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With over 20,000 hits and 275 posts, Buckeye Psychiatry’s Blog was recently named one of the 100 Best Blogs for Psychology Students.  Angela Peterson says “Ohio-based psychiatrist Dr. Adam Brandemihl posts quick, easy-to-understand updates on new developments and trends in psychology”.  http://tinyurl.com/100-best-psych-blogs

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081125_Recession_US_MapThe New York Times (5/18, BU11, Seligson) reports, “Amid high unemployment and layoffs, mental-health professionals are seeing a marked increase in the time they spend talking about career-related issues with patients.” These days, “many people are seeking guidance from therapists about how to confront the storm that has hit the job market and toppled their lives.” Therefore, “sessions are often becoming a mosaic of traditional therapy, loosely defined as more process-oriented and focused on the past, and of coaching, which tends to be more goal- and behavior-oriented.” According to Robert C. Chope, PhD, of “San Francisco State University and president of the employment counseling division of the American Counseling Association,” there is now “more recognition that job issues ‘have a huge mental health component,'” and “a ‘stronger move to understand the context of jobs, toxic co-workers, and the ramifications of massive layoffs.'”

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The safety of students, faculty, staff and patients remains our top priority. We continue to work with local health agencies to receive the most current information, and contingency plans will be implemented quickly if the situation worsens. In the meantime, this list of frequently asked questions has been developed to better inform you. These questions will be posted on the emergency web site http://www.emergency.osu.edu/ and will be updated as needed.
Sincerely,
Bob Armstrong
Director, Emergency Management & Fire Prevention


What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses. Outbreaks of swine flu happen regularly in pigs. People do not normally get swine flu, but human infections can and do happen. The current influenza epidemic in humans is caused by the H1N1 influenza virus and is really a genetic re-assortment of swine, bird and human flu virus. It has not yet been identified in pigs, but is causing human infections.

Is this H1N1 flu contagious? How do you catch it?
The Centers for Disease Control has determined that this influenza virus is contagious but it not known how easily the virus spreads between people.

Spread of this flu can occur in two ways:
Through contact with infected pigs or environments contaminated with swine flu viruses. OR
Through contact with a person with swine flu. Human-to-human spread of this virus is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.

What are the signs and symptoms of H1N1 flu in people?
The symptoms in people are similar to the symptoms of regular human flu and include:
fever greater than 100 degrees
cough
sore throat
body aches
headache
chills and fatigue
respiratory congestion
Some people have reported diarrhea and vomiting associated with this virus. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with this flu infection in people. Like seasonal flu, the H1N1 flu may cause a worsening of underlying chronic medical conditions.

Are there medicines to treat the H1N1 flu?
Yes. The CDC recommends the use of oseltamivir or zanamivir (commonly known as Tamilfu and Relenza) for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).
Ohio State’s Medical Center and Wilce Student Health Center have a ready supply of these antiviral drugs needed to treat this influenza.

How long can an infected person spread the H1N1 flu to others?
People with the H1N1 influenza virus infection should be considered potentially contagious as long as they are symptomatic and possibly for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.
Because of this 7-day incubation period, it is unlikely that anyone who traveled to Mexico for spring break between March 21 – 29 would now be presenting with H1N1 influenza symptoms.

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against H1N1 flu. However, there are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:
Wash your hands with soap and water OR Use alcohol hand rubs which are easy and effective to prevent spread of infection, especially after coughing/sneezing.
Cover your nose and mouth with a tissue when you cough/ sneeze; throw the tissue in the trash after you use it.
Cough/sneeze into your elbow, if you do not have a tissue.
Avoid close contact with sick people.
If you do get sick with influenza, CDC recommends you stay home from work/school and limit contact with others to avoid infecting them.
If employees are sick, they should go to their primary care physician or the University Health Connection in Parks Hall.
If students are sick they should go to the Wilce Student Health Center.

What should I do if I get sick?
If you become ill with influenza-like symptoms – including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea – and you have recently traveled to Mexico or been exposed to someone who has, then you should contact your primary health care provider. Your health care provider will determine whether influenza testing or treatment is needed.
If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.
If you become ill and experience any of the following warning signs, seek emergency medical care:
Difficulty breathing or shortness of breath
Pain or pressure in the chest or abdomen
Sudden dizziness
Confusion
Severe or persistent vomiting

Can I get swine influenza from preparing or eating pork?
No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe. Ohio State University Extension offers detailed information on the proper handling and cooking of pork at


If I received a flu shot this season, am I protected against the H1N1 virus?
No, the current flu shot did not contain strains of the H1N1 influenza virus currently infecting people, so you have not been vaccinated against this virus.

Is it safe to travel to Mexico?
At this time, the CDC recommends that U.S. travelers avoid all nonessential travel to Mexico. Changes to this recommendation will be posted at

http://wwwn.cdc.gov/travel/. Ohio State community members with travel plans are strongly encouraged to check this site for the latest travel information and guidance.  http://www.ag.ohio-state.edu/~news/story.php?id=5153.

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The Ohio State University Medical Center is releasing the following statement this evening (4/29). We want to make sure you received this before it is released to the local news. The Ohio State University Medical Center provided treatment to a patient who was diagnosed with probable swine influenza A (H1N1) virus, which is pending confirmation at the Centers for Disease Control and Prevention (CDC). The patient is an employee of the Medical Center who contracted the virus outside the workplace. The patient responded well to treatment and is being discharged this evening. OSU Medical Center staff followed all recommended precautions to prevent the spread of the illness to others. Individuals who had contact with the patient prior to admission are being notified. The Medical Center is providing prophylactic/preventive medication to those individuals, in accordance with standard CDC recommendations. The Medical Center’s normal patient visitation schedule remains unchanged. The hospital continues to urge all visitors and staff to follow infection control steps including covering your mouth and nose if you have a cough or sneeze, and not visit patients if you are ill. Frequent use of waterless hand sanitizers is also recommended. OSU Medical Center is working in collaboration with the CDC, Ohio Department of Health, and Columbus Public Health and following all appropriate guidelines. For more information on swine influenza, go to http://www.cdc.gov/swineflu. We will provide updates in the following days through e-mail and the university emergency web site http://www.emergency.osu.edu.

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In the Wall Street Journal (4/16) Health Blog, Jonathan D. Rockoff wrote that a new study from ZS Associates, a marketing consultant firm, found that pharmaceutical “reps don’t get in the door to see a doctor on 13 percent of their visits.” Jaideep Bajaj, managing director of sales and marketing consultants ZS Associates, said that the “18 million wasted sales calls each year suggest the extent of a physician backlash against pharma’s marketing push.” Two-billion dollars a year in salaries and expenses represent the cost of the wasted calls to pharmaceutical companies. The Health Blog added that “ZS Associates hasn’t been tracking the success rate for rep visits for very long but it’s clear that doctor access is getting squeezed for the” pharmaceutical-company “detailers.” Pharmaceutical companies, “most recently Johnson & Johnson and Pfizer before that, have reacted by slashing the number of sales reps.”

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Following a HealthDay story, Time (4/15, Kluger) reported that “a sweeping study of the national mood” was “just released in the American Journal of Preventive Medicine.” Researchers from the Centers for Disease Control and Prevention (CDC) “conducted two nationwide surveys,” one from 1993 to 2001, and the other from 2003 to 2006, “of a total of 2.4 million people in more than 3,100 counties across all 50 states.” Survey “respondents were asked to think about their general mental state, including ‘stress, depression, and problems with emotion,’ and then asked how many days in the past month their mental health was generally not good.” Defining frequent mental distress (FMD) “as 14 or more bad days out of 30,” the CDC team found that “between 1993 and 2001, nine percent of Americans were found to be suffering from FMD; by 2006, that number had nosed up to 10.2 percent,” with the “saddest state” being “Kentucky, with a steady 14.4 percent of residents reporting FMD in both surveys.” CNN (4/16, Mann) also reports the story.

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HealthDay (4/2, McKeever) reported that, according to a study published in the journal Psychoneuroendocrinology, “low levels of” the “stress hormone” cortisol “may be responsible for the obsession with routine and dislike for new experiences common in children with” Asperger syndrome (AS). Researchers from the UK’s University of Bristol found that children with AS “do not experience the normal twofold increase of cortisol upon waking up. Levels of the hormone in their bodies do continue to decrease throughout the day, though, just as they do in those without the syndrome.” The investigators pointed out that cortisol “increases blood pressure and blood sugar levels…to signal the body’s need to adapt to changes occurring around it,” and that the “increase shortly after waking” is seen as helping “jump-start the brain for the day ahead.”
        Delving more into the study’s methodology, WebMD (4/2, Hitti) added that the researchers examined “salivary cortisol levels in 20 young men with Asperger’s syndrome and 18 typically developing men of the same age. Participants provided saliva samples upon waking, half an hour later, and about an hour before bedtime.” The study’s authors theorized that “not having that morning spike in cortisol levels may be linked to ‘an extreme need for sameness and resistance to change.'” Still, the study’s “findings don’t prove that; it’s not clear which came first, Asperger’s syndrome or steady salivary cortisol levels in the morning.”

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HealthDay (3/24, Preidt) reported that, according to a study published Mar. 31 in Psychiatry Research: Neuroimaging, “exposure to certain chemicals during the 1991 Gulf War appears to have triggered abnormal responses in the brains of some US veterans.” For the study, researchers from the University of Texas Southwestern Medical Center at Dallas examined “21 chronically ill Gulf War veterans and 17 healthy veterans” who “were given small doses of physostigmine, a substance that briefly stimulates cholinergic receptors on brain cells.” Next, the team “used brain scans to observe levels of cell response in different areas of the brain.” They discovered that areas “in the basal ganglia, hippocampus, thalamus,” and amygdala “responded abnormally to the cholinergic challenge.” The study authors theorized that “changes in functioning of these brain structures” may “cause problems with concentration and memory, body pain, fatigue, abnormal emotional responses and personality changes” often seen “in ill Gulf War veterans.”

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In an op-ed for the New York Times (3/6, A27), Anne Armstrong-Coben, MD, writes, “We have all heard about the wonderful ways in which electronic medical records are supposed to transform our broken healthcare system,” and the “recently passed federal stimulus package provides doctors and hospitals with $17 billion worth of incentive payments to switch to electronic records. The benefits may be real, but we should not sacrifice too much for them.” The computer, she argues, “depersonalizes medicine. It ignores nuances that we do not measure but clearly influence care.” Dr. Armstrong-Coben concludes that “before we embrace the inevitable, there should be more discussion and study of electronic records, or at a minimum acknowledgment of the downside.” She suggests that electronic records should perhaps “be kept only on tablet computers, allowing the provider to write or draw, and to face the patient.” Ultimately, “the personal relationships we build in primary care must remain a priority, because they are integral to improved health outcomes. Let us not forget this as we put keyboards and screens within the intimate walls of our medical homes.”

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Bloomberg News (3/5, Randall) reports, “Americans may soon be able to buy cheap drugs imported from other countries without fear of breaking the law, now that a five-year push in Congress for new rules has gained support in President Barack Obama’s budget.” On Wednesday, Sen. John McCain (R-AZ) and other lawmakers introduced “a proposal to allow drug imports. … Obama called for the changes in his budget last week, and views the measure as one way to reduce healthcare costs so that medical coverage for the uninsured can be expanded.” Data show that “brand-name drugs in other countries cost as much as 70 percent less than in the U.S.” Therefore, “allowing imports would save Americans $50 billion over the next decade, including $10 billion for the U.S. government, the lawmakers said.” Notably, the “Pharmaceutical Research and Manufacturers of America…opposes the legislation. The group has argued that allowing imports would open the door to unsafe, counterfeit medicines.” Meanwhile, “AARP, the largest advocacy group for older Americans, supported” the measure even when it was first introduced on former President George W. Bush.
        CongressDaily (3/5) notes that the lawmakers “expect this to pass,” particularly since “Obama announced in his budget a strong interest in implementing this policy.”

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