is from themselves and the ones they love.
I don't think hardly a year has gone by that I have not known or heard of either a suicide or a homicide by guns within the family in my rural area of Western New York State in the last 50 years of my life. It is always a tragedy, and people tsk tsk but just like our love of cars, our love of guns leads to deaths of the people we love. The only sadder and more tragic thing is that all these deaths were unnecessary and avoidable. It is the price we pay for our chosen life style.
Each day during 2003, an average of six children under 15 years old were killed and another 694 were injured in motor vehicle crashes. This is the leading cause of death and disability for children in the United States.
Recent findings suggest that children aged 4-7 years who use belt-positioning booster seats are 59% less likely to be injured in a motor-vehicle crash, compared with their counterparts using adult safety belts. In a recent national telephone survey conducted by National Highway Traffic Safety Administration only 21% of children aged 4-8 years used booster seats. Although all states have enacted legislation requiring child passenger restraints for infants and toddlers, only 22 states and the District of Columbia have enacted booster seat laws.
Having had two children killed in 1993 in a DWI crash aged 5 and 8, I became aware of the danger of using lap belts alone. Having lived through this personal tragedy, I believe strongly that no child should be restrained with a lap belt only, but should have a shoulder belt as well, and between the ages of 4 and 8 probably should be in a booster seat as well until the shoulder belt fits them well.
Infant mortality rates in the US have been slowly improving and as of 2002 stand at 7 deaths per 1,000 births.
The troubling thing is that the infant mortality rate for black babies is more than twice the rate for white babies, 13.9 per 1,000 as compared to 5.8 per 1,000. This probably is related to poverty which influences maternal health and other factors in significant ways.
It is interesting to me that this report on Reuters of a study in the January, 2005 issue of the American Journal of Psychiatry says that lithium may help compulsive gamblers with a history of bi-polar disorder. I have never thought about this before and it is just in time for a grant submission we are making at GCASA to New York State OASAS for funding for a treatment program for compulsive gamblers.
It seems in this small study that treatment with lithium helped decrease the symptoms of compulsive gambling for some of these patients.