DEPRESSION PLUS HEART DISEASE A PARTICULARLY LETHAL COMBINATION

This is an item I am re-posting from its source.

September 21, 2010 — Patients who have both coronary heart disease (CHD) and depression have a significantly higher risk of dying than patients who have just one of these conditions, according to new research published online September 16 in the journal, Heart.

Compared with patients without depression and CHD, the risk for all-cause mortality was 3 times higher, and the risk for cardiovascular disease mortality 4 times higher, in patients who had both, after adjusting for age and sex, report Hermann Nabi, MD, from Hôpital Paul-Brousse, Villejuif, Paris, France, and colleagues.

This study provides further evidence that the relationship between depression and morbidity–mortality is real,” Dr. Nabi told Medscape Medical News.

Depression and mortality have been studied separately in patients with CHD and in healthy patients, but this does not allow comparisons across risk-factor groups according to depression and CHD status.

In the study, Dr. Nabi and his team examined the effects of both on mortality in nearly 6,000 middle-aged men and women whose mental and physical health were followed-up for about 5.6 years.

Need for a More Integrated Approach: The study findings have implications for research and clinical practice, Dr. Nabi said.

For clinical practice, it implies the need for a more integrated approach in the healthcare system and a shift toward a more “mind–body medicine” approach.

An important step would be to identify cardiac patients who also have depression, he said.

“In this study, depression worsened heart disease, because we observed that participants with both depression and heart disease were at increased risk for death when compared with those with heart disease only. So we should identify those cardiac patients who have clinically significant depressive symptoms.”

Dr. Nabi expressed the wish that his study findings will prompt clinicians to be aware of and look for depression in their patients with heart disease.

He also discussed some limitations of the study. “This study is based on a cohort (population) of civil servants and did not include blue-collar workers, unemployed, or individuals with precarious jobs. This may have underestimated the magnitude of associations observed in our study because the prevalence of depression and the mortality rate are higher in these latter individuals. Thus, it is reasonable to assume that the effect of depression would be greater in studies including various populations.”

Reference: MedscapeCME Clinical Briefs: “Depression Plus Heart Disease a Particularly Lethal Combination”

EFFECTIVE HOSTAGE-NEGOTIATION

Earlier this week, the Philippine National Police embarrassed itself and the nation by bungling the outcome of a hostage situation. (Click here, here, and here for three accounts of the incident: by a local TV station, by Reuters, and by CNN.)

A good friend of mine sent me an email describing how Chinese authorities, in a situation with many similarities, handled their hostage situation. Here it is:

FIRST, I have three demands. Meet them or I shall kill this hostage.

SECOND, The authorities confer in the next room.

THIRD, The head negotiator speaks with the hostage-taker.

FOURTH, Negotiations continue.

FIFTH, Negotiations conclude.

SIXTH, The mess is cleaned up and life move on.

As you can see, the situation was resolved quickly, inexpensively, and effectively. To illustrate one similarity between this situation and the recent Philippine incident, the photo below shows the hostage-taker in the recent Philippine incident. It was was taken during his negotiation with the Philippine authorities.

Why wasn’t he just shot at this point?

Another example of the police’s mistake occurred when they attempted to shatter the bus windows with a sledgehammer. The windows simply bounced back. They should have used a spring-loaded pointed tool or even this $15 pointed hammer:

SKYPE IMAGES 2009 TO 2010 (TO DATE)

RESTRICTED

NEARLY 54 YEARS

RESTRICTED

Whether true or not, it’s better to be safe than sorry.

After tossing her books on the sofa, she decided to grab a snack and get on-line. She logged on under her screen name and saw GoTo123 was on.

She sent him an instant message:

1. ByAngel213: Hi. I’m glad you are on! I thought someone was following me home today. It was really weird!
2. GoTo123: LOL. You watch too much TV. Why would someone be following you? Don’t you live in a safe neighborhood?
3. ByAngel213: Of course I do. LOL I guess it was my imagination cuz’ I didn’t see anybody when I looked out.
4. GoTo123: Unless you gave your name out on-line. You haven’t done that have you?
5. ByAngel213: Of course not. I’m not stupid you know.
6. GoTo123: Did you have a softball game after school today?
7. ByAngel213: Yes and we won!
8. GoTo123: That’s great! Who did you play?
9. ByAngel213: We played the Hornets. LOL. Their uniforms are so gross! They look like bees. LOL
10. GoTo123: What is your team called?
11. ByAngel213: We are the Canton Cats. We have tiger paws on our uniforms. They are really cool.
12. GoTo123: Did you pitch?
13. ByAngel213: No I play second base. I got to go. My homework has to be done before my parents get home. I don’t want them mad at me. Bye!
14. GoTo123: Catch you later. Bye.

Meanwhile, GoTo123 went to the member menu and began to search for her profile. When it came up, he highlighted it and printed it out. He took out a pen and began to write down what he knew about Angel so far.

• Her name: Shannon
• Birthday: Jan. 3, 1997
• Age: 13
• State where she lived: North Carolina
• Hobbies: softball, chorus, skating and going to the mall.

Besides this information, he knew she lived in Canton because she had just told him. He knew she stayed by herself until 6:30 p.m. every afternoon until her parents came home from work. He knew she played softball on Thursday afternoons on the school team, and the team was named the Canton Cats. Her favorite number 7 was printed on her jersey. He knew she was in the eighth grade at the Canton Junior High School She had told him all this in the conversations they had on-line. He had enough information to find her now.

Shannon didn’t tell her parents about the incident on the way home from the ballpark that day. She didn’t want them to make a scene and stop her from walking home from the softball games. Parents were always overreacting and hers were the worst. It made her wish she was not an only child. Maybe if she had brothers and sisters, her parents wouldn’t be so overprotective.

By Thursday, Shannon had forgotten about the footsteps following her. Her game was in full swing when suddenly she felt someone staring at her. It was then that the memory came back. She glanced up from her second base position to see a man watching her closely. He was leaning against the fence behind first base and he smiled when she looked at him. He didn’t look scary and she quickly dismissed the sudden fear she had felt.

After the game, he sat on a bleacher while she talked to the coach. She noticed his smile once again as she walked past him. He nodded and she smiled back. He noticed her name on the back of her shirt. He knew he had found her. Quietly, he walked a safe distance behind her. It was only a few blocks to Shannon’s home, and once he saw where she lived he quickly returned to the park to get his car. Now he had to wait. He decided to get a bite to eat until the time came to go to Shannon’s house. He drove to a fast food restaurant and sat there until time to make his move.

Shannon was in her room later that evening when she heard voices in the living room.

“Shannon, come here,” her father called. He sounded upset and she couldn’t imagine why. She went into the room to see the man from the ballpark sitting on the sofa. “Sit down,” her father began, “this man has just told us a most interesting story about you.” Shannon sat back. How could he tell her parents anything? She had never seen him before today!

“Do you know who I am, Shannon?” the man asked. “No,” Shannon answered. “I am a police officer and your online friend, GoTo123.” Shannon was stunned. “That’ s impossible! GoTo is a kid my age! He’s 14. And he lives in Michigan!”

The man smiled. “I know I told you all that, but it wasn’t true. You see, Shannon, there are people on-line who pretend to be kids; I was one of them. But while others do it to injure kids and hurt them, I belong to a group of parents who do it to protect kids from predators. I came here to find you to teach you how dangerous it is to talk to people on-line. You told me enough about yourself to make it easy for me to find you. You named the school you went to, the name of your ball team and the position you played. The number and name on your jersey just made finding you a breeze.”

Shannon was stunned. “You mean you don’t live in Michigan?” He laughed. “No, I live in Raleigh It made you feel safe to think I was so far away, didn’t it?” She nodded.

“I had a friend whose daughter was like you. Only she wasn’t as lucky. The guy found her and murdered her while she was home alone. Kids are taught not to tell anyone when they are alone, yet they do it all the time on-line. The wrong people trick you into giving out information a little here and there on-line. Before you know it, you have told them enough for them to find you without even realizing you have done it. I hope you’ve learned a lesson from this and won’t do it again. Tell others about this so they will be safe too?”

“It’s a promise!” That night Shannon and her Dad and Mom all knelt down together and thanked God for protecting Shannon from what could have been a tragic situation.

Reposted from our Yahoo Group. Thanks Benj.

ASSERTING YOURSELF



ASSERTING YOURSELF
Poster: http://shop.climb.org

As the poster says:

• express your feelings
• ask for what you want
• say no to something you don’t want
• be aware of your emotional intensity
• be sensitive to the risk of violence

BEFORE YOU CAN BE ASSERTIVE

You must be aware of your self before you can be assertive. Being aware of your self is not at all similar to being aware of yourself. When you are aware of “your self,” you are aware of you as another person. You are aware of your feelings, your reasons, and the risk to your personal situation. “Yourself,” by contrast, refers simply to you. It is merely a pronoun.

You must believe that you have the right to ask for what you want. You must prepare your mind and spirit, sometimes on the spot, for the situation that will arise after you become assertive. Be prepared for anything and above all, always be in control of your own emotions. Do not lose control. Let the other person lose his. He who loses it loses.

DID YOU KNOW?

When you act assertively, you help develop your own sense of self-respect and self-worth. Also, assertive behavior generally wins more respect for you from others. In the long run, being assertive also helps make other people more comfortable with you since they will know where you stand. A few people will decide not to like you but they will be few.

WHY IS IT DIFFICULT TO BE ASSERTIVE?

It can be difficult to act assertively when you are anxious or anxiety-prone. However there is no choice. If you decide to act assertively, you must set aside your anxiety. Do whatever it takes to set aside your anxiety. That is necessary in order to act assertively successfully.

Remember that you can’t be nice or pleasing to everyone. This concern can hold back a person from becoming assertive. Realize that it is possible to become nice or pleasing to people even after being assertive with them. In truth, it depends upon the maturity of every other person. Most people will recognize that you are just being assertive. A few will misinterpret your assertiveness. There is nothing you can do about that. It is a question of maturity of every other person.

In a sense this is the largest risk you take with being assertive. People will reveal, through their individual reactions, some of their inner character.

ALTERNATIVES TO BEING ASSERTIVE

The alternatives are undesirable. You can submit (i.e., be submissive). Submission brings up its particular set of negative consequences. Or you can be aggressive, passive-aggressive, or manipulative. Each is discussed below.

DO NOT CROSS THE LINE. DO NOT BECOME AGGRESSIVE YOURSELF.

You can act too assertively also. Assertive becomes aggressive. And aggressive behavior can cause violence. Refrain from communicating in a demanding, abrasive, or hostile manner. Those are aggressive manners. Unchecked aggression can lead to violence and violence ultimately creates a lose-lose situation.

PASSIVE-AGGRESSIVE

When you react this way, you appear to go along but constantly express your anger and aggressive feelings in covert fashion. Behaving in a passive-aggressive manner tends to be corrosive. The issue that caused your anger becomes sensitive and, unchecked, could grow and dominate your relationship with that person. You’re angry at your boss, so you’re always late for work. Your boss may never understand why you’ve started coming in late. Unless you tell him your boss may attribute your frequent tardiness to another reason. Passive-aggressive behavior tends to confuse other people. Confusion tends to turn into resentment or anger. As illustrated, corrosiveness brings on negative consequences.

MANIPULATIVE

A manipulative person attempts to get what he wants by making others feel guilty or sorry for him. Instead of taking responsibility for his needs, he tries to make others feel guilty or sorry for him. He does this by casting himself as a victim or martyr. If this doesn’t work, he may become openly angry or feign indifference. Be prepared for either reaction. Manipulation only works as long as those to whom it is targeted fail to recognize what is happening.

BACK TO ASSERTIVE

Assertive behavior resembles controlled aggression, in my opinion. It is mostly a matter of intensity. You can be assertive without communicating in a demanding, abrasive, or hostile manner. Be controlled and firm. Be steadfast and clear about your message. Present your message as a direct request. Do not present it as a demand or command. “Boss, I really think I should have been reimbursed.” Say that and stop being late for work.

Source: Marital Counseling

A DISAPPOINTING INTERFACE SPOILED THIS USER’S EXPERIENCE.

Pros: Lightweight, Strong Signal
Cons: Difficult To Use, Awkward Keypad
Best Uses: Making Calls
Describe Yourself: Business Professional, Gearhead, Practical

After becoming accustomed to the iPhone’s touchscreen, this was a disappointment. The importance of the user interface moved to the forefront for me. The trackpad is an awkward substitute. For instance, there doesn’t appear to be any way to modify the tracking range of motion. Consequently, navigating between fields requires a delicate touch and that luxury isn’t always available.

Two lesser reasons for dissatisfaction are the plain-vanilla browser and the difficulty of learning some of the ways to modify the default settings. The browser is merely adequate. Even RIM acknowledges that. As for modifying the default settings, I particularly want to learn now how to (1) reset the clipboard, (2) prevent the phone number from being assigned to the work field when the number is added to contacts, and (3) assign Opera as the default browser.

Unfortunately, my dissatisfaction with the user interface overshadows the rest of this phone’s good features. It makes phone calls very well. As a regular phone therefore it’s been doing a good job. That can be attributed to the phone’s design and the robust coverage of the carrier. As a smartphone, it’s inadequate but that can be attributed to my prior experience with the iPhone.

AVATAR
The movie’s well on its way to becoming a success. It will probably create a cult-like following like Star Trek, Star Wars, Lord of the Rings, and other megahits.

I saw it today in 3D. The plot was familiar but that didn’t detract from the story. The movie’s visual effects were impressive and very enjoyable. My enjoyment of the movie, however, arose from the emotional connection that it made with me. That’s what separates Avatar from other movies that were also rich in visual effects. Waterworld (1995), for instance, was a relative dud despite Kevin Costner’s star (which might have been soaring higher than anyone else’s when the movie was released).

I think that Avatar will succeed on two levels: commercially and as a pop culture icon. There should be nothing deregatory about becoming a pop culture icon. Pop is short for popular and popular culture refers to the “totality of ideas, perspectives, attitudes, memes, images and other phenomena that are deemed preferred per an informal consensus within the mainstream of a given culture.” (Wikipedia)

Incidentally, “avatar” is a fairly new term. One of my first encounters with it occurred in Second Life. However its roots, according to Wikipedia, can be traced to Hinduism where its meaning loosely refers to the descent of a deity into the physical world. In the movie, the human protagonists are projected into the alternate reality of the alien inhabitants of the fictional planet Pandora.

I recommend it. I think you’ll enjoy it.