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How our shopping habits cause asthma in California children

Here is the story of how globalization is ruining the health of California children

The community that epitomizes the pollution warehouses can bring is Mira Loma.“Our quality of life is in the tubes,” said Gene Proctor, 73, who has lived in Mira Loma Village for 43 years. “I wish people shopping in Tucson, Arizona, in other places, I wish they could see the little kids around here, their respiratory problems.” His great-granddaughter has asthma, and his 3-year-old great-grandson, he said, “coughs like a smoker.”

Population 21,000, Mira Loma is so small and poor it doesn’t have a movie theater, a community center, or even a moderately upscale restaurant. What it does have are 90 warehouses and a whole lot of big rigs: Trucks rumble through 15,000 times every day. In just half an hour on a recent afternoon, 269 trucks passed by the big plate glass window in the front of the Farmer Boys truck stop on Etiwanda Avenue.

That is more than one every seven seconds.

Avol, the professor at the USC Keck School of Medicine, began visiting the town in the early 1990s as part of a study of air pollution and children’s health across Southern California. Back then, he said, researchers chose Mira Loma because it sits at the “end of the tailpipe” of the Los Angeles basin, meaning the prevailing winds off the Pacific Ocean blow L.A.’s infamous smog east until much of it arrives in Mira Loma. So it was rural yet had a lot of ozone and smog. Other places in the study, such as Santa Barbara and Long Beach, were picked because they were thought to boast clean air or because they were in industrial areas.

When the study began, Mira Loma residents complained to researchers about the smell of dairy cows, herds of which clustered on vast pastures and cow yards. But in 1987, Riverside county supervisors revamped the general plan for Mira Loma, clearing the way for massive warehouse development.
“In the course of a few years, the dairies disappeared,” and what had been “open pasture became streets and warehouses, lined with trucks,” Avol said. “Mira Loma turned out to be a very interesting place to study.”

The trucks made the already bad air worse, bringing in diesel particulates, very small particles that can enter the lungs and travel to tissues throughout the body. They are associated with asthma, heart disease, neurological problems, and cancer.

In Mira Loma, children were found to be growing up with stunted lungs compared with children living in places with better air. Their lungs were growing at a rate that was 1 to 1.5% slower, Avol said, so that “after their teen years, they were about 10 to 12% lower in lung function than children who had grown up in cleaner places.”

He added: “We have no information at this point that supports the idea that they ever catch up.”

Studies from other Inland Empire communities are also dire. In a neighborhood near the BNSF rail yard in the city of San Bernardino, Loma Linda University researchers found that adults have more respiratory problems, and children alarmingly high rates of asthma, even when compared with other polluted communities.

Why We Don’t Like Stories in Which the Mentally Ill Heroine Recovers

Basically people who recover undermine how psychiatry is practiced now.

The story of modern psychiatry, for many, is triumphant one. The quick-and-dirty history goes like this: Human ingenuity and scientific advances led us from the dark ages of hydrotherapy and solitary confinement to cognitive-behavioral therapy and expertly prescribed medications. While we used to believe the mentally ill were unwell as a result of wayward behavior or demonic possession, we now know that psychic anguish is the result of brain chemistry and nurture, and we’re working harder to analyze the former. We moved, in other words, from mental illness as a moral failure to mental illness as a medical condition.

But if you zoom in on the late 1940s through the early ’60s, a different battle is being waged—a battle between those who believed mental illness was biologically located in the brain, and those who thought mental illness was a matter of emotional disturbance. Back then, those intent upon transforming psychiatry into a reputable science (as opposed to a touchy-feely art) worked tirelessly to develop new methods of medical intervention for the mentally ill. The best-known method was “psychosurgery” (aka lobotomy), which was introduced by neurologist Egas Moniz in 1936. In 1949, Moniz won the Nobel Prize for his work on psychosurgery, and by 1951, the operation had been performed close to 20,000 times.1
Contrast this obsession with the physical brain—slicing it, shocking it, or tranquilizing it—with the ethos held by Chestnut Lodge, the elite private institution where Joanne Greenberg began treatment in 1948. The clinicians at Chestnut Lodge fervently believed that no patient, however psychotic, was impervious to psychotherapy. The champion of this viewpoint was the Lodge’s most famous employee, the gifted psychoanalyst Frieda Fromm-Reichmann. Fromm-Reichmann was Greenberg’s primary analyst and, in both the novel and in real life, led her from insanity to wellness. In the book, Fromm-Reichmann is “Dr. Fried,” and Greenberg so positively depicted the humble German that for years she received letters from struggling fans desperate to track down Dr. Fried and undergo analysis with her. 

Fromm-Reichmann immediately recognized something special in her teenaged patient: Greenberg was quick-witted, well-read, and seemed to retain an appetite for life that many of the doctor’s older, chronically ill patients had lost long ago. Greenberg’s symptoms were often referred to as “florid”—interpretable, extravagant, and suffused with meaning, like a story. When Joanne was struggling, Fromm-Reichmann openly empathized. When she began to retreat, the doctor begged to follow. “Take me along with you,” Dr. Fried tells Deborah during a session. She insisted to her young patient that they must pose a united front. “I believe that you and I,” Greenberg has her say in Rose Garden, “can beat this thing.” And, together, that’s just what they did.

This narrative is a little too pat for our contemporary sensibilities. Perhaps that’s why the book is not as well known as, say, Sylvia Plath’s The Bell Jar. (The Bell Jar still sells briskly; the fiftieth-anniversary paperback edition is ranked 1,730 on Amazon, compared to Rose Garden’s 21,792.2) But Rose Garden does not appeal for another reason: It’s easier to think of the psychiatry of yore as entirely backward and as the poetic casualties of it—Plath, Arbus, Sexton—as victims of that ignorance. Their tragic stories, paradoxically, make us feel more secure in the march of psychiatric progress.

The demise of these women—and the subsequent autopsy of past mental healthcare failures that their paper trails encourages—permits us to rest serenely in the knowledge that the world is moving steadily toward a more scientific, humane psychiatry. But, one has to wonder if this is entirely the case. Frieda Fromm-Reichmann spent four years with Joanne Greenberg; she hiked up to the Disturbed Ward to see patients when they were lying limp in restraints. Now, psychiatrists evaluate patients for 45 minutes before diagnosing them and sending them off to fill prescriptions, and many patients go months between appointments. Efficiency is the goal here; medication the cure, meaningful human connection a distant second priority. It is increasingly rare to find a psychiatrist who also performs talk therapy, despite its many proven benefits.

This might be an even greater tragedy with regard to treatment of schizophrenia, where holistic treatment—that is, one that recognizes both the medical and the emotional components and allows for feedback between the two—might hold particular promise. According to Dr. Allen J. Frances of Duke Medical School and the author of Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, “Cognitive therapy and social skills therapy are very valuable in treating schizophrenia, but they are rarely available.” And the idea of “complete recovery” is downplayed.

If you are a regular reader of this blog, you know that my wife Wendy has struggled with depression for most of her life.   As she has written about before, like many others, she was sexually abused for an extended period growing up and it took a toll on her as she has grown older. It has never gone away and returns with a vengeance each and every summer and causes chaos and pain around here until fall.

This is the process we have to go through to get help.

She needs to go to her family doctor who prescribes depression medication and then writes a referral to the psychiatrist.  Since that is a year to two year wait, she goes back to her family doctor who ups her medication, ups it again, ups it again and then realizes it doesn’t work.  So then she is weaned off her medication and then the doctor does it again.  If that doesn’t work.  Repeat.

Finally she gets to see the psychiatrist (18 months later), she walks in, explains her situation, he tells her she has PTSD and then gives her a prescription for a stronger medication.  Out in 10 minutes.  

That medication may or may not work.  If not, she can go back and is back out in five minutes with a new prescription.  If it does work, it works for about 8 months and then when she tries to go back, she is told that her file is closed.  She needs another referral (and a year wait).

That is what is covered by Saskatchewan Health.  What she really needs is talk therapy as well which is not covered by Saskatchewan Health and runs over $100 a session.   Since it isn’t part of her health care or any kind of continuum of care, the therapist and psychiatrist don’t talk which means that once summer went spent thousands on therapy that did nothing because Wendy’s medication was off.

What we are told is that Wendy’s condition will be with her for the rest of her life and she just needs to keep taking her medication.  In some ways that may be correct but the reality is that it doesn’t have to be as bad as it is or as costly if we spent the resources to treat mental illness like we do other illnesses.  I think that is what makes people so uncomfortable, we know we can do better but do not because of a shortage of psychiatrists and clinical psychologists in our system.  Heck we don’t even benchmark mental illness treatment in Saskatchewan.  How do we hope to get better when we don’t define success?

It’s been a frustrating process to see Wendy struggle like this.  Her public presence like many is far different then her private one and I have been more than willing to move to get her treatment.  We have explored selling the house and our stuff and moving south to the United States but the equity in our house won’t touch long term treatment costs.  So like a lot of families and people who struggle with depression, we stay and try our best to work in the cycle of madness and fight the assumption that mental illness can’t he cured.

Bed bugs ‘dodge insecticides’ with molecular tricks

As someone who has to battle bed bugs from time to time at work, this worries me.

Bed bugs use a range of tactics to render insecticides useless, a study suggests.

Infestations are on the rise around the world, but the pests are growing resistant to some chemicals.

Now scientists have found 14 genes associated with a number of biological changes.

These include the development of a thicker skin that stops poisons from penetrating, and mutations that prevent toxins from hitting the nervous system.

The study, published in the journal Scientific Reports, also suggests that some of the bugs are producing higher levels of enzymes that help to metabolise insecticides more quickly.

Others genes are associated with proteins that interfere with the way the deadly chemicals are carried around the bed bugs’ bodies.

Subba Palli, professor entomology from the University of Kentucky in the US and an author of the study, said that the hardy insects were using a combination of these molecular tricks.

“Some used four different mechanisms, some three and so on,” he explained.

“Bed bugs are employing more than one mechanism of resistance to avoid insecticide toxicity.”

Video: Reduce the lead time for Mental Health and Addictions patients in RUH Emergency

 

The Saskatoon Health Region is being driven by Lean Management.  Like any management theory it has a website, newsletters and even some videos.  While the video production quality is horrible, here is a video on how the Saskatoon Health Region is trying to improve intake and evaluation for Mental Health & Addiction Services at RUH.

Fitness on 25th

So with DeeAnn gone from the Lighthouse, my new office mate is a psychologist who loves to run.  Jeff started to pester me about joining a gym non-stop and I was ignoring it until I decided to take this hike through the backcountry.  As part of the training, I decided to get a Nike Fuel Band to monitor my movement and get myself motivated.  Well that didn’t work out too well.  Well actually it worked too well as it showed me missing my goal of 3000 Nike Fuel every day.  This is how a Nike Fuel Band works.

Basically it taunts you for being inactive.  It’s clever.  It’s not rude as to be mean spirited but it sits there and reminds you that you are no where close to your Nike Fuel goal (for me it’s 3000) and I am surprised how much it bothers me.

After several days of not hitting 3000 (or even coming close), I decided to head down to the YWCA and hit the gym at Fitness on 25th.  Three of my co-workers also came and for 30 minutes we hit the elliptical or the treadmill and had a pretty good work out.  The problem is that it still didn’t get me enough Nike Fuel so tomorrow I am walking to work, walking to the gym, working out, and then walking home… all in the pursuit of the magical Nike Fuel.

I don’t know how long my level of motivation will last the Nike Fuel Band got me to the gym and is making me walk a lot more.  I still hate doing it but lazing around on the sofa isn’t doing a lot for me either.

Now back to Fitness on 25th.  I decided to join there because I believe in the work that the YWCA does in Saskatoon (and know some of their staff).  We have a good relationship with them at The Lighthouse and it’s kind of on my way home from work.  It has 4 treadmills, a bunch of ellipticals and stairclimbers for cardio, a bunch of free weights and stationary bikes.  I spent some quality time on the elliptical which gave my legs a brutal workout and got my right shoulder moving.

The YWCA gym is older but it was quiet and not very busy when we go at 4:00 p.m.  It does offer a free two week trail which I would advise you to check out.  I am not thrilled with having to sign up for a year but I understand why they do it.

Monday

The weekend that was: The lowlight of the weekend was that I was fiddling with a power adaptor with my right hand and jerked my hand away violently when I got shocked.  Of course my right shoulder is the shoulder with the torn rotator cuff.  I have had both shoulders operated on, I have wrecked both MCL and ACLs, I have even had nails go into my feet.  Nothing was as painful as that pain was.  I just screamed in pain for a minute while walking over and sitting down before I passed out.

I was hoping the pain would pass but now every time I use my right hand, there is incredible pain in the shoulder which can’t be a good thing.  Back to my family doctor on Tuesday to see what we can do now.

On Sunday I watched the Lions lose to the Green Bay Packers at Jeff’s place with Sean.  Doing that brought up a lot of Detroit Lions memories and none of them are good.  Wayne Fontes, Scott Mitchell, Matt Millen, 0-16… at least the food was good.

On my to-do list this week: Other than seeing a doctor…

Procrastinating about: Going to see my doctor…

Book I’m in the midst of: The Triumph of the City by Edward Glaesar

Music that seemed to catch my attention this past week: The new Sheepdogs album.

How I’m feeling about this week: Pain.

Another reason why cats are stupid

They can make you crazy

The parasite, which is excreted by cats in their feces, is called Toxoplasma gondii (T. gondii or Toxo for short) and is the microbe that causes toxoplasmosis-the reason pregnant women are told to avoid cats’ litter boxes. Since the 1920s, doctors have recognized that a woman who becomes infected during pregnancy can transmit the disease to the fetus, in some cases resulting in severe brain damage or death. T. gondii is also a major threat to people with weakened immunity: in the early days of the AIDS epidemic, before good antiretroviral drugs were developed, it was to blame for the dementia that afflicted many patients at the disease’s end stage. Healthy children and adults, however, usually experience nothing worse than brief flu-like symptoms before quickly fighting off the protozoan, which thereafter lies dormant inside brain cells-or at least that’s the standard medical wisdom.

But if Flegr is right, the "latent" parasite may be quietly tweaking the connections between our neurons, changing our response to frightening situations, our trust in others, how outgoing we are, and even our preference for certain scents. And that’s not all. He also believes that the organism contributes to car crashes, suicides, and mental disorders such as schizophrenia. When you add up all the different ways it can harm us, says Flegr, "Toxoplasma might even kill as many people as malaria, or at least a million people a year."

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