Also known as high blood pressure, hypertension is a condition in which the force of the blood against the artery walls is too high. Blood pressure is the force of blood pushing against the walls of the arteries, which carry blood from the heart to other parts of the body. Blood pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage the heart and lead to health problems. High blood pressure increases the risk for heart disease and stroke, which are leading causes of death in the United States.
A number of risk factors increase the chances of having hypertension.
Age– Hypertension is more common in people over the age of 60 years.
Ethnicity– Some ethnic groups, such as African Americans are prone to hypertension.
Weight– Being overweight or obese is a key risk factor.
Alcohol & tobacco use– consuming alcohol regularly and smoking tobacco can increase a persons blood pressure.
Preexisting conditions– Cardiovascular disease, diabetes, chronic kidney disease and high cholesterol can lead to hypertension.
Hypertension can be managed through lifestyle & dietary changes.
Reduce the amount of salt- Average salt intake is between 9 grams and 12 grams; to help decrease the risk of hypertension, reducing intake to under 5 grams a day is recommended.
Moderating alcohol consumption-limiting alcohol consumption to two drinks/day for males and one drink/day for females can reduce the risk of hypertension.
More fruits and vegetables and less fats– avoiding saturated fats and total fat can reduce a persons risk for developing hypertension.
Exercise- Doctors recommend that people with hypertension or have significant risk factors for hypertension engage in 30 minutes of moderate-intensity, dynamic, aerobic exercise. This can include: walking, jogging, cycling, and swimming on 5 to 7 days of the week.
Stress Reduction- Avoiding stress or developing strategies for managing stress can help with blood pressure control. Avoiding the use of alcohol, drugs and tobacco to cope with stress will add to hypertensive problems. These should be avoided. Smoking can raise the blood pressure. Smoking cessation reduces the risk of hypertension, heart disease and other health issues.
Common Myths about Hypertension
Myth: High blood pressure runs in my family. There is nothing I can do to prevent it.
Fact: High blood pressure can be hereditary. If your parents or family members have had high blood pressure, you are more likely to develop it, too.
Myth: I feel fine. I don’t have to worry about high blood pressure.
Fact: About 85 million U.S. adults have high blood pressure — and many of them don’t know it or don’t experience typical symptoms. High blood pressure is also a major risk factor for stroke. If uncontrolled, high blood pressure can lead to serious and severe health problems.
Myth: I read that wine is good for the heart, which means I can drink as much as I want.
Fact: If you drink alcohol, including red wine, do so in moderation. Heavy and regular use of alcohol can increase blood pressure dramatically. It can also cause heart failure, lead to stroke and produce irregular heartbeats. If you drink, limit consumption to no more than two drinks per day for men and one drink per day for women. Generally, one drink equals a 12-ounce beer, a four-ounce glass of wine, 1.5 ounces of 80-proof liquor, or one ounce of hard liquor (100 proof).
Myth: I have high blood pressure and my doctor checks it for me. This means I don’t need to check it at home.
Fact: Because blood pressure can fluctuate, monitoring your blood pressure at home can provide your healthcare provider with valuable information to determine whether you really have high blood pressure and, if you do, whether your treatment plan is working.
Myth: I was diagnosed with high blood pressure, but I have been maintaining lower readings, so I can stop taking my medication.
Fact: High blood pressure can be a lifelong disease. Follow your healthcare professional’s recommendations carefully, even if it means taking medication every day for the rest of your life.
Hales, C. M., Carroll, M. D., Simon, P. A., Kuo, T., & Ogden, C. L. (2017). Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Aged ≥18 Years – Los Angeles County, 1999-2006 and 2007-2014. MMWR: Morbidity & Mortality Weekly Report
Give Your Hypertension Coding a Clean Bill of Health With 7 Tips. (2018). Cardiology Coding Alert, 21(1), 3-5.
Elmore, K. E. (2016). Hypertension: Facts and Forecasts. Med-Surg Matters, 25(3), 4-7.
INFLUENZA IN THE ELDERLY
People with multiple medical problems are at a higher risk to have complications if they contract the flu.
Older adults aged 65 and older have an increased risk of developing complications, being hospitalized, or dying from influenza.
BODYACHES AND PAINS
Frequent complications from the flu can include…
Death or extended hospital stays
Avoid close contact
Get a flu shot
Cover your mouth & nose
Wash your hands
Eat healthy, drink plenty of fluids
Get an adequate amount of sleep
The flu shot is an inactivate vaccine made up of the dead virus. The viruses in the flu vaccine are dead, therefor the shot won’t cause you to get the flu. Some people have cold like symptoms following the flu because they were immuno-compromised at the time for the injection.
Places you can get a flu shot:
Your local pharmacy
Your primary care physician
Urgent care centers
Do I need a flu shot each year?
Flu vaccines are updated each season to keep up with changing viruses. Immunity wares off each year so annual vaccination is needed to ensure the best possible protection against influenza.
Antivirals, such as Tamiflu: This medication works best when taken within 48 hours of your first symptoms.
One of the key things to do for people with the flu are to treat the symptoms, such as Tylenol for fevers/ pain and to drink plenty of fluids.
Alluheibi, S. M., Allehaiby, A. H., Ali Aseeri, T., Alqahtani, A. A., Althumali, J. A., Abdu Abudaia, O., & ... Modhish, M. M. (2017). A Review of Knowledge, Attitude and Prevalence of Flu Vaccination and Its Effect among Elderly. Egyptian Journal Of Hospital Medicine, 69(6), 2680-2684. doi:10.12816/0042248
Campos-Outcalt, D. (2017). Latest recommendations for the 2017-2018 flu season. Journal Of Family Practice, 66(9), 570-572.
Green, D. (2015). Fighting flu. Midwives, 1866-67.
A deep vein thrombosis (DVT) occurs when a blood clot forms in one of the veins in your body, the most common site for this is usually in your legs. These clots can become very serious and dislodge and go to your lungs which can then cause a blockage of blood flow (this is then called a pulmonary embolism). More than 200,000 people per year experience DVT’s and of those patients, 50,000 experience complications from a pulmonary embolism (Larkin, Mitchell & Petrie, 2012).
What are symptoms of a DVT?
Some common symptoms of a DVT are:
Swelling in the affected leg
Feeling of warmth on the skin
DVT’s can also occur with no symptoms
What are common causes of a DVT?
The blood clots of DVT’s can be caused by anything that prevents your blood from circulating or clotting normally, such as injury to a vein, surgery, certain medications and limited movement.
Pregnancy increases the pressure in the veins in your pelvis and legs. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.
Birth control pills or hormone replacement therapy increase your blood’s ability to clot.
Smoking affects blood clotting and circulation, which can increase your risk of DVT.
Sitting for long periods of time, such as when driving or flying. When your legs remain still for hours, your calf muscles don’t contract, which normally helps blood circulate. Blood clots can form in the calves of your legs if your calf muscles don’t move for long periods.
What are SCD’s and what are they used for?
A Sequential Compression Device (SCD) is a safe non-invasive therapy for the prevention of a DVT. The SCD sleeve is wrapped around the calf muscle and provides a gentle compression or squeeze to promote the flow of blood back to your heart. The Sequential Compression keeps the blood moving and helps to prevent it from clotting. The SCD mimics the contraction of the calf during walking. The units are to be used while resting or in bed and are placed on patients during surgery to help prevent DVT’s as well. SCD devices sequentially inflate and deflate air-filled sleeves on the lower extremities. With knee-high sleeves, pressure starts at the ankle and moves toward the knee; pressure is approximately 45 mm Hg at the ankle and 35 mm Hg at the knee. With thigh-high sleeves, pressure at the thigh is 30 mm Hg. Each compression lasts approximately 11 seconds.
How to properly apply a SCD?
Make sure the ankle lines up with the ankle indication on the sleeve.
Wrap the sleeve around the patient’s leg and secure it.
Place two fingers between the patient’s leg and the sleeve to ensure a correct fit.
Attach the sleeve to the mechanical pump unit.
To check connections, note the arrows that indicate accurate insertions from sleeve to pump on the pump side and on the patient side of the pump hose.
Turn on the mechanical pump and confirm it’s working properly.
Stay with the patient to assess sleeve inflation and deflation through one full cycle.
Remove the sleeve once every 8 hours to assess skin integrity and neurovascular status of the extremity and to reinforce patient education.
Know that the sleeve should be removed during bathing and when the patient ambulates.
Instruct the patient to call for assistance when preparing to ambulate.
Caution the patient never to ambulate with the sleeve in place due to the risk of falling.
Make sure the sleeve is removed only for a short time daily.
What is some evidence supporting the use of SCD’s?
In a study by Nagahiro et al that included 706 patients undergoing general thoracic surgery, 362 patients were given prophylactic sequential compression devices, and none of these patients developed a pulmonary embolism. Of the 344 patients who did not receive sequential compression prophylaxis, however, 7 developed a pulmonary embolism (Summerfield, 2006).
The use of the SCD for the prevention of DVT is covered by most insurances as a post-operative take-home therapy.
This method is effective in preventing thrombosis, and compares favorably with pharmacological prophylaxis.
In a study done to compare different SCD systems the results yielded that there is no reason to believe that any particular compression is more or less effective in preventing DVT than any other system, Intermittent compression prevents DVT and prevents venous stasis (Morris & Woodcock, 2004).
SCD’s in the media
A new trend in professional athletes has been utilizing the use of compression devices to help mobilize fluid and speed recovery. This technology has been modeled from the SCD’s that can be seen in hospitals and other healthcare facilities. An example of this brand is “Normatec”, the theory is that it provides graded compression in a circumferential manner, it brings away cell metabolites such as lactic acid that can make your muscles feel sore but it also brings increased blood flow to help quicken recovery. There is still more data needed on the research of this product. The trend has spread throughout professional sports such as the NFL and NBA where this product can be seen being used, Good Morning America also did a segment on Normatec and highlighted a few professional athletes such as Lebron James as being an athlete who is actively using this product. While it is apparent the usefulness that SCD’s have provided in preventing DVT’s it is very exciting that there are now products out there that could help to improve professional athletes overall recovery and performance! Technology is continuing to rapidly improve and grow so it will be interesting to see how these devices progress into the future.
Morris, R. J., & Woodcock, J. P. (2004). Evidence-Based Compression: Prevention of Stasis and Deep Vein Thrombosis. Annals of Surgery, 239(2), 162–171. http://doi.org/10.1097/01.sla.0000109149.77194.6c
Ashworth, S. C. (2014). Sequential Compression Devices and Clots. Critical Care Nurse, 34(6), 68-69. doi:10.4037/ccn2014264
Larkin, B. G., Mitchell, K. M., & Petrie, K. (2012). Translating evidence to practice for mechanical venous thromboembolism prophylaxis. AORN Journal, 96(5), 513-527. doi:10.1016/j.aorn.2012.07.011
Summerfield, D. (2006). Decreasing the incidence of deep vein thrombosis through the use of prophylaxis. AORN Journal, 84(4), 642-645. doi:10.1016/S0001-2092(06)63943-4
As seen on the web, medical marijuana is the name given to dried buds and leaves of varieties of the Cannabis sativa plant. It has been known to be helpful in treating symptoms, illnesses and conditions. The most common use for medical marijuana in the United States is for pain control. At this time the U.S Food and Drug Administration (FDA) has not recognized medical marijuana as medicine. However they have found that the marijuana plant contains chemicals that have shown positive results in both reducing and decreasing symptoms in illnesses. At this time further research is being conducted to determine the benefits that medical marijuana has on patients.
Medical conditions positively effected from medical marijuana
Lou Gehrig’s Disease/ALS
Irritable bowel syndrome
Benefits of Medical Marijuana
Helpful in treating nausea and vomiting from cancer chemotherapy
Can be helpful in treatment of neuropathic pain (pain caused by damage nerves)
Helps improve food intake
Those who use may require less pain medicine
THC and CBD slow growth/cause death in certain types of cancer cells growing in lab dishes and slow the spread of some forms of cancer
Helps in managing anxiety
Risks of Medical Marijuana
Can lower the users control over movement
Produce unpleasant thoughts or feeling of anxiety and paranoia
Delivers harmful substances to users and those close by including many of the same substance found in tobacco smoke
Marijuana plants come in different strains making it difficult to predict each users experience
Chronic users can develop a dependence
How to take the next step in considering if medical marijuana is a good option for you?
Your doctor: Reaching out to your primary care physician is a good place to start. Your family doctor may be able to prescribe medical marijuana or refer you to someone to provide you with better medical advice.
Medical Marijuana specialist: A specialist can provide you with better information and understanding of how it can improve you current condition!
Medical Marijuana clinic: A clinic will provide you with staffed members who specialize in medical marijuana therapy. A clinic will also include a dispensary where you will be provided with more information on what strains would be appropriate for you.
In conclusion, at this time further research needs to be conducted to determine the value medical marijuana offers to those battling with an array of illnesses and conditions. After completing significant research on this topic, my findings both on the web and in scholarly journal articles have suggested similar conclusions. Research is weak. More research needs to be done to confirm whether medical marijuana is both safe, and useful. Many practicing doctors at this time are too unfamiliar with medical marijuana therefore not prescribing it to their patients. However as explained above in the video clips, medical marijuana is becoming much more popular and many patients are becoming increasingly interested in trialling medical marijuana for overall medical benefits!
Abuse, N. I. (n.d.). Marijuana as Medicine. Retrieved February 21, 2018, from https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine
Ali, E. (2016). Medical Marijuana. Alive: Canada;s Natural Health & Wellness Magazine, (402), 49- 52.
Grinspoon, M. P. (2018, January 09). Medical marijuana. Retrieved February 21, 2018, from https://www.health.harvard.edu/blog/medical-marijuana-2018011513085
Spencer, N., Shaw, E., & Slaven, M. (2016). Medical cannabis use in an outpatient pallaiative care clinic: A retrospective char revicew. Journal of Pain Management, 9(4) , 507-513.
Vin-Raviv, N., Akinyemiju, T., Meng, Q., Sakhuja, S., & Hayward, R. (2017). Marijuana use and inpatient outcomes amongh hospitalized patients: analysis of the nationwide inpatient sample database. Cancer Medicine, 6(1), 320-329. Doi:10. 1002/ca4.968
Autism Spectrum Disorder (ASD) is a developmental disorder that develops before the age of three and involves impaired social interaction as well as communication. Also commonly seen is a small range of interests and activities for a person with ASD. Originally this disorder was discovered in 1943, by child psychiatrist Leo Kanner. The people with this disorder can have various levels of intelligence ranging from low to normal, as well as difference in severity of symptoms. The key component in all of these children is the lack of social and communication skills.
1 in 68 children in the US have ASD. This is a 30% increase from two years ago, in which it was 1 in 88 children were diagnosed. The reason for this dramatic incline is unknown, it is also possibly that awareness has made it easier for children to be diagnosed earlier during there development.According to Autism speaks many symptoms of the disorder consist of but are not limited to…
Possible signs of autism in babies and toddlers:By 6 months, no social smiles or other warm, joyful expressions directed at people
By 6 months, limited or no eye contact
By 9 months, no sharing of vocal sounds, smiles or other nonverbal communication
By 12 months, no babbling
By 12 months, no use of gestures to communicate (e.g. pointing, reaching, waving etc.)
By 12 months, no response to name when called
By 16 months, no words
By 24 months, no meaningful, two-word phrases
Any loss of any previously acquired speech, babbling or social skillsPossible signs of autism at any age:
Avoids eye contact and prefers to be alone
Struggles with understanding other people’s feelings
Remains nonverbal or has delayed language development
Repeats words or phrases over and over (echolalia)
Gets upset by minor changes in routine or surroundings
Has highly restricted interests
Performs repetitive behaviors such as flapping, rocking or spinning
Has unusual and often intense reactions to sounds, smells, tastes, textures, lights and/or colors
Children may demonstrate some of these behaviors, but not all. Also children who develop some of these behaviors, may not be autistic. If you believe your child may have ASD, contact your pediatrician for testing. Early intervention is extremly important for these children.
Many interventions for ASD are home bases therapies such as
Applied Behavioral Analysis
Causes of ASD… These can be genetic in origin from either parent on chromosome 16 or even a spontaneous gene change during embryonic development. Increase age of either parent also increases the risk, as well as birth complications, premature birth and the birth of multiples such as twins and triplets. ASD is also linked to abnormal brain development at an early age. Women who have been exposed to German Measles or during the course of their pregnancy also put their child at t a higher risk of developing the disorder. Although it is a common myth, vaccines do NOT cause Autism Spectrum Disorder!
These children are also at risk for many other comorbidities. Such as…Epilepsy, gastrointestinal problems, selective or restricted eating habits , sleep disturbances, Attention-deficit/hyperactivity disorder (ADD and ADHD), Anxiety, Depression, and Obsessive compulsive disorder (OCD). Those who have ASD also commonly engage in self injurious behaviors such as but not limited to…head-banging, hand-biting, and excessive self-rubbing and scratching. Which if not monitored can lead to concussions and life-long brain damage. These behaviors tend to be coping mechanisms for too much sensory stimulation, whether it be environmental or internal stressors. With help from early intervention sometimes these self-injuries behavior can be replaced with functional and non-destructive behaviors.
In Conclusion…ASD is a disorder of sensory processing. What may feel normal to a neurotypical brain could be extremly distressing to the ASD brain. These children can lead very happy and healthy lives with early intervention services as well as love and understanding. Remember April is ASD awareness month, more information about advocacy events can be found at www.autismspeaks.org.
For those who are more audio or visual learners, I attached two great videos to help explain Autism Spectrum Disorder. The first is an animated explanation of the disorder. The second video is facts about ASD and even covers popular myths about the disorder as well.
The flu is an acute respiratory illness caused by viruses A or B. It effects the respiratory or gastrointestinal systems. The flu lasts couple weeks but can be life threatening.
The flu is highly contagious
It can last 1-2 weeks and recover or can be life threatening
Reasons why healthy people are dying from the flu is due to the immune system fighting the flu can end in shock, in organ failure and death
The issue with the pneumonia and the dangers of it is that once your body fights the flu for the 4-5 days you feel better but then suddenly get really sick again in which is the bacterial pneumonia and this is what causes hospitalization or death
The flu vaccine is 60% effective but those who have received the vaccine and do get the flu are the cases least likely to be at risk of hospitalization or death
34 million people having been infected with the flu virus
Those most at risk include:
Very young, under 5
Older than 65
Those with an underlying illness
Those with compromised immune system
Symptoms/warning signs to look for in children:
Difficulty breathing or labored breathing
Cyonotic skin (bluish skin)
Unable to hold down fluids
Lethargic or difficulty arousing
Symptoms/warning signs to look for adults:
Pain or pressure in chest or abdomen/stomach
What can you do to prevent the risk of contracting the flu:
Hand washing as often as possible
Getting vaccinated with the flu vaccine
Staying away from anyone who may or does have the flu
Many people agree that smoking cigarettes are harmful, but what about smoking e-cigarettes? Isn’t it just flavored water vapor without all the toxic cancer-causing chemicals in tobacco products?
The short answer is NO.
The science behind vaping
E-cigarette emissions are not just water vapor.
It includes chemicals that heated result in high levels of toxic compounds that can be lethal if inhaled or ingested. Formaldehyde is one thermal product.
What’s alarming is that specific flavors that are proven safe when eaten in food have not been shown to be safe when inhaled. Some contain diacetyl that gives butter popcorn its flavor which has been found to cause lung irritation and respiratory illness in employees that worked in popcorn factories.
In fact, these chemicals haven’t been tested sufficiently to rule out long-term side effects.
Lack of quality measures
Most short-term side-effects are the result of manufacturing problems.
The design of the devices that holds the e-juice is not regulated.
Devices can cause burns since the lithium-ion battery can explode if charged inappropriately.
The most significant concern is child poisoning since liquid nicotine whether ingested or absorbed through the skin can be lethal to a small child.
There is no childproofing on e-cigarette packaging.
Although regulation of manufacturing and quality control will help resolve most of these issues, the lack of consensus among scientists regarding the long-term health effects of electronic cigarettes creates obstacles for the US government to implement a public policy to deal with e-cigarettes use in open spaces. But most research indicates that since the effects of second-hand electronic cigarette smoke are unknown, it’s best not to smoke indoors, yet many people using e-cigarettes smoke indoors since it’s permissible on some airlines, restaurants, and offices.
Better than smoking tobacco?
Supporters of e-cigarettes say there is no tar with all the carcinogenic chemicals and it offers nicotine smokers nicotine without the deadly toxins released when cigarettes are heated.
The key comparison is to smoking and just because the known risks so far are less than smoking tobacco doesn’t make e-cigarettes a good alternative to quit smoking.
Supporters even claim that e-cigarettes help save lives and provide immense benefit to public health by assisting smokers to quit tobacco but downplayed the research findings on degradation by-products, the chemicals released when the e-juice that contains the nicotine is heated up.
Can it help you quit smoking?
A literature review of the use of e-cigarettes in the United States focuses on the debate that they help smokers quit yet it has no hard data to support that claim.
Studies indicate that e-cigarettes are not as helpful as nicotine patches when it comes to quitting. And often e-cigarette users are dual tobacco smoke users.
Regardless of your side on this issue, keep this product away from children!
E-cigarettes haven’t been around for us to know about the long-term health effects, it might be harmless or 20 years from now we will see a spike in lung cancer.
And because it’s less harmful does not mean that it is safe.
(Cheri) Marcham, C. L., & Springston, J. (. (2017). E-Cigarettes: A Hazy Hazard. Professional Safety, 62(6), 46.
Cobb, N. K., & Sonti, R. (2016). E-Cigarettes: The Science Behind the Smoke and Mirrors. Respiratory Care, 61(8), 1122-1128. doi:10.4187/respcare.04944
Cressey, D. (2014). E-cigarettes: The lingering questions. Nature, 513(7516), 24-26. doi:10.1038/513024a
All too often we are inundated with the same tragic cycle. An individual with an assault weapon opens fire on a large amount of people. The media talks about mental health problems in the individual, the victims are laid to rest and the story fades away then it happens again and the cycle repeats. Gun laws remain relatively unchanged as does the mental health system. This blog will attempt to shed some light on some of the current issues related to this horrible phenomenon.
Mr. Muncie speaking
While watching the recent events in Parkland, Florida unfold through the media in real time I was struck by an interview with the Parkland schools superintendent Mr. Robert Runcie. The full scope of the calamity as well as the identity of the shooter had yet to be announced, but he made a very ominous and all too familiar suggestion at the end of his interview, “Mental health issues are growing and they are a big challenge and it’s something that’s going to need to certainly be addressed.” As more information came out, we learned the shooter was essentially a ticking time-bomb, who had suffered many losses and displayed many red flags as to his ability to cope with them in the form of maladaptive behaviors. We have heard how the community reached out to authorities to express their concerns relating to this individual and those calls went unheeded. There are many systemic failures in this case and I will attempt to shed light on some of them
Anyone who watches mainstream media, reads alternative media or just bops around social media can see that gun control is a hot topic following these events. The voices of certain groups call for a ban on everything from assault rifles, to a ban on guns altogether while another group rushes to defend the second amendment. Within those two camps are litany of ideas and the one that I think bares the most relevance to this blog post is the idea of stopping mentally ill individuals from purchasing guns. Statistically the mentally ill are more likely to be victims of gun violence than they are to perpetrate it. (Gold, Simon & Knoll, 2015) Yet according to Knoll mass shootings by people with serious mental illness represent only 1% of yearly gun related homicides or 110 individuals killed. Knoll also rightfully discusses the fact that calling out those with a mental health diagnosis reinforces a negative stigma to mental illness, which creates a major barrier to treatment and worsens the overall public health burden of mental illness.
110 people killed per year in mass shooting events is still a high number so what is being done about it? According to Knoll, attempting to bar the mentally ill from owning firearms will yield little return in terms of lives saved as only 1% of mass shooting deaths can be attributed to the mentally ill, yet lawmakers have written and passed plenty of legislation to do just that. Federal law dictates that anyone committed to a psychiatric hospital or anyone deemed incompetent by a court can be barred from purchasing or owning a firearm according to the Gun Control act of 1968. Yet there are many who don’t understand what that means. People can be held in a psychiatric hospital for anywhere from 72 hours to 10 days while they are being assessed. Those individuals are not necessarily barred from owning firearms. Someone may have had a very difficult day, and made a non-fatal attempt at suicide, at which point they were brought to a hospital against their will. After 72 hours they may report that they feel their suicide attempt was an error, they may discuss future oriented goals, and may then be released. These individuals would not be deemed certified and therefor would be able to walk out of the hospital, and barring any other issues, they would be able to purchase a gun. If after they are held, a psychiatrist deems they need to remain hospitalized that psychiatrist must bring that patient to mental health court and ask that the patient be committed to continue treatment. If the court agrees, the patient is then committed and according to federal law, they are now banned from purchasing or owning firearms. Being deemed incompetent similarly requires court action in conjunction with a medical professional who must assess an individual. One must file a petition in court to have an individual assessed for competency through psychological testing and if the court sees fit, they will rely on the results of that competency evaluation. These cases may involve an elderly individual suffering from dementia, or someone who commits a crime, but is unable to understand the court proceedings and/or communicate meaningfully with their attorney secondary to mental illness, developmental disabilities, Brain injury, etc. (“How to Legally Declare Someone as Mentally Incompetent?”, 2018) For example, imagine someone who is involved in a car accident while driving intoxicated and is left in a vegetative state after the accident. That individual would be more than likely deemed incompetent, as they wouldn’t be able to understand the proceedings. This may also be the case in the event someone is deemed a threat to themselves or deemed unable to manage their own affairs.
Now that we understand the criteria for someone with mental illness to be banned from owning a gun, we can see that as long as an individual is not committed or deemed incompetent, then they cannot be barred from purchasing a weapon based on mental health issues.
In his film entitled “Bowling For Columbine” Michael Moore went after the pharmaceutical industry and their role in the current spate of mass shootings. Moore suggests that the Columbine shooting occurred for no other reason than the fact that the shooters were prescribed Prozac. If we consider that claim we find a mixed bag of data. According to Yasmina Molero and her research, the data regarding homicidal behavior is inconclusive and individuality cannot be ruled out. She did report an interesting observation regarding dosing of Selective Serotonin Reuptake Inhibitors IE: Prozac, Zoloft Etc. and increased potential for violence. She found that adolescents on low doses of SSRI medications are at a greater risk for the potential to violence and suggests further study on this topic. She did not find the same risks in older patients or adolescents on higher doses of SSRI’s. Since 2004 Fluoxetine also known as Prozac carries a black box warning regarding increased risk of suicidal ideation. When we combine the black box warning with the observation of Molero, one may see an easy leap to the conclusion that Prozac was to blame for Columbine, but like many areas of information in the modern world this is only a superficial correlation. A study from Hungary showed the exact opposite to be true. The authors of this study found contradictory data to the FDA warning and rather than seeing a decrease in completed suicides, the countries where the black box warning was displayed saw decreased usage of antidepressants and increased numbers of completed suicides. In Hungary where the black box warning was not issued the authors found increased usage of antidepressants and decreased numbers of completed suicides. (Ekundayo et al. 1-18). In the case of mass shooters who are taking psychotropic medications it is important to realize that they were prescribed these medications for a reason. Someone was concerned enough to take these individuals to a Doctor and that doctor saw enough behavioral symptoms (maladaptive behaviors) to decide to try a medication to help alleviate those symptoms. In other words, theoretically the behavior of the individual was already outside the societal norms and the current medical model is to treat maladaptive behaviors with therapy and/or medicine.
When we look at mass shooting events we need to remember one thing, At the end of the day, an individual carries out an act. That individual may be suffering from a mental illness, they may not be. They may or may not be able to manage their thoughts or their moods. They may be on specific medication, they may not be, but for all mass shooting events two variables remain the same. The individual who perpetrates a mass shooting needs a gun and themselves to complete the act. Without that combination there is no mass shooting. That to me is the area where we have the most pressing need to make changes. The media plays a very important role in pushing agendas after these tragic events, whether filling the airwaves with pundits calling for more gun control, or calling for more guns. It is very difficult to find answers and I hope this blog helps one to understand at least some of the mental health debate that often comes up. At the end of the day, we will never know who is going to perpetrate a horrendous crime such as a mass shooting. We can certainly look for warning signs, but how to decipher a cry for help versus an imminent threat remains an area where we must be vigilant. We also must be vigilant not to make assumptions about someone because they have a mental illness. Mental illness is a disease like diabetes, or heart disease. Sometimes lifestyle choices may have led them into it, sometimes it is completely organic and there was nothing anyone can do. We must remain empathetic if we are to create avenues to treatment and healing as opposed to pathways to a police state. In the early 1960’s Bob Dylan penned his song “Blowing in The Wind” “/” as I worked on this blog I was reminded of the line “How many times must the cannonballs fly, before they are forever banned.” We all know, the answer is blowing in the wind.
Ekundayo, Otuyelu et al. “ANTIDEPRESSANT DRUGS AND TEENAGE SUICIDE IN HUNGARY: TIME TREND AND SEASONALITY ANALYSIS.” International Journal of Psychiatry in Clinical Practice (2015): 1-18. Web. 6 Feb. 2018.
Gold, L., Simon, R., & Knoll, J. (2015). Gun violence and mental illness (1st ed., pp. 81-99). Arlington Virginia: American Psychiatric publishing.
How to Legally Declare Someone as Mentally Incompetent?. (2018). The Law Dictionary. Retrieved 20 February 2018, from https://thelawdictionary.org/article/how-to-legally-declare-someone-as-mentally-incompetent/
Molero, Yasmina et al. “Selective Serotonin Reuptake Inhibitors And Violent Crime: A Cohort Study.” PLOS Medicine 12.9 (2015): e1001875. Web.
CPR, also known as Cardiopulmonary resuscitation, is a medical procedure involving repeated compression of a patient’s chest, performed in an attempt to restore the blood circulation and breathing of a person who has suffered cardiac arrest. CPR certification is needed for a variety of jobs and professions, from doctors all the way through to lifeguards. While the steps performed for CPR have been revised over the years, the technique has largely stayed the same.
According to the American Red Cross, British Heart Foundation, and Healthdirect Australia, the steps to performing CPR are mostly simple and straightforward:
Before Giving CPR-
Check the scene and make sure it’s safe.
Call 911 for assistance .
Open the airway. With the person lying on their back, tilt their head slightly to life their chin.
Check for breathing. Listen carefully, for no more than 10 seconds, for sounds of breathing. If there is no breathing, being CPR.
Push hard, push fast. Place your hands, one on top of the other, in the middle of the chest. Use your body weight to help you administer compression’s that are at least 2 inches deep and delivered at a rate of at least 100 compression’s per minute.
Deliver rescue breaths. With the person’s head tilted back slightly and the chin lifted, pinch the nose shut and place your mouth over the person’s mouth to make a complete seal. Blow into the person’s mouth to make the chest rise. Deliver two rescue breaths, then continue compression’s.
Continue CPR steps. Keep performing cycles of chest compression’s and breathing until the person exhibits signs of life, such as breathing, an AED becomes available, or EMS or a trained medical responder arrives on scene.
For all intents and purposes, this is the universal method for performing CPR. You’re on a safari trip in Africa and some has a heart attack? This is how you perform CPR. Enjoying a swim in the Mediterranean Sea and someone drowns? This is how you perform CPR. Skiing down to side of Mount Everest and someone collapses? This is how you perform CPR.
So if this is the case, one question must be asked: Why is CPR performed so poorly throughout our media? Take this clip from the movie “Poseidon” for example:
Aside from the steps performed prior to giving CPR (after all, they are on a sinking, upside down cruise ship), how does Kurt Russell’s character fail to perform quality CPR? Well first off, he is performing the steps out of order. Kurt decides to first give rescue breaths, followed by embarrassingly small amount of compression’s, and THEN decided to check to see if the person is breathing. Secondly, he is not performing CPR for long enough in order for it to have its desired effect.
How about we take a look at a different clip from the popular show “Lost”:
In this scene, Jack, one of the foremost cardiac surgeons in the world, is giving his buddy, Charlie, CPR. While keeping in mind the CPR steps listed above, we see Jack doing a pretty admirable job performing CPR… until the 2:07 mark of the video. Now, I get dramatic effect and everything, but word to the wise- don’t start hammer fisting the chest of a person who is not breathing. This will not have the effect it did in this clip and will likely decrease the chances of saving that person.
Well, if you think that clip is comical, this clip from “Breaking Bad” is even worse:
Here we have Jesse attempting CPR on his girlfriend, who likely had an overdose, and boy do we see some problems here. To start it off (and unlike the previous two clips where they were stranded on a sinking boat and hidden island) Jesse should have started the process off by calling 911. His positioning is also off, as he is straddling the victim instead of kneeling perpendicular to her. Not only that, he’s performing CPR while on a mattress. How are you supposed compress the chest down two inches when you are essentially bouncing them up and down on springs? On top of that, the procedure is performed completely wrong, with no rescue breaths being given.
So what can we learn from this? First off, don’t try CPR without getting the proper training and certification. CPR classes are given all throughout the country, and can be taken, in some states, starting at 9 years old. Secondly, don’t imitate the techniques or procedures used in popular or mainstream media. CPR is universal, and performed the same way everywhere. If you see a new method used somewhere else, they are likely performing it incorrectly. Lastly, keep up to date with all advances and changes made for CPR. The ratio of compression’s to breaths in children vs adults have changed in the last 10 years. Also, the invention of the AED, or automated external defibrillator, has revolutionized CPR. Keep up to date with these new inventions and regulations and it could be the difference between life and death.
The #metoo movement began in October of 2017 as a virtual hashtag to demonstrate the widespread prevalence of sexual assault and harassment. Tarana Burke originally founded the me too movement to help survivors of sexual violence find a pathway to healing. The movement promoted the idea of “empowerment through empathy” as millions of women posted #metoo across social media.
The #metoo movement has encouraged millions to speak out against sexual violence towards women, particularly in the workplace. Time magazine named the movement person of the year. The cover proudly displayed the “silence breakers,” brave women who first confronted sexual harassment and assault.
The Time magazine article highlights the frustration women in the workplace face when as their bosses cross boundaries or make them feel powerless. The article conveys women do not speak out for they fear retaliation or being fired. These “silence breakers” speak out in support of preventing sexual harassment in the workplace and are encouraging others to do the same.
A recent article published by Brunner and Dever (2014) investigated the prevalence of sexual harassment in the “new economy”. Male and female participants simply could not imagine a workplace free from the influence of appearance and sexuality. They further discussed examples of how power and sexuality infiltrated daily, routine interactions. These findings further support the motivations behind the #metoo movement.
CNN further supports the #metoo movement, speculating the social hashtag could result in social change and reduce sexual abuse of women. The article further calls for men to begin speaking up to truly institute change. Velasquez and LaRose (2015) investigate the impact of effective social media campaigns and determined positive experience online with activism to encourage political activism. This theory applies directly to the #metoo movement. Increased online involvement will lead to increased public awareness and support.
Brunner, L. K., & Dever, M. (2014). Work, Bodies and Boundaries: Talking Sexual Harassment in the New Economy. Gender, Work & Organization, 21(5), 459-471. doi:10.1111/gwao.12048
Eliana, D., Hayley, E., & Stephanie, Z. (2017, December 18). Person of the Year 2017: The Silence Breakers. Time Magazine. Retrieved February 15, 2018, from http://time.com/time-person-of-the-year-2017-silence-breakers/
LaMotte, S. (2017, November 09). #MeToo: From social campaign to social change? Retrieved February 19, 2018, from https://www.cnn.com/2017/10/30/health/metoo-legacy/index.html
Velasquez, A., & LaRose, R. (2015). Social Media for Social Change: Social Media Political Efficacy and Activism in Student Activist Groups. Journal Of Broadcasting & Electronic Media, 59(3), 456-474. doi:10.1080/08838151.2015.1054998