Coronary Heart Disease Deaths And Decreased Smoking Prevalence in Massachusetts, 1993-2003

Cigarettes According to a study published in the August, 2008 issue of the American Journal Of Public Health in the ten years since the implementation of the Massachusetts Tobacco Control Program in 1993, the smoking prevalence rate dropped 29% and the coronary heart disease mortality rates dropped 31 %  with 425 fewer deaths which resulted in 3,365 extra life-years.

As a public health intervention, controlling tobacco use in populations has big health dividends. However, they raise interesting moral issues such as should people be able to engage in life damaging behaviors such as smoking? Should this be an individual choice or should governmental intervention make such choices difficult?

Here is the abstract from the AJPH.

We used the previously validated IMPACT coronary heart disease (CHD) mortality model to estimate the CHD deaths attributable to reductions in smoking prevalence following the introduction of the Massachusetts Tobacco Control Program (MTCP) in 1993. A 29% and 31% decline in smoking prevalence and CHD mortality rates occurred, respectively (from 1993 to 2003). A total of 425 fewer CHD deaths, which generated approximately 3365 extra life-years, were attributable to decreased smoking prevalence. With these results in mind, a comprehensive tobacco control program should be sustained and supported.

Coronary Heart Disease Deaths And Decreased Smoking Prevalence in Massachusetts, 1993-2003 -- Kabir et al. 98 (8): 1468 -- American Journal of Public Health.


Statins Associated with Less Cognitive Decline

Dementia I take my simvastatin every night before I go to bed and my mind is like a steel trap and I'm 62. Is it the simvastatin or am I just a sharp guy? I have a little CRS (can't remember shit) though. My colleague and friend, Garry, says its "nominal aphasia". While I can't remember the person's name I always remember what my problem is called.

The study appeared in the July 28,2008 issue of the journal, Neurology, and the summary appears on Physician First Watch on July 28, 2008. Here is what the Physician Watch article says:

Elderly people on statins showed a lower rate of cognitive decline than those not taking them, according to a prospective observational study in Neurology.

Researchers followed a population-based cohort over 5 years, examining the participants' medicine cabinets for prescription drug use and measuring their cognitive status annually. The cohort comprised nearly 1700 Mexican American subjects, all over age 60, roughly a quarter of whom took statins at some time during the study.

By the end of the study, those who'd taken statins were about half as likely to have developed either dementia or cognitive impairment without dementia as others in the cohort.

The authors point out that there have been no primary prevention trials of statins for dementia. Writing in Journal Watch Cardiology, Joel M. Gore says that such studies are needed "before statins are routinely deployed

I wonder if John McCain takes Statins? Watching him speak has left me with the impression that he has come cognitive difficulties.

Statins Associated with Less Cognitive Decline - Physician's First Watch.


The collective unconscious and net neutrality- the connection

Netneu Andrew Boyd in his book, Daily Afflictions, defines "The Collective Unconscious"  this way: "An unspoken, consensual hallucination of social order that permits the individual to mask any responsibility he or she might feel for government wrongdoing or social ills in a web of numbed-out apathy and mass denial." p.91

Having read Rick Shenkman's book, Just How Stupid Are We?, I have thought a great deal about what is wrong with "We, The People". I am coming to the conclusion that we are not stupid in the intellectual sense although there is plenty of evidence that we are, but rather than we are unaware as a people and that, in this age, is causing great problems.

The problem that The People face is not an intellectual one but rather a psychological and spiritual one.

In a sense, Americans have been brainwashed and we are in denial because of the soporific effect of our materialism and greed. Because of materialism and greed we are willing to allow Wal Mart to come into our communities and destroy our local economies, we are willing to destroy the planet driving gas gussling vehicles, we are willing to discard tons of plastics and garbage that pollute our lands and seas, we are willing to let our children become obese and narcissistic in ways that would leave their grandparents and great grandparents horrified, we are willing to elect leaders who promise us the moon and then wreak havoc on the world for spurious reasons while forcing us and future generations to pay for their exploitive policies.

The collective unconscious allows us to continue to live in a delusional world that becomes increasingly dysfunctional because of the collusion of political and corporate power used to keep Americans anesthetized on cheap material goods, fast food, and entertainment.

There are pockets of awareness but no social institutions which nurture it except perhaps blogs on the Internet. Net neutrality is a huge issue upon which the future of the soul of America is based. Without the Internet, the information, encouragement, and inspiration for we The People to become conscious is severely constrained.

One of the most important campaign issues for 2008 is net neutrality. Let's bring this issue to the fore for once and for all. The soul of America depends on the net staying free. It is the hope of awakening the slumbering masses who have been sedated by shopping.

Video well worth watching lasts 10:24


Catholic church has got it wrong on birth control - catholic critics ask pope to lift contraception ban

Birth control

















Yahoo News, using a piece from Reuters, reports on July 25, 2008, about a paid advertisement in a major Italian newspaper placed by 50 Catholic organizations to lift the Vatican's ban on birth control. Here is a snippet from the article:

More than 50 dissident Catholic groups published an unusually frank open letter to Pope Benedict on Friday saying the Church's ban on contraception has been "catastrophic" and urging him to lift it.

The letter was published as a paid half-page advertisement in Corriere della Sera, Italy's largest newspaper, on the 40th anniversary of the late Pope Paul VI's controversial encyclical "Humanae Vitae," which enshrined the ban.

While criticism of the Vatican and its views is fairly common in articles and editorials in Italian newspapers, it is unusual for a group to take out paid advertising against the pope, particularly in a large-circulation mainstream newspaper.

The letter, written in Italian, said the Church's anti-contraception policy "has had a catastrophic impact on the poor and powerless around the world, endangering women's lives and leaving millions at risk of HIV."

Of course, changing the teaching is long overdue. The church has been wrong about this teaching for decades since Humanae Vitae, the encyclical in the 60s by Paul VI, that started the controversy and dissent by the laity. Since that time the church has lost credibility and the faith of the people it professes to lead.

How about considering the standard discernment question, What Would Jesus Do? I think Jesus would fully support the use of birth control.


Print Story: Catholic critics ask pope to lift contraception ban on Yahoo! News.


Suicidal soliders is not so much a mental health problem as a spiritual crisis

Suicidal soldiers Reading about the increased incidence of sucides in the military and the huge numbers of soldiers with PTSD has gotten me interested in something which very few people in American society talk about and that is what Dr. Rachel MacNair calls "Perpetration-Induced Traumatic Stress", PITS.

PITS is the anguish and guilt which one human being feels when he/she kills another human being. This has been increasinly labeled as a mental health problem which it surely is, but even more, it is a spiritual problem in my view. All the mental health treatment in the world, and all the medications cannot absolve the guilt induced by the willful, deliberate killing of another human being.

There is a good article that attempts to describe this problem which was published in the Seattle Times 4 years ago on July 21, 2004. Here is a snippet:

Tucked behind a gleaming machine gun, Sgt. Joseph Hall grins at his two companions in the Humvee.

"I want to know if I killed that guy yesterday," Hall says. "I saw blood spurt from his leg, but I want to be sure I killed him."

The vehicle goes silent as the driver, Spc. Joshua Dubois, swerves around asphalt previously uprooted by a blast.

"I'm confused about how I should feel about killing," says Dubois, who has a toddler back home. "The first time I shot someone, it was the most exhilarating thing I'd ever felt."

Dubois turns back to the road. "We talk about killing all the time," he says. "I never used to talk this way. I'm not proud of it, but it's like I can't stop. I'm worried what I will be like when I get home."

The men aren't Special Forces soldiers. They're troops with the Army's 2nd Armored Cavalry Regiment serving their 14th month in Iraq, much of it in daily battles. In 20 minutes, they will come under attack again.

Many soldiers and Army psychiatrists say these constant conversations about death help troops come to grips with the trauma of combat. But mental-health professionals within and outside the military point to the chatter as evidence of preventable anguish.

It is very difficult for us as a nation to face up to the immoral and illegal war which we have perpetrated and are paying for which was based on lies and deceit by our government, let alone for our soldiers who have actually killed other human beings, civilians, women, children, for reasons that are not clear at behest of psychopathic and irresponsible leaders. What does this killing do to a person's soul other than lead to anguish, revulsion, self-recrimination, and too often self destruction in one form or another.

Families of these suffering souls have wanted to be proud of their relative's service and to believe it was for a good cause, but the truth does not match the delusion. The inability of people back home to "understand", let alone accept, the truth, leaves the suffering soldier even more isolated and tormented.

What is the answer to the spiritual suffering? The truth and repentence. Will McCain or Obama lead us there? I doubt it very much unless we as a country are willing to face our demons and admit that what has been done in our name is wrong. Witnessing the suicides and PTSD of our returning soldiers fortunately or unfortunately won't let us ignore or forget the heinous acts they have been asked and compelled to do in our name. The guilt belongs to us all not just to the perpetrators, but they are the more active participants while we just watch, cheer them on, and lie to them telling them they are doing grand, honroable, and glorious things when deep in their souls they know better.

I intend to write more on this topic so I am adding a new category to my blog today called Perpetration induced stress.

Nation & World | Soldiers trained to kill, not to cope | Seattle Times Newspaper.

 

Suicide of troops only one symptom of National spiritual dysfunction in the U.S.A.

I passed a car this morning that had a yellow ribbon on it which said "Support The Troops", and a decal on it which said, "Thank them for their service protecting our country." And I wondered to myself how do you thank people who are engaged in immoral and illegal activity of waging a pre-emptive war for a corrupt government than has waged war based on lies?

The Nurmeburg trials after World War II developed the principle that "just following orders" does not absolve a person from legal and moral guilt. The fact is that many of our troops are engaged in illegal and immoral activities, activities which they cannot justify to themselves or to others and so when they return home "from duty", from engaging in these activities they are killing themselves in greater and greater numbers.

Our chauvanistic and patriotic jingoism does not help these soldiers at all because they know what they did, and they are not proud, and they cannot say anything when they are being falsely adulated, and continued to be lied to that they have done brave and noble things.

What our soldiers and our country needs more than anything is the truth, because it is the truth that sets people free not lies in spite of what the current administration tells us.

When American soldiers choose suicide over life back in the U.S.A. that should tell us something. They know something we don't know and that is that our spirit is seriously broken and corrupted as a nation.

Truth, honesty, repentence, forgiveness, exoneration, reconciliation are badly needed in our national soul and the prophetic leadership is sadly lacking. Until it emerges our returning troops will continue to suffer and kill themselves.

It is a mistake to view the suicide and psychiatric crises in our returning veterans as mental health problems alone. At the core they are spiritual problems, and Americans as a whole share a spiritual responsibility for the state of our nation's soul. The suicide of our soldiers is only one symptom of serious spiritual dysfunction of our country.

James Jenkins was a Marine who served two rotations in Iraq. He became increasingly agitated and dispairing over the 212 people he states he killed and he told his mother he didn't understand why he was there. It seems that a very promising, bright, hard working, intelligent young man joined the service "for college money" and "to serve his country" only to find out that the "service" involved unspeakable activities that he would rather kill himself for than have to live with. It is a very sad commentary on how the current administration and our country has exploited its youth and their potential for very dishonorable , deceiftul, and destructive policies.

The blood of James Jenkins, the 212 people he killed, and the thousands and millions who have suffered because of this tragic policy falls on George Bush and his ilk and all the idiots in this country who voted for them.

Video lasts 7: 16


Pennsylvania Injuries Rise After Repeal of Helmet Law

Motorcyling I have argued this point with various people over the last few years that motorcyle helmets and bicycle helmets save lives and traumatic brain injuries. Only 20 states require motorcyle helmets, New York where I live, being one of them. Two years ago, Pennsylvania stupidly rescinded its helmet law and guess what? Right. Head injuries and deaths have gone up dramatically. Here is a snippet from the June 11, 2008 Reuters HealthDay article based on an article which will appear in the August issue of the American Journal of Public Health:

In the two years after Pennsylvania repealed its universal motorcycle helmet law, there was a 32 percent increase in motorcyclist head injury deaths and a 42 percent increase in head injury-related hospitalizations, a University of Pittsburgh study says.

The state's universal helmet law was repealed in 2003. Currently, only riders under age 21 and those with less than two years' experience who haven't taken a safety course are required to wear helmets.

The researchers analyzed data from the state's health and transportation departments for the years 2001-02 and 2004-05 and found helmet use by motorcyclists involved in reported crashes decreased from 82 percent to 58 percent in the two years after the helmet law was repealed.

While the head injury death rate increased by 32 percent, there was no increase in the non-head injury death rate.

Along with the 42 percent increase in head injury-related hospitalizations after the repeal of the helmet law, there was an 87 percent increase in the number of head-injured, hospitalized motorcyclists who required further care at facilities specializing in rehabilitation and long-term care.

Total acute care hospital charges for motorcycle-related head injuries increased 132 percent in the two years after repeal of the law, the study found.

I was talking to a young 16 year old client of mine who is a true libertarian and who advocates for goverment to stay out of people's lives and let people to do as many stupid things as they like such as drink alcohol, drug, have promiscuous sex, ride motorcyles helmet free, etc. His point is that it would be an exercise in social darwinism, that is, the stupid will die young and not reproduce. In a way I think he has a point. It could be that New Yorkers are a little smarter when it comes to public health than Pennsylvanians. Certainly our auto insurance and health insurance companies prosper while Pennsylvanian insurance companies are paying the price of stupidity as well as individuals and their families.


MedlinePlus: Pennsylvania Injuries Rise After Repeal of Helmet Law.


Excessive texting is a tell tale sign of infidelity

Texting There was a brief article in the Telegraph, a newspaper in the United Kingdom, on 06/25/08 about how excessive text messaging can be a sign of infidelity. Here is part of what the article says:

Excessive texting and emailing is now the number one sign of infidelity, a leading law firm has said.

Family lawyers said an addiction to text messages or emails has replaced "working late" at the office as the main tell tale signs of an extra-marital affair.

Andrew Newbury, partner at specialist law firm Pannone said: "We see the same features in so many of the marital disputes that we deal with.

In the last 3 months I have had 5 couples where the spouse is objecting to the number and type of text messages being sent by his/her spouse. In one case, the wife objected that her spouse had sent 6,000 text messages to a female co-worker the preceding month. The husband claimed it was merely a friendship with a co-worker and there was nothing romantic going on.

Last night, I saw an upset husband who stated that his wife is getting all kinds of text messages from male co-workers at all times of the day and on weekends and when he asked what was going on, his wife became very defensive and denied any wrong doing. She was further defensive when he called the cell phone company wanting the phone records.

I have several other cases now where text messaging and setting up of accounts on MySpace has concerned spouses that their spouse is engaging in behavior that could lead to infidelity. In my experience, sometimes this has happened. In one case and unhappy wife of 26 years, left her husband to meet some man she had been corresponding with on the Internet who lived in another state. The wife knew nothing about this person other than from the emails.

It is interesting to learn how the new technology is being used in human relationships. Often the concern is for children and protecting them from predators and other questionable activities like taking and circulating nude photos of themselves (which I had one 13 year old client do). And yet, it seems that adults are getting into just as much, if not more, trouble.

Like any new technology, the technology itself is value free - in and of itself is amoral, but the use to which humans put it often raises all kinds of moral issues. With technology like text messaging, we are only being to learn how this new form of communication will affect human relationships.


Excessive texting is a tell tale sign of infidelity - Telegraph.


McCain gets it wrong on birth control

Many insurance companies cover prescriptions for Vigara but not for birth control. John McCain doesn't know what he thinks about the issue, needs to check with his handlers, before he takes a position.

This is not a difficult issue. Birth control definitely should be covered by health insurance. It clearly is in the patient's interest and society's interest for people to be able to control their fertility. McCain gets it wrong.

Video lasts 2:14


Praying for clients?

Praying for clients Continuing with the discussion of spirituality in therapy I was struck by Lorraine Wright's statement that she sometimes prays for her clients. Here is part of what she writes in her article, “Spirituality, Suffering, and Beliefs”,

“ Over the past few years, I have on occasion, independently adopted Dossey’s (1993) practice of praying for, although not with, clients and families with whom I work. As Dossey (1993) suggested, if a health professional believes that prayer works, not to use it is analogous to withholding a potent medication or surgical procedure: ‘Both prayer and belief are nonlocal manifestations of consciousness, because both can operate at a distance, sometimes outside the patient’s awareness. Both affirm that, “it’s not all physical”, and both can be used adjunctively with other forms of therapy.” (p.141) In praying for our clients, we perhaps also heighten our connection with them and our investment in their recovery and well-being.”

P. 64 in Spiritual Resources In Family Therapy edited by Froma Walsh

In further research, Dossey's claims have not been affirmed and it appears that there is no physical benefit to praying for someone who does not know they are being prayed for.

However, I wonder if praying for clients detracts from the psychotherapy? Is this a counter transference issue that would enhance the therapeutic alliance or interfere with it in some ways? If you had a student or supervisee who told you in clinical supervision that he/she was praying for his clients without the client's knowledge how would you handle it? Supposing it was with the client's knowledge?

Is praying for clients something that should be encouraged or discouraged? 

I, myself, sometimes pray for my clients and if wishing them well is considered praying, I pray for them all. I think that whether a therapist or a health care provider prays for clients would depend on the therapist's beliefs and spiritual practices. Certainly, clients pay a health care professional for a professional service and not for prayer, but I think that most clients would want their therapist to wish them well and care about their lives and the outcome of the therapy and not just be in it for the money.

Unfortunately, health care has turned into a business. It has become a commercial enterprise and is no longer a human service or a ministry in the broad sense of the word. I do not run my practice only as a business enterprise. I want to be of service to my clients and my community and take a number of clients pro bono and at reduced fees. I could make more money if I only served the more affluent who could pay me full fee, but that is not why I became a therapist and that is not what I believe God has called me to do with my professional skills.

Perhaps it is this desire to serve that is a prayer in and of itself.