1
2 HIV, the Invisible Enemy
Traveling and Its Benefits
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An Imbalance Between Coverage & Service
Physiological Effects of Cold Weather
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6 Mental Health Reform: A Response to Mass Shootings
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13
The Heart of a Competitor
5
Hypertrophic Cardiomyopathy in athletes
Could Social Media be the Secret to Weight Loss?
8 She’s a Broken Bone
Schizophrenia and other mental illnesses
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Oh No! It’s that Terrible Itch Again!
the story of allergic contact dermatitis
12 Too Much
Mammography?
and its impact on breast cancer Cover reproduced from [1] | Table of Contents reproduced from [2]
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HIV
Did You Know? •
•
the invisible enemy “
”
- Mean Girls
Hopefully, your high school health class was not as woefully inadequate as that in Mean Girls. However, HIV (Human Immunodeficiency Virus)/AIDS (Acquired Immunodeficiency Syndrome) may not have received much attention, or you could use a refresher. HIV/AIDS is something you need to worry about, especially as a student. The Centers for Disease Control and Prevention (CDC) and the American College Health Association estimate that 1 in 500 college students are infected with HIV. Chances are you’ve been in class or a dorm with someone who is HIV-positive. Between 2006 and 2009, the number of people aged 13-29 years old infected with HIV rose by 21%, as other age groups’ infection rates stayed constant or dropped. Yet studies indicate that 75-85% of heterosexual college students don’t think HIV poses a real threat to them. You are vulnerable. HIV/AIDS can happen to you. And you have a responsibility to yourself, to your partner(s), and to your family to know about the dangers of HIV/AIDS and how to keep yourself and your partner(s) safe. Below are some facts and debunked myths about HIV/AIDS, and ways for you to take control of your health.
Reproduced from [3]
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• • •
By Ariel Wampler
At your age, you’re gonna be having a lot of urges. You’re gonna want to take off your clothes, and touch each other. But if you do touch each other, you will get Chlamydia. And die.
•
© The Student Body 2013
• • •
•
HIV attacks the cells of your immune system, and eventually causes your immune system to fail (at which point you have developed AIDS). When you have AIDS, life-threatening cancers and infections thrive in your body – and you could die from infections that would be minor if you were HIV-negative. HIV is spread through the exchange of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Oral, vaginal, or anal sex, or sharing drug needles can all spread HIV. An infected woman can pass on HIV to her child during pregnancy or through breastfeeding. HIV cannot be transmitted through kissing, sharing drinks, holding hands, hugging, or other forms of casual contact. All it takes is once – one unprotected fling, or one condom breaking – for you to get HIV or for you to give it to another person. HIV/AIDS can happen to anyone, no matter your race, sex, age, or sexual orientation. However, men who have sex with men are at higher risk. There is no cure for HIV/AIDS. Once you get HIV, you have it for life. And you will always pose a threat to your partner(s), whether you were infected a day ago, a few weeks or months ago, or 15 years ago. There is no vaccine for HIV, and you cannot be “immune” to HIV/AIDS Condoms or female condoms, used correctly, are the only effective barrier to HIV. Birth control pills, IUDs. You cannot tell whether or not someone has HIV/AIDS by looking at them. An HIV-positive person often looks perfectly healthy, but you could be infected if you have sex or share needles with him/her. You cannot tell whether or not you have HIV/AIDS unless you get tested. If you’re HIV-positive, you might not notice any signs until 10 or more years after you’ve been infected.
What Should I Do? •
Protect yourself! – To stay safe, use a condom every time you have sex. Condoms, when used correctly, are effective in protecting you from HIV. Make sure that you know how to correctly use a condom (follow the directions on the packaging, or look for information at Gannett or a SAFE or SHAG event). If you use injectable drugs, Gannett does not offer a needle exchange program, but other providers in Ithaca do have clean needles available. • Assume that your partner is infected and take the proper precautions. Many infected people aren’t aware of their HIV status, or will lie about it to have sex. You can’t rely on the other person to watch out for your safety. • Don’t have sex if you’ve been drinking or using other drugs. Drugs and alcohol increase your risk of getting HIV by making you more likely to have unprotected sex, to have sex with people who you do not know well, to have sex with multiple partners, or to use a condom improperly. • Remember, sex is never 100% safe – the only guaranteed way to avoid HIV is to not engage in sexual activity. Unless you and your partner are both new to sex, you never truly have sex with only one person – you’re exposing yourself to everyone your partner has ever had sex with, and everyone whom each of those people has ever had sex with, etc. • Get tested! Knowing your status is important. If you engage in risky sexual behaviors (sex with multiple partners, don’t use condoms, etc), definitely get tested.
You can buy an Oraquick® HIV test for $40 at your local pharmacy – you can take the test in the privacy of your own room and know your results in less than 30 minutes. Or, if you want a professional involved in your test, several locations in Tompkins County, including Gannett – for free if you’re on Cornell’s insurance, for a small fee if you have other insurance – offer testing (see http://www.gannett. cornell.edu/services/medical/hiv/index.cfm for details). • If your test is negative: You (probably) don’t have HIV. But you can still get HIV, and you still need to protect yourself. • If your test is positive: It will be hard, but the responsible thing to do is to contact your recent sexual partners and let them know that they may have HIV as well and should get tested. If you keep your past or current sexual partners in the dark about your HIVpositive status, you could be sued, serve time in prison, and even have to register as a sex offender for the rest of your life. On the medical front, once you learn that you are HIV-positive, talk with your doctor about treatment options. • 2 notes about testing: 1. HIV tests are highly accurate, but if you were infected within the last 3 months, your test may say that you are HIV-negative. This is because the HIV test doesn’t directly look for the virus – instead it looks for the anti-HIV antibodies in your blood, which can take 3 weeks to a few months to show up. 2. 2 types of testing are available: confidential and anonymous. a. Anonymous tests are performed without your name, and the only people who will know your results are yourself and the people you choose to tell. b. Confidential test results are included in your medical records, and anyone who can see your medical records will be able to know your status. Ideally, medical records are protected, but if an employer or insurance company finds out about your HIV status, you might face discrimination and be unable to find a job or health insurance. Over the past 25 years, anti-retroviral drugs have made it possible to live a longer and more fulfilling life despite having HIV. But once you have HIV/AIDS, your life will never be the same. Effective drugs may be available, but they are expensive and can cause serious side effects, including rashes, nausea, vomiting, diarrhea, depression, anxiety, mood swings and paranoia. Imagine having to sort out your 10 to 15 medications in a pill planner at the same time as your grandparents are using theirs. If you’re a woman, you won’t be able to have children without the fear that your baby would be infected with HIV from birth. Since HIV can mutate very quickly, the viruses in your body could become resistant to the drugs you’re taking – multi-drug resistant strains of HIV have already cropped up, and it’s possible that those patients are irresponsibly spreading their disease to others. Finally, it is a sad truth that being HIV-positive can make you a victim of discrimination and maltreatment by anyone that knows your status – and laws against such conduct cannot always protect you. Why play Russian roulette with your life, health, relationships and finances? The next time you think about “getting some,” play it safe, so you don’t get anything more than you bargained for.
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Could SOCIAL MEDIA be the Secret to Weight Loss?
Traveling and its Benefits By Yoon Jo (Crystal) Chung
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By Taylor Bicchieri
Reproduced from [9]
osing weight alone can be tricky. Oftentimes, there is no one to keep you on track, no one marking your progress or awarding you gold stars for your efforts. There’s little responsibility to keep up with your plan and no one is holding you accountable but yourself.
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or most college students today, vacation is rarely an option. We are kept busy with massive amounts of work during the academic year and with internships and jobs during the breaks. There seems to be no time to relax, let alone go on a vacation. However, it is important to remember the words of a distinguished writer, Charles Buxton; he once said, “You will never find time for anything. If you want time, you must make it.” A lot of students think that there is no time for a vacation, but the truth is there is no time for anything. Time is what we make for ourselves and it is important for us to utilize that time wisely. Recently, I traveled alone to Montréal, Canada. I didn’t have a single friend or a family member in Montréal and the only word I could (barely) speak in French was “bonjour”. It was an impulsive—some might even say an irrational—decision, but traveling alone was something I had wanted to experience for a long time. So, I booked a flight from New York the next day and flew off to Canada. I stayed at a hostel in Downtown Montréal and started what I would call my 5-day adventure. I went to see the famous NotreDame Basilica of Montréal, hiked up Mont Royal to see the night view of the city, took pictures of the ice hotel and igloos in Snow Village, walked across Pont de la Concorde to see a famous housing complex called Habitat 67, and even took a 3 hour bus ride to explore Québec City. All the things that I saw in Montréal were so interesting and different and made me curious about other things in the world that I haven’t seen yet. Seeing all the buildings and attractions that I was interested in made me happy and being by myself made me relaxed. I had time to myself and nothing else was on my mind but to explore Montréal. Plus, all the walking and hiking benefited my physical health. To properly express my thoughts on the
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Reproduced from [4-8]
trip, I would have to say that it was THE best five days that I have ever had in my life. Perhaps it was the freedom I had to wander and explore an entire new city by myself, or even the delicious poutine I got to try. Either way, the trip was reenergizing and peaceful. Luckily, it was just the thing I needed at the time. Sometimes, we just need some time alone, time to breathe and to get away from all the stressful matters in our lives. Unfortunately, we rarely recognize this need. We tend to focus on homework we have, prelims coming up, and friends we have to catch up with. We forget about the most important person in our lives: us! We all need to pause this race we call life, take time to look back and reflect on ourselves. And, traveling helps us to do all this by providing the necessary time and space. According to the US Travel Association, “blood pressure, heart rate, and levels of epinephrine – a stress hormone – decline on holidays.” Taking a vacation clearly has physical health benefits because high blood pressure and high levels of epinephrine can lead to serious health problems. US Travel Association also stated, “a clear majority of students who traveled on an international exchange program felt they had become more trusting, open-minded, flexible, confident, and tolerant as a result of their travel experiences.” Traveling has mental health benefits because it clears people’s minds and allows them to reevaluate themselves to make changes in their lives. So, think for a second: is a vacation what you need right now?
“We forget about the most important person in our lives: us!”
© The Student Body 2013
Enter the world of social dieting. The premise is fairly simple. There are hundreds of people looking to lose a few pounds, whether it’s your closest friend or someone halfway across the world, who, without the Internet, you never would’ve met. Suppose there were a way for you to connect with people with similar goals and provide each other with the support and encouragement of a human network. Online social networks have the unique ability to provide just that.
weight loss tips with other users or post pictures to track their progress and includes an iPhone app to make updates easy. Weightloss forums and apps have become increasingly popular as well. www.SparkPeople. com provides users with an easy way to track daily caloric intake or calories burned through exercise, graphs to show progress and nutrition information behind what you’re eating, as well as an extensive messaging board that is filled with advice, success stories, and the daily struggles people face on this journey. The extra encouragement has proven successful in keeping people on track and achieving their goals. Like DietBet, SparkPeople offers an app for smart phones, so that its users can easily update their meal plans for the day and keep connected with what others are posting.
“healthy behaviors can Researchers have found a spread virally, much like a surprisingly simple formula funny YouTube video, when to keep mice lean: providing them with an enriched delivered on the right platenvironment, room to run form. Humans by nature around, and lots of friends. Social engagement in hu- are connected beings, and so mans is thought to have the their health is also same positive effects in aiding weight loss. interconnected.” Dr. Nicholas Christakis of Harvard Medical School suggests that healthy behaviors can spread virally, much like a funny YouTube video, when delivered on the right platform. Humans by nature are connected beings, so their health is also interconnected. One of the most innovative ways that social dieting is being utilized is on the website www.DietBet.com. The site invites users to “Start a Game” and bet on themselves losing 4% of their bodyweight in 28 days. At the end of a month, those who are successful split the earnings! Aside from the financial incentives, the site also offers users a messaging platform, where they can share
If your friends and social circle are overweight or obese, you are more likely to also fit into this category; this is a scary statistic behind the growing obesity trend in America. Social dieting aims to use this knowledge in the reverse direction. When your friends and social circle are losing weight, are you are likely to join their initiative? The success of dieting websites, social networks, and apps seem to say yes. In the coming years it will be interesting to see how these platforms grow and take shape in an ever-changing technological and web-based environment.
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Physiological Effects of Cold Weather By Alison Buermeyer
Cold weather is also known to increase blood pressure. Muscles in human bodies attempt to minimize blood flow to the body’s extremities in order to route extra blood towards vital organs and conserve body heat, and this adaptation subsequently raises blood pressure. This is a leading cause of the large increase of heart attacks and strokes seen in the winter. If you suffer from any sort of heart trouble it is important to be aware of your body’s responses to the cold in this respect. Even those without heart trouble should be aware that their blood pressure spikes during periods of cold temperatures. Bundling up in the cold weather is important to relieve our hearts of the extra exertion they put in to maintain our core temperatures. Those with heart trouble should refresh warning signs of a possible cardiovascular attack, such as chest pain shortness of breath, dizziness, and nausea as well as sweating.
always connected to a personal issue. It is just as likely for those same moods that you attribute to personal issues to be connected to your body’s natural reaction. The difference is these moods can be treated! Another medical concern that frequently arises during times of cold weather is contracting the flu. Although many students choose to get their flu shots, it is still important to recognize signs that one may have the flu. Symptoms of colds and the flu are similar, often making an illness difficult to distinguish. Both include mild to extreme headaches, runny noses, scratchy throats, chills, fever, fatigue, coughs, aches, and loss of appetite. However, flu symptoms tend to come on more quickly and severely than a cold and can cause fever up to 104 degrees. If symptoms are rapidly progressing and seem severe, the flu is likely causing one’s illness. Colds may cause individuals to feel quite sick but should gradually clear up within ten days. Those suffering from the flu usually suffer for about a week. Whichever ailment one suffers for, it is likely medicine is needed, and rest and treatments should not be blown off when our bodies are so vulnerable. Although there is no cure for many colds and viruses, medicines can lessen your symptoms. According to Consumer Reports, antibiotics should be avoided because they will not affect viruses, such as the flu.
“...5% of Americans suffer from seasonal affective disorder, a type of depression induced by cold winter temperatures.”
W
hether it’s your first semester or fourth year in Ithaca, you’ve likely noticed the temperamental nature of the weather. One day, you’re soaking up the sun in short sleeves as you meander to class and the next, you’re rubbing your hands together at the bus stop in snow boots. When cold weather can roll in frequently and at any moment, it is important to understand how cold temperatures affect your body and what this means for your health. Human body temperature is meant to stay within a 2-3°F range from the average body temperature of 98.6. In order to maintain optimal temperature, our bodies have developed many adaptations to cold air and water. For example, when exposed to low temperatures, blood vessels constrict to reduce blood flow and volume and minimize heat loss due to blood circulating near our bodies’ surfaces. Additionally, our bodies conduct muscle contractions to produce heat and maintain warmth, commonly known as shivers. Despite our body’s defense mechanisms, we are still vulnerable to illness. One way that cold temperatures bypass our defense
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mechanisms is by suppressing our Reproduced from [10] bodies’ immune systems, increasing the risk of infections and illnesses. Scientists hypothesize that this is likely because breathing in cold air though one’s nasal passages diminishes the local immune response there (white blood cells), one of our first lines of defense. Our bodies’ decreased battle systems for fending off illness leave us very susceptible to colds and the dreaded flu. In addition to flu viruses’ increased chance of successful infection in the cold weather due to our responses, many strains actually thrive in colder temperatures leaving them stronger than ever. Another side effect of inhaling cold air is increased asthmatic suffering. The contractions of airways in the lungs, known as bronchospasms, experienced by asthmatic individuals can be much easily triggered as cold air is inhaled. Therefore, during cold weather, these patients should be more careful in taking their anti-asthma medications before exertion or long exposure to cold weather. If you’ve experienced asthma in the past, it is strongly advised to take this precaution before trekking to class in cold weather. © The Student Body 2013
In addition to physiological responses to cold weather, many humans have an emotional response to cold temperatures. In fact, according to an article released by Consumer Reports in January of 2010, 5% of Americans suffer from seasonal affective disorder, a type of depression induced by cold winter temperatures. The dread you feel in going out and doing things you enjoy in the cold may in fact be more severe than you originally thought. Excessive fatigue, social withdrawal and the inability to focus are symptoms of seasonal affective disorder. If you find yourself lacking happiness during times of cold weather, experts suggest aerobic exercise in the mornings and devoting time to activities that are personally enjoyable to you. If the situation is drastic and persistent, some see a doctor for light therapy or even anti-depressants for the winter season. If you are feeling less motivated during times of cold weather, make sure to prioritize finding an activity that keeps you happy and seeing a doctor if you feel you may be becoming depressed. It’s important to know that your moods aren’t
During times of chilly weather, increased awareness of your body’s reactions to the cold can help you be sure you’re going about your day in the most comfortable manner possible. If you’ve been experiencing any number of the symptoms we’ve discussed here, from asthmatic attacks to a racing heart to simply a feeling of being emotionally weighed down, know that the weather may Reproduced from [11] be partially to blame and that seeing a doctor can always potentially help your situation. And, after learning about all that a cold environment can do to you, be sure to bundle up! Reproduced from [12]
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By Lucia You
“She’s bipolar.” “He’s schizophrenic.” “That child is autistic.”
havior. While the movie gives a relatively accurate perspective of a person living with schizophrenia, parts of the disease are dramatized.
When most people refer to those who have a mental illness, they often speak as though the mental illness is all that matters. Yet when it comes to other categories of illnesses or physical maladies such as cancer, high blood pressure, broken bones, et cetera, suddenly people’s phrasing change: “My neighbor just got diagnosed with breast cancer.” “Unfortunately, my sister and I have high blood pressure.” “Poor Jane broke her leg.”
According to A.D.A.M. Medical Encyclopedia, depending on the intensity, strength, and type of schizophrenia, the recipient can suffer a variety of symptoms, which may include hallucinations, visual and/or auditory, inappropriate emotional responses, and inability to think or act clearly and normally. To this day, mental health experts are uncertain about the exact causes of schizophrenia, but most classify it with two-hit system, meaning that genetics predisposes an individual for schizophrenia but a change in environment, such as drug overdose or problem during pre-natal development, could trigger the individual’s first schizophrenic episode. For the most part, the more immediate the relation with schizophrenia, the greater risk for the mental illness.
There is an assumption with mental illnesses that the person affected becomes the mental illness. That if their minds are compromised, their entire value as human beings are too. The mentally ill have a history of being known as inferior. In an article titled “Bedlam 1946” by Maisel, mentally ill patients have been Chronic or acute schizophrenia prosecuted by society, hidden – symptoms developing steadiaway by shamed families, and ly over years versus a sudden tortured by facilities known onset of symptoms within a as insane asylums, which in short of a time as a few weeks the past believed that mental – can lead to these four general illness was brought about by types. A.D.A.M. Medical Encydemons and hellish spirits. In clopedia’s article on schizoall cases, the mentally ill were phrenia categorizes symptoms treated not as having a disin a progression of severity ease, an outside enemy sepawith time. First, small personrate from themselves, but as ality changes like increased having an innate defect. For irritability or decreased focus those living day-to-day with arise. Then, depending if the Reproduced from [13] the effects of a mental illness, case is chronic or acute, the the additional social stigma is crushing. changes can slowly or rapidly progress to symptoms, which include increasingly illogical behaviors, hallucinaWhile all ailments affecting the mind are of great sig- tions, flat affect (lack of emotion), feelings of isolation, nificance and have life-altering symptoms, one of the delusions, and loose associations, which are instances of most well known yet most stigmatized mental illnesses randomly connecting words of no relation together. For is schizophrenia. Movies, like A Beautiful Mind, which de- example, as explained in Cornell University’s own Introtails the genius and horrific effects of schizophrenia on duction to Psychology course, one would say, “Someone Economics Nobel Laureate John Nash, establish the pub- rang the doorbell.” A person with loose association would lic perspective of schizophrenia as an illness of bright latch onto one of the words (in this case, let’s say ‘rang’) colors, of paranoia, of voices, and of uncontrollable be- and possibly
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© The Student Body 2013
“bitch”.
In conjunction with these general characteristics, a few more symptoms further separate schizophrenia into types known as disorganized, catatonic, paranoid, and undifferentiated. Childlike behavior and a flat affect are typical of disorganized schizophrenia. Uncontrollable expression and odd posture and little social response to others categorize catatonic schizophrenia. High anxiety, anger, and the intense delusion of harm classify paranoid schizophrenia as in the case of the story of John Nash portrayed by A Beautiful Mind. Finally, undifferentiated schizophrenia may include symptoms from more than one type.
Recently, a friend of mine, who is a normal, intelligent, and funny individual from a middle class family, noticed that I was writing an article about mental illness. To my surprise, he proceeded to act like he had hallucinations, calling the empty air beside him “Jeff” and expecting me to laugh and continue the act. I was shocked and not a little angry, but a moment later, I realized just how pervasive and how insidious mental stigma is in society. My friend had not meant any harm or insult to people with mental illnesses – on the contrary, once I explained my solemn countenance, he apologized for offending me and spent a few minutes in quiet contemplation – but his actions had revealed his perspective that that sort of exaggerated, shallow imitation was socially acceptable and, unfortunately, joke-worthy.
Usually antipsychotic medication is proscribed to treat the symptoms of schizophrenia. According to Mayo Clinic, schizophrenia requires “lifelong treatment” and various professionals are involved from psychologists to social workers. Often, individuals hospitalized for schizophrenia must undergo therapy and training to enable them to regain normal lives. Most people think schizophrenia will never touch their lives. By statistics, this is relatively true. According to the National Institute of Mental Health, only 1% of Americans currently have this disease. However, the rate of mental illness is much, much higher. Over one in four people in the US have some type of mental illness. Given the extraordinarily high rate, the stigma against those with mental illnesses or disorders is a significant issue that needs to be addressed. I mentioned that the public encompasses the individual with their mental illnesses or disorders. Most individuals do the same. According to Mayo Clinic, those with mental illnesses often withhold telling family members or doctors any symptoms or signs due to fear of being judged and personally judging the appearance of a mental illness as a personal weakness. Most incorrectly assume that those with mental illness cannot re-enter society or even overcome their mental disability and need to be cared for their entire lives. Another common misperception is that mental illness “contaminates” communities; a perception that led to mass genocides of the mentally ill in Nazi Germany. The stigma surrounding mental illness is deeply ingrained in society to the point that “bipolar” is associated with other insults like “freak”, “nutcase”, or
Not even medical professionals escape from this stigma. On August 10, 2011, the York Region, part of the Metroland Media Group, published online an article about a man named Constantin Nastic titled, “Mans battles stigma”. The short, succinct title expands into a startling story of how he had almost failed in his battle against depression, anxiety, and attention deficient disorder. Constantin had avoided hospitals in fear of encountering the unfair and harsh judgments and the stigma from nurses and doctors alike in his previous visits. On the brink of committing suicide, Constantin recalled a voice urging him to go to the hospital and for once, he listened. Once there, a brief but deeply poignant set of words from a compassionate nurse cracked his own belief that no one cared enough to give kindness or compassion to someone who was mentally ill. He now travels to schools and hospitals, telling his story and battling mental stigma with an organization known as Ontario Central Local Health Integration Network. His speeches have influenced the making of a program, Opening Minds, sponsored by the Mental Health Commission of Canada. In Constantin’s words, “The teaching protocol sensitizes health care professionals about unfair stereotyping. Since mental health issues don’t present themselves like a cut or broken bone, they don’t always seem real. The stigma of the mental illness is worse than the illness itself.” Mental stigma has great influence on individual recovery and a great impact on emotional wellbeing. No one would ever say, “She is a broken bone” or “He is a heart attack”. So why ever imply that someone is their mental illness? Reproduced from [14]
She’s A Broken Bone!
reply with, “clang, bang, gang, fang”.
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Mental Health Reform: Anushka Mehrotra
A Response to Mass Shootings T
he December shooting at Sandy Hook Elementary in Newton, Connecticut has been a wake up call for many Americans as it tragically reminded us that we live in a nation characterized by violence and passivity towards gun control. Over the last four years, there have been 43 mass shootings in 25 states in the U.S. Reactions vary from those that demand banning all handguns, those that only want to ban assault weapons, and those that refuse to impose any ban whatsoever. However, a viral blog post titled “‘I Am Adam Lanza’s Mother’: A Mom’s Perspective On The Mental Illness Conversation In America” introduces new depth to the gun control debate. Many believe that the solution to minimizing mass violence lies in the reformation of American mental health policy and not simply in altering existing handgun laws. So, how exactly is the country attempting to enact mental health reform? The National Rifle Association supports the creation of a national registry of mentally ill people and using it to limit their ability to purchase handguns. Obama has advocated more comprehensive background checks for potentially dangerous gun buyers. Furthermore, he supports the expansion of mental health care in the form of more thorough treatment and screening for mental illness. Increasing mental health services is a key component of Obama’s plan to combat gun violence in addition to closing background check loopholes, banning military-style assault weapons, and making schools safer. His plan encourages doctors to report to the authorities any concerns regarding potentially violent patients and to inquire whether patients who show signs of mental illness or have mentally ill people in their family possess firearms at home. Obama stresses the necessity of open communication regarding firearms between doctors and patients that show signs of mental illness. Oftentimes, these patients did not show signs of mental illness when purchasing their firearms.
Proponents of mental health reform argue that simply outlawing handguns or making it harder to attain one will not prevent those with malicious intent from committing crimes. They believe that the only way to truly minimize these crimes from occurring is through determining who is mentally ill and prone to acts of aggression and getting them the help that they need before they commit an act of violence. Most states already have laws in place to prevent those who have previously been institutionalized for mental illness from attaining handguns. But, that is not the problem. The problem is that there are many mentally ill people in the United States that have not been institutionalized and that it is fairly easy for these people to acquire handguns. Though these people show signs of mental illness, they are currently not receiving help due to the lack of expansive mental healthcare in the United States. One aspect of gun control policy that both liberals and conservative interest groups such as the National Rifle Association agree on is that some sort of mental health reform is necessary in order to prevent the mentally ill from possessing firearms. The exact nature of these reforms, however, is still being debated.
In addition, they argue that the people who commit the majority of mass shootings do not fit the profile of being deemed dangerous. Though these people are mostly mentally ill, it is extremely difficult to detect them through screening. They often appear to be completely normal until something triggers their aggression, which they exert in the form of violence. Opponents also emphasize that mentally ill people only commit 5% of overall violent attacks in the United States and that targeting them oversimplifies the broader issue regarding gun culture in America. They claim mental health reform as a response to the shootings perpetuates the untrue notion that the mentally ill are more violent in comparison to the rest of society. Though the vast majority of people with mental illnesses are nonaggressive, it remains indisputable that they are more likely to commits acts of mass violence such as the Sandy Hook shooting and that it is important for there to be measures to prevent them from owning firearms. Though these unprecedented acts of violence cannot always be prevented, we as a nation can take
steps to minimize the chance of them occurring in the future. The best approach lies in a combination of strengthening gun control and mental health reform. An example of a preventative mental health reform completely independent of gun control is Obama’s proposal to ensure that at-risk students and young adults get treatment for mental health issues. The goal of this proposal is to identify signs of mental illness early and get affected people treatment before potential outbreaks of violence or aggression. Therefore, the White House is in favor of spending $25 million on state-based mental health initiatives to identify signs of mental illness in troubled young adults as well as ensuring that private health plans cover mental health services for those at risk. Finally, Obama supports extending Medicaid plans to provide quality mental health coverage. The American Psychiatric Association is in full favor of these reforms. Hopefully, these reforms can be passed in order to maximize the safety of the American public as well as provide those affected with mental illness with the treatment they deserve in order to become healthy.
Opponents of the reformation of America’s mental health policy stress that current gun laws only apply to licensed gun dealers. Mentally ill people can easily attain guns from gun shows and other unlicensed gun dealers, which are often poorly regulated by the government. The legality of gun shows and other displays of firearms, however, is another issue in itself. Opponents believe that mental health reform does not address the core issue of how easy it is to acquire a gun in the United States. If assault weapons are restricted to all people, then the issue of whether the mentally ill can attain them becomes negligible.
Reproduced from [15]
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© The Student Body 2013
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Too Much Mammography?
The Heart of a Competitor By Alison Jarmas
By Jodie Smith
T
Photomicrograph of mucinous breast carcinoma, reproduced from [16]
he ongoing battle of breast cancer continues today. This disease phenomenon has swept the homes of many and touched the hearts of countless. There is no question of the severity of breast cancer and what it entails for not only for those diagnosed with it, but also for the loved ones surrounding them. Statistics show that 1 in 8 women of the United States will develop invasive breast cancer over her lifetime. It is imperative that women take the initiative to become more aware of their bodies and get involved in mammography. Early detection is key. However, studies have shown that many women have been misdiagnosed with breast cancer. Too much mammography, possibly? Over the past 30 years, more than one million women in the Unites States were misdiagnosed with breast cancer. Routine mammography detected tumors that led doctors to believe breast cancer was attacking the women’s bodies. It was later found that these tumors previously detected were harmless. Approximately 1.3 million women unnecessarily endured the invasive treatments for breast cancer. Scientists have attributed this issue to routine mammography. Those that were wrongfully diagnosed with cancer were forced to undergo major medical procedures. These procedure included surgery, radiology, hormone therapy, and chemotherapy. Gilbert Welch of Dartmouth College and Archie Bleyer of Oregon Health & Science University conducted a mammography study published in the New England Journal of Medicine. The study showed that the amount of earlystage breast cancers doubled simultaneous to mammograms becoming the standard in the United States. The study revealed that 234 of 100,000 women had tumors.
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Reproduced from [17]
However, in that same period, the rate of women diagnosed with late-stage breast cancer dropped by 8%. Welch and Bleyer hypothesized that this evidence supports the claim that routine mammogram plays a role in doctors over diagnosing breast cancer. The tumors originally detected by screening did not lead to the clinical symptoms of breast cancer. Over the past 30 years, 1.3 million have been unnecessarily diagnosed with cancer. The studies conducted by Welch and Bleyer were confirmed in a 2011 paper published in the Annals of Internal Medicine. The research paper stated, “Some women need mammograms more frequently than others. Based on personal risk factors such as age, breast density, family history of breast cancer, and even a woman’s personal preference could help reduce overtreatment and unnecessary testing.” Even so, mammography is essential for detecting early-stages of cancer. Doctors stress that it is through this process that women’s lives are saved everyday. Not every tumor suggests breast cancer, but some are malignant to the body. Many doctors stress that women, especially for those over the age of 40, should make mammography a regular routine. But when does it get to be too much? There should be balance between safe and being suspicious. As humans, our instinct is to protect ourselves and we take steps to do that everyday. Maybe mammography should be treated just the same. It is a way of protecting ourselves not only in the present but also in the future. Doctors stress the importance of mammography because it helps to detect the early stages of breast cancer. It is important that we follow the laws of safety. We often live by the motto, “It is better to be safe than to be sorry.” But what happens when our safety makes us sorry? © The Student Body 2013
A
ny college athlete knows that you have to put your heart into the game. College athletes also know that hard work, dedication and rigorous training are necessary for success. Yet most are unaware of hypertrophic cardiomyopathy (HCM), a genetic heart condition that inevitably makes the news when the sudden death of a local athlete rocks a community. The main effect of HCM is a generalized thickening of the heart muscle, which puts stress on the heart as it pumps blood throughout the body. The left ventricle is most significantly affected.
heart catheterization procedures are necessary in some cases. Electrocardiograms (EKGs) can also be used to detect associated changes in heart rhythm. Regularly scheduled sports physicals are often ineffective in identifying young athletes with such heart conditions. Successful diagnosis is complicated by the fact that patients often do not have a history of any cardiac symptoms. Any possible symptoms – such as chest discomfort, a racing heartbeat or a feeling of lightheadedness during exercise – are often dismissed as dehydration, fatigue or typical side effects of an athlete’s intense training regimen.
“The risk of cardiac death is nearly three times greater for athletes as compared Coping with a diagnosis of HCM can be extremely challenging for to non-athletes.”
It is estimated that between one in five hundred and one in two hundred people in the general population are affected by such genetic cardiac abnormalities. The risk of cardiac death is nearly three times greater for athletes than for nonathletes, with HCM contributing to 30 to 40 percent of all sudden non-traumatic deaths in competitive athletes. Heart attack, stroke and cardiac arrest are potentially fatal complications of HCM in young athletes.
Just as athletes train to build skeletal muscle, the muscular heart can also enlarge as a result of sustained physical activity. Unlike skeletal muscle, which typically grows stronger with increasing size, cardiac muscle is weakened when enlarged. Often, a mild thickening of the heart muscle may be within the normal limits of what doctors describe as an “athlete’s heart”. Thus, differentiating between typical and abnormal heart enlargement can be challenging. Electrocardiography is currently considered the most viable diagnostic tool, although cardiac MRIs or
young athletes, as it often requires giving up participation in competitive sports. For college students, participation in sports is often a defining part of their college experience, so the restrictions on activity level are both sudden and particularly devastating. Unlike typical sports injuries, rehabilitation and steady recovery are not an option. Patients with HCM should be regularly monitored for changes in blood pressure and heart rate, and family members should be tested for similar genetic mutations. Though treatments such as blood thinners, medications to address abnormal heart rhythms, surgical removal of the thickened tissue and the implantation of pacemakers have been effective in managing the symptoms for some patients, the specific nature and severity of the disease dictate the activity level permitted. For some college athletes, sitting on the sidelines might just save their lives.
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AnImbalance between C o v e r a g e Reproduced from [18]
W
ith the successful passage of the Affordable Care Act, many Americans will be guaranteed healthcare coverage. In 2014, the ACA will come into effect and healthcare coverage will expand to 30 million more Americans. That is 30 million more who do not have to rely solely on the more expensive ER visits for routine treatments. However, are health services and care guaranteed for these 30 million optimists? In a 2012 report, the Association of American Medical Colleges (AAMC) evaluated the supply and demand for health care services from 2008 projected to 2020. The projection shows a steady supply of health care services but a steadily increasing demand. According to AAMC, the United States is expected to be 90 thousand physicians short by 2020. In addition, the number of medical school graduates choosing a career in primary care has dropped from 5,746 to 4,210 (-27%) between 2002 and 2007. As the newly insured will trigger to the primary care’s doctor offices, the already decreasing number of primary care physicians will become overburdened.
and S e r v i c e
By Mytien Nguyen
Reproduced from [19]
What does this mean for us as patients? It could mean longer waiting times and shorter times with our primary care doctors. Physicians’ offices and hospitals will be busier with an increase in patients but no significant increase in physician supply. This imbalance could possibly lead to lower quality care.
What is being done to prevent this physician shortage? The AAMC is encouraging medical schools to increase their enrollment rate by 30%, making it possible for more students to obtain their M.D. degree. But obtaining an M.D. does not mean you’re a doctor yet. M.D.s must undergo training as residents in teaching hospitals for an average of three to four years before they can begin treating patients on their own. The expense of training future doctors is costly, including training fees, resources, and
“...the United States is expected to be 90 thousand physicians short by 2020.” salaries. Historically, Medicare has partially funded for these trainings. However, in 1997 with the passage of the Balanced Budget Act, the federal government has put a freeze on medical training funds. With this freeze, the financial pressure on teaching hospitals is increasing: salaries are increasing, new technologies are more costly, and the overall cost of training resi-
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© The Student Body 2013
dences is increasing steadily. Research has shown that medical training per resident increased an average of 62.6% between 2000 and 2010. Teaching hospitals must find a solution to this financial difficulty in training residents. One solution is to train more nurses and physician assistants to collaborate with doctors to efficiently treat patients and provide optimal quality care. Another solution is to output more physicians, especially primary care physicians. The AAMC is calling for a quantitative increase, requesting the federal government to remove its freeze on medical training funds to support the training of physicians. The ACA also includes a physician training provision for training more primary care doctors, but the effect remains to be seen. Most medical graduates aim for specialized medicine because that is where the higher salaries are. To the Cornell pre-medical undergraduates who are looking into specialties like surgery and cardiology, please do not overlook the possibility of primary care. Though it is often overlooked because of its lower wages, primary care physicians will be most in-demand by 2014, and they are what the majority of the population needs.
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t a h t s ’ t I … o Oh N Itch Again! e l b i r r Te T
he dashing necklace shimmers in the sun, matching the colors of your beautiful dress. But as time ticks away, you cannot help but feel the consistent itch on your neck and the slow red rashes that spread out over the skin. There is a high chance that the culprit of these symptoms is nickel, one of the most common allergens found in coins, fake jewelry, and zippers. Meant for temporary, disposable, and affordable ornaments to match specific outfits, many types of costume jewelry (“fake jewelry”) contains nickel instead of real gem and valuable metals. Allergic contact dermatitis is the scientific name that pertains to allergy to fake jewelry. An allergic reaction is our body’s natural defense system to protect ourselves against perceived invaders. Often these invaders (allergens) can come from the environment, such as pollen, or other selective elements, such as nickel. For example, when the nickel allergen touches our skin, our immune system responds by sending a signal to secrete antibodies immunoglobulin E (IgE). The IgE would bind to basophils in the bloodstream and mast cells in our tissues, sensitizing our body towards that specific allergen. The first exposure is asymptomatic and is merely preparing the body to fight back in the case of second exposure. When exposed to the allergen the second time, the basophils and mast cells bounded by IgE would release powerful chemicals and hormones called “mediators”, which would cause symptoms such as irritation, swelling and inflammation of the tissue. A common mediator is called histamine, which causes the red rashes and swelling that we see in the area close to the fake jewelry’s contact.
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By Judy Wang
Similarly to this idea, the first time we are stung by a bee may only result in redness and pain; but the second exposure may develop dangerous symptoms such as hives or respiratory problems. Therefore, the annoying symptoms that we experience in most types of allergies, such as wheezing, running nose, itching, irritation, are all the result of our own immune response trying to fight back the allergens.
meet the team Editor-in-Chief Editor Structure/Content Editor Copy Editors
Sarah Parauda Helen Tian Jodie Smith Anushka Mehrotra Jimmy Guo
Graphic Editor Assistant Graphic Editor
Mytien Nguyen Kathy Zhang
Treasurer Secretary Outreach Chair
Other types of common allergens aside from nickel include pollen, insect venom, and dust. The best way to deal with allergic reactions is to avoid the allergens completely, if possible. For example, if you are allergic to nickel, you should look for jewelry avoid jewelry made of nickel and replace them with jewelry made of stainless steel, sterling silver, or even real gold. If extremely sensitive, you should also be mindful of consuming foods such as fish, chocolate, and beer, which are rich in nickel. For other types of allergic reactions, medications such as antihistamines, decongestants, and corticosteroids can also help lessen the symptoms of allergies, although they cannot provide the cure for allergies. For allergens that are unavoidable, such as pollen and dust, allergen immunotherapy such as allergy shots, can be used to decrease the severity of the symptoms.
Advisor Produced by
Susan Duan Alison Jarmas Ariel Wampler Bruce Lewenstein Mytien Nguyen, Kathy Zhang, Moriah Shires, Judy Wang, Amy Chen, Vinayak Portonovo, Ann Lei, Becky Roh, and Ali Soong.
Photo References
By being aware of your own allergies and simple ways to decrease exposure to these allergens, you can control the irritating swellings and botches that creeps over the skin. Next time you match the beautiful necklace with your outfit, you can confidently pass the day with absolute comfort and happiness. Reproduced from [20]
© The Student Body 2013
1. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / m o r o c c a n prince/8352034538 2. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / p a g e d o o l ey/8317353105 3. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / f u t u r e shape/515755645 4. http://pixabay.com/en/airplane-transportationplane-26560/ 5. http://rugby-pioneers.blogs.com/.a/6a00d834525c47 69e2017d40d49999970c-800wi 6. http://www.flickr.com/photos/peterhut/4445183542 7. http://farm5.staticflickr.com/4018/4285364706_9ec0 9b2179_z.jpg?zz=1 8. http://farm9.staticflickr.com/8181/7978800587_ a983531b0b_z.jpg 9. h t t p : / / f a r m 4 . s t a t i c f l i c k r . com/3285/2945559128_53078d246b.jpg 10. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / w i d e r -
bergs/6831075657/ 11. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / p i n k s h e r bet/2214419283 12. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / k a t i e h a r bath/8323608781 13. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / 7 9 9 4 9 2 0 @ N03/2281844019/ 14. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / l a i n a m a r ie/6833534625/ 15. h t t p : / / w w w . f l i c k r . c o m / p h o t o s / h a p a _ p r i n cess/8298051437 16. http://www.flickr.com/photos/euthman/4685665498 17. http://www.fotopedia.com/items/flickr-5112344521 18. http://fitnessandwellnessnews.com/wp-content/uploads/2013/02/EKG-heart-beat-pic.jpg 19. http://www.flickr.com/photos/striatic/229529792 20. http://www.flickr.com/photos/verypurpleperson/4442858872
Be Heard. Write or design for The Student Body. Contact: Sarah Parauda (scp69) Mytien Nguyen (mtn29)
The Student Body is an undergraduate student organization affiliated with Gannett University Health Services. Publication of The Student Body is funded by SAFC. The contents of The Student Body are the works of the authors and do not necessarily reflect the views or beliefs of the organization, its affiliates, advisers, or Cornell University.
The Student Body Š 2013