Casie A. Forbes

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Monthly Archives: May 2012

Proposed revision to Conversion Disorder in DSM-5 inadequate

Proposed revisions to the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders,” which is scheduled to print in May 2013, have many people with mental illnesses scrambling to submit feedback.

The American Psychiatric Association list the rationale for each proposed revision to the conversion disorder entry for the DSM-5. Screenshot taken from www.DSM5.org

The DSM is published by the American Psychiatric Association, and its most current version, the DSM-4, was printed in 1994. The manual serves as a diagnostic tool for mental health professionals in diagnosing and treating patients with mental disorders.

According to DSM5.org, “These criteria for diagnosis provide a common language among clinicians. By clearly defining the criteria for a mental disorder, DSM helps to ensure that a diagnosis is both accurate and consistent.”

One proposed revision to the DSM-5 is to entry of Conversion Disorder, which is a somatic symptom disorder.

  1. Including the name Functional Neurological Symptom Disorder, or FNSD.
  2. Removing the need for psychological factors.
  3. Removal of previous criterion that symptoms are not intentionally being produced or feigned.

 

Bridget Mildon, the founder of the non-profit group FND Hope, said there are other revisions that should also be included:

“If someone doesn’t put enough anxiety into being sick, they are diagnosed with ‘la belle indifference’; however, now if there is too much anxiety it is another diagnosable illness,” she said. “This criterion is obviously being written by people that have little understanding of the frustration of this type of disorder of unknown causes.”

In addition, Mildon said the severity of physical disabilities regarding conversion disorder is not being recognized enough.

“This has severe impact on the social services that patients are receiving,” Mildon said. “Many are not receiving the benefits and services that are available to other disabled people because of the lack of clarification that this disorder has.”

Individuals who are diagnosed with conversion disorder, or those who know someone with CD, are many of the individuals signing the FND Hope petition. The petition closes on June 1, and will be submitted to the APA on June 15. Screenshot taken from www.FNDhope.org

Mildon wrote a petition that is open until June 1. She will be sending the signed petition to the APA board and the Somatic Work Group before the June 15 deadline.

“The APA Board has a real opportunity to provide a clearer and more accurate definition that would inform and assist clinicians and patients in their quest for appropriate and effective treatment strategies,” she said.

To read and sign the petition, go to http://www.fndhope.org/letter-to-apa/.

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com

Reserve seats for 2013 “CHAIR-ity” Event

 

Washington County residents donated more than $1,700 through the silent auction held April 6, 2012. Artist Gina Jrel plans to make this event an annual activity open to art lovers of all ages. Casie Forbes/Freelance Journalist

Art lovers of all ages are invited to create and donate chairs for the Second Annual “CHAIR-ity” Event hosted by local artist Gina Jrel to benefit the Utah Foster Care Foundation.

A collection of individuals and businesses volunteered their time and efforts this year in building, refurbishing and designing chairs that were auctioned off during the event to raise money for the UFCF.

“I have had a long-standing, strong commitment to use my artwork for purposes that make a positive difference in the world I live in,” Jrel said. “I have been partnered with the Utah Foster Care Foundation for many years through their chalk art festivals,

and I have gotten to know the people who run that organization. I was so impressed with their commitment and passion, and I believe strongly in their cause.”

The UFCF is a non-profit agency with a mission to recruit, educate and support foster families to meet the needs of children within the foster care system, said Debbie Hofhines, the UFCF Southwest Region representative.

“Our contracted funds do not stretch far enough to support families who are already sacrificing much to meet the needs of traumatized and hurt children,” Hofhines said. “Due to state budget constraints, resource families are not paid as much as they deserve.”

This chair, created by Elan Women Magazine, was donated to the CHAIR-ity event as part of its silent auction. Casie Forbes/Freelance Journalist

Mike Hamblin, the UFCF director of foster family recruitment, said the financial support received from the state isn’t able to cover some opportunities that help children in foster care heal.

Hamblin said: “Perhaps the greatest thing donations can help with is what children in foster care need most. Donations can help us reach out to members of the community and find families to care for, love, and nurture children in foster care. Families that can help children heal as their own families work to make home a safe place to return to.”

Jrel extended a personal invitation to those within the Washington County area to attend and donate funds to help place Utah’s children in need of foster homes. The event, held April 6, raised more than $1,700 this year. This total didn’t include the cost of prizes and time donated by various businesses and individuals within the area. Jrel said she hopes the community will attend future events.

“To meet the end goal we need the public to do their part, show up at the event, whip out their kind hearts and wallets, and bid on their favorite chair(s),” Jrel said. “The concept is not new, but I liked it a lot, and I knew it had never been done down here. I thought it would be an awesome way to help a charity of choice and get the public’s creative juices involved and flowing!”

Although next year’s theme has not yet been determined, individuals and businesses can start creating chairs for the second annual event or log on to the UFCF website to make a donation.

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.

Don’t get exploited, realize value in works

Starting off as a new freelance journalist, writer, photographer, or videographer can be an exciting experience, but it can quickly turn sour if freelancers don’t take certain precautions.

It is obvious that experience will ultimately teach a freelancer valuable lessons, but there are ways around learning the hard way. One such lesson is who owns the rights to the copyrighted works that are produced.

According to the U.S. Copyright Office: “Under the copyright law, the creator of the original expression in a work is its author. The author is also the owner of copyright unless there is a written agreement by which the author assigns the copyright to another person or entity, such as a publisher. In cases of works made for hire, the employer or commissioning party is considered to be the author.”

Journalists are taught these basic copyright laws along with the differences between the types of ownerships, but those who are self-taught may or may not know how to protect themselves against companies, publishers, or people who are looking to exploit the author’s works.

One area to be aware of is works-for-hire. According to the Professional Artists League, “Work-for-hire grants authorship and ownership of the work produced to the individual or company (hiring party) who commissioned the work.”

In order for a work to be considered a work-for-hire, it must meet two criteria: first, there must be a written agreement explicitly stating that the work being done is a work-for-hire, and second, both the creator and the person commissioning the work that is created have signed an agreement.

Some contractors might wonder why this is so important; it is important so that both the person(s) commissioning the works and the contractor hired to do the works are absolutely clear on what he or she is expected to do and what he or she is getting in the deal so both parties are legally protected if something goes awry.

Journalist Gus Koernig, a Mesa, Ariz. resident, has spent the last 46 years working as a freelance journalist, and many of his jobs have been works-for-hire.

“My advice is probably born out of experiences where I got exploited,” Koernig said. “[Right out of school] you’re desperate and you want some work. Don’t loose sight of the fact you have a commodity that is valued by employers.”

Koernig recalled times where he did work-for-hire projects where he was paid much less than he said he should have because he needed work.

“I did a lot of stuff for less than half of minimum wage for a website,” Koernig said. “My daughter finally said, ‘you have to get off that website because you’re giving away your talent.’”

Koernig said a lesson freelance journalists should learn is that the clients individuals want to work for are those more interested in quality and not cost. He said, “Clients that are shopping for price usually are pains in the neck as clients because they want the moon and stars for very little money.

To prevent rate problems, or to find out more about work-for-hire, Koernig suggested going online to see the rates within a freelancer’s specific area. The Writer’s Market is also a book Koernig suggests for those looking for work and rates.

“The Writer’s market gives you a good range of pricing; I think The Writer’s Market is hugely valuable,” Koernig said.

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.

Patients should take proactive approach with medical records

A patient walking into a medical office expects a certain amount of privacy regarding his or her records, but there are instances where this privacy is invaded.

Doctors swear to the Oath of Hippocrates, which states, “…whatsoever I shall see or hear in the course of my profession…I will never divulge, holding such things to be holy secrets.” With such an oath comes an understanding between a doctor and a patient that there is some form of confidentiality included with his or her medical records, and that the records will not be released or disclosed without the patient’s permission.

According to the Washington Post Magazine, “Millions of individual medical records float around these days in a vast electronic network that serves both commerce and scientific research…Some of the records are even available through the Internet, part of a $40 billion medical information industry.”

When medical records are released without the permission of a patient, patients can possibly be harmed or lose the trust of the medical facility in which the breach takes place. In some instances, patients can have serious setbacks in treatment. However, the invasion of privacy can reach out to insurance companies as well.

New York Daily News reporter Karen Angel wrote that in her search for a health insurance plan, BlueCross Blue Shield emailed Angel someone else’s application. Angel explained the incorrect application was for another woman with the first name Karen, but nothing else was in common. The women were from two different states, two different Social Security numbers, and more. However, the incorrect application being sent to Angel was a violation of the Health Insurance Portability and Accountability Act, as well as an invasion of privacy.

There are instances where some patients are willing to have their medical records shared with outside sources.

Ashley Bell, a nursing aide at the Oregon Department of Human Services, said: “The doctors in the clinic my husband and I go to work in teams of four to six, and they talk to the other doctors to get input. I think it’s fine because it’s always nice to get an outsider’s prospective on how to better treat a patient.”

Bell said she didn’t see an issue of doctors within the same facility or clinic sharing medical records, but if it is outside of the same medical facility, a doctor should make a patient aware of it.

“If a patient isn’t comfortable with the sharing of information,” Bell said, “the patient can tell the doctors not to share the information, or the patient could find a different clinic.”

In 2003 the HIPAA was set in place. The HIPAA is the national standard for the privacy of health information, according to Privacy Rights Clearinghouse. The act allows patients to access his or her records at any time, and helps protect patients against invasions of privacy. Even with the HIPAA, patients need to take extra steps to prevent any invasions of privacy. Privacy Rights Clearinghouse provides some suggestions for patients:

  1. Discuss concerns of confidentiality with the doctor.
  2. Ask health care providers to take extra precautions when making any photocopies.
  3. Don’t be so quick to fill out marketing-related questionnaires.
  4. Be careful not to divulge health information on health-related websites.
  5. Maintain your own health history.

 

For more tips about how to protect your medical records, visit www.privacyrights.org.

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.

Exposing Conversion Disorder

Casie Forbes prepares for an EEG at the Mayo Clinic in Phoenix, Ariz. in September 2009. Forbes is one of many recently diagnosed with CD who suffer from symptoms such as partial seizures, muscle weakness, incoordination, tics, and more. To learn more about CD, visit http://www.ehow.com/about_6168021_conversion-disorder-inpatient-treatment.html.

Conversion Disorder can be a constant battle for those who suffer from its symptoms; CD patients are frequently warding off comments from doctors, family members, friends and strangers calling them liars and telling CD patients it is “all in your head.”

Last week I published a video briefly describing some of what it’s like living with CD. In the process of researching CD, I came across several closed groups on Facebook that created a space for CD patients to converse and share stories, personal problems, or how their day was going. Some individuals within the groups even had personal YouTube accounts, blogs, or videos posted of episodes they have had with CD. For CD patients, this is a very personal and frightening thing to share because they put themselves out there for judgment. This video was shared with individuals with and without CD, and the responses to the video only came from patients with CD.

One CD patient on Facebook wrote, “It’s awesome.” Another CD patient on Facebook sent a message saying: “I like your video. I thought you did a great job. I can’t wait to see more of your work.” Unfortunately, many individuals couldn’t see the video because their anti-virus software reported my site as malicious.

However, I have learned what other CD patients are going through on a daily basis. One CD Facebook user is in the process of creating a CD foundation to bring awareness and healing to those with CD and their friends and families. It is meant to demonstrate that the symptoms are very real and uncontrollable. These CD patients have inspired me to create a series featuring interviews of different CD patients, neuropsychologists, psychotherapists, and other physicians about the misunderstood disease.

Individuals living with CD have a lot to teach us. Are we listening?

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.

Dr. Google leaves some patients with cyberchondria

It happens to a lot of us: a cough, a muscle ache, abdominal pain, and suddenly we are on the Internet searching what illness we may have contracted.

Since there is a plethora of information available at the click of a button, many people are becoming more proactive in their health management by searching for illnesses that match the symptoms they are having. According to a Harris Poll, American adults who look to the Internet for health information is up to 175 million versus the 154 million people the previous year.

Despite the fact that people could find some helpful information online, there is a point where it can become counterproductive. Cyberchondria is, “an unfounded anxiety concerning one’s wellness brought on by visiting health and medical websites,” according to the American Medical Association. With eight in 10 Americans using the Internet for health information, there is an increase of individuals self-diagnosing themselves with information that could or could not be misinformation.

“In this era, self diagnosis is inevitable. We as physicians need to approach this as teachers and listen to patients’ concerns and educate them about their symptoms, said Dr. Kit C. Lee, a clinical assistant professor in the department of family medicine at the Loyola University Chicago Stritch School of Medicine.

According to the AMA, the most common self-diagnoses include fibromyalgia and lupus because these diseases have vague, but common, symptoms like fatigue, fever, and joint pain.

“Dr. Google has certainly sent me his share of referrals,” Dr. Sharon Horesh Bergquist, an assistant professor of medicine at Emory University, told CNN. “A lot of my patients do a preliminary search and get frightened by something they read. They’ll go to the doctor for something they wouldn’t have initially gone for.”

The AMA reports that the increase in the Internet self-diagnosing patients is partially due to physicians encouraging patients to become proactive in their healthcare in order to improve health outcomes.

“It’s important to stay up on health-related information…but because information on the web is so unfathomably plentiful, so readily available, and so unsorted, it’s easy for someone to jump to the conclusion that they have a brain tumor when in fact it’s just a sinus infection,” Judy Segal, professor of English at the University of British Columbia said. “The problem is, though, that even when the information is reliable, our ability to know what to do with it isn’t. Medical problems are often complicated, and someone without a medical background may jump to false conclusions.”

Berquist said the risks are higher in misdiagnosis when the symptoms are common and vague. In a survey by Wolters Kluwer Health, researchers found Google to be right on a diagnosis 58 percent of the time, but these results depends on the knowledge base of the person searching for answers on a disease. Individuals with a higher knowledge in medicine are more likely to successfully find a correct diagnosis than those without a medical background.

Have something to say? Take a moment to make a comment below, or email Casie at casieaforbes@gmail.com.

Fashion Week marks start of new CFDA guidelines

Many people look forward to New York Fashion Week each year to see the newest trends, but for some, they are looking forward to seeing an updated set of guidelines that address concerns about unhealthy models.

The Council of Fashion Designers of America—composed of fashion designers such as Diane von Furstenberg and Steven Kolb—released new guidelines to protect models from problems such as eating disorders.

“Although these guidelines are good ‘suggestions,’ no real health protections exist in this industry for those under 18. That is particularly worrisome in an industry that is not only known for extreme thinness – in fact, it’s practically required – putting its models at dramatically increased risk of developing an illness that has the highest mortality rate of any other mental illness,” said Lynn Grefe, president and CEO of the National Eating Disorders Association.

The modeling industry has been no exception to deaths from eating disorders. In November 2010 Isabelle Caro died after battling with eating disorders, and she is preceded by Hila Elmalich, an Israeli model who died at a total weight of 66 pounds.

The reason models should be at least 16 years old is so they are mature enough to deal with rejection from designers or disrespectful remarks from photographers or other models, according to the CFDA.

Tory Burch, a fashion designer, said: “There is still an issue, and there is still a lot of work to be done. There have been positive steps. But I see some girls coming in who are really emaciated. It is still a problem.”

Elettra Wiedemann, a 28-year-old model, started off at the young age of 14.

“I did experience when I first started modeling a lot of pressure from my agency in Italy. They asked me to get a breast reduction. They asked me to get a nose job. They constantly critiqued my weight,” Wiedemann said. “You go through a period of sadness and anger and self-loathing, and then I just decided, ‘You know what, I’m much more than just a number on a scale.’ I chose to have a boundary for myself.”

The updated guidelines include the following:

• Educate the industry to identify the early warning signs in an individual at risk of developing an eating disorder.

• Encourage models who may have an eating disorder to seek professional help in order to continue modeling. And models who are receiving professional help for an eating disorder should not continue modeling without that professional’s approval.

• Develop workshops for the industry (including models and their families) on the nature of eating disorders, how they arise, how we identify and treat them, and complications if they are untreated.

• Support the well-being of younger individuals by not hiring models under the age of sixteen for runway shows; not allowing models under the age of eighteen to work past midnight at fittings or shoots; checking IDs to ensure that models are the appropriate age; providing regular breaks and rest. Consult the applicable labor laws found at www.labor.state.ny.us when working with models under sixteen.

• Supply healthy meals, snacks, and water backstage and at shoots and provide nutrition and fitness education.

• Promote a healthy backstage environment by raising the awareness of the impact of smoking and tobacco-related disease among women, ensuring a smoke-free environment, and address underage drinking by prohibiting alcohol.

To find out more information about the CFDA’s updated guidelines, visit http://www.cfda.com/health-initiative-guidelines-updated-by-the-cfda/.

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.

Caffeine: Now just a click away

AeroShot Lime
AeroShots, as seen above, are the newest energy shot product that allows individuals to inhale a combination of vitamins and caffeine to create an energy boost for consumers.

Each day thousands of individuals go out to get their morning fix—whether it be coffee, energy shots, energy drinks, or soda—to make it through the day; now consumers can receive their quick fix in a breathable form.

A new product known as AeroShot went on the market in January in Massachusetts, New York, and France. The lipstick-sized tube packs a punch of B vitamins, sweeteners, flavors, and, of course, caffeine. This may appeal to many individuals, but the new product is not being received by all with open arms.

The U.S. Food and Drug Administration officials will be investigating the AeroShots to determine whether it is safe for consumers along with whether or not it fits into the category of dietary supplement like its manufacturer has branded it.

Despite the fact inventor David Edwards, a Harvard biomedical engineering professor, has claimed the product is safe, politicians are expressing their concerns for the citizens. New York’s Senator Charles Schumer is one such politician.

“I am worried about how a product like this impacts kids and teens, who are particularly vulnerable to overusing a product that allows one to take hit after hit after hit, in rapid succession,” Schumer said.

Each AeroShot gives consumers four to six puffs of the energy concoction, according to the product’s website. It is being marketed to a younger generation, along with athletes and college students.

Edwards told CBS News that he understands Schumer’s comments since students are looking for a quick and cheap energy fix, and many have started drinking caffeine-packed alcoholic drinks like Four Loko, which has been given the nickname “blackout in a can” due to the potency. Edwards said he is targeting individuals 18 years or older.

“Even with coffee—if you look at the reaction in Europe to coffee when it first appeared—there was quite a bit of hysteria,” Edwards said. “So anything new, there’s always some knee-jerk reaction that makes us believe ‘Well, maybe it’s not safe.’”

Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, said too much caffeine can be dangerous and have side effects such as heart palpitations, nausea, vomiting, diarrhea, restlessness, anxiety and insomnia.

“In my view, frequent use of caffeine inhalers has the potential to lead to abuse,” Glatter said.

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.

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Sound healing offers alternative to Western medicine

St. George, Utah is mainly known for its retirement appeal and golfing spots, but what really appeals to many around the world are the activities going on within the Green Valley Spa.

One event held weekly at the Green Valley Spa is a gong shower, which utilizes both a large gong and harmonic Tibetan bowls. The artists of this local event are Jacque and Donell De Marquess. The couple each had their own way of being introduced to the various instruments, but both individuals agree the sound has both healing properties as well as emotional, spiritual, and mental benefits.

Hear how Donell De Marquess got started in sound healing below.

Sound Healing by Casie McNaughton-Forbes

Have something to say? Take a moment to make a comment below, or email me at casieaforbes@gmail.com.