Saturday, December 31, 2016

Gift Funds Neuroscience Research into Medical Marijuana


10.8.14


http://harvardmagazine.com/2014/10/mclean-mind-gift

MCLEAN HOSPITAL, THE LARGEST psychiatric affiliate of Harvard Medical School, has received a $500,000 gift that funds their new Marijuana Investigations for Neuroscientific Discovery (MIND) Program. The donation, announced on October 6, comes from best-selling crime novelist Patricia Cornwell.
Most studies on medical marijuana to date have focused on its efficacy, or on patients’ symptoms. MIND head researcher Staci A. Gruber, director of the Cognitive and Clinical Neuroimaging Core at McLean and associate professor of psychiatry at Harvard Medical School, hopes that the new initiative, the first of its kind, will begin to answer questions about whether medical marijuana affects cognitive function, positively or negatively—and why—by gathering empirical data about change over time within patients.
The initial phase of the program is expected to run for approximately two years. Researchers will collect data from subjects who, suffering from conditions including pain, anxiety, and post-traumatic stress disorder, have been certified to take medical marijuana but have no substantial history of recreational use, and have not yet begun this course of treatment. Participants will take a number of cognitive tests, on paper and on the computer, and will undergo brain scans. The studies will also gather clinical information on the patients’ perceptions about how they feel, and about their quality of life. After a baseline is established, the subjects will maintain weekly contact with the researchers, checking in physically with the hospital at the three-month, six-month, and one-year mark for more extensive tests, including some using multi-modal imaging equipment. If the program were to grow, Gruber says, the next phase would use the collected data to design and conduct clinical trials, administering the drug to individuals.
Though marijuana has been used medicinally, spiritually, and recreationally around the globe for some 5,000 years—and American doctors had, since the mid-nineteenth century, used it to treat conditions ranging from asthma to insomnia—the federal government classified it as a Schedule 1 drug in 1970 (grouping it with heroin and LSD), with profound effects on criminal justice in the United States. Recent years have seen dramatic cultural shifts in attitudes toward marijuana, accompanied by legal change. California was the first state to legalize medical cannabis, in 1996, and now 35 states permit some form of medical marijuana use. Medical marijuana clinics operate in 20 states and in Washington, D.C. The resulting rift between state and federal law—and the often conflicting policies of employers, health-insurance providers, and other parties—has caused confusion about the terms of legal medical use.



Yet those legal gaps find their match in scientific uncertainties, meaning that lawmakers deciding which conditions qualify patients for marijuana treatment currently make those decisions based on very little hard clinical knowledge. As Gruber puts it, “Policy has outpaced science.” For example, though patients have a variety of methods for taking medical marijuana, including as vapor, oil, tincture, or smoke, these substances bear little resemblance to the manufactured, standardized cannabinoids—the chemical compound patients need from the marijuana—studied in many trials; most of these synthetic versions have yet to reach end-users. (Gruber hopes to gather and analyze samples of what her subjects are using.) A June 2014 literature review in the New England Journal of Medicine, surveying the gaps in current knowledge, singled out what it called “the need to improve our understanding of how to harness the potential medical benefits of the marijuana plant without exposing people who are sick to its intrinsic risks.”
In a press release, Gruber stated that marijuana, which has “shown promise in alleviating a range of symptoms, could potentially improve cognitive performance” of patients suffering from severe medical disorders that disrupt their cognitive function and mood. “Equally critical,” she added, is that “Data showing a loss or impairment of cognitive function following the use of medical marijuana could inform alternative courses of treatment and prevent unjustified exposure to harm, especially in vulnerable populations.”
Gruber’s previous research into the subject has focused on the impact of heavy recreational marijuana use on the developing brain—a question increasing in urgency as use has begun to climb among high-school students after more than a decade of decline (even as cigarette smoking and alcohol use continue to drop). Her studies have found that the drug alters white-matter connections in the brain and reduces inhibitions, resulting in more impulsive behavior. On MRI scans taken while participants completed cognitive tests, early-onset marijuana smokers activated a different part of the brain region controlling inhibition, attention, and error processing than did late smokers. (Gruber has appeared on ABC’s Nightline and on the Dr. Sanjay Gupta’s CNN documentary Weed to speak about her findings, and will moderate a conversation with Gupta on medical marijuana at Harvard’s Institute of Politics tonight, October 8, at 6 P.M.)
Patricia Cornwell, who funded the program, is also a supporter of the Harvard Art Museum: she endowed the position of Cornwell Conservation Scientist at the Straus Center, and has donated collections of works by James McNeill Whistler, Augustus Edwin John, and Walter Sickert, in addition to advanced technological equipment. Her relationship with McLean coincides with her relationship with Gruber: they met when Cornwell visited McLean, on the recommendation of her contact at the Fogg Museum, to learn about brain imaging for a book project. “She asked incredibly good questions,” Gruber recalls. They married in 2005.

Thursday, December 29, 2016

Depression On the Rise, Especially Among Adolescent Females







http://www.neurologyadvisor.com/neurobehavioral-disorders/depression-on-the-rise-especially-among-adolescent-females/article/573138/


HealthDay News — Depression is on the rise among American teens and young adults, with adolescent girls showing the greatest vulnerability, according to research published in Pediatrics.

Ramin Mojtabai, MD, PhD, MPH, a professor in the department of mental health at the Johns Hopkins University Bloomberg School of Public Health in Baltimore, and colleagues examined data collected between 2005 and 2014 by the US National Surveys on Drug Use and Health. Included in the study were 172,495 American teens (aged 12 to 17) and 178,755 young adults (18 to 25).


Overall risk over the course of a single year rose from 8.7% in 2005 to 11.3% by 2014 among all teens, and from 8.8% to 9.6% among young adults. Teenage girls were found to be significantly more vulnerable to depression than teenage boys, the researchers said. Back in 2005, the risk of major depressive disorder for teenage boys was 4.5%, and 13.1% for teenage girls. By 2014, however, boys' risk of depression rose to 5.7%, but for girls it increased to 17.3%.
Dr Mojtabai told HealthDay that the jury remains out as to why, though he and other researchers have theorized that girls may simply be exposed to more depression risk triggers than boys. For example, "there is some research indicating that cyberbullying may have increased more dramatically among girls than boys," Dr Mojtabai said. In addition, "as compared with adolescent boys, adolescent girls also now use mobile phones with texting applications more frequently and intensively. And problematic mobile phone use among young people has been linked to depressed mood. These associations, however, remain speculative," he noted.
References
  1. Mojtabai R, Olfson M, Han B. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. Pediatrics. 2016 Nov 14; doi:10.1542/peds.2016-1878 [Epub ahead of print]
  2. Glowinski AD, Amelio G. Depression Is a Deadly Growing Threat to Our Youth: Time to Rally. Pediatrics. 2016 Nov 14; doi:10.1542/peds.2016-2869 [Epub ahead of print]

Tuesday, December 27, 2016

Medical marijuana and the mind



http://www.health.harvard.edu/mind-and-mood/medical-marijuana-and-the-mind



More is known about the psychiatric risks than the benefits.
The movement to legalize marijuana for medical use in the United States has renewed discussion about how this drug affects the brain, and whether it might be useful in treating psychiatric disorders.
Unfortunately, most of the research on marijuana is based on people who smoked the drug for recreational rather than medical purposes. A review by researchers in Canada (where medical marijuana is legal) identified only 31 studies (23 randomized controlled trials and eight observational studies) specifically focused on medical benefits of the drug.
A separate review by the American Medical Association (AMA) also concluded that the research base remains sparse. This was one reason that the AMA urged the federal government to reconsider its classification of marijuana as a Schedule 1 controlled substance (prohibiting both medical and recreational use), so that researchers could more easily conduct clinical trials.
Consensus exists that marijuana may be helpful in treating certain carefully defined medical conditions. In its comprehensive 1999 review, for example, the Institute of Medicine (IOM) concluded that marijuana may be modestly effective for pain relief (particularly nerve pain), appetite stimulation for people with AIDS wasting syndrome, and control of chemotherapy-related nausea and vomiting.
Given the availability of FDA-approved medications for these conditions, however, the IOM advised that marijuana be considered as a treatment only when patients don't get enough relief from currently available drugs. Additional research since then has confirmed the IOM's core findings and recommendations.
Although anecdotal reports abound, few randomized controlled studies support the use of medical marijuana for psychiatric conditions. The meager evidence for benefits must be weighed against the much better documented risks, particularly for young people who use marijuana.
Key points
  • Medical marijuana may be an option for treating certain conditions, such as nerve pain or chemotherapy-related nausea.
  • There is not enough evidence to recommend medical marijuana as a treatment for any psychiatric disorder.
  • The psychiatric risks are well documented, and include addiction, anxiety, and psychosis.
Challenges in drug delivery
Marijuana is derived from the hemp plant, Cannabis. Although marijuana contains more than 400 chemicals, researchers best understand the actions of two: THC (delta-9-tetrahydrocannabinol) and cannabidiol.
THC is the chemical in marijuana primarily responsible for its effects on the central nervous system. It stimulates cannabinoid receptors in the brain, triggering other chemical reactions that underlie marijuana's psychological and physical effects — both good and bad.
Less is known about cannabidiol, although the research suggests that it interacts with THC to produce sedation. It may independently have anti-inflammatory, neuroprotective, or antipsychotic effects, although the research is too preliminary to be applied clinically.
Drug delivery remains a major challenge for medical marijuana. The FDA has approved two pills containing synthetic THC. Dronabinol (Marinol) combines synthetic THC with sesame oil. Most of the active ingredient is metabolized during digestion, however, so that only 10% to 20% of the original dose reaches the bloodstream. Nabilone (Cesamet) uses a slightly different preparation of synthetic THC that is absorbed more completely into the bloodstream. Among the concerns about both of these drugs, however, are that they do not work rapidly, and the amount of medication that reaches the bloodstream varies from person to person.
Another medication under investigation in the United States (and already approved for sale in Canada) combines THC and cannabidiol. In Canada, it is marketed as Sativex. This drug is sometimes referred to as "liquid cannabis" because it is sprayed under the tongue or elsewhere in the mouth, using a small handheld device. However, it takes time to notice any effects, as the drug has to be absorbed through tissues lining the mouth before it can reach the bloodstream.
Inhalation is the fastest way to deliver THC to the bloodstream, which is why patients may prefer smoking an herbal preparation. But while this method of drug delivery works fast, smoking marijuana exposes the lungs to multiple chemicals and poses many of the same respiratory health risks as smoking cigarettes. Limited research suggests that vaporizers may reduce the amount of harmful chemicals delivered to the lungs during inhalation.
More psychiatric risk than benefit
Part of the reason marijuana works to relieve pain and quell nausea is that, in some people, it reduces anxiety, improves mood, and acts as a sedative. But so far the few studies evaluating the use of marijuana as a treatment for psychiatric disorders are inconclusive, partly because this drug may have contradictory effects in the brain depending on the dose of the drug and inborn genetic vulnerability.
Much more is known about the psychiatric risks of marijuana (whether used for recreational or medical purposes) than its benefits.
Addiction. Observational studies suggest that one in nine people who smokes marijuana regularly becomes dependent on it. Research both in animals and in people provides evidence that marijuana is an addictive substance, especially when used for prolonged periods.
Addiction specialists note with concern that THC concentration has been increasing in the herbal form of marijuana. In the United States, THC concentrations in marijuana sold on the street used to range from 1% to 4% of the total product; by 2003, average THC concentration had risen to 7%. Similar trends are reported in Europe. This increased potency might also accelerate development of dependence.
Less conclusive is the notion that marijuana is a "gateway drug" that leads people to experiment with "hard" drugs such as cocaine. The research is conflicting.
Anxiety. Although many recreational users say that smoking marijuana calms them down, for others it has the opposite effect. In fact, the most commonly reported side effects of smoking marijuana are intense anxiety and panic attacks. Studies report that about 20% to 30% of recreational users experience such problems after smoking marijuana. The people most vulnerable are those who have never used marijuana before.
Dose of THC also matters. At low doses, THC can be sedating. At higher doses, however, this substance can induce intense episodes of anxiety.
It is not yet known whether marijuana increases the risk of developing a persistent anxiety disorder. Observational studies have produced conflicting findings. Studies of recreational users suggest that many suffer from anxiety, and it's difficult to know what underlies this association. Possibilities include selection bias (e.g., that anxious people are more likely to use marijuana), a rebound phenomenon (e.g., that marijuana smokers feel worse when withdrawing from the substance), and other reasons (e.g., genetic vulnerability).
Mood disorders. Little controlled research has been done about how marijuana use affects patients with bipolar disorder. Many patients with bipolar disorder use marijuana, and the drug appears to induce manic episodes and increases rapid cycling between manic and depressive moods. But it is not yet clear whether people who use marijuana are at increased risk of developing bipolar disorder.
The small amount of research available on depression is also muddied. In line with what studies report about anxiety, many marijuana users describe an improvement in mood. Animal studies have suggested that components of marijuana may have antidepressant effects. Yet several observational studies have suggested that daily marijuana use may, in some users, actually increase symptoms of depression or promote the development of this disorder.
For example, an Australian study that followed the outcomes of 1,601 students found that those who used marijuana at least once a week at ages 14 or 15 were twice as likely to develop depression seven years later as those who never smoked the substance — even after adjusting for other factors. Young women who smoked marijuana daily were five times as likely to develop depression seven years later as their non-smoking peers. Although such studies do not prove cause and effect, the dose-outcomes relationship is particularly worrisome.
Psychosis. Marijuana exacerbates psychotic symptoms and worsens outcomes in patients already diagnosed with schizophrenia or other psychotic disorders. Several large observational studies also strongly suggest that using marijuana — particularly in the early teenage years — can increase risk of developing psychosis.
An often-cited study of more than 50,000 young Swedish soldiers, for example, found that those who had smoked marijuana at least once were more than twice as likely to develop schizophrenia as those who had not smoked marijuana. The heaviest users (who said they had used the drug more than 50 times) were six times as likely to develop schizophrenia as the nonsmokers.
Until recently, the consensus view was that this reflected selection bias: Individuals who were already vulnerable to developing psychosis or in the early stages (the prodrome) might be more likely to smoke marijuana to quell voices and disturbing thoughts. But further analyses of the Swedish study, and other observational studies, have found that marijuana use increases the risk of psychosis, even after adjusting for possible confounding factors.
Although cause and effect are hard to prove, evidence is accumulating that early or heavy marijuana use might not only trigger psychosis in people who are already vulnerable, but might also cause psychosis in some people who might not otherwise have developed it.
Certainly genetic profile mediates the effect of marijuana. People born with a variation of the gene COMT are more vulnerable to developing psychosis, for example. Because there is as yet no reliable way for clinicians to identify vulnerable young people in advance, however, it is safest to restrict use of medical marijuana to adults.
Other effects
A review of side effects caused by medical marijuana found that most were mild. When compared with controls, people who used medical marijuana were more likely to develop pneumonia and other respiratory problems, and experience vomiting, and diarrhea.
There's no question that recreational use of marijuana produces short-term problems with thinking, working memory, and executive function (the ability to focus and integrate different types of information). Although little research exists on medical marijuana, anecdotal reports indicate that some patients take the drug at night to avoid these types of problems.
The real debate is about whether long-term use of marijuana (either for medical or recreational purposes) produces persistent cognitive problems. Although early studies of recreational users reported such difficulties, the studies had key design problems. Typically they compared long-term marijuana smokers with people who had never used the drug, for example, without controlling for baseline characteristics (such as education or cognitive functioning) that might determine who continues to smoke the drug and who might be most at risk for thinking and memory problems later on.
Studies suggest that although overall cognitive ability remains intact, long-term use of marijuana may cause subtle but lasting impairments in executive function. There is no consensus, however, about whether this affects real-world functioning.
Additional research, focused on the benefits and consequences of medical marijuana use for specific disorders, may help to clarify some issues. In the meantime, there is not enough evidence to recommend marijuana as a medical treatment for any psychiatric disorder.
Crippa JA, et al. "Cannabis and Anxiety: A Critical Review of the Evidence," Human Psychopharmacology (Oct. 2009): Vol. 24, No. 7, pp. 515–23.
Grinspoon L, et al. Marijuana: The Forbidden Medicine (Yale University, 1997).
Iversen LL. The Science of Marijuana, Second Edition (Oxford University Press, 2008).
Wang T, et al. "Adverse Effects of Medical Cannabinoids: A Systematic Review," Canadian Medical Association Journal (June 17, 2008): Vol. 178, No. 13, pp. 1669–78.
For more references, please see www.health.harvard.edu/mentalextra.
Originally published: April 2010

Sunday, December 25, 2016

Nutritional strategies to ease anxiety

POSTED APRIL 13, 2016, 9:30 AM


http://www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441



According the National Institute of Mental Health, anxiety disorders are the most common mental illness in the United States. That’s 40 million adults—18% of the population—who struggle with anxiety. Anxiety and depression often go hand in hand, with about half of those with depression also experiencing anxiety.
Specific therapies and medications can help relieve the burden of anxiety, yet only about a third of people suffering from this condition seek treatment. In my practice, part of what I discuss when explaining treatment options is the important role of diet in helping to manage anxiety.
In addition to healthy guidelines such as eating a balanced diet, drinking enough water to stay hydrated, and limiting or avoiding alcohol and caffeine, there are many other dietary considerations that can help relieve anxiety. For example, complex carbohydrates are metabolized more slowly and therefore help maintain a more even blood sugar level, which creates a calmer feeling.
A diet rich in whole grains, vegetables, and fruits is a healthier option than eating a lot of simple carbohydrates found in processed foods. When you eat is also important. Don’t skip meals. Doing so may result in drops in blood sugar that cause you to feel jittery, which may worsen underlying anxiety.
The gut-brain axis is also very important, since a large percentage (about 95%) of serotonin receptors are found in the lining of the gut. Research is examining the potential of probiotics for treating both anxiety and depression.
Foods that can help quell anxiety
You might be surprised to learn that specific foods have been shown to reduce anxiety.
  • In mice, diets low in magnesium were found to increase anxiety-related behaviors. Foods naturally rich in magnesium may therefore help a person to feel calmer. Examples include leafy greens such as spinach and Swiss chard. Other sources include legumes, nuts, seeds, and whole grains.
  • Foods rich in zinc such as oysters, cashews, liver, beef, and egg yolks have been linked to lowered anxiety.
  • Other foods, including fatty fish like wild Alaskan salmon, contain omega-3 fatty acid. A study completed on medical students in 2011 was one of the first to show that omega-3s may help reduce anxiety. (This study used supplements containing omega-3 fatty acids). Prior to the study, omega-3 fatty acids had been linked to improving depression only.
  • A recent study in the journal Psychiatry Research suggested a link between probiotic foods and a lowering of social anxiety. Eating probiotic-rich foods such as pickles, sauerkraut, and kefir was linked with fewer symptoms.
  • Asparagus, known widely to be a healthy vegetable. Based on research, the Chinese government approved the use of an asparagus extract as a natural functional food and beverage ingredient due to its anti-anxiety properties.
  • Foods rich in B vitamins such as avocado and almonds
  • These “feel good” foods spur the release of neurotransmitters such as serotonin and dopamine. They are a safe and easy first step in managing anxiety.
Are antioxidants anti-anxiety?
Anxiety is thought to be correlated with a lowered total antioxidant state. It stands to reason, therefore, that enhancing your diet with foods rich in antioxidants may help ease the symptoms of anxiety disorders. A 2010 study reviewed the antioxidant content of 3,100 foods, spices, herbs, beverages, and supplements. Foods designated as high in antioxidants by the USDA include:
  • Beans: Dried small red, Pinto, black, red kidney
  • Fruits: Apples (Gala, Granny Smith, Red Delicious), prunes, sweet cherries, plums, black plums
  • Berries: Blackberries, strawberries, cranberries, raspberries, blueberries
  • Nuts: Walnuts, pecans
  • Vegetables: Artichokes, kale, spinach, beets, broccoli
  • Spices with both antioxidant and anti-anxiety properties include turmeric (containing the active ingredient curcumin) and ginger.
Achieving better mental health through diet
Be sure to talk to your doctor if your anxiety symptoms are severe or last more than two weeks. But even if your doctor recommends medication or therapy for anxiety, it is still worth asking whether you might also have some success by adjusting your diet. While nutritional psychiatry is not a substitute for other treatments, the relationship between food, mood, and anxiety is garnering more and more attention. There is a growing body of evidence, and more research is needed to fully understand the role of nutritional psychiatry, or as I prefer to call it, Psycho-Nutrition.


http://www.health.harvard.edu/blog/nutritional-strategies-to-ease-anxiety-201604139441

Friday, December 23, 2016

Mindfulness meditation may ease anxiety, mental stress

OSTED JANUARY 08, 2014, 1:05 PM , UPDATED JANUARY 15, 2016, 10:38 AM


My mom began meditating decades ago, long before the mind-calming practice had entered the wider public consciousness. Today, at age 81, she still goes to a weekly meditation group and quotes Thich Nhat Hanh, a Zen Buddhist monk known for his practice of mindfulness meditation, or “present-focused awareness.”
Although meditation still isn’t exactly mainstream, many people practice it, hoping to stave off stress and stress-related health problems. Mindfulness meditation, in particular, has become more popular in recent years. The practice involves sitting comfortably, focusing on your breathing, and then bringing your mind’s attention to the present without drifting into concerns about the past or future. (Or, as my mom would say, “Don’t rehearse tragedies. Don’t borrow trouble.”)
But, as is true for a number of other alternative therapies, much of the evidence to support meditation’s effectiveness in promoting mental or physical health isn’t quite up to snuff. Why? First, many studies don’t include a good control treatment to compare with meditation. Second, the people most likely to volunteer for a meditation study are often already sold on meditation’s benefits and so are more likely to report positive effects.
But when researchers from Johns Hopkins University in Baltimore, MD sifted through nearly 19,000 meditation studies, they found 47 trials that addressed those issues and met their criteria for well-designed studies. Their findings, published in JAMA Internal Medicine, suggest that mindfulness meditation can help ease psychological stresses like anxiety, depression, and pain.
Dr. Elizabeth Hoge, a psychiatrist at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard Medical School, says that mindfulness meditation makes perfect sense for treating anxiety. “People with anxiety have a problem dealing with distracting thoughts that have too much power,” she explains. “They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit.”
“If you have unproductive worries,” says Dr. Hoge, you can train yourself to experience those thoughts completely differently. “You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,'” says Dr. Hoge.
One of her recent studies (which was included in the JAMA Internal Medicine review) found that a mindfulness-based stress reduction program helped quell anxiety symptoms in people with generalized anxiety disorder, a condition marked by hard-to-control worries, poor sleep, and irritability. People in the control group—who also improved, but not as much as those in the meditation group—were taught general stress management techniques. All the participants received similar amounts of time, attention, and group interaction.
To get a sense of mindfulness meditation, you can try one of the guided recordings by Dr. Ronald Siegel, an assistant clinical professor of psychology at Harvard Medical School. They are available for free at www.mindfulness-solution.com.
Some people find that learning mindfulness techniques and practicing them with a group is especially helpful, says Dr. Hoge. Mindfulness-based stress reduction training, developed by Dr. Jon Kabat-Zinn at the University of Massachusetts Medical School in Worcester, MA, is now widely available in cities throughout the United States.
My mom would point you to Thich Nhat Hahn, who offers this short meditation in his book Being Peace: “Breathing in, I calm my body. Breathing out, I smile. Dwelling in the present moment, I know this is a wonderful moment.”

http://www.health.harvard.edu/blog/mindfulness-meditation-may-ease-anxiety-mental-stress-201401086967

Wednesday, December 21, 2016

Managing worry in generalized anxiety disorder

POSTED FEBRUARY 17, 2016, 9:00 AM

Srini Pillay, MD, Contributor

http://www.health.harvard.edu/blog/managing-worry-in-generalized-anxiety-disorder-201602179172

Everyone worries, but some people worry more than others. When worry is excessive, people may develop generalized anxiety disorder (GAD). In fact, close to a quarter of people who go to their primary care physicians with anxiety suffer from this.
In general, stressful events in childhood and adulthood, having strained economic resources, being divorced, and being female all put you at risk for GAD. But what do all of these different high-risk groups have in common psychologically? Why do they worry so much? And what can they do about this?
The surprising benefits of worry for people with GAD
A recent study explained why people with GAD worry so much — and the findings may surprise you. While many people think they are just worriers, they do not realize that they actually worry for a reason. Their worry is an attempt to protect themselves! If you’re wondering how such a nagging, persistent, annoying, and sometimes distressing psychological state can be helpful, you’re probably not alone. But the findings do in fact make some sense.


It turns out that worrying about something puts your mind into a negative state, but this helps, because when something negative does happen, you don’t feel that much worse. You’ve already been feeling bad. For people with GAD, it’s better to feel bad most of the time so that a negative event — someone being ill, sudden financial challenges, or rejection from a loved one — doesn’t have the power to create a massive emotional swing. It’s the sudden shift from a neutral or positive mood to a negative one that is of great concern to worriers. They will do anything to avoid this, include preparing to be miserable. They really hate the contrast of a situation unexpectedly going south. To people who aren’t worriers, this would sound counterintuitive, but they don’t have the same sensitivity to sudden emotional shifts. In fact, for them, worry is undesirable, whereas worriers find worry helpful.
This poses a dilemma for treatment, then. If someone has GAD, just asking them to lose the worry will not work. And if you have GAD, expecting your brain to simply stop worrying on command is a tall order. Another study has helped us understand that people who are prone to worrying are soft-wired to pay attention to threatening news, thereby building up a library of evidence in their brains that worrying is necessary. Think about it. On any given day, there are so many threatening things happening in the world — anything from new viruses, terrorist attacks, or political conflicts to a hostile email or upcoming storm are all real events. Yet, if you only pay attention to the threats, you have no space left in your brain to process anything else. Threat becomes your reality, and worry becomes your justifiable response. Anyone telling you to give up your worry will sound out of touch, to say the least.
What you can do to get your worry under control


As challenging as this sounds, there are things that you can do to retrain your brain to stop worrying. Cognitive behavioral therapy, a type of talk therapy where you simply revisit your assumptions in an attempt to reframe your thoughts, works according to some studies but not others.
It’s important to remember that you can benefit from other forms of talk therapy, though, and that you can benefit from medications as well. But if you want to try changing the way you think right now, prior to therapy or while you’re waiting, you might consider the following approach.
Rather than challenging yourself or someone else about worry, you can actually accept that the worry is serving a purpose — to avoid a sudden negative swing. Then, start to delve deeper so you can discover that the negative swing is probably less negative than you think. Giving up the struggle and control with worry, and accepting that it has not been helpful, is the next step. You can then re-examine your library of negative “proof” and swap out threatening realities for positive ones. In fact, this kind of deliberate optimism can protect you from GAD.
Worry in GAD can be debilitating, but there is an increasing amount of data that shows you can address this effectively.


http://www.health.harvard.edu/blog/managing-worry-in-generalized-anxiety-disorder-201602179172

Monday, December 19, 2016

The Strange Psychology of Stress and Burnout


The Strange Psychology of Stress and Burnout. Machine Intelligence Explained. America's Top Spy on Our Ominous Future.

http://www.bbc.com/capital/story/20161116-stress-is-good-for-you-until-it-isnt?utm_source=pocket&utm_medium=email&utm_campaign=pockethits



  • By Alina Dizik
17 November 2016
As a neonatal nurse, Jennifer Welker learned to thrive under stress.
Rather than allowing the pain of handling a sick infant to affect her, Welker deftly handled some of the most challenging moments in her career, and quickly moved on from difficult situations.
She credits her efficiency to the advantages of working under stress. Harnessing the innate pressure that came with her role, she says, improved her productivity and performance. Still, it was a fine line between harnessing the pressure and ignoring it altogether.
“I was almost too good at my job,” says Welker who would often have to spend time in the morgue. “I had become cold and callous because you have to emotionally withdraw from the moment.”
After some time, the stress involved in her work reached a tipping point and won out. She could neither control nor ignore it any longer.
I was almost too good at my job
“I saw a lot of death and people on their worst day – that weighs on you,” she said. Ultimately, she began to suffer from what is termed chronic stress. Symptoms can include anything from decreased immunity to sleep problems. She launched a jewellery business as a therapeutic outlet from the demands of nursing.
With her health beginning to suffer, Welker quit her job three years ago and turned to her jewellery business fulltime.
It can be good for you – until it’s not
While bouts of workplace stress can help you better focus on tasks and increase efficiency, chronic stress can impact the quality of your work, jeopardising your employment, and your life outside of the office.
It’s difficult to tell when the stress hits a breaking point, and you start suffering the effects of burnout. While stress is emotional or mental strain that can come and go, burnout is the physical, mental emotional exhaustion that occurs after prolonged stress. It emerges over time and can be more difficult to recover from.
“It’s not always made explicit, but in reality there are consequences that people face when they appear not to deal with their stress in the workplace,” says Stefano Petti, a partner at Asterys, an organiational development firm in Rome.


Saturday, December 17, 2016

Inhibitory motor control problems may be unique identifier in adults with ADHD

By Victoria M. Indivero

November 15, 2016

http://news.psu.edu/story/437963/2016/11/15/research/inhibitory-motor-control-problems-may-be-unique-identifier-adults

SAN DIEGO — Young adults diagnosed with ADHD may display subtle physiological signs that could lead to a more precise diagnosis, according to Penn State researchers.
In a recent study, young adults with ADHD, when performing a continuous motor task, had more difficulty inhibiting a motor response compared to young adults who did not have ADHD. The participants with ADHD also produced more force during the task compared to participants without ADHD.
Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder that can continue to affect up to 65 percent of these children as they become adults, according to the researchers.
"A large group of individuals have the label 'ADHD,' but present with different symptoms," said Kristina A. Neely, assistant professor, kinesiology. "One of the goals of our ADHD research is to discover unique physiological signals that may characterize different subgroups of the disorder."
Previous studies have shown that some individuals with ADHD may have poor control of their motor systems, but until recently, the way that it was measured was not very sensitive.
"In previous tasks, motor and cognitive function was evaluated with a key-press response: You hit the button or you didn't," said Neely. "We measure precisely how much force an individual is producing during a continuous motor task. This type of task provides us with more information than the dichotomous 'yes/no' response."
In a recent study using a continuous motor task, participants produced force with their index finger and thumb in response to cues on a visual display. Participants were instructed to produce force when the visual cue was any color except blue. In the "blue" trials, participants were told to withhold force production.
Neely and colleagues found that participants with ADHD symptoms produced more force on trials when they were told to withhold a response, compared to those without ADHD. Further, the amount of force that was produced during these trials was correlated with specific ADHD-related symptoms. The researchers present their findings at the annual Society for Neuroscience meeting today (Nov. 15).
"The use of a precise and continuous motor task provides a more nuanced understanding of inhibitory control, compared to a button-press task," said Neely. "We found that young adults with ADHD produced more force on the 'blue' trials compared to young adults without ADHD. And the amount of force produced was related to self-report of ADHD-related symptoms of inattention, hyperactivity and impulsivity. Moving forward, we will manipulate the parameters of our force-production task to determine which aspects of motor control are related to specific symptoms."
Understanding the impact of particular types of ADHD and their effect on motor function could lead to more targeted diagnoses -- which could aid in determining optimal treatment options for patients based on their specific symptom profile.
Peiyuan Wang, graduate student, kinesiology; Amanda Chennavasin, recent undergraduate, biomedical engineering; Jacqueline R. Tucker, sophomore, biomedical engineering; Marissa Reynolds, project coordinator; Cynthia L. Huang-Pollock, associate professor, psychology; and Koraly PĂ©rez-Edgar, associate professor, psychology, all at Penn State; and Shaadee Samimy, graduate student, psychology, now at The Ohio State University, also contributed to this research.
This work was supported by the Penn State Clinical and Translational Science Institute and a CTSI Mentored Training Award to Neel

Thursday, December 15, 2016

4 ways to boost your energy naturally with breakfast


Healthful protein, slowly digested carbohydrates, fruit or vegetables serve up best morning mix


http://www.health.harvard.edu/staying-healthy/4-ways-to-boost-your-energy-naturally-with-breakfast





As you sleep, your body is hard at work digesting yesterday's dinner. By the time you wake up, your body and brain are demanding fresh fuel. "Breaking the fast" is a key way to power up in the morning. Do it right and the benefits can last all day.
If you miss the day's first meal, notes Dr. David S. Ludwig, a nutrition expert at Harvard-affiliated Children's Hospital Boston, you may start off with an energy deficit and have to tap into your energy reserves.
What's a good breakfast? One that delivers some healthful protein, some slowly digested carbohydrates, and some fruit or vegetables. A vegetable omelet with a slice of whole-grain toast qualifies, as does a bowl of high-fiber cereal topped with fresh fruit and reduced-fat or soy milk, along with a handful of almonds or walnuts.
Try these 4 tips for creating your own energy-boosting breakfast:
  1. Choose whole grains. High-fiber, whole-grain cereals and breads can help keep your blood sugar on an even keel and avoid a midmorning energy crash. With the hundreds of types of cereal on the market, bran cereal, bran flakes, and steel-cut oatmeal are typically the healthiest bets. To choose the healthiest breakfast cereal, read the label and look for:
    • 5 grams or more of fiber per serving
    • less than 300 milligrams of sodium per serving
    • less than 5 grams of sugar per serving
    • whole grain as the first item on the ingredient list
  1. Include protein. Yogurt is a good choice; Greek yogurt has more protein than regular yogurt. Eggs (up to one a day) are okay for healthy people. Although yolks are high in cholesterol, eggs have proteins, vitamins, and other nutrients and don't appear to increase the risk for developing heart disease.You might also include foods that have healthful fats such as those in nuts or salmon. Limit processed meats to the occasional treat as these foods are associated with a higher risk of colorectal cancer, heart disease, and type 2 diabetes.
  2. Eat in, not out. You can enjoy a healthful breakfast out if you stick to oatmeal. But much of the traditional fare will start your day with loads of refined carbohydrates and saturated fat. Like most processed food, the breakfast offerings from fast-food chains tend to be high-sodium, low-fiber disasters.
  3. Blend up a breakfast smoothie. Combine fruit, juice, yogurt, wheat germ, tofu, and other ingredients. Toss them in your blender with a bit of ice and you have a refreshing, high energy breakfast.
For more on developing natural strategies for boosting your energy, buy Boosting Your Energy, a Special Health Report from Harvard Medical School.

Updated: October 28, 2016
Originally published: March 2013

Tuesday, December 13, 2016

Guidelines May Have Helped Curb ADHD Diagnoses


Still, too few with disorder receive behavior therapy, child psychologist says

By Steven Reinberg


http://www.webmd.com/add-adhd/news/20161115/guidelines-may-have-helped-curb-adhd-diagnoses-in-preschoolers#1



TUESDAY, Nov. 15, 2016 (HealthDay News) -- In a bit of good news, the rate of diagnoses for attention-deficit/hyperactivity disorder (ADHD) among U.S. preschoolers has leveled off, a new study finds.
At the same time, the prescribing rate of stimulant medications for these young patients has also stayed steady, a promising trend that researchers credit to treatment guidelines that were introduced in 2011.
The guidelines, issued by the American Academy of Pediatrics (AAP), called for a standardized approach to diagnosis, and recommended behavior therapy -- not drugs -- as the first-line therapy for preschoolers.
"There [was] a concern that preschoolers get too much behavioral diagnosis and medications for behavior problems," explained study author Dr. Alexander Fiks. He is associate medical director of the Pediatric Research Consortium at Children's Hospital of Philadelphia.
One in every three children diagnosed with ADHD is diagnosed during preschool years, Fiks said. Of these kids, 47 percent are treated with medication alone or in combination with behavior therapy, according to the study authors.
Among more than 87,000 children aged 4 to 5, about 0.7 percent were diagnosed with ADHD before the guidelines, the study showed.
After the guidelines, 0.9 percent of more than 56,000 kids were diagnosed with the disorder. And, the rate of prescribing stimulant medications such as Ritalin remained constant, at 0.4 percent of those diagnosed with ADHD, according to the report.

"One might have worried that if you were telling pediatricians how to manage preschool ADHD that all of a sudden there would be an explosion in the number of kids being diagnosed, or many more would be on medication. And the fact that the increasing trend leveled off is reassuring and that medication use didn't increase is also reassuring," Fiks said.
"It suggests pediatricians are taking the guidelines to heart and not using them as a reason to willy-nilly label kids with ADHD," Fiks said. "When parents of preschoolers are confronted with a child with behavior problems, it's reasonable to talk with their pediatrician."

Sunday, December 11, 2016

When is Compromise a Sign of Strength?



http://bigthink.com/influence-power-politics/when-is-compromise-a-sign-of-strength





As children, many of us read in our U.S. history classes about the “great compromiser,” Henry Clay, congressman and secretary of state under John Quincy Adams.  Clay argued effectively for compromise on major issues of the day.  A young Abraham Lincoln admired him as an ideal statesman.
Compromise has become repulsive to many in the current U.S. Congress – a sign of weakness rather than a pragmatic way forward when opposing parties disagree strongly.  This wholesale denigration of a fundamental part of negotiation leaves aspiring statespersons, and people who would follow their lead in professional and personal life, figuratively limping about as if missing one of their legs.  Our persuasion and negotiation options are being limited because a core strategy is being rendered unusable.
To disparage compromise as a sign of moral or intellectual weakness is foolhardy and deceptive.  So often nowadays we read or hear, “We will not compromise” even before discussions begin on national issues.  Such an attitude disguises an inability to engage in the process with any degree of success. 
Compromise is challenging.  It requires us to understand and even appreciate the views of people with whom we staunchly disagree.  This is hard work; it’s much easier to remain entranced by one’s own views.  
But, where would the world be without the advancements enabled by many centuries of compromise in governance, commerce, finance, industry, marriage and other aspects of life?
What to do?  It’s time for myopic leaders to step back and think about what constitutes good compromise -- for all of us to do so.  What characteristics of time, place, opportunity, and amount justify the effort to move away from intransigent positions to some level of agreement? 
Here are five key conditions under which compromise is likely to be a constructive alternative to such dogmatism:
(1) Prioritizing -- When the outcome you (or others you represent) may obtain is significantly better than current conditions.
(2) Anticipating -- When compromise on the obstacle issue would open the door to movement forward on a more important issue.
(3) Relational Focus -- When refusal to compromise is likely to exert long-term or even irreparable harm to the relationships of the parties involved.
(4) Fairness or Balance -- When reciprocity requires at least some compromise for working or personal relationships to endure.
(5)  Breaking habits – In order to interrupt a dysfunctional pattern that the parties have inadvertently, mindlessly or antagonistically adopted.
There are others, but these are important considerations before shutting down the option of compromise.
Amputating a valuable method for dealing with disagreement is as intellectually, psychologically and politically dysfunctional as it is just plain ludicrous.  Standing pat in order to appear strong actually results in the appearance, and often the reality, of weakness.  When the issues are complex and threatening to healthy relationships and a civilized society, the more strategies available the better.  

photo: fotoscool/shutterstock.com

Friday, December 9, 2016

Increased smartphone screen-time associated with lower sleep quality

Date:
November 10, 2016
Source:
PLOS
Summary:

Exposure to smartphone screens is associated with lower sleep quality, according to a study that used a smartphone app to record the daily screen-time of over 650 adults.

https://www.sciencedaily.com/releases/2016/11/161110155020.htm


xposure to smartphone screens is associated with lower sleep quality, according to a study published November 9, 2016 in the open-access journal PLOS ONE by Matthew Christensen from the University of California, San Francisco, USA, and colleagues.
Smartphones are increasingly becoming part of everyday life, but questions remain about the effects of frequent use on sleep. Poor sleep is associated with health conditions such as obesity, diabetes and depression.
Christensen and colleagues sought to test the hypothesis that increased screen-time may be associated with poor sleep by analyzing data from 653 adult individuals across the United States participating in the Health eHeart Study. Participants installed a smartphone application which recorded their screen-time, defined as the number of minutes in each hour that the screen was turned on, over a 30-day period. They also recorded their sleeping hours and sleep quality.
The researchers found that each participant totaled an average of 38.4 hours over this period, with smartphones being activated on average for 3.7 minutes in each hour. Longer average screen-time was associated with poor sleep quality and less sleep overall, particularly when smartphones were used near participants' bedtime.
The authors state that their study is the first to measure smartphone exposure prospectively, but caution that the study also had some important limitations, including the self-selection of study participants and self-reporting of data. While the authors' findings cannot show causation or exclude the "effect-cause" that poor sleep could lead to more screen time, the association they found could fit with the theory that bedtime smartphone use may negatively impact sleep.

Story Source:
Materials provided by PLOS. Note: Content may be edited for style and length.
/story_source

Journal Reference:
  1. Matthew A. Christensen, Laura Bettencourt, Leanne Kaye, Sai T. Moturu, Kaylin T. Nguyen, Jeffrey E. Olgin, Mark J. Pletcher, Gregory M. Marcus. Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep. PLOS ONE, 2016; 11 (11): e0165331 DOI: 10.1371/journal.pone.0165331

Tuesday, December 6, 2016

Autism Pregnancy / Obstetrics Pharmacy / Pharmacist ADHD / ADD Acetaminophen use in pregnancy linked to autism, ADHD in offspring

Written by Honor Whiteman
Published: Monday 4 July 2016

http://www.medicalnewstoday.com/articles/311418.php

Acetaminophen is one of the very few painkillers considered generally safe to use during pregnancy. A new study, however, suggests it may not be so safe after all, after identifying a link between prenatal exposure to the drug and symptoms of autism and attention deficit hyperactivity disorder




The study - led by researchers from the Center for Research in Environmental Epidemiology (CREAL) in Barcelona, Spain - is published in the International Journal of Epidemiology.
Also known as paracetamol, acetaminophen is one of the most commonly used over-the-counter medications during pregnancy. Around 65 percent of expectant mothers in the United States use the drug.
All pregnant women should seek medical advice before taking any medications, but for most mothers-to-be, acetaminophen use is deemed safe. A 2010 study from the Centers for Disease Control and Prevention (CDC) found no increased risk of major birth defects with use of acetaminophen in the first trimester of pregnancy, and some studies have even suggested it may lower the risk of birth defects.
However, there has been some evidence that acetaminophen use during pregnancy may interfere with the brain development of offspring. In 2014, a study published in JAMA Pediatrics found that expectant mothers who used acetaminophen were more likely to have children with behaviors associated with attention deficit hyperactivity disorder (ADHD).


Assessing the link between acetaminophen and ADHD, autism
For this latest study, lead author Claudia Avella-Garcia, a researcher at CREAL, and colleagues set out to further investigate the association between acetaminophen use in pregnancy and ADHD among offspring, as well as determine whether there might be a link with autism.
The team enrolled 2,644 expectant mothers to their study. At 12 and 32 weeks of pregnancy, the women completed a questionnaire, in which they were asked whether they had used acetaminophen in the month prior to becoming pregnant or during their pregnancy.
The women were also asked how often they had used the drug, though the exact doses used could not be assessed, due to mothers being unable to recall them.
The neuropsychological development of 88 percent of the women's offspring was assessed at the age of 1 year, while 79.9 percent were assessed at the age of 5 years.
At 1 year, the children's neuropsychological development was evaluated using the Bayley Scales of Infant Development (BSID), while a number of tests - including the McCarthy Scales of Children's Abilities (MCSA) and the Childhood Autism Spectrum Test (CAST) - were used for evaluation at 5 years.


Prenatal acetaminophen exposure linked to autism symptoms in boys
The researchers found that 43 percent of the children assessed at the age of 1 and 41 percent of those assessed at age 5 were born to mothers who used acetaminophen in the first 32 weeks of pregnancy.
Compared with children born to mothers who did not take acetaminophen during pregnancy, the researchers found that those whose mothers used acetaminophen in the first 32 weeks of pregnancy were 30 percent more likely at age 5 to have attention impairments, often found in children with autism or ADHD.
Children prenatally exposed to acetaminophen were also more likely to have symptoms of hyperactivity or impulsivity at the age of 5. Those who had been persistently exposed to the drug performed worse on tests of attention, impulsivity, and visual speed processing.
Furthermore, the researchers found boys with prenatal acetaminophen exposure were more likely to have clinical symptoms of autism than non-exposed boys, and the incidence of such symptoms increased with persistent exposure to the drug.
This finding, the team says, could explain why boys are much more likely to develop autism than girls.
"The male brain may be more vulnerable to harmful influences during early life," says Avella-Garcia. "Our differing gender results suggest that androgenic endocrine disruption, to which male brains could be more sensitive, may explain the association."
Overall, the researchers say their findings indicate that children exposed to acetaminophen in the womb may be at greater risk of symptoms of autism or ADHD.

http://www.medicalnewstoday.com/articles/311418.php

Monday, December 5, 2016

9 Signs That You Might Be a Perfectionist

you might be perfectionist and not even know it




https://www.psychologytoday.com/blog/better-perfect/201611/9-signs-you-might-be-perfectionist



You may not have a meticulously organized junk drawer or a closet full of clothes organized by color or sleeve length, but perfectionist traits may still be affecting your life—and holding you back. Can you relate to any of these habits?

  1. You think in all-or-nothing terms. Something is either right or wrong, good or bad, perfect or a disaster. You tend to think in one extreme or the other, rather than seeing the characteristics of people and situations existing along a continuum. For example, you tend to think, "She is mean,” instead of, “She can sometimes be mean.”
  2.  
  3. You think, and then act, in extremes. Have you ever acted on a sentiment like this, more than once?: "I had one cookie and screwed up my diet...I might as well eat them all.”
  4.  
  5. You can’t trust others to do a task correctly, so you rarely delegate. Others may see you as a micro-manager or control-freak, but you see your actions as just wanting to get the job done right.
  6.  
  7. You have demanding standards for yourself and others. You believe in always giving your best and you expect others to do the same. And you are scared to death of looking like a failure.
  8.  
  9. You have trouble completing a project because you think there is always something more you can do to make it better. You obsess about sharing your book, project, meal, invitation, business card, website, article, or speech with others. You want to make sure your work is the best it can be before revealing it.
  10.  
  11. You use the word “should” a lot. “I should do this," and “They should do that,” may be common phrases, both out loud and inside your head. You have certain “rules” you believe that you, and others, should follow. And when those rules aren't followed, you are not pleased.
  12.  
  13. Your self-confidence depends on what you accomplish and how others react to you. You strive for excellence and need validation from others to feel good about your accomplishments. What’s more, once you have achieved a goal, you quickly move on to the next one.
  14.  
  15. You tend to fixate on something you messed up. You may have done something right, but still focus instead on the one mistake you made.
  16.  
  17. You procrastinate, or avoid situations where you think you might not excel. It may seem counterintuitive, but many people who procrastinate or avoid doing something are actually perfectionists: They're afraid they will fail. Their rationale is, “I might not be able to do it perfectly, so why bother at all?”

Voting is an important right that the government has granted to all US citizens

The US Constitution in various Amendments has expanded and reformed the voting rights of American citizens.  However, the rights of our disabled citizens were only addressed by the Americans with Disabilities Act of 1990 (ADA), the National Voter Registration Act of 1993 (Motor-Voter Act) and the Help America Vote Act of 2001 (HAVA).
In 1999, the NYS Attorney General reviewed the accessibility of polling places and discovered many issues that required improvement.  Since 1999, NYS has tried to improve the voter turnout among the disabled however, as the past election of November 8, 2016 can attest, many problems are still present, depriving voters with disabilities their constitutional right to vote.
Voting is an important right that the government has granted to all US citizens.  Through voting the average citizen will obtain a voice in their government.  This allows our citizens to have a say in decisions that will have a significant impact on their lives.  Therefore, when polling sites are not fully compliant with State and Federal laws, the disabled persons’ participation in the democratic process is obstructed.
In New York City, numerous examples of lack of accessibility have been brought to our attention.   The past Presidential Election was obviously a game changer and the Polling Sites should have been fully staffed with well-trained poll workers and additional support staff on standby.  Instead we heard numerous complaints, some are listed below:
  1. The Ballot Marking Device assists voters with marking their selections on the paper ballot.  The voter can view the ballot in different languages or font sizes.  The BMD can aid people with various physical problems that may impede their voting rights.  The BMD is attended by a Republican and a Democrat.  However, we have been informed of instances where no one was stationed at the BMD.  Eventually, when the voter was noticed, it was reported that poll workers not fully trained in use of the BMD, were called over to assist.  This led to long waits further inconveniencing those with disabilities.
  2. Another common complaint was that of the lack of an accessibility clerk.  This clerk ensures that the alternate accessible entrance to the poll site is available to disabled voters.  The accessibility clerk is also responsible for completing every 2 hours an  ADA check list.  The clerk also places outside signage that informs the voters of the location of the alternate accessible entrance.  It was brought to our attention that signs were missing and that clerks were not present.
  3. The next issue affected all voters, but was particularly troublesome for voters having mobility issues.  A couple of months ago, PBS reported on the purging of 126,000 voters from the election rolls and I believe that there are still outstanding issues related to missing voters.  After waiting at some polling places for over an hour, people were told again that they weren’t listed, a very stressful event.  For some people with disabilities, an absentee ballot may work well, however many people want to be part of the voting experience and after taking the trouble to wait online, they do not want to be handed an affidavit.  This problem must be resolved.  This past April, City Comptroller Scott Stringer released a statement acknowledging “that there is nothing more sacred in our nation than the right to vote, yet election after election, reports come in of people who were inexplicably purged from the polls, told to vote at the wrong location or unable to get in to their polling site”.

I hope that the above events experienced by myself and others, will bring finally to the attention of the Board of Elections and the Attorney General of New York State, the various issues that have caused stress to our voting public and in particularly those with disabilities.  This past Presidential Election was extremely important and I believe that potential voters did not all vote due to the above listed concerns.  For those of us that have disabilities, the lack of people assigned to the Ballot Marking Devices, or the lack of appropriate translators and the improper location of outside signs, may have deterred people from casting their votes.  It is our duty to provide a safe and accessible location for all American Citizens to vote.  These basic complaints were prevalent throughout all the 50 States.  The Federal government must vigorously address these complaints and issues with stronger language to the states to resolve these problems.  Hopefully, by the next election, these recurring issues will be addressed and the general public will not experience any deterrents to our constitutional rights.  

Sunday, December 4, 2016

Accessibility for Voting on November 8 2016

The US Constitution in various Amendments has expanded and reformed the voting rights of American citizens.  However, the rights of our disabled citizens were only addressed by the Americans with Disabilities Act of 1990 (ADA), the National Voter Registration Act of 1993 (Motor-Voter Act) and the Help America Vote Act of 2001 (HAVA).
In 1999, the NYS Attorney General reviewed the accessibility of polling places and discovered many issues that required improvement.  Since 1999, NYS has tried to improve the voter turnout among the disabled however, as the past election of November 8, 2016 can attest, many problems are still present, depriving voters with disabilities their constitutional right to vote.
Voting is an important right that the government has granted to all US citizens.  Through voting the average citizen will obtain a voice in their government.  This allows our citizens to have a say in decisions that will have a significant impact on their lives.  Therefore, when polling sites are not fully compliant with State and Federal laws, the disabled persons’ participation in the democratic process is obstructed.
In New York City, numerous examples of lack of accessibility have been brought to our attention.   The past Presidential Election was obviously a game changer and the Polling Sites should have been fully staffed with well-trained poll workers and additional support staff on standby.  Instead we heard numerous complaints, some are listed below:
  1. The Ballot Marking Device assists voters with marking their selections on the paper ballot.  The voter can view the ballot in different languages or font sizes.  The BMD can aid people with various physical problems that may impede their voting rights.  The BMD is attended by a Republican and a Democrat.  However, we have been informed of instances where no one was stationed at the BMD.  Eventually, when the voter was noticed, it was reported that poll workers not fully trained in use of the BMD, were called over to assist.  This led to long waits further inconveniencing those with disabilities.
  2. Another common complaint was that of the lack of an accessibility clerk.  This clerk ensures that the alternate accessible entrance to the poll site is available to disabled voters.  The accessibility clerk is also responsible for completing every 2 hours an  ADA check list.  The clerk also places outside signage that informs the voters of the location of the alternate accessible entrance.  It was brought to our attention that signs were missing and that clerks were not present.
  3. The next issue affected all voters, but was particularly troublesome for voters having mobility issues.  A couple of months ago, PBS reported on the purging of 126,000 voters from the election rolls and I believe that there are still outstanding issues related to missing voters.  After waiting at some polling places for over an hour, people were told again that they weren’t listed, a very stressful event.  For some people with disabilities, an absentee ballot may work well, however many people want to be part of the voting experience and after taking the trouble to wait online, they do not want to be handed an affidavit.  This problem must be resolved.  This past April, City Comptroller Scott Stringer released a statement acknowledging “that there is nothing more sacred in our nation than the right to vote, yet election after election, reports come in of people who were inexplicably purged from the polls, told to vote at the wrong location or unable to get in to their polling site”.

I hope that the above events experienced by myself and others, will bring finally to the attention of the Board of Elections and the Attorney General of New York State, the various issues that have caused stress to our voting public and in particularly those with disabilities.  This past Presidential Election was extremely important and I believe that potential voters did not all vote due to the above listed concerns.  For those of us that have disabilities, the lack of people assigned to the Ballot Marking Devices, or the lack of appropriate translators and the improper location of outside signs, may have deterred people from casting their votes.  It is our duty to provide a safe and accessible location for all American Citizens to vote.  These basic complaints were prevalent throughout all the 50 States.  The Federal government must vigorously address these complaints and issues with stronger language to the states to resolve these problems.  Hopefully, by the next election, these recurring issues will be addressed and the general public will not experience any deterrents to our constitutional rights.