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Monday, December 31, 2007
Saturday, December 29, 2007
Most Psychiatrists Open to Discussing Spiritual Concerns
In fact, more than 90 percent of psychiatrists surveyed said it's always or usually appropriate to ask patients about their religious faith or spirituality, while just 53 percent of other doctors thought so.
On the other hand, psychiatrists were much more likely to report that crises of religious faith can worsen a patients' suffering.
"Although psychiatrists are not [typically] religious themselves, they are the doctors most comfortable with talking about spiritual issues," said study lead author Dr. Farr Curlin, an assistant professor of medicine at the University of Chicago.
According to Curlin, there has long been a tension between psychiatry and people of faith, in no small part because the father of modern psychology, Sigmund Freud, was deeply skeptical of religion. In addition, psychiatrists have "for a long time tended to associate religious belief and practice as being a sign of, if not mental illness, at least delusional behavior," Curlin contended.
The study does support the notion that, compared to other types of clinicians, psychiatrists are more dubious of religion. For example, 18 percent of psychiatrists surveyed said they were not religious, compared to 10 percent of other doctors. And, on a measure of "intrinsic religiosity," 47 percent of psychiatrists were rated as "low," compared to 36 percent of other doctors.
There have, however, been efforts to repair this "breach" between spirituality and psychology, said Curlin, who studies the roles of religion and spirituality within the context of medicine.
In the new study, researchers randomly surveyed 2,000 physicians about patients and religion, including 100 psychiatrists. A total of 1,144 doctors responded.
The findings were published in the December issue of The American Journal of Psychiatry; other findings from the survey were reported earlier this year.
"We found that if you look at doctors in general, the less religious they are, the less likely they think it's appropriate for them to address spiritual issues at all," Curlin said. "The opposite seems to be the case among psychiatrists. They're the least religious doctors, but they're the ones who basically see this is as part of their bailiwick, part of what they do."
Eighty-two percent of psychiatrists thought religion leads to increased suffering in some cases, compared to 44 percent of the other doctors.
"We observe that some patients really go through existential crises when they get sick -- they wonder if they've been abandoned by God, and they relive old sins," Curlin said.
On the other hand, about three-quarters of both groups said religion can help patients cope with and endure sickness.
Also in the survey, 36 percent of psychiatrists and 28 percent of other doctors said patients "sometimes" used religion or spirituality as a reason to avoid taking proper care of themselves.
Curlin believes it's appropriate for doctors to bring up religion or spirituality "anytime they think it's relevant to the patient's experience of illness or decision-making regarding course of treatment or response to that illness."
But to some doctors, he said, "there's still a strong sense that the spiritual is personal and that the practice of medicine is professional, and those two domains ought to be kept apart as far as possible."
Richard P. Sloan, professor of behavioral medicine at Columbia University, said it is disturbing that doctors believe that spiritual beliefs can lead patients to delay or refuse treatment.
Should doctors ever ask about religion in the first place? Sloan, who's written skeptically about the study of religion's role in medicine, said it can be appropriate in certain contexts.
"You need to know what characteristics of your patients might interfere with your ability to treat them well," Sloan said. Patients who are fasting during Ramadan, for example, might not be able to take four doses of a pill per day.
"The concern that I have is a number of physicians who go way beyond what's necessary and run the risk of manipulating their patients, even coercing them, invading their privacy, taking on spiritual matters as objects of intervention," he said. According to Sloan, appropriate inquiries are fine, but proselytizing has no place in the doctor's office.
More information
For more on spirituality and health, visit the U.S. National Center for Complementary and Alternative Medicine.
Wednesday, December 26, 2007
Health Tip: Get Plenty of Potassium
The agency lists common symptoms of potassium deficiency:
- An abnormal heart rhythm (particularly in people with heart conditions).
- Constipation.
- Fatigue.
- Weakness in the muscles, or muscle spasms.
- Paralysis, including paralysis of the lungs.
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Saturday, December 22, 2007
Health Tip: Holiday Blues?
Here are suggestions to help you beat the holiday blues, courtesy of the American Psychological Association:
- Don't try to deal with issues that you have with family members -- try to steer clear of them and avoid conflict.
- Exceeding your holiday budget on gifts will only add more stress. Stick to a budget you can afford, and look for meaningful -- not necessarily expensive -- gifts.
- Only go to holiday get-togethers that you really want to attend. Don't feel like you need to say "yes" to every invitation.
- Make time for yourself when you need it. If you're going through a tough period, talk with understanding family and friends.
- If you feel like your "blues" may be more serious or long-term, seek counseling from a psychiatrist or psychologist.
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Wednesday, December 19, 2007
Bone Density Tests Do Predict Women's Fracture Risk
And, according to the largest and longest prospective study of osteoporosis ever, women who had a spinal fracture at the beginning of the study had four times the risk of sustaining another fracture later on.
The bottom line: "Women need to talk to their doctors about the risk of osteoporosis," according to Jane Cauley, lead author of the study and professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.
Her team published the findings in the Dec. 19 issue of the Journal of the American Medical Association.
"I agree with the guidelines that all women after the age of 65 have bone density tests, and Medicare will pay for that," Cauley said. "Women who are postmenopausal, 50 to 64 years of age, should consider having a bone density test if they have other risk factors for osteoporosis or if they want to know what their bone density is before they consider any other treatment."
The findings don't change current standard practice, experts said, and they don't change the basic message to women: Don't ignore bone health, especially in middle and old age.
"The only really major advance here is that it's a longer term study. Mostly studies are five years typically. This one went out 15 years," said Paul Brandt, associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine in College Station. "Women need to get their bone mineral density tested after they start menopause and if they stay on hormone replacement therapy or an anti-osteoporotic treatment." he said.
Postmenopausal women are particularly vulnerable to fractures resulting from osteoporosis, a degenerative weakening of the bones. Some 10 million Americans, including one in five American women over the age of 50, suffer from osteoporosis, which is the most common type of bone disease.
Spinal fractures are the most common type of fracture resulting from osteoporosis, affecting 35 percent to 50 percent of women over 50 (about 700,000 vertebral fractures annually in the United States).
But many, if not most, of these fractures go undetected. "Osteoporosis is sometimes called the silent thief," Cauley said. "It basically robs the skeleton of strength and resources, and women don't really know about it. About 75 percent of all spine fractures actually occur silently."
"Identifying risk factors for spine fractures is less well developed. You have to systematically look for them by repeated X-rays," Cauley continued.
The findings from this study are based on bone mineral density data from 2,300 women over the age of 65 who enrolled in the Study of Osteoporotic Fractures (SOF), initiated in 1986.
After 15 years of follow-up, it was evident that 25 percent of women who had low BMD at the beginning of the study developed fractures of the spine, compared with only 9 percent of women with normal BMD.
"It was pretty much a strong gradient of risk," Cauley explained. "If you had normal bone density when you entered and did not have an [existing] fracture, the risk of having a new spine fracture was about 9 percent, compared to a risk of 56 percent in women who had osteoporosis and who had an existing fracture. So, the range of risk varied dramatically depending on bone density and previous spine fractures."
According to Brandt, one interesting finding from the study is that a previous vertebral fracture topped even bone mineral density as a predictor for future fracture.
This indicates that women with an existing vertebral fracture should be treated for osteoporosis regardless of their BMD, the authors reported.
"People think osteoporosis is an inevitable consequence of aging, but it is preventable and treatable," she said.
More information
There's more on age-linked bone loss at the U.S. National Library of Medicine.
Saturday, December 15, 2007
Wednesday, December 12, 2007
Kama Raja
Common causes for erectile dysfunction include diseases that affect blood flow and nerves, psychological factors such as stress, depression, and performance anxiety, and injury to the penis.
According to the National Institutes of Health, a majority of men at some point in their life experience occasional failure to achieve erection which can occur for a variety of reasons such as drinking too much alcohol or from being extremely tired.
Failure to achieve erection less than 20% of the time is not unusual and medical treatment is rarely needed. But the causes for this minor problem might lead to a permanent condition where failure to achieve erection occurs more than 50% of the time.
Once this stage of erectile dysfunction is reached, medical treatment is required to reverse the situation. Approximately 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience erectile dysfunction on a long-term basis.
Western medicine relies on aggressive prescription drugs and surgery to deal with many problems related to sexual dysfunction. Unfortunately, these methods often result in unwanted and even dangerous side effects. Non-medical methods of penis enhancement through exercise using weights, straps, rings, and pumps have proven destructive to muscle tissue.
And natural pills provide fleeting, inconsistent results. Ayurveda, the science of life, prevention and longevity, is the oldest and most holistic and comprehensive medical system available. Its fundamentals can be found in Hindu scriptures called the Vedas - the ancient Indian books of wisdom written over 5,000 years ago. Ayurveda uses the inherent principles of nature to help maintain health in a person by keeping the individual's body, mind, and spirit in perfect equilibrium with nature.
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Friday, December 07, 2007
Health Tip: End-of-Life Planning
Here are some suggestions, courtesy of the American Academy of Family Physicians:
- Be sure that your loved one makes advance directives, including instructions on what kinds of medical services he or she wants (or doesn't want) if unable to communicate.
- Talk to your loved one about receiving hospice care, which can help provide comfort as a disease or condition progresses.
- Be sure the person's finances are in order. Review the will, life insurance policy, and other legal documents with an attorney.
- Make funeral arrangements, according to your loved one's wishes.
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Sunday, December 02, 2007
Health Tip: The Road to a Healthy Heart
- Do housework yourself, instead of hiring someone else to do it.
- Work in the garden or mow the grass. Using a riding mower doesn't count.
- Go out for a short walk before breakfast, after dinner or both. Start with a 10-minute walk and work up to 30 minutes.
- Walk or bike to the corner store.
- When watching television, pedal a stationary bicycle.
- Park on the outskirts of a shopping mall and walk to the stores.
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