Sunday, 19 June 2016

Princess Health and AMA, led by Ky. doctor, says gun violence is public-health crisis; calls for research, background checks, waiting periods for all guns. Princessiccia

The American Medical Association, led by a Kentucky emergency-room physician, declared gun violence a public-health crisis last week and endorsed waiting periods an background checks for purchases of all firearms, not just handguns.

"The AMA, the country's largest doctor group, also vowed to lobby Congress to overturn a decades-old ban on gun violence research by the Centers for Disease Control and Prevention," two days after the Orlando shooting that left 49 dead and 53 wounded, reports Kimberly Leonard of U.S. News and World Report. "The AMA joins the American College of Physicians in its position, which has been calling gun violence an epidemic since 1995."

Dr. Steven Stack
AMA President Steven Stack of Lexington said the research "is vital so physicians and other health providers, law enforcement and society at large may be able to prevent injury, death and other harms to society resulting from firearms. . . . With approximately 30,000 men, women and children dying each year at the barrel of a gun in elementary schools, movie theaters, workplaces, houses of worship and on live television, the United States faces a public-health crisis of gun violence."

Leonard notes, "Federal law doesn't technically outlaw the CDC from studying gun violence, but prohibits the agency from using federal dollars to advocate or promote gun control. Though President Barack Obama lifted the research ban through executive order nearly three years ago, Congress has blocked funding for these studies."

The National Rifle Association has called the public-health approach a back-door path to more gun control, Leonard writes, and "has said that doctors shouldn't be asking patients about gun ownership because they are not gun safety experts."

"Who will Congress listen to now: the healers or the merchants of death?" Lexington Herald-Leader columnist Tom Eblen asked to start his Sunday column. "The AMA's stand is unlikely to change anyone�s mind about gun control. But it underscores the absurdity of Congress� two-decade effort to block legitimate scientific research that could reduce gun deaths and injury."

Suicides accounted for about two-thirds of the 33,390 firearms deaths in the U.S. in 2014. The CDC "said 627 people were killed in Kentucky that year with firearms, a rate of 13.8 per 100,000 population, higher than the national average of 10.2," Eblen reports. He said research on gun violence could reduce those figures, just as research into auto accidents has reduced such fatalities.

Read more here: http://www.kentucky.com/news/local/news-columns-blogs/tom-eblen/article84482382.html#storylink=cpy
Read more here: http://www.kentucky.com/news/local/news-columns-blogs/tom-eblen/article84482382.html#storylink=cpy

Saturday, 18 June 2016

Princess Health and  June 18th, 2016 Long Day. Princessiccia

Princess Health and June 18th, 2016 Long Day. Princessiccia

June 18th, 2016 Long Day

It's been a long day. I traveled to Edmond on a business related trip then made it back into the area just in time to be the guest DJ for the wedding of a former colleague's daughter.

Good thing I rested well last night! I'm planning on a good long sleep tonight, too.

I maintained the integrity of my maintenance calorie budget. I remained abstinent from refined sugar and I exceeded my daily water goal.

Keeping tonight's edition short. I'm looking forward to a nice, relaxing and restful Father's Day.

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Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Panel considers involuntary, court-ordered outpatient treatment for mentally ill; foe says would infringe on personal rights. Princessiccia

            Princess Health and  Panel considers involuntary, court-ordered outpatient treatment for mentally ill; foe says would infringe on personal rights. Princessiccia



Representatives from five groups involved in mental health offered legislators solutions June 15 for ending the revolving door between hospitalization, incarceration and homelessness that often exist for those with severe mental-health conditions.

Many who spoke at the three-hour meeting of the  Interim Joint Committee on Health and Welfare said judges should be able to order mentally ill adults who meet strict criteria into an "assisted outpatient treatment" program. Others said that would add costs and a burden to the judicial system, and infringe on personal liberties. But all agreed that the state lacks resources to care for such adults.

Shelia Schuster, executive director of the Kentucky Mental Health Coalition, voiced strong support for the idea. She said its main goal would be to create a narrowly defined program "to access supported outpatient treatment under a court order, again without having to be involuntarily committed or coming through criminal justice system."

Now, a mentally ill person who needs care but does not want it can only be court-ordered into treatment after being released from a hospital or jail.

Various versions of this legislation have have been filed in the General Assembly since 2013. Last year's version, House Bill 94, passed out of the Democrat-led House, but died in the Republican-led Senate. The bills are often referred to as "Tim's Law," named for Tim Morton, a schizophrenic who was hospitalized involuntarily 37 times by his mother because this was the only way she could get him the treatment he needed. Morton died in 2014.

�We do want to make sure that those individuals, like Tim Morton, who are very ill and who are unable to recognize it, who spend much of their lives in the revolving door of hospitalization, homelessness, or incarceration, are afforded a new opportunity to stay in treatment long enough to see the positive effects and the road to recovery,� Schuster said.

Steve Shannon, executive director for the Kentucky Association of Regional Programs, said the state needs assisted outpatient treatment to keep those with mental-health conditions out of the criminal justice system.

"If we can keep a person out of criminal justice involvement, it is better for them, " he said. "Folks have enough challenges already; why add that piece to it? . . . It affects housing, it affect employment."

Shannon also proposed that the state seek a Medicaid waiver to help pay for housing and supported employment for such adults, and a spend-down option to allow the poor on Medicare to also get Medicaid, which offers more services.

Jeff Edwards, division director of Kentucky Protection and Advocacy, who supports does not support Tim's Law said "assertive community treatment" teams are already available to this population, but only on a voluntary basis. He also noted that the ACT program is laden with issues, including geographical access, wait times to get services, and frequent staff turnover.

"Right now, you have to live in one of 56 counties to get the ACT services," he said. "We have to expect quality services, no matter where a person lives in the state."

Ed Monohan of the Department of Public Advocacy, a long-time opponent of the court-ordered treatment model, said  he supports enhancing the ACT teams, which provide a comprehensive array of community supports to this population through individual case managers who are available 24 hours a day.

"Long-term, engagement with clients, with people, is a far superior long-term strategy than coercion through a court system," Monohon said. "The mental-health system, rather than the court system, is the better place to really address this long-term. ... Their liberty is at stake with this coercion."

"I know it is about civil liberties and the rights of individuals, but for them, in the disease process, they have lost the ability sometimes to make those decisions clearly for themselves," said Rep. Addia Wuchner, R-Florence, after sharing deeply personal stories about a family member who had severe mental illness.

During an impassioned plea of support for Tim's Law, Kelly Gunning, director of Advocacy National Alliance on Mental Illness in Lexington, told the story of how her son, while under the care of an ACT team, "brutally assaulted" both her and her husband in January. She emphasized that while the ACT program does offer a "robust array of services," it is based on voluntary compliance.

"They are voluntary. Do you hear me? They are voluntary! If my son doesn't want to open the door for his ACT team, or his doctor who comes to his home, he doesn't have to," she said. "And (as) we were cleaning out his home, we found a years stockpile of medication untouched, untaken because he doesn't believe he has an illness."

Allen Brenzel, clinical director with the state Department for Behavioral Health, Development and Intellectual Disabilities, along with many others at the meeting, acknowledged that a lack of resources is a large part of the problem.

"I mostly hear unity around the issue that we must do better," he said, adding that not only assisted outpatient treatment is needed: "It's going to be the allocation of resources and the moving of resources to appropriate places."

Committee Co-Chair Sen. Julie Raque-Adams, R-Louisville, encouraged the group to examine this issue "holistically" and committed to working on a solution. "Across the board, this is one of those issues that we can no longer stick our heads in the sand and ignore,"' she said.

Friday, 17 June 2016

Princess Health and  June 17th, 2016 A Day, Better Rested. Princessiccia

Princess Health and June 17th, 2016 A Day, Better Rested. Princessiccia

June 17th, 2016 A Day, Better Rested

Mom and I had a good visit last evening. I picked her up from her doctor's appointment and after a couple of stops, and deciding it was too early for dinner, we settled at a Starbucks. She had some reading material and I worked on this blog.

Dinner was great, the visiting is always good--and I was able to get home and go to bed at a relatively decent time. The extra sleep had a noticeable effect on my day today. It was an accomplished day. I made a list of things to get done and marched right through the list. It's funny because I act so surprised when I experience a day, better rested. I needed a better rested day because today was twelve hours.

I really enjoy my weekend nights when I know I can sleep in the next morning. I'm a night person by nature. This is my time. And I'll still get a full seven or eight hours sleep.

I enjoyed preparing an amazing dinner tonight. It was a challenge! I like occasional cooking challenges. My goal: Enjoy a fried catfish dinner with a confident/accurate as possible, calorie count. I accomplished the goal. The Live-Tweet Stream contains the process.

I completed a nice workout in my living room tonight. Body weight strength training exercises really work well for me. So well, I'm questioning why I don't do this longer version of the #morningdeal, more often. It feels great.  This is absolutely something for me to consider a little more.

I'm sleeping in on my Saturday morning. And I'm looking forward to it like you wouldn't believe.

The integrity of my daily maintenance calorie budget was maintained. My abstinence from refined sugar remains solid (779 days and counting). I participated in a few one on one support exchanges. I enjoyed some kitchen creativity. I exceeded my daily #watergoal and my home workout was fantastic.

It's really been a great day. I needed a good one.

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Thank you for reading and your continued support,
Strength,
Sean

Princess Health and Donna Arnett, new UK public-health dean, says research is important to reducing Kentucky's huge health disparities. Princessiccia

Donna Arnett, dean of the College of Public Health at the University of Kentucky, says research is essential to reducing Kentucky's huge health disparities, as illustrated by the recent release of data showing a wide range in life expectancy among counties.

In a UK news release and video, Arnett, a genetic epidemiologist and native of London, noted the "devastating impact" that obesity, diabetes, cancer, drug-abuse and overdose deaths have in her native state.

�Public health is at the heart of answering the challenges of those critical diseases in Kentucky, " Arnett said. "We in public health are really at the forefront of first detecting these epidemics, and then finding strategies and interventions to help eliminate those disparities.�


Arnett's passion for research began during her early career as a nurse when she was working next to a dialysis clinic at a Department for Veterans Affairs hospital and noticed that more African-American men were sent to the clinic than men of other races.

�I�ll never forget, in my hallway in this VA hospital, every day men would be coming down the hallway, and they�re almost all African American,� Arnett said. �I said, �You know, there has to be something about being African American and having kidney failure.��

This prompted her to create an informal hypothesis that this was linked to a genetic code in African American men that put them at a higher risk of kidney failure. She was right. While her original hypothesis evolved, it was validated after numerous studies.

Arnett obtained a doctorate in epidemiology from the University of North Carolina and built a career in public health. She has received research funding from the National Institutes of Health for more than 20 years, and brought three active NIH projects to UK when she became dean of the public-health college in 2015. Among other leadership roles, she has served as the president of the American Heart Association.

Serving as AHA president showed Arnett that "solving the most urgent health problems in the nation requires the collaboration among different professionals and organizations devoted to health and uniting the research efforts and knowledge of diverse investigators," and she is working to establish partnerships across the state, the UK release and video say.

"Science now is really multi-disciplinary," Arnett said, "so we have to function in a team."

Thursday, 16 June 2016

Princess Health and  June 16th, 2016 Yes Man. Princessiccia

Princess Health and June 16th, 2016 Yes Man. Princessiccia

June 16th, 2016 Yes Man

I really did it all wrong last night. It was an epic learning experience. 

I'll spare you the specific details of my schedule because those aren't the point or problem. Last night, I put myself in a very poor time management situation. My path to this was my occasional tendency to say "yes" when the best thing for me to do, was say "no." 

I've improved dramatically in this area. I spent a lot of years being a "yes man." I was always a yes man because I was afraid to say no, in fear someone might not like me. The interesting thing is this-- I didn't like me, so my constant search for external signs of love and acceptance was a primary focus, hoping-if enough people liked me, maybe I could be convinced I was worthy, somehow. And saying yes every time, even if it was the opposite of what was truly best for me in a particular situation, was-in my mind, the path to fixing this internal dislike. Trying to be everything to any and everybody, left me lost and hollow, most of the time.

I no longer operate that way. I love me, fully and unconditionally. And I don't give two flips if someone doesn't like me for whatever reason. They don't even need one, it's cool. It's none of my business why someone wouldn't.

I'm fine because I'm okay with me.

And that peace and calm is something I never knew or understood before this transformation. My brain is no longer constantly trying to answer the question, "will I be loved/liked?" My decisions are no longer dictated by this constantly running program. The program has been removed from my system directory. Because I'm okay with me. 

So what happened last night? Well, occasionally I still say yes when I need to say no. But it's not because I want to be liked or loved by someone. Now, it's difficult if it's someone for which I have enormous respect and admiration, and if that person is a loved one, a friend, a colleague or client--it's extra challenging. I love to listen to people's stories. So if I'm genuinely engaged in a fascinating conversation and the other person asks, "Do you have time for this?" I will sometimes say yes when I should have exited the conversation forty-five minutes ago. Or an hour and forty-five minutes ago.

The other part of the deal that became last night's epic learning experience was the accountability factor.

Maintaining integrity with accountability measures is something on a sacred level. It must be or the accountability measure loses its effectiveness.

I exchange goals with a few people each day. I typically include my list of non-negotiable elements. It basically looks like: "My goals today: Maintain the integrity of my calorie budget, remain abstinent from refined sugar and meet or exceed my daily water goal. I will do these things." And on a day when I feel I can't go another without a really good workout, I'll make an accountability declaration like I did yesterday: "I will go to the gym for a great workout, come what may."

Come What May. 

The idea of "come what may" is usually thought of as outside forces/circumstances, not circumstances created by less than the better choices.

To wrap this up-- and tie it all together, I was working out at 12:30am while listening to Arianna Huffington speak about the critical importance of getting enough sleep on Dan Harris's 10% Happier podcast. My life is often rich in irony.

I kept my accountability declaration. And I felt great about that--because I had violated one the day before--and there wasn't any way I was about to break another. Maintaining integrity with accountability measures is critically important.

The key is making sure what I'm declaring to do is something I can do--and something I plan into my schedule--and understanding, what I do leading up to it makes a big difference...in other words, how I manage my time. If I'm not managing my time well, I shouldn't engage in "come what may" accountability declarations.

I take it serious for a reason. Without this importance level, I'd still be over five hundred pounds or six feet under at this point.

I highly recommend listening to Arianna Huffington on Dan Harris's podcast. She said many things that run parallel to what I've explored and discussed within these pages. One thing after another popped out at me. I'm absolutely buying her new book, The Sleep Revolution.

It's been a very long day. I'm about to have dinner with mom and head home. I'll be dropping in bed at a great time tonight. I do not want to endure this self-imposed feeling of exhaustion, tomorrow.

I'm learning. I'm absolutely learning. Good things, good things.

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Thank you for reading and your continued support,
Strength,
Sean
Princess Health and  Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee. Princessiccia

Princess Health and Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee. Princessiccia

"Accidental overdoses aren't the only deadly risk from using powerful prescription painkillers," The Associated Press reports. "The drugs may also contribute to heart-related deaths and other fatalities, new research suggests."

A study of of more than 45,000 Medicaid patients in Tennessee from 1999 to 2012 found that "those using opioid painkillers had a 64 percent higher risk of dying within six months of starting treatment compared to patients taking other prescription pain medicine," AP reports. "Unintentional overdoses accounted for about 18 percent of the deaths among opioid users, versus 8 percent of the other patients."

"As bad as people think the problem of opioid use is, it's probably worse," said Vanderbilt University professor Wayne Ray, the lead author of the study report. "They should be a last resort and particular care should be exercised for patients who are at cardiovascular risk."

The report in the Journal of the American Medical Association noted that opioids can slow breathing and worsen the disrupted breathing associated with sleep apnea, which could lead to irregular heartbeats, heart attacks or sudden death.

The patients in the study "were prescribed drugs for chronic pain not caused by cancer but from other ailments including persistent backaches and arthritis," AP reports. "Half received long-acting opioids including controlled-release oxycodone, methadone and fentanyl skin patches. . . . There were 185 deaths among opioid users, versus 87 among other patients. The researchers calculated that for every 145 patients on an opioid drug, there was one excess death versus deaths among those on other painkillers. The two groups were similar in age, medical conditions, risks for heart problems and other characteristics that could have contributed to the outcomes."