Use THRIVE to reduce sexual violence against children

A recent report released June 5 by the Centers for Disease Control and Prevention showed that sexual violence against children is on the rise – particularly in seven countries. The United States was not among that list, but that does not mean our children are free from that type of violence.

In the report, the CDC found that in most countries more than 25% of females and more than 10% of males reported experiencing childhood sexual violence. In about half of the countries, more than 10% of women reported unwanted penetrative sexual encounters. Interestingly, many of those children who sought services (which were very few) did not receive them. What’s wrong with this picture?

The countries in the report were Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe. All of the abuse cases were reported between 2007 and 2013, thus, the data is very new. The biggest concern here is not only that the children were sexually abused, but that services were not provided to assist them at the time of the incident  – even when they were sought out.

In the United States, the statistics are very similar. The National Sexual Violence Resource Center reported that more than 20% of all children are sexually abused before the age of 8 while 24.7% of girls and 16% of boys are sexually abused before age 18. In addition, 14% of those children were under age 6 at the time of the encounter; and about 40% of the time, the abuser was a family member.

While the CDC’s recent report doesn’t include the US statistics, the agency does recognize that children is just about every country are sexually abused.

As a result of the recent CDC report, a new strategy was developed to help countries such as those researched by the CDC reduce violence against children. The THRIVES strategy is a group of actions that reflects  evidence-based practices to help reduce and potentially eliminate violence against children. This strategy includes:

T = Training in parenting. This will assist parents in how to reduce violence in the home and to also recognize potential abuse in your child.

H = Household economic strengthening. This area provides economic security that will reduce various acts of violence prompted by economic pressures that may occur in the home.

R = Reduced violence through protective policies. Creating laws and regulations with accompanying strict punishments can assist with violence reduction.

I = Improved services. Offer services to all who need them, no one should be turned away.

V = Values and norms that protect children. The idea here is to change attitudes that promote violence against children. This includes a paradigm shift in attitudes, values and beliefs in particular as they relate to children.

E = Education and life skills. This includes family education as well as in-school academic knowledge that builds life skills and empowers children to prevent date violence and rape, particular against girls.

S = Surveillance and evaluation. To ensure other policies and procedures are in place and working effectively, it is important to monitor and evaluate them on a regular basis.

 

While the strategies were specifically developed for those aforementioned countries, they are certainly applicable for families in the United States. If you suspect abuse of a family member or neighbor, you should report it to the police.

 

Works used for this article:

National Sexual Violence Resource Center. (2015). Sexual violence against children. Retrieved from http://www.nsvrc.org/projects/lifespan/sexual-violence-against-children

Prevalence of sexual violence against children and use of social services in seven countries – 2007-2013. (June 5, 2015). Morbidity and Mortality Weekly, 64(21), 565-569. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6421a1.htm?s_cid=mm6421a1_w

If Your Hair Could Talk

There’s a completely different world out there when it comes to drug testing. I recently had an experience where I needed to have a drug test as part of the hiring process for a part time job. Naïve as I am in this particular world, I thought that most everyone in the testing center was doing the same thing as I was doing, however, most of them were there for DUI testing, random drug tests as part of their probation, or court-ordered for a plethora of reasons.

From a public health standpoint, drug testing is important…and not just for alcohol abuse most commonly found in DUI incidents, but for various reasons of public and health safety. What was most interesting was learning from the testing site about the various kinds of drug tests that some people must endure. This includes the traditional urine analysis and blood tests, but also sweat tests, saliva tests and a rather new technique known as the hair follicle test.

Hair follicle testing is a hair screening that uses a small sample of hair strands to identify specific drugs that have been in the person’s body over 90 days. Who knew our hair could contain so much historical data on our personal habits?

The hair sample is cut close to the scalp, with at least 1.5 inches in length. Because they need multiple strands about the width of a pinky finger, several small strands are cut from various places on the head; thus, recipients do not come out with what might be considered a butchered haircut. Of interest, if the person’s head hair isn’t at least that long (such as in bald men), they can use chest hair or even pubic hair if necessary.

Drugs found through the follicles in your hair include cocaine, marijuana, opiates, methamphetamines, and phencyclidine. When there is suspicion for one of these drugs, the federal government actually mandates this type of test. Of interest, our hair can tell us an interesting story about our drug use. After a substance is ingested, metabolites are produced by the body as the drug circulates through the body. In essence, they enter and actually nourish the hair follicle, which then becomes part of the chemical make-up of your hair.

Every single hair on your body regenerates every 7 years, so it is impossible to go beyond that time frame for drug samples. The standard period of time used for hair follicle testing is 90 days because the likelihood of losing your hair from breakage or cutting is less likely.

The hair follicle test was discovered by accident in 1966-67 as a researcher was looking into tissue regeneration in rats. It was found that the properties of hair follicles contained significant information on cell properties. They are rather new, not even 50 years old yet.

The key in the public health world is that we are truly trying to keep you safe from harming yourself and others. Drugs and alcohol are elements that should not be part of your regular regime. Get caught and you may be subject to testing. It may be easy to trick someone with a urine test, but it’s much harder to tamper with your hair follicles.

 

Works used for t his article:

 

I Passed My Drug Test. (n.d.). Hair Follicle Drug Testing FAQ. Retrieved from http://www.ipassedmydrugtest.com/hair_drug_test_FAQ.asp.

Plikus, M. V. (2014). At the dawn of hair research – testing the limits of hair follicle regeneration. Experimental Dermatology, 23(5), 314-315.

There's a New BUG in Town

Now that summer is peeking over the horizon, those who live in the Northeast are preparing for flea and tick season. Most of us are aware of deer ticks and the potential for Lyme disease. But, there’s a new bug in town that may be just as deadly as its sister. This one is known as Powassan Virus

The disease is relatively new and was discovered in Powassan, Canada in 1958 when a 5-year-old boy died from encephalitis caused by the Powassan virus. While very few cases have been reported in the past, the incident rate is slowly rising with most of the cases coming out of Minnesota and New York. According to the Centers for Disease Control and Prevention, there have been 17 reported cases of the disease from 2004 to 2013 in New York and 20 from Minnesota over the same time span. Pennsylvania reported only 1 case.

That doesn’t really tell the whole story. Those numbers only represent those that were tested and reported. Cases of Powassan virus are often mistaken for other health issues. The Powassan virus can act like Lyme Disease but it can also cause two very distinct diseases: encephalitis and meningitis. Both illnesses cause inflammation in the head and brain: encephalitis is an inflammation of the brain itself and meningitis is an inflammation of the membranes that surround the brain and spinal cord. Both are deadly.

There are various strains of encephalitis, but the one closely connected to Powassan is TBE – Tickborne Encephalitis. The Powassan virus is not always caused by TBE but the virus is often not tested for either. Of interest, the focal areas of TBE are Europe and Asia with an average of 8,500 cases reported annually. For the most part, it is travelers who are at greatest risk of bringing TBE back to the states, if they are infected.

While human cases of Powassan are low, there have been more cases of the virus discovered in at least 38 other mammals including rodents, woodchucks, skunks, dogs, and cats.

A blood or spinal fluid test would be able to determine if the virus was in the body. This test must specifically look for antibodies that the immune system would make in order to detect viral activity. Lyme disease is very different from Powassan in that there is a treatment. Lyme disease is a bacterial disease that antibiotics can effectively treat. Powassan is a flavivirus similar to West Nile or Dengue fever and does not have a cure or treatment regime.

The North American Powassan virus is being classified as coming from a newly evolved subtype of the deer tick. According to the Expert Review of Anti-Infective Therapy, a journal focused on infectious diseases, the Powassan virus is specific to three tick species: Ixodes cookei, I. marxi and I. spinipalpus. To the general population, the names are useless, but for those in the field, this provides crucial information to track and monitor the potential spread of Powassan-carrying ticks. As it appears that the disease incidence is slowly rising, it is critical to stop the spread of the culprit ticks.

One of the keys to keep the Powassan virus at bay is through routine monitoring and tracking. If we can avoid spreading the disease, we can keep the incidence rates low.

Those at high risk for Powassan are those who live in wooded areas, particularly the same locations as you might encounter ticks and Lyme disease. What makes this virus so deadly is that it often doesn’t come with symptoms. The person simply just develops encephalitis or meningitis after as long as a one-month incubation period.

The best way to reduce infection is to avoid contact with ticks – much like you would to reduce your risk of contracting Lyme Disease. Treating skin and clothing with insect repellents while in heavily wooded areas are recommended as well.

If you find a tick on your skin, remove it quickly before it has a chance to bite. After being in the woods, it is best to do a full body check before you walk into your home. Check all pets and equipment as well. Then, shower within two hours after being outdoors.

If you have been or believe you have been bit by a tick, consult your healthcare provider immediately. While it may not be Lyme disease or Powassan virus, you certainly want to make sure.



Works used for this article:

Centers for Disease Control and Prevention. (2015). Powassan virus. Retrieved from http://www.cdc.gov/powassan/index.html

EI Khoury, M. Y., Camargo, J. F., and Wormser, G. P. (2013). Changing epidemiology of Powassan encephalitis in North America suggest the emergence of the deer tick virus subtype. Expert Review of Anti-Infective Therapy, 11(10), 983-985.

El Khoury, M. Y., Camargo, J. F., White, J. L., Backenson, B. P., Dupuis II, A. P., Escuyer, K. L., Kramer, L., St. George, K., Chatterjee, D., Prusinski, M., Wormser, G. P., and Wong, S. J. (2013). Potential role of deer tick virus in Powassan encephalitis cases in Lyme Disease-endemic areas of New York, USA. Emerging Infectious Diseases, 19(12), 1926-1933.

 

 

Head Transplants: Frankenstein or Science Fiction?

While public health is more aligned with population well-being, professionals are keeping a watchful eye on the recent talk of the first-ever human head transplant that has been in the news lately.

For those who may not have been paying attention to the medical news lately, reports from various reputable sources have found that Italian surgeon Dr. Sergio Canavero plans to conduct the world’s first human head transplant within the next two years. He actually has his patient set and ready to go. The donor body has yet to be identified.

Canavero first proposed the idea two years ago as a means of extending people’s lives whose bodies have been riddled with illnesses, cancers, or other incurable medical disorders. The first patient willing to have his head transplanted onto a new body is Valery Spiridonov, a 30-year-old Russian who suffers from Werdnig-Hoffman disease, a genetic disorder that causes his muscles to deteriorate. A donor body will be attached to Spiridonov’s head through spinal cord fusion, a process that has had some success in animals.

The first successful animal head transplant took place in 1970 where the head of a monkey was transplanted onto the body of another primate. The monkey lived for nine days before the body rejected the new organ. However, in the 1970s, there were few processes and medications that helped to keep transplanted organs from being rejected. Since then, the invention of drugs that assist with the acceptance of transplants, such as with lungs and hearts, can reduce the risk of rejection significantly.

For a head to be transplanted onto a new body, the spinal cord of the donor body will have to be fused onto the spinal cord of the recipient’s head. The process was described in a recent issue of the journal Surgical Neurology International.

What are the consequences for society if we are able to successfully transplant heads? Are we moving closer to the Frankenstein movies of the past or the upcoming science-fiction movies that haven’t yet been created?

Looking at the progression of organ transplantation, the field has brought forth tremendous challenges, the biggest one being a shortage of organs. As most people are aware, there is an organ transplant waiting list for various operations: liver, kidney, lung, eyes, heart and so on. Then, another big concern is the issue of organ trafficking and transplant tourism. In some cases, organ donation was no longer a voluntary notion but one of coercion and profit-making. That brought up the issue of organ trafficking. In Germany in 2012, a significant number of patient records were tampered with to increase the number of organs that could be used for transplants. In other words, people were donating organs that they had no intentions of giving up.

Earlier, organ trafficking involved the forced removal of organs from people, mainly those in prison who were to be executed. The practice was very common in China. It wasn’t until 2001 when the public became aware of the unethical removal of executed prisoners’ bodies.  Chinese authorities claim that the organ harvesting took place after the execution with permission, but these official statements are still questioned today. It was later discovered that some Chinese hospitals were actually taking organs from living people without permission and under torturous conditions.

What about head transplants? Could this possibly happen to someone’s head? When a donor (with or without consent) provides a kidney, lung or part of a liver, that person can still live and breathe. When a head is removed from a person’s body, death is eminent. The ethical nature of head transplantation could become a huge human rights concern if we aren’t careful in how we handle it.

The ethics of the head transplantation project that will likely take place a few short years from now must be investigated now before human head trafficking occurs much like other organ harvests of the past. Bioethical committees in many countries are now looking into the potential concerns that will likely follow a successful head transplant.


Works used to create this article:

30-year-old Russian man volunteers for world’s first human head transplant. (April 13, 2015). Retrieved from http://www.medicalnewstoday.com/articles/292306.php

Thomson, H. (Feb. 25, 2015). First human head transplant could happen in two years. Retrieved from http://www.newscientist.com/article/mg22530103.700-first-human-head-transplant-could-happen-in-two-years.html

Trey, T., Caplan, A. L., and Lavee, J. (2013). Transplant ethics under scrutiny – responsibilities of all medical professionals. Croatian Medical Journal, 54(1), 71-74.

 

 

Sick or Hospitalized? What happens to your pet?

It’s no secret that pets are wonderful for people of all ages, especially as we age. They keep us grounded, providing stress relief, loneliness support, and regular activity. But, what happens if you live alone and end up sick or in the hospital? What do you do with your pet?

According to the American Veterinary Medical Association, 36.5% of households own a dog, 30.4% own a cat, 3.1% have birds, and 1.5% have horses. In most cases, that ownership expands to one or more pets in the same house.

Research shows that about 30% of people age 65 and older live alone, with most of those being women. Most of them do not care to live with their adult children as this is often viewed as a sign of dependence. The key is that they prefer to stay as independent as possible. Because living alone – at any age – can promote periods of loneliness, pets have become excellent companions.

Older adults find that owning a pet has various psychological, physical and social health benefits. As part of the companionship aspect, pets prevent depression and mental stress. One particular study even found that seniors with pets had fewer doctor visits than those without pets. They also provide exercise – dogs need walked and cats need to play. Furthermore, the social benefit occurs especially among dog owners as walking a dog promotes conversation with other dog walkers and strangers who just want to pet your puppy. For older adults, regular conversation and interaction with people is necessary for enhanced mental well-being.

Okay, so we know pets are great for your health, but what happens to those same pets if the senior who owns them becomes sick, hospitalized, or dies? What then? Many people don’t consider the possibility and family members end up scrambling to take care of their loved ones furry companion. The Michigan State University School of Law discovered back in 2000 that about one quarter of pet owners will include their pets in their wills. For those famous pets, such as those formerly owned by actors and actresses, they will truly be taken care of simply because they have the money to ensure that it does. For the rest of us, it’s not really a given even if the pet is listed in the will.

The University’s School of Law also said that in most cases where money is left in a will to take care of the pets, the act cannot be carried out because there is no legal entity to serve as the beneficiary to enforce that gift. The animal usually ends up in a shelter or euthanized.

To make sure your companion is taken care of through your illness, hospitalization, or death, the Humane Society of the United States suggests taking several actions now to ensure your furry friend(s) is well cared for.

1. Find at least two responsible friends or family members who will agree to serve as a temporary emergency caregiver. Write down feeding instructions, veterinarian information, and any relevant details that they should know about your pet.

2. Carry a wallet-size card with the names and phone numbers of these emergency caregivers. This way, if you are hospitalized or unable to make the calls yourself, this card will be handy. Keep it with your medication listing or medical alert information so it will be easily visible. Yes, you could even create a bracelet much like the medical condition bracelets that people often wear.

3. Place the same information on the inside of both your front and back doors in case you die or are incapacitated at home and are rushed to the hospital.

4. Draw up a formal agreement with your long-term pet caregivers and have it notarized. Check annually that they are still able to fulfill that agreement. Remember, circumstances change and one of your caregivers may have relocated to a place that does not allow pets. Always keep that agreement updated.


Keep in mind that if you do nothing for your pet’s future, do not assume that your pet will be re-homed through a local shelter.  Shelters are already overcrowded with homeless animals. You may run the risk of euthanasia if you do not have alternative arrangements. There are some organizations nationwide that offer “pet retirement homes” or “sanctuaries” but these are rare. They often require a fee or donation to reserve a place for your pet.

One more thing to bear in mind: your pet has been used to personal attention and affection. Being placed in a facility – even a retirement pet home – is like confinement or institutionalization. They truly do not want to be caged any more than you would want to be confined. Your best option is to arrange for a family member or friend to take your pets in the event of an emergency and/or death. Don’t wait until you’re already ill or gone…work on it now so that your furry companions will be able to spend the rest of their lives in a happy home.

 

Works used for this article:

American Veterinary Medical Association. (2012). U.S. pet ownership statistics. Retrieved from https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx.

Beyer, G. W. (2000). Pet Animals: What happens when their humans die? Retrieved from https://www.animallaw.info/article/wills-trusts-pet-animals-what-happens-when-their-humans-die

Hara, S. (2007). Managing the dyad between independence and dependence: Case studies of the American elderly and their lives with pets. International Journal of Japanese Society, 16(1), 100-114.

Humane Society of the United States. (n.d.) Providing for your pet’s future without you. Retrieved from https://www.petfinder.com/dogs/bringing-a-dog-home/providing-pets-future/

Do You Suffer from Exploding Head Syndrome?

Last week, I stumbled across a Yahoo! article that made me do a double-take: Exploding Head Syndrome.

Exploding what??

You may have run across it as well, yet, I wasn’t sure if this was scientific or a bunch of bunk. I did a little digging and discovered that “Exploding Head Syndrome (EHS)” actually exists. Research published last year in Cephalalgia, a journal published by the International Headache Society, looked into EHS as a significant and common occurrence among people when they move from sleep to awake and vice versa.

Of interest, this really isn’t a new phenomenon as it was discovered in medical literature dating as far back as 1890. It was described as a loud noise or pistol-shot in the brain. At the time, it was considered a significant disorder usually which occurred because the individual was suffering from another mental health disorder such as depression, compulsions or anxiety.

Thanks to modern science and research, we have learned that EHS is a benign disorder that occurs when people move from sleeping to waking or waking to sleeping. There is no pain involved; however, the violent boom can be terrifying and often described by individuals as pain.

Researchers found that explosion comes from the auditory neurons shutting down at once – basically crashing at once with a loud bang. Because of the extreme loudness in the head, people often mistake it for a seizure or a brain aneurysm. It is far more common in females than males. As reported in Cephalalgia, 61% of those suffering from EHS have been female ranging in age from 12 to 84. So, it can happen at just about any age; however, it is far more common among those in their 50s.

The American Sleep Association notes that EHS is not dangerous, but it does affect your ability to have a good night’s sleep. EHS is still associated with many mental disorders and some antidepressant drugs can eliminate the phenomenon. However, it has been noted that most often the main culprit is stress. The American Sleep Association strongly recommends that anyone suffering from poor sleep habits, not just EHS, consider stress-reducing techniques such as reading, yoga, music or a relaxing bath before bedtime.

Although it is not a significant health concern, the American Academy of Sleep Medicine strongly recommends that if your EHS is chronic (meaning that you have heard these noises regularly), that you may have something more serious such as another sleep disorder, a medical condition, mental health issue or substance abuse.

It is important to talk with your doctor about your EHS should it become a regular annoyance or if it significantly affects your ability to sleep.



Works used for this article:
American Academy of Sleep Medicine. (2014). Exploding head syndrome – overview and facts. Retrieved from http://www.sleepeducation.com/sleep-disorders-by-category/parasomnias/exploding-head-syndrome/overview-facts

American Sleep Association. (2015). Exploding head syndrome. Retrieved from https://www.sleepassociation.org/patients-general-public/exploding-head-syndrome/.

Birch, J. (2015). Exploding head syndrome: The weird sleep phenomenon that’s way more common than you thought. Retrieved from https://www.yahoo.com/health/exploding-head-syndrome-the-weird-sleep-115029839587.html.

Frese, A., Summer, O., and Evers, S. (2014). Exploding head syndrome: Six new cases and review of the literature. Cephalalgia, 34(10), 823-827.

 

Look left FIRST, then right…

One of the most annoying actions I have seen lately is the carelessness of drivers. I’m not referring to the speeders, the stop-sign runners or even the DUI offenders. I’m also not referring to the youth of today who may seem out of control when groups pile into one car for a joy ride through town. I’m referring to a simple rule that most of us seem to have forgotten: looking both ways before crossing the street!

The key here is “looking.” When you come to an intersection, the Pennsylvania Driving Manual states that you need to make sure the intersection is clear before proceeding. What it doesn’t say is how to do that. While it should be common sense, this simple act is not that simple for some people. The proper etiquette is to look left first, then right, then left. Regardless of which way you are turning (left or right) or going straight, you should always look to your left first because that direction displays the lane of traffic closest to you at that intersection. Once you look left, you need to look to your right – the lane farthest away from you – to check for oncoming traffic. Then, you look left again to double-check that the lane is still clear. After you established that it is safe, that you will not hit any person or another moving vehicle, you can continue on your way.

I cannot tell you how many times I have been nearly run into as a pedestrian, cyclist, or motor vehicle because someone did not look before pulling out at an intersection (usually a stop sign; sometimes out of a driveway). Just to ascertain that I wasn’t a personal target, I conducted an informal observation of my street intersection and found that nearly every vehicle pulled up to the stop sign, looked RIGHT only and then pulled out. Oh, and if they looked left at all, it was as they were pulling out…sometimes in front of other cars, pedestrians, or cyclists.

This is not a phenomenon unique to Pennsylvania roads…I’ve seen it many places in my travels across about half of our states. 

According to the Centers for Disease Control and Prevention, 4,743 pedestrians were killed in traffic accidents in the United States in 2012 and another 76,000 were injured. The National Highway Transportation Safety Administration stated that the number of pedestrian deaths by motor vehicle represents a 6 percent increase over the prior year. NHTSA revealed that 89 percent of those fatalities occurred in normal weather conditions with a large percentage being children.

It is also important to note that 52 percent of those car-pedestrian accidents were unrelated to alcohol (by either the pedestrian or driver), indicating other reasons for the collisions such as drivers or pedestrians simply not paying attention (i.e. not “looking”).

Whatever happened to looking both ways before you cross the road? We still teach our kindergarteners how to look left, right and then left again before crossing the street; why don’t we retain that through our adulthood? And, why don’t we use that same logic when operating a motor vehicle?

The old adage “look left, then right, then left again” actually is better because when you are crossing a two-way street, the lane closest to you will be coming from your left. So, you should look left first, then check the right side (the lane furthest from you) and re-look to your left before crossing the street.

The same is true if you’re in a car: look left toward the traffic that is in the lane closest to you, then right, then left again.

The point here is safety.

 

Works used for this article:

Centers for Disease Control and Prevention. (2015). Pedestrian safety. Retrieved from http://www.cdc.gov/Motorvehiclesafety/Pedestrian_safety/

National Highway Transportation Safety Administration. (2014). Traffic Safety Facts 2012 Data. Retrieved from http://www-nrd.nhtsa.dot.gov/Pubs/811888.pdf.