2012年10月4日 星期四

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Depression blog to take a break
Oct 4th 2012, 05:00


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  • Depression blog

  • Oct. 4, 2012

    Depression blog to take a break

    By David Mrazek, M.D.

Dear visitor,

The depression blog is transitioning to a new medical editor. Dr. David Mrazek, long-time medical editor of this blog, appreciates your support and sharing of your personal stories. Many of you have been kind, caring and thoughtful in trying to help each other.

Need more help?
  • National Suicide Prevention Lifeline
    1-800-273-TALK (8255)
  • Go to the nearest hospital or emergency room
  • Call your physician, health provider or clergy
  • National Alliance on Mental Illness
    www.nami.org
    1-800-950-NAMI (6264)

For those of you who may need immediate help, please use the toll-free phone numbers and websites seen on the blog.

As we make this transition, please continue to read the blog and comments. We'll suspend the ability to post new comments until our medical editor comes on board to participate.

Mayo Clinic appreciates your support and patience until we resume active blogging.

Sincerely,

The staff at MayoClinic.com

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What will it take to reverse the obesity epidemic?
Oct 3rd 2012, 05:00

  • image.alt
  • With Mayo Clinic nutritionists

    Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

    read biography

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  • Nutrition-wise blog

  • Oct. 3, 2012

    What will it take to reverse the obesity epidemic?

    By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

The prestigious medical journal "JAMA" recently devoted an entire issue to the topic of obesity — from research on risk factors for childhood obesity to outcomes of gastric bypass surgery. It also provided a wide range of viewpoints on the role of genetics, medications, environment, online apps, self-control and the government in the "battle of the bulge."

Also just released was the Trust for America's Health and the Robert Wood Johnson Foundation report "F as in Fat: How Obesity Threatens America's Future 2012." The report reveals staggering statistics about obesity. It also forecasts the 2030 adult obesity rates for each state and the associated rise in obesity-related disease and health care costs:

  • Currently 35.7 percent of American adults and 16.9 percent of children ages 2 to 19 are obese (defined as a body mass index over 30).
  • If trends do not change, by 2030 the obesity rate for adults could top 44 percent nationally. In addition, rates could exceed 50 percent in 39 states and 60 percent in 13 states.
  • Currently more than 25 million Americans have type 2 diabetes, 27 million have chronic heart disease, 68 million have hypertension and 795,000 suffer a stroke each year. Approximately one in three deaths from cancer each year (approximately 190,650) are related to obesity, poor nutrition or physical inactivity.
  • In the next 20 years, obesity could contribute to more than 6 million cases of type 2 diabetes, 5 million cases of coronary heart disease and stroke, and more than 400,000 cases of cancer.
  • By 2030 costs associated with treating preventable obesity-related diseases are estimated to increase by $48 billion to $66 billion a year. The loss in economic productivity could be between $390 and $580 billion annually.
  • It's also projected that if the average body mass index was reduced by just 5 percent by 2030, thousands or millions of people could avoid obesity-related diseases, thereby saving billions of dollars in health care costs.

I'm encouraged that these reports show that we're getting serious about obesity and acknowledging that it's a massive public and personal health problem. Health care professionals are no longer pessimistic in their approach to obesity. Government is funding research into causes, effects, prevention and novel treatments.

There is no "silver bullet" and it will take the combined efforts of every segment of society to address this disease. This is nothing new. After all this is what it took to address other public health threats, such as HIV/AIDS, infant mortality, polio, car safety and tobacco.

I want to add that the most important aspect of reversing the obesity epidemic is personal responsibility and taking care of ourselves, our family and friends.

What are you contributing to the solution? You might start by watching the short video "The Obesity Epidemic" on the Obesity Society website: www.obesity.org/news-center/the-obesity-epidemic.htm.

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References
  1. Livingston EH, Zylke JW. Obesity: A JAMA theme issue. JAMA. 2012;308:1063.
  2. F as in fat: How obesity threatens America's future 2012. Trust for America's Health and the Robert Wood Johnson Foundation. http://healthyamericans.org/report/100. Accessed Oct. 1, 2012.
  3. The obesity epidemic. Obesity Society. http://www.obesity.org/news-center/the-obesity-epidemic.htm. Accessed Oct. 1, 2012.

Cultural shift under way in addressing Alzheimer's
Oct 2nd 2012, 05:00

  • Alzheimer's blog

  • Oct. 2, 2012

    By Angela Lunde

With the Alzheimer's epidemic on our doorstep, the fight is on. Over the past couple of months, many of you have written to express that while prevention and cure is a noble and necessary fight, it isn't the only fight. I wholeheartedly agree — our biggest fight may be about something else.

The fight I'm speaking of is about a making a dramatic shift in how persons with dementia are viewed, cared for and integrated into our communities.

It's a shift from perceiving people living with dementia in a "disability" way with a degenerative disease without a cure, to seeing a person living with dementia as a whole person.

Persons living with dementia (Catherine and Carole, for example, who've written in previous postings) have demonstrated that having dementia is about the continuation of living life to the fullest, of maintaining a sense of meaning and purpose, and of fulfilling needs that are at the core of who they (and all of us) are.

Persons living with dementia teach that we're all mortal, and that living life is about experiences and relationships — that never changes.

Yet, many see a person with Alzheimer's or a related dementia as someone "less than" and as someone who can longer contribute. Current approaches to care often exclude persons living with dementia from decision-making.

Persons with dementia are viewed as incapable of communicating their experiences, and thus unable to make meaningful contributions to their own lives and the lives of others.

A symptom of dementia is a change in verbal communication skills, and society often marginalizes those who can't communicate or who communicate inappropriately.

Behavioral disturbances from a person living with dementia cause them to be labeled as "bad", "challenging" or "diseased" instead of just being frustrated at being unable to communicate effectively.

As an example, it's not uncommon for a person living with advanced Alzheimer's to repeatedly cry out, "Help me, help me." A nurse or staff person may respond to this by assessing whether the person is hungry, wet, in pain or any number of physical conditions. If all of these conditions fail to determine a possible cause, the person may be labeled as difficult or attention seeking. As a result, staff may ignore the behavior (hence the person), and consequently the cries may get louder.

For the person with dementia, the cries may be the only way they have of reaching out. Reaching out for what you might ask. I would strongly suspect they're seeking love — a reassuring human connection.

As a society, we fail to remember that although persons living with dementia may be losing their cognitive powers, their capacity to experience and feel as human beings is largely unaffected. Their need to give and receive love, feel useful and worthy and maintain purpose remains unchanged.

There's some good news, however — a cultural shift is unfolding. I've seen progress, but we have a long way to go and many obstacles to overcome.

The first step occurs when we start seeing a person living with dementia as a full and complete human being. Another shift will take place when persons living with dementia are embraced and immersed into society in a way that accommodates instead of isolates. And someday, we will come to a place where persons living with dementia are no longer defined by their diagnosis; they will simply be ... Catherine or Cathy.

Research will continue to seek new medications and other medically based treatments to prevent or cure Alzheimer's and related dementias. This is important. Yet, the fight is about seeing people living with dementia as complete and whole. The fight is about training care staff in the art of relationships not simply medical care. The fight is about a nation coming together to find better ways to care for one another.

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