2016年1月30日 星期六

Farmers' Suicide in India: Is Mental Health the Leading Cause?

from:  http://sites.ndtv.com/cultivatinghope/video-details-page/farmers-suicide-in-india-is-mental-health-the-leading-cause-401085/

 

Farmers' Suicide in India: Is Mental Health the Leading Cause?


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Studies shows that there is a direct relationship between suicide and mental health. However, here in India, only a few people talk about mental illness. And even fewer want to address it in the context of farmer suicides. The major agrarian causes of farmers' distress in the country include indebtedness, crop failure, drought, socio-economic and personal conditions. Through this segment of the Cultivating Hope campaign, we aspire to raise awareness about the adversities faced by farmers in India and find ways to overcome challenges by adapting to solutions. Join hands with our #FarmersForFuture Movement and write in to us with your suggestions, for improving the current state and future of our farmers.

2014年7月16日 星期三

When healthy eating becomes an unhealthy obsession

Date
The Blonde Vegan, aka Jordan Younger, found her blogging masked an eating disorder. The Blonde Vegan, aka Jordan Younger, found her blogging masked an eating disorder. Photo: The Blonde Vegan Facebook Page
Jordan Younger wasn't just any old vegan.
She was 'The Blonde Vegan', whose blog and Instagram account detailed her meals and recipes to tens of thousands of followers.
As someone obsessed with healthy eating, it came as a surprise to Younger when, just over a year into her public journey with veganism, the 23-year-old began to feel tired all the time, suffered skin breakouts and stopped getting her period.
Jordan Younger has turned away from veganism and is recovering from orthorexia nervosa.Jordan Younger has turned away from veganism and is recovering from orthorexia nervosa. Photo: The Blonde Vegan Facebook Page
She recently told People magazine she had been diagnosed with orthorexia nervosa, a condition characterised by an overwhelming focus on a limited diet with elaborate rules that can evolve from an obsessive approach to diet, health and well being.
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"I was spending the entire day obsessing about eating only vegetables, green juices, fruits and occasionally nuts and grains," said Ms Younger, adding food was no longer enjoyable. "I was following thousands of rules in my head that were making me sick."
The term orthorexia nervosa was coined in 1997 by Californian doctor Steve Bratman in a book titled Health Food Junkies. He defined the condition as a fixation on healthy eating or pure food such as vegetables. The rigid approach to healthy eating usually includes extensive and even punitive exercise regimes.
While the condition isn’t officially recognised by the Diagnostic and Statistical Manual of Mental Disorders, Australia’s peak body for body image illnesses said it conforms to the behaviours that define eating disorders, which affect more than 900,000 Australians.
There are four broad types of eating disorders, including anorexia nervosa, bulimia nervosa and binge eating. According to the Butterfly Foundation, Orthorexia fits into the fourth category: identifiable sets of behaviours that make up a condition not otherwise specified.
Chief executive Christine Morgan told Fairfax Media eating disorders have a genetic predeterminant that is triggered by a nutritional deprivation.
“Nutritional deprivation is one of the key behavioural elements of an eating disorder. This can manifest in many forms, either by excluding whole foods groups or food types and then obsessively managing the consumption of these foods. Other behaviours include excessive exercise, withdrawal from social settings where food is involved, secrecy and covert behaviours.”
Jordan Younger launched The Blonde Vegan in early 2013, accumulating more than 70,000 Instagram followers, sharing photos, tips and recipes.
In a recent blog post explaining why she was transitioning away from veganism - she has since renamed herself The Balanced Blonde - Ms Younger said her online persona had obscured her understanding of what she was going through.
"My blog made it hard for me to see that I had an eating disorder. If I wasn't so closely tied to the vegan identity I'd given myself, I would have realised it a lot sooner," Ms Younger said.
Amanda Benham, a practising nutritionist with a masters in health science, said
veganism was an ethical position rather than a fad diet.
“It would be a bit of a stretch to blame veganism for an eating disorder,” Ms Benham said. “My guess is she had a predisposition for this, so whether she went on a vegan or a paleo or a low-carb diet, the outcome might have been the same.”
She said that provided vegans followed a few basic principles, they could maintain a healthy diet and life.
If you are concerned that you or someone close to you is grappling with an eating disorder, seek help. The Butterfly Foundation: 1800 334 673; Lifeline Australia: 13 11 14; Kids Helpline: 1800 551 800.


Read more: http://www.smh.com.au/lifestyle/diet-and-fitness/when-healthy-eating-becomes-an-unhealthy-obsession-20140716-ztjz9.html#ixzz37cJpAvDn

A vision of better mental health care for children

Suzanne Kreiter/Globe staff

In a few weeks, clinical psychologist Robert Franks will take over leadership of the Judge Baker Children’s Center, a century-old Harvard affiliated center that addresses children’s mental health. There’s a lot more that can be done to support children’s mental health, said Franks, currently an assistant clinical professor at the schools of medicine at both Yale University and the University of Connecticut.

Q. What do you think are the most important issues facing children’s mental health today?
A. Ensuring that children and families have access to quality care. There tends to be a gap between what we know works and what’s actually done. I’ve tried to narrow that gap. The other issue that is really important to me is engaging parents and families in care.

Q. Are the mental health needs of children different than the needs of adults?
A. As adults, if we struggle with mental health, it might interfere with work, relationships, leisure. For children, it really disrupts their ability to play, to engage in appropriate social relationships, to live harmoniously in a family environment. It has a huge impact on school performance. It affects their lives, but it also affects their future.

Q. You’ve said that childhood trauma is far more common than most of us realize.
A. About 70 percent of kids, by the time they reach adulthood, have experienced some kind of significant, scary event — abuse, neglect, loss of a loved one. There just hasn’t been quality care for these kids.

Q. Is there effective help?
A. There are proven treatments that really help kids. We have 30 centers in Connecticut that deliver quality care. What we’re seeing is 80 percent of kids who go through [our centers] are having full remission of their PTSD diagnosis, which is just tremendous.

Q. And addressing these problems early helps keep the problems from getting worse later?
A. When bad things happen to kids when they’re very young children, if they go untreated, they can turn into lifelong mental health and health problems: things like cancer, heart, disease and other chronic illnesses as adults. Children who are victimized or struggle with untreated mental health [can] end up later in the juvenile justice system.

Q. How many children need mental health services?
A. In the general population, 20 to 40 percent of kids will need some mental health treatment at some time, particularly if they have a loss or an accident or something terrible happens to them.

Q. Do social norms exacerbate childhood violence?
A. Our children are faced with a lot of violent content; if you look at the video games kids play, the movies and TV shows they watch, we’re feeding them a constant diet of violence. You are what you eat. That’s going to have an effect on young people’s development, particularly people who may have problems to begin with.

Q. Is the stigma around childhood mental illness changing?
A. Stigma is still a big issue. We see stigma issues differ depending on people’s ethnic and cultural backgrounds. [But] we’ve come a long way.

Q. There has been a lot of discussion lately about whether we’re overmedicating kids for mental health issues: 4-year-olds treated with multiple heavy-duty medications, etc.
A. We tend to remember those extreme cases. It’s important to remind people that there are many, many children treated successfully every year — more than not. In any medical field we have to make sure there are checks and balances in place to make sure quality care is being delivered.

Q. What do you see as the biggest issues for parents of children in the mental health system?
A. I’ve talked to a lot of parents who struggle because they can’t take time off work to get to the appointment with their child. They can’t afford to get across town to get to the appointment. These are very practical barriers. And as a result, we are not adequately meeting the needs of our kids.

Q. How does Massachusetts, which is known for its conservative medical care, compare with other states in terms of mental health care for children and young adults?
A. I see Massachusetts as a great seeding ground for innovative and best practices. Compared with other states there’s a much higher density of providers here. There are many providers who were trained originally in very traditional models. It takes time to steer that ship.

Q. Presumably, funding issues are affecting mental health care?
A. It is challenging to make sure many of our community-based providers and practitioners make ends meet. Working in the mental health field is not a lucrative profession, so it’s sometimes difficult to have a stable workforce that is well trained.

Q. What is your vision for Judge Baker? What do you hope to accomplish there?
A. I’ve spent a lot of time in my career focused on implementation. That’s the knowledge I want to bring to the Baker. I’d like to establish the Baker as a resource for the state so we can work to improve the quality of care.

Q. What motivates you to do what you do?
A. As long as I can remember, I’ve loved children.

Q. Is it depressing to care for children who are suffering, who’ve experienced trauma?
A. It’s actually the most hopeful profession there is. When people come to seek help, they want to have change in their lives. And change is possible. They can recover. It’s very gratifying.
Interview was edited and condensed. Karen Weintraub can be reached at weintraubkaren@gmail.com.

The Diet That Fights Stress

from: http://www.outsideonline.com/news-from-the-field/Dont-Eat-To-Feel-Feel-Better.html


News From the Field
Monday, July 14, 2014

The Diet That Fights Stress

Why carbs are not always (ever?) your friend


No, really, you are what you eat. Photo: Crafty Cook Nook/Google CC
In a national survey administered by the Harvard School of Public Health, the Robert Wood Johnson Foundation, and NPR found that more than one-third of participants change their diets during times of stress. More often than not, those changes are not good.
Stress causes many to turn to comfort foods, such as sugary foods or refined carbohydrates, which actually led to discomfort and more stress in the form of a tighter waistband.
In a separate study by researchers at Harvard University published in the journal Pediatrics, breakfasts high in protein, high in fiber, and high on the glycemic index were pitted against one another to see which type caused participants to become hungry again quickly. Researchers found that foods high on the glycemic index cause a spike in blood sugar and a hunger-inducing crash, plus a surge in the stress hormone adrenaline.
Although a cookie or plate of pasta may seem like a quick fix to a stressful situation, the connection between what you eat and your mood should make you reach for foods that can make your body more resilient to its stress responses. Joe Hibbeln, a researcher at the National Institutes of Health, points at sources of omega-3 fatty acids and nutrient-rich foods as best to beat stress.
"One of the most basic ways that omega-3s help to regulate mood is by quieting down the [body's] response to inflammation," Hibbeln told NPR.
Fish (even canned), Swiss chard, eggs, chia seeds, leafy greens, and dark chocolate are all chock-full of nutrients such as zinc, magnesium, potassium, and vitamins that can help strengthen immune response, boost your mood, and, most important, satisfy hunger.
So next time you are feeling like you are going to crack from the pressure, crack a few eggs and whip yourself up a stress-busting breakfast.
http://www.outsideonline.com/fitness/nutrition/The-High-Performance-Benedict.html
Next time you feel like you're going to crack from the pressure, crack a few eggs and whip up a stress-busting breakfast.

2014年7月15日 星期二

High blood pressure may protect elderly against dementia

from: http://www.health24.com/News/High-blood-pressure-may-protect-elderly-against-dementia-20140715


High blood pressure may protect elderly against dementia

In the extreme elderly those with the highest blood pressure were the least likely to have dementia, according to new research.


New research suggests high blood pressure may not be all bad. Elevated levels might help to stave off mental decline among the extreme elderly, the study suggests.
The finding follows a decade spent tracking high blood pressure and dementia among 625 men and women aged 90 and up.
Those with the highest blood pressure levels were the least likely to have dementia, the researchers found. But that doesn't mean older people shouldn't try to control elevated blood pressure, they said.

Read: Hypertension in the elderly

High blood pressure must still be treated


"On the basis of this work we are absolutely not recommending that high blood pressure not be treated among the elderly," said study co-author Maria Corrada, an associate adjunct professor in the department of neurology at the University of California, Irvine.
"What we are saying is that from observing a group of very old people we now have some evidence that developing high blood pressure at a late age may be helpful in terms of maintaining intact thinking abilities," she said.
The reason behind this association isn't clear, Corrada said. "It could be that high blood pressure improves the blood flow to their brain... But we don't know. It will certainly require more study to better understand the mechanism behind this."
The study didn't prove that high blood pressure leads to improved mental acuity among the very old, it just found a link between the two.

Read: Improved treatment for high blood pressure
Corrada and her colleagues are scheduled to discuss their findings this week in Copenhagen, Denmark at an international meeting of the Alzheimer's Association. Research presented at meetings is considered preliminary until published in a peer-reviewed medical journal.
Battery of tests

For the study, the study authors focused on men and women aged 90 to 103 – the "oldest old."
Almost seven in 10 participants were women, and at the start of the study none had dementia. All underwent an initial battery of mental health and neurological testing, as well as blood pressure assessments.
Then, for up to 10 years, all participants were re-evaluated every six months.
Overall, 259 were diagnosed with dementia. And nearly three-quarters took some form of medication to control high blood pressure, which is linked to heart disease and stroke.

Read: A healthy heart may keep your mind sharp

Even lower dementia risk


The research team found that those who had developed high blood pressure during their 80s faced a lower risk of developing dementia than those with normal blood pressure. And participants first diagnosed with high blood pressure during their 90s had an even lower dementia risk.
Even those whose blood pressure was slightly elevated – called "pre-hypertension" – had a lower risk for dementia than those with normal blood pressure, the study found.
The absolute lowest dementia risk was seen among those whose high blood pressure was the most advanced. The association held whether or not people took medication for their high blood pressure.

Read: Seniors need less blood pressure medication

Conclusion


This led the research team to conclude that high blood pressure seems to be associated with a lower risk for dementia among the extreme elderly. Moreover, the worse a person's blood pressure status is, the better their thinking capacities, the researchers said.
"Now it should be said that people who survive to age 90 and above are, by definition, very different than people who survive to their 70s or 80s," said Corrada. "Obviously, they didn't have stroke or heart disease that took their lives. Or maybe they didn't have it at all. And more specifically, these may be people who have developed high blood pressure now, but did not struggle with it throughout their life."

Catherine Roe, an assistant professor of neurology at Washington University School of Medicine in St. Louis, said the findings seem to "fit with what we know about high blood pressure".

Read: Brain structure influences thinking
"High blood pressure during middle-age is a risk factor for later development of dementia," Roe said. "That's pretty clear from past research. But the study results have been mixed on whether high blood pressure for people in their 60s and 70s is related to cognition problems or not." Cognition refers to thinking and memory.
It appears that high blood pressure becomes less of a risk factor for mental decline in old age, Roe added. However, "high blood pressure is probably still bad for a lot of other reasons," she said.
Perhaps people who live to very advanced ages have a kind of "super health" that helps them withstand the impact of high blood pressure, she suggested. 

2014年7月13日 星期日

Blowing mind games up in smoke


Blowing mind games up in smoke
REPRESENTATION PIC
HEALING THROUGH DRUGS?

Many psychiatric patients as young as 14 years, have taken to self-medication with mind-altering substances to gain control over medical disorders

Ruhi, a resident of Vashi, was hit by an overpowering libido when she was barely 13-and-half years old. Not only did she take to unprotected sex with strangers, she even forced her 11-year-old brother into oral sex. She also had a sex clip made of herself in the act and let it go viral.

By 15, not knowing how to deal with her irrepressible nymphomaniac tendencies, she turned to methamphetamine and cocaine. Substance abuse gave her control over her personality disorder, but the minor's selfmedication brought her to the doorstep of a Pune-based NGO, a couple of weeks ago, to cure her of her new addiction.

It is a given that many junkies take to drugs to fight depression or other psychological issues. These were mostly people who have not recognised their state as a clinical condition but just drifted to substance abuse. But lately, de-addiction centres are noting that some cases, alarmingly many of them minors, coming to them are known clinical psychiatric patients who have turned to narcotics as a self-medication initiative.

Twenty-year-old Tejas, from Pune, in his final year of graduation in commerce, was diagnosed with schizophrenia. He had spiritual hallucinations about the deity Ram, perched atop a mountain. He was prescribed anti-depressants. But struggling with drug adherence, Tejas' condition worsened. Putting away his prescription, he sought solace in marijuana. The cannabis rid him of the apparition that haunted him, but also hooked him into a dependency he could do without.

Waking up to his conditions, his parents brought him to Practical Life Skills De-addiction and Rehabilitation Centre, Pashan. Pune's sixteen-year-old Aditya, in his junior college studying commerce, was on anti-depressants to cope with his clinical condition. But the medication was not helping, when his friends introduced him to the joy of sniffing glue. Aditya's depression drove him to masochistic behaviour and he often nicked or inflicted other physical abuse on himself. The glue came to his rescue.

After eight months of sniffing glue, his failing health caught his parents' attention, who dragged him to the deaddiction centre last month. "In past couple of months, we have admitted about six such cases, all aged between 15 and 24, who have indulged in self-medication with mind altering or mood changing substances.

More than alcohol, children as young as 15-16 are trying to take care of their psychiatric inconsistencies with substance abuse," noted Indrajit Deshmukh, project head at Practical Skills. "Our in-patient department (IPD) earlier dealt largely with people above 40 years in age. However, in the past eight to 10 months we are seeing a stream of young patients mostly in the age bracket of 14 to 20 years.

Many of them took to substances in the hope that they would be cured of their mental distress." said Dr Nitin Dalaya, director at the Nityanand Rehabilitation Centre, a 300 bedded facility at Katraj. Most of his patients come from Maharashtra, Madhya Pradesh, Gujarat and Goa. "Some of these kids have even graduated to multiple/poly-drug abuse.

The new thing going around is a combination of Vicks Action 500 along with Nitrazepam, Nitravet and Spazmo Proxyvon, These drugs taken in combination, yield a high far above what comes from cocaine or marijuana. Their physical impact is also equally exponential and prolonged use can use can lead to renal and liver failure or gastric ulcers.

We had two teenagers from Mumbai who had come with renal failures within four months of doing this permutation," Dr Dalaya said. "The age of people with diagnosed clinical psychiatric condition taking to self-medication in this manner, have certainly come down.

Cannabis is the preferred substance for them. Since at Muktanagan we don't admit kids of that low age we cannot give the details, but yes, in the last seven-eight months we were approached by many cases aged between 15 and 18, who we redirected to centres that do pediatric admissions," said Sanjay Bhagat, project co-ordinator, Regional Resource and Training Center West Zone 1, and coordinator at Muktangan De-addiction and Rehabilitation Centre. He added that the rising numbers indicate an urgent need to educate children on the adverse effect of such abuse.

Apart from the de-addiction centres, even psychiatrists are aware of this rising number of patients switching to illegal stimulants as selfmedication. "Five years ago, I would barely get a teenager patient who had taken to narcotics despite being a clinically diagnosed psychiatric patient. In the last six months, however, I have seen over 20 such cases.

All the cases were aged between 15 and 25 years,"said Dr Amod Borkar, a psychiatrist with private practice at Karve Nagar. Dr Ulhas Luktuke, life fellow at the International Council of Sex Education and Parenthood and life fellow at Indian Psychiatrists Association, too acknowledging the increasing trend of self-medication with drugs, pointed out, "Easy accessibility to the drugs and the absence of watchful eyes in a nuclear family is engendering this situation.

More than medication, what is required here is sensitisation of parents through workshops, so they have a better understanding of their growing children and provide the necessary support to them."

►►► We are seeing a stream of young patients between 14 to 20 years who took to substances to be cured of mental distress

- DR NITIN DALAYA, Director, Nityanand Rehabilitation Centre

2014年7月12日 星期六

Report: Patient-Generated Data Will Help Shape Future of Medicine

from: http://www.ihealthbeat.org/articles/2014/7/11/report-patientgenerated-data-will-help-shape-future-of-medicine

Report: Patient-Generated Data Will Help Shape Future of Medicine


Patient-generated data will play a critical role in the future of medicine and will help shape the evidence base that physicians, patients and policymakers use to improve the quality of care, according to an analysis published in Health Affairs, Modern Healthcare's "Vital Signs" reports (Conn, "Vital Signs," Modern Healthcare, 7/9).

Report Details

from: http://www.ihealthbeat.org/articles/2014/7/11/report-patientgenerated-data-will-help-shape-future-of-medicine

For the analysis, Duke University researchers examined the effect of collecting real-world data directly from 


patients as opposed to gathering such data through randomized controlled trials (Dvorak, FierceHealthIT, 7/10).
The authors defined patient-generated data as patient-reported outcomes.

Report Findings

The report found that patient-generated data will be "critical to developing the evidence base that informs decisions made by patients, providers and policymakers in pursuit of high-value medical care."
Specifically, the researchers wrote that the "key to high-quality, patient-generated data is to have immediate and actionable data" that allows patients to realize the importance of the data for research, as well as their personal care.
They added, "The easier it is for patients and clinicians to navigate [personal data], the more relevant that information will be to patient care, the more invested patients and clinics will be in contributing high-quality data, and the better the data in the big-data ecosystem will be" ("Vital Signs," Modern Healthcare, 7/9).
The researchers noted that physicians are increasingly using data captured directly from patients to help understand patients' health outcomes. They added that the ability to capture such data is growing in part because of the widespread adoption and use of electronic health records and monitoring devices.
However, they noted that full EHR implementation and interoperability have yet to be achieved (FierceHealthIT, 7/10).
In the meantime, the researchers recommended that physicians take simple steps to better familiarize patients the data collection efforts, such as by physicians telling a patient that they have seen their "symptom report" ("Vital Signs," Modern Healthcare, 7/9).