Healthy Living

Reducing the Stigma of Mental Illness

Updated 5 years ago

By- Dr. David PrescottWhy Is Reducing the Stigma of Mental Illness Important? There are probably dozens of reasons that challenging the stigma of mental illness and addiction is important. But none seem more compelling than the fact that nearly two-thirds of people who experience a mental illness never receive any type of professional help for their problems. The negative attitudes, fears, and stereotypes that surround mental illness are one of the largest barriers to people receiving professional help. Stigma: A Mark of Social Disgrace? One definition of stigma is “a mark of social disgrace.” The concern is that our own personal fears and distrust lead us to think about people with mental illness in a way that makes the problem worse. Stigma leads to treating people with mental illness differently than we would treat them if they didn’t have a mental illness. Examples of the forms that stigma against mental illness can take include: Stereotyping People with Mental Illness – for example, assuming that people with severe mental illness can never have a job or a family of their own. Fearfulness – not talking to someone with mental illness or purposefully avoiding them. Discrimination – for example, not considering a person with known mental illness for a volunteer position, renting an apartment, or considering them for a job, based solely on the knowledge that they have, or have had, a mental illness. Language – talking about mental illness in a way that makes fun of people with mental illness or perpetuates stereotypes, makes it harder for stigma to be eliminated. Avoid the Temptation to Say “Mental Illness Doesn’t Affect Me: People usually are not very happy if someone suggests they are prejudiced or hold negative stereotypes. Or, many people may see the issues around mental illness and addiction as not really affecting them or their family. However, the fact is that one in five people worldwide will have a mental or neurological disorder at some time in their life. This statistic virtually guarantees that everyone will be impacted by mental illness, and our ability to provide help in promoting recovery. Steps Towards Reducing Stigma: Eliminating societal level stereotypes of mental illness is an enormous goal. But, like all big problems, there are important steps that start with individuals. Some things that you could do include: Become More Knowledgeable: When we don’t know the facts, it is easier to rely on a stereotype or false belief. Knowledge about mental illness is readily available on the web or in books. Knowing a few simple facts, like that the majority of people with mental illness recover from that illness, can help reduce stigma. Watch your Language: One good place to start is to use “people first” language – saying “people with mental illness” instead of “the mentally ill.” And, obviously, eliminating derogatory terms like “psycho” is important. Listen: If you know someone with mental illness, listen to their story and their experience. You don’t need to have professional knowledge about treatment to listen. Just offer the respect and dignity you would offer any friend. For More Information: Federal Substance Abuse and Mental Health Service Administration’s “What A Difference a Friend Makes” Campaign: www.whatadifference.samhsa.govAcadia Hospital Web Site: www.acadiahospital.orgNational Alliance for the Mentally Ill: www.nami.org

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Walk This Way; Child Pedestrian Safety

Updated 5 years ago

By- Dr. Amy Movius School is back in session and for households with children, this necessitates a shift of routine that includes getting kids to and from school as well as school related activities. The logistics of more coming/going from more places deserves some special attention, as each year approximately 900 children in the US are killed while walking and more than 50,000 are injured. Unlike adult, child pedestrians tend to be injured in broad daylight under optimal conditions – meaning no impairment of visibility or poor road conditions. Boys outnumber girls in injuries sustained. Looking back, the number of child pedestrian fatalities has decreased by almost 50% since 1997. Before congratulating ourselves, however, we must realize this is not due to an improvement in pedestrian safety. Rather it is merely a consequence of fewer kids walking at all. In 1969, 42% of all children walked or biked to school: increasing to 87% for those who lived within a mile of school. Today, a whopping 16% of children walk or bike to school and a large proportion of kids living less than a mile away are still driven to/from school. This behavior is consistent with the alarming increases in obesity and decreases in exercise seen in our country’s children. One of the goals of the Healthy People 2010 initiative is to increase the proportion of trips less than a mile that are made by walking. Weather permitting, school travel is a great opportunity to incorporate this healthy lifestyle, though obviously not at the expense of children’s safety. Safety is the second most common reason cited by parents who opt not to have their children walk to school. Evaluating the factors that contribute to child pedestrian injuries can be helpful in creating safer walking conditions for children. The first contributor to child pedestrian injuries is the child him/herself. Children have limited ability to scan traffic activity and are poor judges of vehicle distance, speed, and estimating time needed for street crossing. Children are also inherently quick moving and impulsive. That most child pedestrian accidents occur when children dart into the street, not at intersections is further proof of this. Adults tend to overestimate the ability of our children to navigate traffic, simply because we don’t appreciate the physical and perceptive limitations of their age. For this reason, the AAP states children less than 10 should not be unsupervised pedestrians. A second contributor to pedestrian accidents is, unsurprisingly, the driver. It is more difficult to see children because they are small. This is even worse in vehicles of elevated height such as SUVs, vans, and trucks. (Incidentally, the injuries caused by these vehicles tend to be worse than normal passenger cars). Also just as children are poor judges of traffic distance, drivers are poor judges of child pedestrian distance, again because of their smaller size. Speed is a huge contributor to accident occurrence and severity of injuries. Cars going fast take longer to slow and stop. Whereas there is an 85% chance of survival for a pedestrian struck by a vehicle going 20mph, there is an 85% chance of death for a pedestrian stuck by a vehicle going 40mph. A last consideration is the environment in which a child walks. In urban areas, high traffic and poor visibility due to parked cars are concerns. For more rural areas, few traffic lights, lack of sidewalks or any barrier between pedestrian and vehicle routes are major concerns. Encouraging children to walk more is a worthwhile effort and a few guidelines can make is much safer. First, supervision by an adult is the most effective tool to keeping child pedestrians safe. Remember, no child pedestrian under 10 yrs of age should be unsupervised. Second, adults should be good role models when walking. We can hardly expect our children to take crosswalks, sidewalks and crossing signals seriously if we do not. Plan the safest route to your child’s destination, perhaps enlisting community and government resources to establish and protect these paths. The pedestrian equivalent of a car pool can also be formed, where parents take turns walking a group of children to school. Several resources such as Safe Routes to School (which is federally funded), Kids Walk, and Walk to School Day can help get you started. Lastly, children who have been involved as pedestrians in accidents have a very high incidence (30%) of Acute Stress Disorder and Post-Traumatic Stress Disorder. This is true even for very minor accidents. Most are not brought to professional help. If your child has been in a “near miss” accident they may have symptoms such as reexperiencing the incident, avoidant behavior, hyper arousal, or dissociation (shut down). Please take your child to their medical provider if there is any concern. Reference:Policy Statement – Pedestrian Safety, American Academy of Pediatric 2009, www.aap.org www.healthypeople.gov www.saferoutesinfo.org www.cdc.gov/nccdphp/dnpa/kidswalk/resources.htm www.walkingschoolbus.org

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Don’t Guess, Call EMS

Updated 5 years ago

By- Joan Marie PellegriniThis is to quote Thomas Judge, Director of Lifeflight of Maine. For years, we have known that Mainers are hesitant to call the ambulance when they are having chest pain. There are many reasons for this. Most people think that their pain is “really no big deal.” There is denial that they may actually be having a heart attack. Also, who want “all those ambulances and people showing up at my door.” All the neighbors will be wondering what is going on. Also, the ambulances are busy and should be left to pick up the “really sick” people. And, for people who live fairly close to a hospital, “I can get their faster by just driving myself.”Most people think that they will know if they are having a heart attack. This is because they assume the symptoms are the same for everyone. Unfortunately, this is not true. The chest pain can come on gradually or suddenly. It can be mild or severe. It can be in the front or back of the chest. It can radiate up to the chin or down the arms or even seem to be in the abdomen. A heart attack can happen to people who appear healthy and who feel well. A heart attach can happen even if you’ve had a physical that states you are healthy. Sure, there are other diagnosis that can cause similar symptoms but aren’t as serious (reflux disease, gallbladder disease, joint and muscle disease). However, this is the job of the Emergency Room physicians to determine.Here is what most people forget: the treatment starts once the Emergency Medical personnel arrive. They can get you oxygen, aspirin, and other medications that may be indicated. They can look at your heart rhythm. They can communicate directly with the doctors at the Emergency Room. If you truly are having a heart attack, timing is everything. The saying is “Time is muscle:” the more time that goes by without enough oxygen to the heart muscle, the more muscle that dies. There are some patients who need to have a procedure right away to open one or more of the arteries in their heart. This procedure is done in the cardiac catheterization lab (cath lab). If you are one of the patients who are having this type of heart attack, it is the goal of the doctors treating you to have you in the cath lab in less than 90 minutes. Your chances of getting your treatment this quickly are much higher if you call an ambulance.So, if there is even a remote possibility that you may be having a heart attack, pick up the phone and call 911. Don’t even think twice about it. So, if there is even a remote possibility that you may be having a heart attack, pick up the phone and call 911. Don’t even think twice about it.

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Who Needs a Kids’ Menu?

Updated 5 years ago

By- Dr. Jonathan WoodFrench friesMozzarella sticksHot dogsSpaghetti with red saucePB & JMac and cheeseChicken fingersGrilled CheeseSound familiar? Pick any five of the above and you have the classic all-American Kids’ Menu! And increasingly, this is not just a restaurant menu: it’s the home menu as well!Why do we expect so little from children when it comes to eating?Why are their choices so few and so boring?Why so unhealthy? Where are the fruits? Vegetables? Complex carbohydrates?Do we precondition children to this at an early age?And then continually reinforce it over the course of their early years?Does this stunt their taste buds? What about their culinary imagination and adventurousness?Bottom line:Where is the fresh fish?Where are the beans or broccoli?Where is the grilled teriyaki chicken?Where is the tabbouleh or hummus?Does all the above encourage an unhealthy diet in later childhood, adolescence, and adulthood, one that contributes to obesity and promotes certain diseases and cancers? The definitive answer to this question is difficult to pin down, but the logical answer is “yes”!We are programmed to want sweet high energy food from the time we are born. Breast milk fits the bill and we add to the sweet and fatty selections throughout infancy and childhood. The taste for salt is active by 6 month and we continue to feed that desire through our entire life. Bitter foods (e.g. spinach) typically require repeated exposure in order for one to develop a desire for the taste. In order for children to develop a taste for some of the more “difficult” flavors, it (1) takes time and patience and (2) is easier if it is done early in childhood.Americans are busy people (too busy?) and increasingly have less time for meal preparation. Furthermore, as parents we seem programmed to worrying about our children starving themselves. They won’t! If presented with healthy food, children will eat it. If we worry about their rejected choices and immediately substitute with one of those sweet or fatty or salty foods that we know they will eat, we may feel better. But they will ultimately suffer. Your kids may miss the opportunity to develop tastes for more healthy foods and be destined to look for and get the Kids’ Menu throughout childhood.Sooooo…How can we combat this?How can we change the fact that the most common vegetable eaten by toddlers is French fries?How do we capitalize on the fact that what children eat in the first 2 years of life is a strong predictor or whether they are eating fruits and vegetables at age 10?Make a point of repeatedly offering young children a variety of foods.Start early with fruits and vegetable as snacks – – establish good habits and life will be much easier down the line.Be patient – – don’t rush to replace good stuff on their plate with just any calories. Children will NOT starve themselves!Don’t focus on “it’s good for you”. Simply tell them “this is what’s for dinner”.Make it a family affair – – choose a good balanced menu and don’t “dumb down” the choices for the younger kids.Don’t go cold-turkey on the tasty “unhealthy” stuff – – research also shows that kids may well overindulge later on the “forbidden delights”Avoid the Kids Menu! If you go to a restaurant, inquire about small portions of the adult selections. Or let the kids order some healthy choices from the appetizer menu.Finally, consider offering some exciting or even exotic choices to kids early on. Challenge those developing taste buds and you may provide them with the inclination to stretch their diet down the line. The more they have experienced as kids, the more desirable options they will likely have for a healthy diet as adults.Some books to consider if interested in further reading:Hungry Monkey: A Food-Loving Father’s Quest to Raise an Adventurous Eater by Matthew Anster-Burton (Houghton Mifflin)The Gastokid Cookbood: Feeding a Foodie in a Fast-Food WorldBy Hugh Garvey and Matthew Yeomans (Wiley)My Two-Year-Old Eats Octopus: Raising Children Who Love to Eat EverythingBy Nancy Tringali Piho (Bull Publishing) (due in November 2009)

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An Aspirin a Day Not for Everyone

Updated 5 years ago

By- Dr. Erik SteeleAbout one-third of the adult U.S. population — more than 50 million people — take aspirin to prevent heart disease.But doctors are quick to point out that the century-old drug is a double-edged sword. Although aspirin can fight blood clots that can cause heart attacks and strokes, high doses can increase the risk of bleeding. This can lead to gastrointestinal bleeding and strokes caused by bleeding, known as hemorrhagic strokes.But a daily aspirin regimen isn’t healthy for everyone, and doctors say people should take more care when they decide to self-prescribe. They say it’s important to take aspirin daily only in consultation with a doctor or other health care provider.Self-prescribing a daily aspirin regimen is unwise and widespread.General guidelines call for men ages 45 to 79 and women ages 55 to 79 to take aspirin if benefits, such as preventing heart attacks or strokes, outweigh possible problems, such as gastrointestinal bleeding,. Health.com: Should I take aspirin against heart attacks?And while taking an aspirin in the event of chest pain is widely accepted to limit a heart attack, taking an extra aspirin with the onset of stroke-like symptoms can worsen a stroke if it causes bleeding into the area of the brain experiencing the acute stroke.Another reason against self-prescription of aspirin is that for many people, the drug has very little effect.It may be that up to 20 percent of people who take aspirin don’t benefit from it at all, according to research by Dr. Francis Gengo of the Dent Neurologic Institute, and the University at Buffalo, State University of New York.Being resistant to aspirin makes patients four times more likely to suffer a heart attack or stroke or even die from a pre-existing heart condition, compared with nonresistant patients. Health.com: Heart attack risk calculatorSome self-prescribers may be unaware of how aspirin interacts with over-the-counter supplements and herbal remedies. Saint John’s wort has some anti-clotting effects and it may exacerbate the risk of dangerous bleeding if taken along with aspirin.Other patients may forget to take their aspirin, and in some patients, aspirin isn’t absorbed into the bloodstream well. Doctors can use a test to see how well aspirin is being absorbed.”The mechanisms for aspirin resistance are varied, and they’re not really very well understood,” Gengo said. Possible factors include genetic differences, effects of other diseases and blood flow around abnormally narrow vessels. “It can be a whole array of things,” he said.Doctors say that more study is needed on the effects of aspirin and other anti-platelet drugs such as the highly prescribed Plavix. As 20 percent of the U.S. population is expected to be above 65 years old by 2030, finding new ways to combat the risk of heart attacks and strokes could have widespread benefits.

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Antidepressant Medication Use Increases – but Depression Still Undertreated

Updated 5 years ago

By- Dr. David PrescottStudy Shows Use of Antidepressant Medication has Increased in Past Decade: In a study released this month by, it appears that the percentage of people in America who receive antidepressant medication climbed from just under 6% (5.4%) in the mid-1990’s, to just over 10% in this decade. Dr. Mark Olson at Columbia University and Dr. Steven Marcus at that University of Pennsylvania report that more and more people are receiving antidepressant medication, currently more than 27 million Americans. Number of Patients Receiving Psychotherapy for Depression may be Decreasing: In general, it is estimated that only around 1/3 of people with mental illness receive adequate treatment. For depression, while the number of people receiving antidepressant medication increased over the past decade, it may not mean that everyone is receiving the right treatment. Other findings from the same study conclude: The percentage of people on antidepressants who also received psychotherapy decreased from 31.5% to 19.8% between the mid 1990’s and the mid’2000’s. Much of the increase in use of antidepressants was for conditions other than depression. For example, antidepressant medications are often used to treat chronic pain. From other research, we know that depression causes more people to become disabled than diseases like cardiac illness, arthritis, or asthma. What is the Difference between Major Depression and a case of “The Blues” Major depression, or clinical depression, is more than simply feeling down for a day or two. To be diagnosed with major depression, a person must experience at least five symptoms of depression over a two week period. Some, but not all, of these symptoms include: Persistent sad or irritable mood Decrease in energy and motivationFeeling hopeless or excessively guiltyLoss of appetitePoor Memory or ConcentrationPreoccupation with Death or SuicideLack of enjoyment in activitiesWhat if You or Someone You Know is Reluctant to Get Help? Encouraging people to get help for depression may take time and patience. The following tips may help: Treatment for Depression Improves your Physical and Emotional Well-Being: For some people, realizing that depression is associated with poorer physical health may encourage them to seek treatment. Benefits of treatment include more energy and better sleep. Treatment Outcomes for Depression are Quite Good: Most studies show that the majority of people with depression improve with either medication or psychotherapy. When psychotherapy and medication are used together, about 75% of people show significant improvement within a couple of months. Medication Isn’t the Only Treatment: Most major studies show that both counseling and medications have significant benefit in treating depression. There are good options of many types available if you are struggling with depression. Treatment isn’t forever: Unlike many physical health problems, treatment for depression doesn’t usually go on for the rest of your life. Many people are able to go to counseling or stay on medication for a few months, then gradually taper off.

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Sodas Should be Reserved for “Special Occasions”

Updated 5 years ago

By- Dr. Joan Marie PelligriniWe’ve all heard that sodas are bad for you. Most of us just don’t believe that a few sodas a day or a week are going to cause a problem. It is true that it is hard to make the connection between a few sodas and tooth decay and bone loss. The studies that support this hypothesis have focused on participants whose fluid intake each day was in the form of soda. However, the more real concern for all of us is the hidden and “empty” (meaning no other nutritional value) calories that are in soda drinks. It is estimated that at least 7% of Americans’ extra calorie intake is due to soda drinks alone. There are many foods that are not helping Americans’ fight with obesity but soda drinks are probably the most ubiquitous. How long does it take to go through your day before you are either offered a soda or see someone drinking soda? I want to focus on the relationship of the extra calories in soda and weight gain.It is estimated that it takes about 3500 extra calories to gain a pound. Most soda drinks have about 30 grams of sugar per serving. A serving size for a drink is 8 ounces. A gram of sugar has 4 calories. That means that each serving of soda has 120 calories due to sugar alone. Add to this that very few sodas come in an 8 ounce serving size. Most are sold as 12-20 ounces. That means that each 12 ounce bottle or can has approximately 180 calories (or 240 calories for a 16 ounce bottle). Let’s say you drink one 12 ounce serving of soda a day and you do not increase your activity level (in other words, you are not burning any of these extra calories). That would be 180 calories extra per day, 1260 calories a week, and 5040 calories a month. You would gain over a pound a month and as much as 12-20 pounds a year. These are hidden calories that you are completely unaware of consuming. Children are even more unaware because they do not usually consider the number of calories they are consuming.You are not going to find me telling anyone not to drink soda. I do, however, want soda-consumers to be aware of the hidden calories. Limit your intake. Increase your activity level. Think of soda as a dessert or sweet and forgo something else with “empty” calories at the same time. We need to teach our children also that soda is an “extra”. It is not the best means for hydration. It is because of the extra calories and the rise in childhood obesity that educators wish to limit access to sodas in our public school system. Adults also can learn from this message.

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Bye-Bye Necktie?

Updated 5 years ago

By- Dr. Amy MoviusThe necktie, despite having no practical use, has been a symbol of (male)professionalism and power for centuries.  Male physicians who sport ties, along with the ubiquitous white coats, instill increased confidence in their patients, especially those of an older generation.  Another common thread (pardon the pun) between white coats and neckties is that they are rarely – maybe never for ties – laundered. Professionalism for its own sake has value but it is becoming less clear if this “cuts the mustard” for white coats and neckties as the problem of hospital acquired(nosocomial) and resistant infection grows.   In Britain and Scotland, the answer to this is a resounding  “no” as both countries have recently instituted dress codes banning white coats and neckties and other “functionless clothing”.  In addition, Britain has a “bare below the elbows” policy and Scotland is providing shortsleeve  tunics to all health care workers.  The reasons are simple and easily understood.  Clothing and accessories travel between patients on health care workers.  Patients may have infections or be especially susceptible to them because of their medical condition.  Pathogenic bacteria – i.e.  bacteria responsible for infections – can “hitch a ride” on the clothing or other items medical staff carry with them, much as they can be transmitted by unwashed hands.   Items such as neckties and lanyards also tend to hang or swing directly in front of patient’s faces during examinations.  Not incidentally, these two items aren’t typically washed. Though there is no direct evidence of patient illness being transmitted in this way, there is a great deal of evidence suggesting it is more than possible.   Contamination of long sleeve/coat cuffs, neckties, lanyards, ID badges, and even nurses caps has been investigated.  A wide variety of bacteria have been cultured from all of them, including resistant strains.  If cleaning these items between patients were as easy as, say, washing your hands, the demise of the iconic white coat and tie for doctors might not be up for consideration.  The American Medical Association has not thus far mandated any specific change.  However, the AMA has its eye on the issue and did make a statement in June of this year that they “advocate for the adoption of hospital guidelines for dress codes that minimize transmission of nosocomial intections, particularly in critical and intensive care units”.  With this in mind, don’t be surprised if your health care provider starts looking less like Marcus Welby MD, and more like Zach Braff  from SCRUBS.  Its all in the name of good medicine.

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Eating Disorders – More Common Than You May Think

Updated 5 years ago

By Dr. David PrescottEating Disorders are More Common than You Think: Eating Disorders, which include anorexia nervosa, bulimia, and binge eating disorder, are estimated to impact about 10 million people in the United States. While this statistic looks even more significant when contrasted to other significant conditions. For example, the number of people with eating disorders is close to 5 times the number of people with schizophrenia (around 2.2 million) and more than twice the number of people with Alzheimer’s disease (around 4.5 million). Thus, eating disorders touch the lives of many, many people in your city, town, or community. Another alarming statistic: anorexia nervosa has the highest premature death rate of any psychiatric disorder. However, some good news: while treatment for anorexia may take several years, treatment outcomes over the long run are generally better than other conditions relating to weight, such as treatment for obesity. What are the Types of Eating Disorders? There are three major types of eating disorders. Anorexia Nervosa involves having a distorted body image where a person sees themselves as overweight even when they are dangerously thin. People with anorexia have an intense fear of gaining weight, and often develop unusual habits such as refusing to eat around other people. Anorexia usually occurs in women, and is often accompanied by infrequent or absent menstrual periods. Bulimia Nervosa involves eating excessive quantities of food, sometimes in secret, then trying to purge the body of the food and calories by using laxatives, vomiting, exercising or diuretics. People with bulimia nervosa usually feel ashamed and disgusted as they binge, yet also feel relieved of tension once the binge-purge cycle is complete. Binge Eating Disorder involves frequent episodes of excessive, out-of-control eating. However, there is no attempt to purge the body of excess calories. How do I know if I am at risk for an Eating Disorder? Obviously, the determination of when concerns with food, eating and body image cross the line from “normal concern” to “psychological problem” varies from person to person. However, if you answer “yes” to any of the following questions, it may suggest that you are at risk for an eating disorder: Are you constantly preoccupied with weight and intense fear of becoming fat?Do you believe that your body weight needs to be below what is recommended by physician or dietician? If you are a woman, have you skipped or stopped a menstrual period when you were losing weight? Do you frequently feel out of control when you eat? How much of your eating is secretive or hidden from others? Have you tried, or strongly considered, trying to lose weight by vomiting, using laxatives, or exercising according to how much you eat? What Causes Eating Disorders? Many people believe that American society is largely to blame for the high rate of eating disorders, since we emphasize thinness and appearance to an extreme degree. Adolescent and young women account for 90 percent of eating disorder cases according to the National Institute of Mental Health. Other factors which appear to play a role include: Personality traits like low self-esteem, perfectionism, or feeling helpless. Family relationships that involve excessive teasing about appearance, or excessive emphasis on dieting or controlling food intake. Other psychological disorders like depression, anxiety disorders, or substance abuse. It is important to understand eating disorders as a treatable psychological disorder, rather than a failure of will or lack of behavioral control. Is Treatment for Eating Disorders Necessary? The sooner that treatment starts for an eating disorder, the easier it is to treat. Eating disorders don’t usually go away by themselves. And, if left untreated, eating disorders can cause serious physical problems (like anemia, tooth decay, and hair and bone loss) as well as severe emotional distress, getting help is vitally important. Treatment often involves working with a licensed psychologist or therapist, dietician, and physician. Where else can I find help? Information about eating disorders is available at:· American Psychological Association (www.apa.org)· National Institute of Mental Health (www.nimh.nih.gov)· National Eating Disorders Association (www.nationaleatingdisorders.org)Information about mental health and substance abuse, including eating disorders is available at: · Acadia Hospital – 1-800-640-1211 or www.acadiahospital.org

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The Effects of Media on our Children and Adolescents

Updated 5 years ago

-By Dr. Jonathan WoodWhat can we do?On average, children and adolescents spend more than 6 hours a day with media – more time than in formal classroom instruction. In addition, parental monitoring of media use is extremely difficult and US youth have unprecedented access to it: two-thirds have a television set in their bedroomshalf have a VCR or DVD playerhalf have a video game consolealmost one-third have Internet access or a computer.It is now clear that media has an influence on a variety of health issues, such as sex, drugs, aggressive behavior, obesity, eating disorders, and suicide. While the media are not the leading cause of any pediatric health problem in the United States, they do make a substantial contribution to many health problems, including the following:Violence Research on media violence and its relationship to real-life aggression is substantial and convincing. Young persons learn their attitudes about violence at a very young age and, once learned, those attitudes are difficult to modify. Conservative estimates are that mediaviolence may be associated with 10% of real-life violence. Office counseling about media violence and guns could reduce violence exposure for an estimated 800 000 children per year.Sex Several longitudinal studies have linked exposure to sex in the media to earlier onset of sexual intercourse, and 8 studies have documented that giving adolescents access to condoms does not lead to earlier sexual activity. The media represent an important access point for birth control information for youth: however, the major networks continue to balk at airing contraception advertisements at the same time they are airing unprecedented amounts of sexual situations and innuendoes in their prime-time programs.Drugs Witnessing smoking scenes in movies may be the leading factor associated with smoking initiation among youth. In addition, young persons can be heavily influenced by alcohol and cigarette advertising. More than $20 billion a year is spent in the United States on advertising cigarettes ($13 billion), alcohol ($5 billion), and prescription drugs ($4 billion).Obesity Media use is implicated in the current epidemic of obesity worldwide, but it is unclear how. Children and adolescents view an estimated 7500 food advertisements per year, most of which are for junk food or fast food. Contributing factors to obesity may include that watching television changes eating habits and media use displaces more active physical pursuits.Eating Disorders The media are a major contributor to the formation of an adolescent’s body self-image. In Fiji, a naturalistic study of teenaged girls found that the prevalence of eating disorders increased dramatically after the introduction of American TV programs. At the same time, clinicians need to recognize the extraordinary positive power of the media. Antiviolence attitudes, empathy, cooperation, tolerance toward individuals of other races and ethnicities, respect for older people – the media can be powerfully pro-social. Media can also be used constructively in the classroom in ways that are better than traditional textbooks. For instance, middle school students are often assigned to read Romeo and Juliet as their first exposure to Shakespeare. Might it not be more effective, given that Shakespeare wrote hisplays to be observed and not to be read, to watch one of the at least 10 different versions available on DVD? Reading Civil War history using a textbook pales in comparison to watching a TV documentary bring history to life. What could be a more entertaining way to teach highschool physics than using episodes of Mythbusters? In addition, no drug or sex education program is complete without a media component.A kinder, gentler, more responsive public media would be nice but is unlikely. Hollywood has been resistant to any outside criticism, the Motion Picture Association of America ratings have remained closed to scrutiny for decades, and the TV ratings are not understood by most parents. The Internet cannot be regulated. More graphic violence on TV shows and movies, more sexual suggestiveness in primetime shows, and more edgy advertising can be expected in the future. Easier access to media will occur as cell phones are used to download TV shows and movies, and soon a personal Internet device (about the size of a paperback book) will allow instant online access anytime and anywhere. Conclusion? The solution to children’s exposure to inappropriate media cannot rely on its producers.So what can we do? How can parents, teachers, pediatricians work together to minimize the negative effects of media and at the same time celebrate the positive aspects?Broad based education of parents, teachers, and clinicians through PTA meetings, teacher in-service training, and conferences is necessary. Education of students about the media should be mandatory in schools. Parents have to change the way their children access the media:o not permitting TV sets or Internet connections in the child’s bedroom. Research has clearly shown that media effects are magnified significantly when there is a TV set in the child’s or adolescent’s bedroomo limiting entertainment screen time to less than 2 hours per day, and o co-viewing with their children and adolescents. o PG-13 and R-rated movies need to be avoided – the content is clearly inappropriate for young children.Clinicians need to ask 2 simple questions at routine visits. Is there a TV set or Internet connection in the bedroom?How many hours per day does the child or adolescent spend with a screen? The media is a powerful teacher of children and adolescents – the only question is what are they learning and how can it be modified? When children and adolescents spend more time with media than they do in school or in any activity except for sleeping, much closer attention must be paid to the influence media has on them.

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Surviving a Heart Attack

Updated 5 years ago

– By Dr. Erik SteeleA heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.Heart attack is a leading killer of both men and women in the United States. But fortunately, today there are excellent treatments for heart attack that can save lives and prevent disabilities. Treatment is most effective when started within 1 hour of the beginning of symptoms. If you think you or someone you’re with is having a heart attack, call 9-1-1 right away.Heart attacks occur most often as a result of a condition called coronary artery disease (CAD). In CAD, a fatty material called plaque builds up over many years on the inside walls of the coronary arteries (the arteries that supply blood and oxygen to your heart). Eventually, an area of plaque can rupture, causing a blood clot to form on the surface of the plaque. If the clot becomes large enough, it can mostly or completely block the flow of oxygen-rich blood to the part of the heart muscle fed by the artery. Heart With Muscle Damage and a Blocked ArteryDuring a heart attack, if the blockage in the coronary artery isn’t treated quickly, the heart muscle will begin to die and be replaced by scar tissue. This heart damage may not be obvious, or it may cause severe or long-lasting problems. Severe problems linked to heart attack can include heart failure and life-threatening arrhythmias (irregular heartbeats). Heart failure is a condition in which the heart can’t pump enough blood throughout the body. Ventricular fibrillation is a serious arrhythmia that can cause death if not treated quickly.Get Help QuicklyActing fast at the first sign of heart attack symptoms can save your life and limit damage to your heart. Treatment is most effective when started within 1 hour of the beginning of symptoms. The most common heart attack signs and symptoms are:Chest discomfort or pain-uncomfortable pressure, squeezing, fullness, or pain in the center of the chest that can be mild or strong. This discomfort or pain lasts more than a few minutes or goes away and comes back.Upper body discomfort in one or both arms, the back, neck, jaw, or stomach. Shortness of breath may occur with or before chest discomfort. Other signs include nausea (feeling sick to your stomach), vomiting, lightheadedness or fainting, or breaking out in a cold sweat. If you think you or someone you know may be having a heart attack:Call 9-1-1 within a few minutes-5 at the most-of the start of symptoms. If your symptoms stop completely in less than 5 minutes, still call your doctor. Only take an ambulance to the hospital. Going in a private car can delay treatment. Take a nitroglycerin pill if your doctor has prescribed this type of medicine. Each year, about 1.1 million people in the United States have heart attacks, and almost half of them die. CAD, which often results in a heart attack, is the leading killer of both men and women in the United States. Many more people could recover from heart attacks if they got help faster. Of the people who die from heart attacks, about half die within an hour of the first symptoms and before they reach the hospital.From 6/23/09The Organ Donation Process – By Dr. Joan PellegriniThere is extensive information available about how to become an organ and tissue donor. Most of us by now know that there are 100,000 people in the US waiting for a life-saving organ transplant. We even make it easy in the State of Maine by allowing you to designate yourself as a donor when you get or renew your driver’s license. However, there is almost no information out there about what this might mean for your loved ones if the time comes for them to be notified that you are a potential organ donor.The vast majority of organ donors sign a declaration card without knowing exactly what this will mean for their family and loved ones if in fact something tragic really does happen to them. I very much want everyone to be an organ donor but I also want donors and their families to be well-informed about the processes that will take place. Once you sign an organ donor card, please tell your family about your wishes. Then, tell them what might happen if you are a potential donor. Our local resource is the New England Organ Bank (www.neob.org or 800-446-6362). Their website does not have this type of information but you may call them with questions. Alternatively, you may print this page to help you discuss this with your family.Many of us think that if we are an organ donor, then our organs will be taken as soon as we die. Unfortunately, if your heart is not beating, then the doctors will not be able to use your organs. You may still be a bone and tissue donor though. In order for you to donate organs, your heart and lungs must still be alive in order to keep your organs alive.Most organ donors have had a sudden illness such as a stroke or heart attack or have been critically injured. If this were to happen to you, before approaching your family about donating your organs, the doctors usually first determine that your brain is dead and there is no chance for recovery. In order for your organs to be donated, the doctors and nurses must keep your heart and lungs alive on a breathing machine in the intensive care unit. Your illness or injury may not be visible and so you may look very much alive to your loved ones. Because you may look “OK”, the news will be even more difficult for your family to understand. Your family will be devastated by the bad news and this would be a terrible time for them to learn that you wish to be an organ donor in the event of your death.Organ donation does not happen immediately after it is determined that you are a potential donor. In fact, it may take 12-24 hours or even more. The reason for this is that the organ procurement organization (OPO) must review your medical history and do lab tests to look for reasons why they may not be able to use your organs. Some of these tests take hours for the results to come back. Also, some of these tests are actual procedures that take some time to be done (cardiac catheterization, bronchoscopy, tissue biopsies to name a few). Once your organs are found to be transplantable, the OPO must then match them to people on the waiting list who have your same blood type and tissue characteristics. Coordinating this effort takes time.Steps that you should take:Decide to be an organ and tissue donor.Let your family and loved ones know about your wishes.Tell your family that if something terrible were to happen to you, the doctors and nurses will help them to understand what is happening.If the medical team determines that your illness is likely nonsurviveable, they will discuss organ donation with your family.If you become an organ donor, the team will need several hours to coordinate this effort. The medical team will spend quite a bit of time with your family to help them understand the process.

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The Organ Donation Process

Updated 5 years ago

- By Dr. Joan PellegriniThere is extensive information available about how to become an organ and tissue donor. Most of us by now know that there are 100,000 people in the US waiting for a life-saving organ transplant. We even make it easy in the State of Maine by allowing you to designate yourself as a donor when you get or renew your driver’s license. However, there is almost no information out there about what this might mean for your loved ones if the time comes for them to be notified that you are a potential organ donor.The vast majority of organ donors sign a declaration card without knowing exactly what this will mean for their family and loved ones if in fact something tragic really does happen to them. I very much want everyone to be an organ donor but I also want donors and their families to be well-informed about the processes that will take place. Once you sign an organ donor card, please tell your family about your wishes. Then, tell them what might happen if you are a potential donor. Our local resource is the New England Organ Bank (www.neob.org or 800-446-6362). Their website does not have this type of information but you may call them with questions. Alternatively, you may print this page to help you discuss this with your family.Many of us think that if we are an organ donor, then our organs will be taken as soon as we die. Unfortunately, if your heart is not beating, then the doctors will not be able to use your organs. You may still be a bone and tissue donor though. In order for you to donate organs, your heart and lungs must still be alive in order to keep your organs alive.Most organ donors have had a sudden illness such as a stroke or heart attack or have been critically injured. If this were to happen to you, before approaching your family about donating your organs, the doctors usually first determine that your brain is dead and there is no chance for recovery. In order for your organs to be donated, the doctors and nurses must keep your heart and lungs alive on a breathing machine in the intensive care unit. Your illness or injury may not be visible and so you may look very much alive to your loved ones. Because you may look “OK”, the news will be even more difficult for your family to understand. Your family will be devastated by the bad news and this would be a terrible time for them to learn that you wish to be an organ donor in the event of your death.Organ donation does not happen immediately after it is determined that you are a potential donor. In fact, it may take 12-24 hours or even more. The reason for this is that the organ procurement organization (OPO) must review your medical history and do lab tests to look for reasons why they may not be able to use your organs. Some of these tests take hours for the results to come back. Also, some of these tests are actual procedures that take some time to be done (cardiac catheterization, bronchoscopy, tissue biopsies to name a few). Once your organs are found to be transplantable, the OPO must then match them to people on the waiting list who have your same blood type and tissue characteristics. Coordinating this effort takes time.Steps that you should take:Decide to be an organ and tissue donor.Let your family and loved ones know about your wishes.Tell your family that if something terrible were to happen to you, the doctors and nurses will help them to understand what is happening.If the medical team determines that your illness is likely nonsurviveable, they will discuss organ donation with your family.If you become an organ donor, the team will need several hours to coordinate this effort. The medical team will spend quite a bit of time with your family to help them understand the process.

Read more on The Organ Donation Process…


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