Slashdot Mirror

Or alcohol.

Thank you, NRA and Congress, for giving our brave service men and women the freedom and personal responsibility to kill themselves when things get too tough.

http://touch.latimes.com/#sect...
Programs to prevent psychological problems in troops questioned
By Alan Zarembo
February 20, 2014, 7:34 p.m.

Many federal programs aimed at preventing psychological problems in military service members and their families have not been evaluated correctly to determine whether they are working and are not supported by science, says a new report commissioned by the Defense Department.

"A lot of their programs don’t have any good data behind them," said Kenneth Warner, a professor of public health at the University of Michigan who led the Institute of Medicine committee that produced the report. "We remain uncertain about which approaches work and which ones are ineffective."

At the same time, some proven interventions are not being used, the committee found. Researchers said there was ample evidence to suggest that limiting access to personal firearms on military bases would reduce suicides. About 60% of service members who take their own lives do it with guns — usually their own.

"Means restriction has been demonstrated to work," said David Rudd, a psychologist and suicide expert at the University of Memphis who served on the committee.

But in 2011, Congress prohibited the Defense Department from regulating legally owned personal firearms and ammunition on military bases.

http://iom.edu/Reports/2014/Pr...
Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs
February 20, 2014

Among the small number of DOD-sponsored reintegration programs that exist, none appears to be based on scientific evidence. The committee was unable to identify any DOD evidence-based programs addressing the prevention of domestic abuse. More recently, the services have implemented a number of prevention interventions to address military sexual assault, yet a DOD review found that critical evaluation components needed to measure their effectiveness are missing.

The committee also found that environmental strategies with strong evidence of effectiveness are underutilized, such as restricting access to lethal means such as personal firearms to prevent suicide or homicide in domestic violence cases or placing restrictions on the sale of alcohol to reduce substance misuse.

In place of these proven approaches, the committee typically found interventions such as campaigns, Internet tools, or in-person events with no evidence for their effectiveness at preventing the targeted problem.

After you get your level checked, you'll have to then decide what level is a good thing.

Here are four different recommendations for optimal levels in increasing order

IOM:
http://www.iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/DRI-Values.aspx
>20 ng/mL (but their recommendations sort of imply not much more than that is important)

Dr. Fuhrman:
http://www.drfuhrman.com/library/vitamin_D_recommendations.aspx
35–55 ng/mL

Grassroots Health:
http://www.grassrootshealth.net/recommendation
40–60 ng/mL

Vitamin D Council:
http://www.vitamindcouncil.org/treatment.shtml
50–80 ng/mL (or higher for some specific conditions)

So, it's great to have a level. But even then there are disagreements about what is best.

Remember, parents have been warned heavily over the last decade or two to keep their kids out of the sun.

The vitamin D hpothesis easily explains stuff like the high rate (5X) of autism among Somali children or the high rate (9X) of schizophrenia among second generation Afro-Caribbeans in the UK.
http://www.huffingtonpost.com/david-kirby/minneapolis-and-the-somal_b_143967.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2418996/
http://bjp.rcpsych.org/cgi/content/abstract/167/3/362

No doubt there are socieconomic issues at play in the disparity, but 5X and 9X?

Note that in the link you provide, the units were different (nmol/L which requires a higher level to be in the right range).

I'm still not following their logic to dismiss what they found: "Age-standardized means based on observed serum 25(OH)D concentrations were significantly (P http://articles.mercola.com/sites/articles/archive/2010/07/22/pregnant-women-advised-to-get-more-vitamin-d.aspx
"Please do not assume your levels are fine, as Drs. Hollis and Wagner found that over 87 percent of all newborns and over 67 percent of all mothers had vitamin D levels lower than 20 ng/ml, which is a severe deficiency state. As a result, the researchers recommended that all mothers optimize their vitamin D levels during pregnancy, especially in the winter months, to safeguard their babies' health. This finding could easily help to explain the disproportionately high numbers of poor outcomes among African American births, as deficiency is extremely common among people with darker skin colors."

However, another variable is how much vitamin D do people with different ethnicities or skin color need? So, even the general ranges above, are they appropriate for all ethnicities? Maybe people with darker skin have other adaptations to function well on less? So, there remains more to research about all this. But with that said, just look at how much sun people got 1000 years ago, and look at how much people get now, and considering how melanoma is one of the easiest to detect and treat cancers, how much sun or vitamin D supplements seems "conservative" considering the conditions human are adapted for? Pretty much no humans in the past spent all their lives in caves that I'm aware of (except maybe rich ones, but they probably got diseases of affluence like diabetes, heart disease, cancer, and so on).

We got hit by this ourselves with health issues with our kid (as well as a C-section, which turns out to also be at increased risk with vitamin D deficiency). We just naively followed all the advice to stay out of the sun, etc.. I actually asked our pediatrician if we should be giving vitamin D sup

As sibling poster pointed out, the concept of "getting rid of bad doctors" is simplistic. For reference, see the Institute of Medicine Report To Err is Human. One salient quote from the report brief:

One of the report's main conclusions is that the majority of medical errors do not result from individual recklessness or the actions of a particular group--this is not a "bad apple" problem. More commonly, errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them.

In your example above with the wrong dosing, don't forget that there is a chain of people that that dose goes through -- e.g. the pharmacist, the nurse, etc...It is their jobs as well to question medication. In fact, nurses will state that if a wrong medication is given, then they are liable for it, even if the doctor ordered it (this is anecdotal, I do not know exact policies and procedures around this). Of course, people will argue that if nurses question a doctor they will never win. And while this argument is appealing to our preconceived notions of power structures and roles, the reality is different and there are procedures to escalate issues such as this. Again, this is to underscore that medical errors are mostly due multiple failures in the system or deficiencies in the system itself. Let's face it -- to expect perfection from one person (a doctor, a priest, the president, you name it) is unreasonable at best and irrational at worst.

As sibling poster pointed out, the concept of "getting rid of bad doctors" is simplistic. For reference, see the Institute of Medicine Report To Err is Human. One salient quote from the report brief:

One of the report's main conclusions is that the majority of medical errors do not result from individual recklessness or the actions of a particular group--this is not a "bad apple" problem. More commonly, errors are caused by faulty systems, processes, and conditions that lead people to make mistakes or fail to prevent them.

In your example above with the wrong dosing, don't forget that there is a chain of people that that dose goes through -- e.g. the pharmacist, the nurse, etc...It is their jobs as well to question medication. In fact, nurses will state that if a wrong medication is given, then they are liable for it, even if the doctor ordered it (this is anecdotal, I do not know exact policies and procedures around this). Of course, people will argue that if nurses question a doctor they will never win. And while this argument is appealing to our preconceived notions of power structures and roles, the reality is different and there are procedures to escalate issues such as this. Again, this is to underscore that medical errors are mostly due multiple failures in the system or deficiencies in the system itself. Let's face it -- to expect perfection from one person (a doctor, a priest, the president, you name it) is unreasonable at best and irrational at worst.

How is the kool aid anyway?

It is estimated that 18,000 Americans die every year due to a lack of health care insurance. That is 6 times the number of people who died in 9/11 attacks, EVERY YEAR!

Where is our all out war against lack of health insurance? Why aren't we spending billions of dollars to prevent these tragic deaths? Shouldn't we take a few billion of the hundreds of billions we have spent on the war to save American lives rather than take Iraqi lives?

http://www.iom.edu/?id=17632&redirect=0

Yes, being able to put that $200+ billion in annual administrative costs back into the economy for equivalent levels of care made universally available to the entire country certainly would suck.

Oh wait, it would actually rock.

More people in the united states have NO HEALTH COVERAGE than the entire population of Canada. The USA spends more per capita on health care than Canada does. If you are an American, that means your tax dollars are being wasted to support a health care system that caters primarily to the wealthiest citizens of the country. Any libertarian who does not support single payer health care is either a) stupid or b) ignorant. Perhaps both.