Understanding Blood Pressure

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

blood-pressure-monitor-350930_640By Dr. Mary O’Brien MD

Blood pressure (BP) is a measurement of the force exerted against the walls of the arteries as the heart pumps blood to all the tissues and organs of the body. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.

BP is measured using an inflatable arm cuff and a pressure gauge. The reading is given in millimeters of mercury (mmHg) and includes two numbers: an upper number (systolic pressure) that reflects the pressure in the arteries when the heart contracts and pumps blood into the arteries [comma deleted] and a lower number (diastolic pressure) that is a measure of the pressure in the arteries as the heart relaxes after contraction (between beats).

When BP readings are found to be consistently elevated, a diagnosis of high blood pressure (hypertension) can be made. Chronic hypertension increases the risk of serious health problems, including heart attack, heart failure, kidney failure, and stroke. These complications are often referred to as end-organ damage because damage to these organs is the end result of long-standing hypertension.       Unfortunately, hypertension may be undetected for many years because it is typically slow to develop — and quite often asymptomatic. It has been estimated that one out of every five U.S. adults with high BP does not know that she has it.

The American Heart Association (AHA) estimates that hypertension affects approximately one in three adults in the United States. However, the prevalence of elevated BP that is either below the cut-off point for hypertension or undetected is much higher. For example, in 2012, 31 percent of all U.S. adults aged 18 years and older were hypertensive, and an additional 31 percent had pre-hypertension (blood pressure that is higher than normal but not yet in the high BP range).

Moreover, among individuals with hypertension, only about half (47 percent) have their condition under control even though seven in 10 hypertensive U.S. adults use medication to treat the condition.  These numbers are consistent with the most recent National Health and Nutrition Examination Survey.

Despite recent advances in the medical treatment of hypertension, and the introduction of public health campaigns designed to increase awareness of this condition, hypertension remains a significant public health problem in the United States. Our home-study course will address the definition, symptoms, causes, risk factors, complications, and treatment options for hypertension. Information about these components can provide the necessary tools to reduce the prevalence of hypertension and related health problems.

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Emotions, Mood & Mood Swings

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology, Seminars, Webinars

girl-1149933_640The word “emotion” comes from the Latin word emovere (to move), suggesting an action or state opposite to being still or calm. Human emotions have been studied since the days of Charles Darwin, who described about a dozen separate emotions and argued that the expression of many of them served adaptive evolutionary functions. Emotions have only recently become a subject of serious inquiry in the field of psychology.

Emotion is related to goals; it stems from situations that enhance or threaten the likelihood of attaining a goal. If a person perceives a threat to attaining a goal, a negative emotion results, and if a person makes significant progress towards reaching a goal, the result is a positive emotion. Emotions, whether fear, pleasure, or love, are mostly transient in nature—a fluctuating response to our thoughts about our surroundings.

Although experiencing emotions is both natural and invaluable, emotions can also become intense and unremitting. When emotions persist and are not tied to a particular stimulus, they are called moods. Moods tend to last longer than specific emotions and set the emotional tone for what we think, feel, and do. Moods are less

Mood swings are shifts in moods that can occur over a period of time, either in the course of a day, or over many months. Most of us experience subtle changes in mood based on small things that happen during the day, and often we’re not even aware of these changes.

Extreme and persistent mood states can result in mental disorders such as depression and anxiety. Depressed people feel unrelenting sadness and an inability to derive pleasure from positive situations. Extreme mood swings can be a hallmark of bipolar disorder, with mood swings occurring as frequently as several times a day or alternating over the course of months, from depression to a euphoric or irritable mania that may or may not be pleasurable.

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Childhood Nightmares

Posted on Posted in Brain Science, Continuing Education, Psychology, Seminars, Webinars

fantasy-1152677_640Sleep disorders occur in 35 to 45 percent of children ages 2 to 18 years,  with peak incidence in children ages 3 to 6 years.

Nightmares occur sporadically in many children and are frightening events for the entire family. Nightmare disorder is characterized by repeated episodes of a frightening or unpleasant dream that disrupts the child’s sleep. The child’s reaction often interrupts the parents’ sleep as well. On awakening from a nightmare, a child is alert and aware of the present surroundings, but the sleep disturbance causes distress and impairment in everyday functioning.

Nightmares are often confused with the parasomnia known as night terrors, which, as noted earlier, are episodes of extreme panic and confusion associated with vocalization, movement, and autonomic discharge. Children with night terrors are difficult to arouse and console and do not remember a dream or nightmare.

Other considerations include:

  • Nightmares are not associated with specific physical findings.
  • Heart rate and respiratory rate may increase or show increased variability before the child awakens from a nightmare. Mild autonomic arousal, including tachycardia, tachypnea, and sweating, may occur transiently upon awakening.
  • Approximately seven percent of individuals who have frequent nightmares have a family history of nightmares.
  • Nightmares are more common in children with mental retardation, depression, and CNS (central nervous system). An association also has been reported with febrile illnesses.
  • Medications may induce frightening dreams, either during treatment or following withdrawal. Withdrawal of medications that suppress REM (rapid eye movement) sleep can lead to an REM rebound effect that is accompanied by nightmares.
  • Nightmares may result from a severe traumatic event and may indicate post-traumatic stress disorder.

Management of nightmares is based on reassurance. Although all stressors cannot be removed from a child’s life, parents can attempt to make bedtime a safe and comfortable time. Parents should be encouraged to spend time in the evening reading, relaxing, and talking with the child.

If the child has a recurring nightmare, it may help to have parents encourage the child to imagine a good ending. Psychological evaluation is indicated when nightmares occur more than twice a week over several months. Medications are neither helpful nor indicated.

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Horses as Therapeutic Animals

Posted on Posted in Continuing Education, Elder Care, Homestudy, Psychology, Webinars

horse-1330690_640By Barbara Sternberg, Ph.D.

Hippotherapy is the technical term for therapy with horses. While it has been around for more than a century, hippotherapy came to the fore when a woman named Liz Harwell, whose legs were essentially paralyzed by polio, won the Silver Medal in dressage at the 1952 Helsinki Olympic Games. Today, half a century later, hippotherapy programs are ongoing in multiple countries, and therapeutic riding programs have been developed for people with physical, psychological, cognitive, social, and behavioral problems including cerebral palsy, spina bifida, mental retardation, and depression. The North American Riding for the Handicapped Association makes a distinction between hippotherapy, or horse-based physical therapy under the direction of a licensed therapist, and therapeutic riding, which utilizes different methods to improve strength, muscle control, eye-hand coordination, and social skills.

Riding a horse involves what physical therapists refer to as three-dimensional movement. With each step, the person’s pelvis tilts up, sideways and forward, and back. The horse repeats the sequence and the sensation of these bodily motions for people with physical or neurological handicaps, reacquainting their muscles with how they are supposed to move. The pressure of the horse’s hooves hitting the ground is also three-dimensional, and stimulates the rider’s knees, hips, and spine. It is believed that this movement stimulates the brain, directly affecting the nervous system.

Even speech and language therapy can be enhanced by therapeutic riding programs. Ruth Dismuke-Blakely, a speech therapist from New Mexico, has been working with patients on horseback since 1981. She believes that most speech therapy addresses only the mouth and the brain, disconnected from the rest of the body, but that in fact, the rest of the body is very important for speech. Horses, with their well organized neurological systems, “lend their ordered system to a disordered one.”

Other speech therapists also find horseback riding a therapeutic venue in which to conduct treatment because patients learn more quickly when engaged in real-life settings than when in an office. Hippotherapy is actually approved by the American Speech and Hearing Association as a therapeutic modality.

Psychotherapy takes place in the realm of horses, too, specifically in the stall, along with the horse, the patient, and the therapist. According to psychotherapist Marilyn Sokoloff, PhD the additional aspect of having a horse to touch and interact with speeds up the pace of psychotherapy. The human-horse interaction gives the therapy a here-and-now component to analyze that can cut through resistances that have hindered progress for years. Sokoloff has used horses in group therapy sessions with women, convening the sessions in a horse barn with the women seated in chairs in a circle and the horses in their stalls all around them. Physical contact with the horses is encouraged as a mode of putting the women in touch with their feelings. These women suffer from depression, anxiety, eating disorders, and physical and sexual abuse and are challenged by the horses to find new ways of control. Getting a horse to do what you want raises issues of power and control which are confronted by the women in the group, often to powerful effect.

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