Acupuncture May Help Depression



A new study finds acupuncture to be highly effective in treating depression.


 

ACUPUNCTURE MAY HELP DEPRESSION

At least 1 in 10 Americans have been afflicted with major depression at some point in their lives, and some studies suggest that as many as 1 in 5 Americans have experienced significant depression before.  At any given time, an estimated 7 percent of adults in the United States are suffering from major depression.  (For reasons that are not entirely clear, women are twice as likely as men to be diagnosed with major depression.)  In view its very high incidence, it is not surprising that major depression is the leading cause of disability in the U.S. for people between the ages of 15 and 44.

There are a variety of potentially effective therapies available for depression including, primarily, cognitive therapy (i.e., meeting with a therapist for counseling) and antidepressant medications.  However, in view of the limited coverage made available for cognitive therapy by health insurers, there has been an increasing reliance upon antidepressant medications in the U.S. for many years.  While many of these medications can significantly reduce the signs and symptoms of major depression, they are often associated with significant side effects, and as many as half of all patients with severe chronic depression will fail to respond to most such medications.

A newly published prospective randomized controlled study from England suggests that acupuncture may be as effective as cognitive therapy and antidepressant medications as a treatment for depression.  This study appears in the online journal PLOS Medicine.

In this study, 755 patients with documented chronic major depression were randomized to one of three different treatment groups: acupuncture, cognitive therapy (counseling), and “usual care alone.”  (The latter group, which also included the use of antidepressant medications, served as the “control group” for this clinical study.)  All patient volunteers were subsequently reassessed with validated diagnostic tests throughout the 12-month course of this clinical study.

On average, the patient volunteers who participated in this clinical trial underwent 10 acupuncture sessions and 9 counseling sessions.  Compared to “usual care,” there was a statistically significant decrease in depression-associated symptoms in both the acupuncture and the counseling groups at 3 months and at 6 months after the start of this clinical study (by 12 months, however, the patients in the “usual care” group had improved to a level comparable to the acupuncture and counseling groups).  To summarize, acupuncture and counseling were each found to be highly effective in reducing the severity of depression-associated symptoms in patients with moderate-to-severe depression, and both were actually found to be more effective than the “usual care” (including antidepressant medications) received by the control group of patient volunteers at 3 months and at 6 months. 

This small study suggests a potential role for acupuncture in the treatment of major depression, and should stimulate additional research in this, and other, non-pharmacologic therapies for depression, particularly given the minimal risks associated with acupuncture in otherwise healthy patients.  However, if you are already taking antidepressant medications, and you are interested in trying acupuncture as a treatment for depression, please do not stop taking your medications without your doctor’s approval, as doing so could result in a worsening of your depression!

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, more than 3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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American Surgeons in Crisis: Implications for Healthcare






 

A new study finds that more than half of surgeons are experiencing work-home conflicts that threaten their personal and professional wellbeing.


 

AMERICAN SURGEONS IN CRISIS:  IMPLICATIONS FOR HEALTHCARE

As I have discussed in previous columns (The Silent Epidemic of Surgeon Burnout and DepressionEpidemic of Alcohol Abuse Among Surgeons), there are quiet and evolving, and disturbing, developments within the community of American surgeons, and these developments may portend of significant potential future problems for surgeons, and for patients who require surgical care.  Now, a newly published research study, which appears in the current issue of the Archives of Surgery, further suggests that the epidemic of surgeon burnout and depression is indeed real, and has serious potential implications for both surgeons and their patients.

In this study, 7,197 active surgeons were surveyed, electronically, by the American College of Surgeons, using questions from validated surveys that assess for career burnout, depression, quality of life, alcohol use, and other measures of satisfaction with both personal and professional life attributes.

When asked if they had experienced any significant conflicts between their “work lives” and their “home lives” within the previous three weeks, an astounding 53 percent of the queried surgeons replied, “Yes.”  Thus, more than half of all surgeons who participated in this confidential survey reported substantial and distressing conflicts between their professional lives and their home lives within the preceding three weeks.

When the study’s authors analyzed the personal and professional factors that were most closely associated with “work-home conflicts,” and with both personal and professional dissatisfaction, a clearer picture emerged.  For example, the number of hours worked per week, having children, the surgeon’s gender, and the type of surgical practice were all closely linked with work-home conflicts, and with lower levels of personal and professional satisfaction.  For example, surgeons who practiced at Veterans Administration hospitals were 91 percent more likely to report work-home conflicts when compared to surgeons in private practice, while surgeons who practiced at an academic medical center were 19 percent more likely to report such conflicts when compared to private practice surgeons.  Not surprisingly, having children at home was associated with a 65 percent greater likelihood of work-home conflict when compared to surgeons without children at home.  Working more hours per week and being younger were also factors associated with a higher likelihood of work-home conflict, as was being a female surgeon (i.e., when compared to male surgeons).  Surgeon specialty was also significantly linked to work-home conflicts and overall lower satisfaction levels, with broadly practicing general surgeons being twice as likely to report work-home conflicts as surgeons in other specialties (e.g., breast surgeons, heart surgeons, neurosurgeons, and other subspecialist surgeons).

The high level of work-home conflicts identified among surgeons is an issue of great concern to all of us, as such conflicts were significantly associated with career burnout, exhaustion, decreased quality of life, depression, relationship difficulties, alcohol abuse, and overall career dissatisfaction by scientifically validated surveys.  Surgeons reporting recent work-home conflicts were also substantially less likely to recommend surgery as a career option to their children.

In addition to higher levels of burnout, depression, alcohol abuse, relationship difficulties, and career dissatisfaction, surgeons who reported recent work-home conflicts were also 77 percent more likely to be planning to reduce their clinical work hours, and71 percent more likely to be planning to leave their surgical practices for reasons other than planned retirement.

At a time when the demand for some types of surgical care is already outstripping the supply of experienced, competent surgeons in many areas of the country, the findings of this study are cause for considerable concern.  For example, looking into the near future, our population is aging, and many acute and chronic diseases that require surgical treatment are more common in elderly patients.  Therefore, there is real concern that an increasingly burned-out surgeon workforce, and a declining interest in the more challenging surgical specialties (like general surgery) by today’s medical students, will someday soon leave the United States with an inadequate number of experienced surgeons to meet our nation’s healthcare needs.

All of the above noted adverse factors within the American surgeon community, once again, raise the concern that adequate levels of surgical care may not be available in the not too distant future if significant changes in surgical training and surgical practice are not considered and implemented, particularly in the workhorse specialty of general surgery.  The surgical community has been, admittedly, slow to appreciate or embrace generational changes in perceptions about work-life balance, and has only grudgingly (and recently) acquiesced to external pressures to treat its surgeons-in-training in a more considerate and supportive manner, compared to the conditions that surgery interns and residents toiled under during my era of training, as well as previous generations of surgical trainees.  (When I was a surgical intern, in the late 1980s, there were no limitations on the number of hours that interns and residents were expected to work in the hospital, including the number of nights spent on call for emergencies within the hospital, and it was not uncommon for us to spend 100 to 120 hours inside the hospital each and every week.)  Regardless of how more senior surgeons feel about it, it must be acknowledged that the current generation of medical students and young surgeons, both male and female, are much more concerned about work-life balance, and overall quality of life issues, than was typical for my generation of surgeons.

On a brighter note, the American College of Surgeons’ sponsorship of this research study, and others like it, suggests that the older generation of surgeons who currently serve as senior leaders and mentors for young surgeons and surgical trainees may, finally, be coming to grips with the rather dramatic shift in attitudes and priorities among their young charges. Hopefully, it is not too late to make meaningful structural changes in surgical training and surgical practice conditions before there are widespread adverse public health consequences to the ongoing crisis among the community of surgeons in the United States….

 

A Cancer Prevention Guide for the Human Race is now available in both printed and digital formats from all major bookstores.  Get your copy now, and begin living an evidence-based cancer prevention lifestyle!


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Dark as Night, Part 1


Dark as Night, Part 1

Dark as Night, Part 1


At this time, more than 8 percent of Americans are unemployed.  According to the Bureau of Labor Statistics, however, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is now more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 





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Chronic Anxiety and Depression Significantly Increase the Risk of Early Death




 

A large new study suggests that chronic anxiety and depression are associated with a higher risk of premature death than was previously appreciated.


 

 

CHRONIC ANXIETY AND DEPRESSION SIGNIFICANTLY INCREASE THE RISK OF EARLY DEATH

As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, most previous research studies have suggested only rather weak links between chronic stress and cancer risk, although there is some data linking chronic depression with breast cancer risk.  However, in view of the increasing number of people around the world who are currently experiencing chronic anxiety and depression during these economically and geopolitically troubled times, the findings of a new public health study that psychological distress significantly increases the risk of premature death from serious illnesses, including cancer, is concerning.  This new study appears in the current issue of the British Medical Journal.

Altogether, 68,222 adults in Great Britain were followed for an average of more than 8 years within the prospectively conducted Health Survey for England study.  All of these study participants were clinically free of serious physical illness when they first joined this very large public health study.  All of the participants in this study were assessed for psychological stress using a validated assessment questionnaire, which was administered in their homes by research staff.  Subsequently, the incidence of serious physical illnesses during the course of this study was then correlated with the degree of measured psychological distress.  The rather dramatic findings of this large prospective public health study illustrate the magnitude of the impact of chronic, severe stress on our bodies, including the risk of premature death due to stress-associated physical illnesses.

After adjusting for preexisting serious physical illnesses, lifestyle-associated risk factors for serious illnesses, and socioeconomic factors known to be linked to chronic, serious illnesses, this study still identified a highly significant increase in the risk of premature death associated with the extent of psychological distress among volunteers in this very large study.  When the “psychological distress score” was compared with death rates, having a score of 1 to 3 (compared to a score of “0,” which reflects no evidence of psychological distress) was associated with a 20 percent increase in the risk of premature death.  A psychological stress score of 4 to 6 was associated with a 43 percent increase in the risk of early death, while a distress score of 7 to 12 was associated with a whopping 94 percent increase in the risk of premature death when compared to study volunteers who were without evidence of any significant psychological distress!

Upon further analysis, death due to cardiovascular disease and other non-cancer causes increased significantly, and proportionally, with each increase in the psychological distress score.  Cancer-associated deaths also increased with rising psychological distress scores, although this association was only observed among volunteers with significantly elevated distress scores.  However, for non-cancer causes of death, the risk of premature death was significantly elevated with evenmild increases in psychological distress.

The potential impact of this study’s findings are highly significant, as they not only reveal a “dose-dependent” relationship between stress levels and the risk of premature death from serious physical illnesses, but the sheer magnitude of the impact of high levels of chronic anxiety and depression on the risk of premature death is much higher, potentially, than has been observed in previous and much smaller studies.

Although this study was not designed to identify the biological mechanisms whereby prolonged periods of increased psychological distress lead to early death, numerous prior studies have shown that chronic depression and anxiety can directly activate an inflammatory response in humans which, in turn, is known to increase the risk of cardiovascular disease, infection, and cancer, as well as other chronic, serious illnesses.  It is also well known that chronic anxiety and chronic depression increase the likelihood of unhealthy behaviors that have also been linked to serious, chronic illnesses, including smoking, excess alcohol or other drug intake, unhealthy diets, and lack of exercise, in addition to other unhealthy behaviors.  What is especially unique about this new study (other than its sheer size), however, is that the researchers were able to identify and adjust for preexisting unhealthy behaviors among the study’s volunteers when they analyzed the study’s data, which increases the likelihood that the adverse effects of chronic anxiety and depression on the risk of premature death observed in this research study are actually a direct result of psychological distress rather than unhealthy lifestyle choices.

If you are experiencing high levels of chronic stress, and if you are frequently anxious or depressed, then please seek help from your personal physician or a mental health professional.  If you are thinking of harming yourself, or someone else, then please seek immediate help.  These are very trying times for many people, and the ongoing worldwide challenges that have provoked such high levels of stress do not appear likely to disappear any time soon.  Knowing that so many other people around the world are also feeling worried and chronically stressed can make each of us feel less alone in our distress.  However, sometimes the awareness that others are experiencing similar levels of distress is, by itself, not enough to ease our anxiety or depression.  So, if you are struggling with anxiety or depression, and especially if you are feeling alone and isolated at the same time, then please seek the help and support of others.  In the vast majority of cases, feelings of hopelessness or helplessness will eventually pass when you get help and support during dark times in your life.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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Depression After Childhood Abuse May Be Linked To A Specific Gene







 

A new study suggests that a variant of a recently discovered gene may double the risk of lifelong depression after childhood abuse.


 

 

CHRONIC DEPRESSION AFTER CHILDHOOD ABUSE MAY BE LINKED TO A NEW GENE

The age-old debate about “nature versus nurture” has become increasingly complicated as we continue to learn more about the impact of individual genes on our risk for various illnesses.  While it has become widely accepted that specific genetic patterns may predispose some of us to a very high risk of certain physical illnesses, such as cancer and cardiovascular disease, the potential linkage between specific genes and the risk of mental illness has been less clear.  At the same time, however, it has long been known that some mental health disorders, including depression, anxiety disorder, panic disorder, bipolar disorder, and schizophrenia, tend to run in families, which suggests that there may be at least some genetic component to these illnesses.

Over the past 5 years, fundamental new research has begun to suggest that certain genes may indeed be associated with an increased risk of specific mental illnesses.  However, most mental health experts believe that having a specific form of a gene linked to mental illness does not, by itself, mean that an affected individual faces a 100 percent risk of developing a mental illness.  Getting back to that “nature versus nurture” debate once again, it appears that having a genetic variant associated with a specific mental health illness probably predisposes an affected person to develop that particular mental health disorder, but does not guarantee that this will happen.  More specifically, an individual person’s experiences and environment during early life (i.e., the “nurture”) appear to have a significant impact on whether or not genes associated with an increased risk of mental illness (i.e., the “nature”) will actually lead to the development of mental illness.

Now, a newly published clinical study provides strong evidence that a specific form of a single gene can significantly increase the likelihood of major depression in adults following physical abuse during childhood, while another variant of this same gene appears to decrease the risk of chronic depression in similarly abused adults.  This intriguing research study appears in the current issue of the Archives of General Psychiatry.

This new research study was inspired by previous research with laboratory animals that identified a network of neurons in the brain that use chemicals called endocannabinoids to communicate with each other.  (If the word “endocannabinoid” sounds vaguely familiar, it is because these naturally occurring neurotransmitters in the brain also have counterparts in the plant world, most notably in cannabis, or marijuana, plants!)  Previous research has also suggested that the endocannabinoid system in the brain may play an important role in adaptation to stress, including the moderation of our mood following stressful events.

In this new study, two groups of patient-volunteers were included.  The first group consisted of 1,041 young adult female twins in the United States, while the second group consisted of 1,428 Australian adults known to be addicted to heroin. (An additional 506 Australian volunteers without heroin addiction participated in this study as the control group for the heroin-addicted volunteers.)  The presence of depression, and in particular, depression with anhedonia (a term that indicates the inability to enjoy experiences that most of us find pleasurable), was assessed among all of these patient-volunteers.  The absence or presence of a history of physical abuse, by a parent or caregiver, during childhood was also evaluated.  Testing of the gene which codes for the human endocannabinoid receptor in the brain was performed on all of these research volunteers, as well.

The findings of this study were highly significant.  Not surprisingly, the study volunteers who reported having experienced significant childhood physical abuse had a much higher incidence of depression when compared to those volunteers who did not experience physical abuse as children.  Among the volunteers who had experienced significant physical abuse during childhood, a single, specific variant of the endocannabinoid receptor gene appeared to be highly protective against anhedonic depression when compared to volunteers who possessed the more common variant of this gene.  Specifically, only 29 percent of abused volunteers with this less common variant of the endocannabinoid receptor gene experienced anhedonic symptoms, while 57 percent of the previously abused volunteers with the most common form of this same gene were found to have symptoms of anhedonic depression.

The findings of this study strongly suggest that certain naturally occurring variants of specific genes may either increase or decrease the risk of mental illness (and in the case of this clinical study, major depression with anhedonia) following stressful experiences earlier in life.  Not only do this study’s findings suggest a method of screening patients who might be at significantly increased risk for major depression following stressful events in their early lives, but the linkage of a specific gene within the brain’s endocannabinoid system with depression following traumatic childhood experiences may someday allow for a more effective treatment for post-traumatic major depression, using medications targeted at the specific genetic variation that leads to this increased risk of depression following childhood trauma.


At this time, more than 8 percent of Americans are unemployed.  According to the Bureau of Labor Statistics, however, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is now more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.

 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 











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Epidemic of Alcohol Abuse Among Surgeons





A new study indicates that chronic alcohol abuse among surgeons is far more common than among the general population.


 

 

EPIDEMIC OF ALCOHOL ABUSE AMONG SURGEONS

In a previous column (Surgeon Performance and Alcohol), I reviewed a clinical research study that revealed just how significantly alcohol intake degrades surgical skills among surgeons, even well into the day following alcohol intake.  In another recent column, I examined a study that revealed a disturbingly high rate of burnout and depression among American surgeons (Surgeon Burnout and Depression).  This week, I will present a newly published clinical study that, once again, raises serious concerns about the health and wellbeing of many surgeons in the United States.

In a study that appears in the current issue of the Archives of Surgery, more than 7,000 surgeons in the United States agreed to participate in a confidential assessment of alcohol abuse and alcohol dependence among members of the American College of Surgeons.  Validated surveys and tests were administered to these surgeon-volunteers, and the resulting data was analyzed.

Based upon the results of the Alcohol Use Disorders Identification Test, 15 percent of the responding surgeons, overall, were identified as meeting the criteria for either chronic alcohol abuse or alcohol dependence.  Further evaluation of the data collected in this study revealed that 14 percent of the participating male surgeons met the criteria for chronic abuse of alcohol or alcohol dependency, while 26 percent of the corresponding female surgeons met these same worrisome criteria.  Moreover, surgeons who reported having committed a major medical or surgical error within the previous 3 months were 45 percent more likely to abuse alcohol, or to be dependent upon alcohol, when compared to surgeons who did not report any recent errors.  Similarly, surgeons who reported feeling burned out in their professional lives were 25 percent more likely to be problem drinkers when compared to surgeons who did not report professional burnout.  Finally, surgeons who reported symptoms consistent with depression were nearly 50 percent more likely to abuse alcohol than surgeons who did not report feeling depressed.

Interestingly, surgeons were less likely to have alcohol abuse and dependency problems if they were older, male, or had children.  (Approximately 11 percent of adult males in the general population are thought to have chronic alcohol abuse problems, while only about 5 percent of adult females in the general population appear to abuse alcohol on a regular basis.)

The findings of this study, once again, indicate a disturbingly high rate of substance abuse among American surgeons; and this is the first study to show that female surgeons, unlike women in the general population, are twice as likely as their male counterparts to regularly abuse alcohol.  Taken together with previous studies showing very high rates of depression and career burnout among surgeons in the United States, the findings of this latest study are rather worrisome.  (Previous studies have also linked an increased likelihood of medical and surgical errors to surgeons who are depressed, and who abuse alcohol and other drugs.)

I should also note that only 29 percent of the surgeons who were contacted agreed to participate in this confidential study.  Because this participation rate is much lower than what is typically seen in most survey-based research studies, it raises the important question as to whether or not the rate of alcohol abuse and alcohol dependency might actually be considerably higher among surgeons, in general, than what is reflected in this study.  Indeed, most statistics experts believe that a very common reason for nonparticipation in survey-based studies is a reluctance to divulge negative information about oneself.  Moreover, even people who elect to participate in survey-based studies often “fudge” their responses in ways that tend to underestimate their bad habits and other self-perceived shortcomings.  Therefore, it is entirely possible that the incidence of chronic alcohol abuse and alcohol dependency among surgeons may be even higher than what was reported in this study….

 

As I have observed in previous columns, surgeons who abuse alcohol, or other drugs, are more likely to be associated with medical errors and worse patient outcomes.  However, the stigma of reporting oneself as having an alcohol, or other drug, problem is so great in the medical profession that impaired surgeons (as with other physicians) are generally extremely reluctant to admit that they have an alcohol or drug problem.  Most medical boards still require physicians to indicate whether or not they have a history of drug or alcohol abuse on licensure applications, and the medical profession, in general, still seems to be in a state of denial regarding the unusually high incidence of drug and alcohol abuse among physicians when compared to the general public.  It also goes without saying that the potential consequences of being operated upon by an impaired surgeon can be catastrophic to both patients and their loved ones, and, therefore, the still prevailing “head in the sand” approach to identifying, and rehabilitating, impaired physicians would not appear to serve the public interest very well, in my view.

 

While the vast majority of surgeons are passionately devoted to providing the best possible care to their patients, and would therefore not engage in personal behaviors that might potentially endanger their patients, it is becoming increasingly clear that a sizable percentage of surgeons in the United States are seriously impaired by burnout, depression and other mental health illnesses, and by alcohol and drug abuse.  Therefore, a better system of screening out surgical trainees who are predisposed to these serious health problems should be considered, while, at the same time, medical authorities at the state and federal levels should make it easier, and less threatening, for currently impaired physicians and surgeons to reach out for help without fearing that they will be punished or professionally sanctioned as a result.  I, therefore, applaud the American College of Surgeons for sponsoring and publishing this important study as a preliminary step forward in this direction.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a lighthearted perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 








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Effective New Treatment for Chronic Pain

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New research shows that behavioral therapy combined with an exercise program may be the most effective treatment for chronic pain.


 

 

EFFECTIVE NEW TREATMENT FOR CHRONIC PAIN

According to the American Academy of Pain Medicine, chronic pain afflicts nearly 1 out of every 3 American men, women and children, and is associated with an estimated cost to society of $560 to $635 billion per year.  While there are many causes of chronic pain, they all share a common trait in that almost all types of chronic pain are associated with significant physical and psychological disability in afflicted patients.

Unlike acute pain (like the pain that follows a fresh cut on your hand, or spraining your ankle, for example), which subsides very quickly, chronic pain usually does not improve on its own.  Moreover, while you may hop around and shout out a few choice words after smashing your thumb with a hammer, the acute pain caused by a poorly aimed hammer usually does not leave a person feeling depressed or completely disabled like chronic pain so often does.  Over time, as chronic pain persists, the area in the brain (the limbic system) that attaches emotional content or value to our experiences and sensations becomes increasingly involved with interpreting the chronic barrage of pain sensations from damaged nerves or chronic inflammation, which leaves many chronic pain sufferers debilitated, and often depressed.  Because of the biological complexity of chronic pain, when compared to acute pain, it can be very difficult to effectively treat this lingering form of pain.  Patients suffering with chronic pain frequently find their symptoms both physically and emotionally disabling, and medications commonly used to treat acute pain are often ineffective in managing chronic pain.  As I have noted, depression is a common feature of chronic pain, and often requires treatment with antidepressant medications and behavioral therapy in addition to treating the original cause (or causes) of a patient’s pain.

Now, a newly published prospective randomized clinical research study offers new hope for the estimated 116 million Americans who suffer from chronic pain.  This study, which appears in the current issue of the Archives of Internal Medicine, randomized 442 patients with chronic pain to receive one of the following interventions for a period of 6 months:  (1) telephone-based behavioral therapy, (2) a graded, step-wise exercise program, (3) a combination of both telephone-based therapy and a graded exercise program, or (4) standard treatment for chronic pain.  All of the study volunteers were assessed at the time that they entered into the study, 6 months later, and again at 9 months.

The results of this innovative study were quite interesting.  Following 6 months of standard chronic pain management, only 8 percent of the study volunteers randomized to this intervention group noticed any significant improvement in their symptoms, and this result was unchanged 9 months after the start of this clinical study.  Among the patients who underwent 6 months of telephone-based behavior therapy, 33 percent felt that their chronic pain was improved at 9 months.  After 6 months of treatment, 35 percent of the patients who participated in a graduated exercise program felt improved, although this effect decreased over time, with 24 percent of this group of patients reporting improvement in their chronic pain symptoms at 9 months.  Finally, the combined therapy group (behavioral therapy and exercise) experienced the greatest improvement in their symptoms, compared to the other treatment groups, with 37 percent of patients in this group reporting significant improvement at both 6 months and 9 months.

This study represents an extremely important advance in the management of chronic pain, a condition that is highly resistant to most conventional therapies and medications.  As a cancer physician who regularly treats cancer patients with chronic pain, I am not surprised by the extremely poor response of patients to conventional chronic pain management approaches in this study.  While the 37 percent positive response rate noted in this study to combination therapy may seem like a rather poor result, chronic pain syndromes are so difficult to effectively treat that this study’s 37 percent response rate is actually extremely impressive.  Based upon the results of this important study, behavioral therapy combined with exercise therapy appears to be the most effective and long-lasting treatment approach for patients with chronic pain.  At the same time, the dismal response rate associated with standard chronic pain management approaches, as noted in this study, should cause pain management specialists to seriously reevaluate current methods of treating patients with chronic pain.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author



For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam



I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 





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Deep Brain Stimulation May Help Severe, Refractory Depression

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DEEP BRAIN STIMULATION MAY HELP SEVERE, REFRACTORY DEPRESSION

Depression is both a common and a potentially very serious mental health disorder.  According to the Centers for Disease Control (CDC), nearly 10 percent of the adult population in the United States can currently be classified as having active depression, and approximately 4 percent of the population currently meets criteria for severe, major depression.

The incidence of depression varies considerably between different groups of people.  For example, women are 70 percent more likely than men to experience depression.  Although depressed women are more likely than men to attempt suicide, men are far more likely to be successful in their suicide attempts.  Other high risk groups include people between the ages of 45 and 64 years, people from ethnic minority groups, people with less than a high school education, people who are divorced and who have not remarried, the unemployed, and those without health insurance.  (Clearly, in view of the still ongoing recession in the United States, the number of people in several of these high-risk categories has increased significantly over the past four years.)

There are multiple effective therapies available or depression, including antidepressant medications, psychotherapy, and electroconvulsive therapy (ECT).  More recently, transcranial magnetic stimulation, vagus nerve stimulation, and other experimental treatments have been evaluated in patients with depression that fails to respond to conventional therapies.  Another recently developed experimental therapy for severe, refractory depression is deep brain stimulation (DBS).  In small pilot studies, small numbers of patients with severe depression, and who have failed every other form of depression treatment (including ECT), have had surgically implanted electrodes placed into their brains, followed by electrical stimulation of their brains through these deep brain electrodes.  While it is too soon to conclude that DBS is both safe and effective in the management of severe, refractory depression, a new prospective clinical research study suggests that DBS may, indeed, produce significant remissions in refractory major depression.  This newly published study appears in the current issue of theArchives of General Psychiatry.

In this small but innovative clinical trial, 10 patients with major depression and 7 patients with bipolar disorder underwent surgical implantation of deep brain stimulation electrodes into both hemispheres of the brain.  Initially, all patients underwent simulated (“sham”) DBS, without the patients’ knowledge.  (This sham stimulation was done to test whether or not the patients’ expectation of benefit, or a true potential benefit simply from having the electrodes surgically placed, might have influenced their depression independent of actually stimulating their brains.)  Following 4 weeks of sham stimulation, all patients then initially received 24 weeks of actual DBS.  Following this period of actual DBS, active stimulation of the deep brain electrodes was then temporarily stopped.  (Once again, this discontinuation of active DBS was not revealed to the patients.)  These patient volunteers were then treated with DBS and monitored for up to 2 years.

In this group of patients who had previously failed, literally, all other forms of conventional therapy for their severe depression, DBS was associated with complete remission of depression in 18 percent (3) of the patients, and a significant improvement in depressive symptoms was observed in 41 percent (7) of the patients after 24 weeks of active DBS.  After 2 years of active DBS, 12 patients remained in the study, and 92 percent (11) of these patients experienced significant improvement in their depressive symptoms, including 58 percent (7) who experienced a complete remission of their depression!

The findings of this small prospective, controlled clinical research study are both dramatic and important, and for several reasons.  First of all, the clinically significant improvement seen in almost all of these patients is extraordinary in view of the severity of their depression and the completely refractory nature of their depressive symptoms.  Secondly this study included several patients with bipolar disorder, a disease which is characterized by alternating episodes of mania (a state of extreme mental and physical hyperactivity) and depression.  (Earlier studies of DBS had suggested that this treatment might not be as effective in patients with bipolar disorder, and might also lead to an increased risk of episodes of mania.  However, in this small pilot study, DBS was as effective in treating the symptoms of depression in patients with bipolar disorder as it was in patients with depression alone.  Moreover, DBS did not appear to increase the likelihood of episodes of mania in patients with bipolar disorder.)

 

Depression is a common mental health disorder, and severe cases of depression can leave patients feeling miserable and hopeless.  In especially severe cases, depressed patients may be unable to function in their daily personal or professional lives.  For some unfortunate patients with depression, suicide or accidental causes of death may also end their lives prematurely.  Based upon the findings of this small, preliminary clinical study, DBS may be a safe and effective treatment option for patients with chronic, severe, and refractory depression.

 

If you are depressed, and you are having thoughts about harming yourself (or harming someone else), please immediately contact your mental health provider, a suicide hotline, your personal physician, a close and trusted friend or relative, or your clergy person.  Even during times when you feel like there is no hope that life will get better for you, it almost always will get better if you get some help.

 


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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Physicians and Mental Illness

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New research confirms that physicians frequently suffer from mental illness, and are more reluctant than non-physicians to seek help.



PHYSICIANS AND MENTAL ILLNESS

While physicians are less likely than the general population to die from heart disease or cancer, we doctors are significantly more likely to die from suicide than our lay brothers and sisters.  Indeed, a very troubling statistic is that suicide is the second most common cause of death among medical students (accidents are the number one cause of death).

Multiple studies have shown that physicians are at greater risk of developing significant mental health problems when compared to the general population, including depression and bipolar disorder.  Physicians also have higher rates of alcoholism, and other forms of substance abuse, when compared to the general public.  Although the potential reasons behind this higher incidence of mental illness among physicians continue to be debated, most experts agree that doctors with mental health problems are notoriously reluctant to seek help.  They often do not recognize that they are ill, in the first place; and when they do become aware that they are not well, they are less likely than non-physicians to seek professional help.  Moreover, there are still tremendous stigmas associated with mental illness among health care professionals, causing many impaired physicians to avoid reaching out for help.  As if these adverse factors that discourage physicians from seeking help are not already bad enough, most state medical boards require physicians to disclose whether or not they have ever been diagnosed or treated for a mental illness (or substance abuse) as a precondition for initial licensure or renewal of an existing medical license.  (In many cases, disclosing a prior or current history of mental illness, even if the physician is receiving appropriate treatment, can result in very negative professional and financial consequences for physicians who disclose their history of depression or other mental health problems.)

 

 

In view of these disturbing statistics regarding physicians and mental illness, I find the results of a newly published clinical research study to be quite revealing (and disturbing).  In this study, 108 physicians were asked to confidentially complete a 56-item questionnaire that assessed their distress levels and their willingness to accept various forms of assistance for their feelings of severe distress.  This study appears in the current issue of the Archives of Surgery.

Within the preceding year, fully 79 percent of the surveyed physicians had experienced either a serious adverse patient event or a traumatic personal event that left them feeling very distressed.

When asked about their willingness to seek support or assistance regarding stressful issues in their lives, 72 percent of the doctors indicated that they would be willing to seek help for legal problems, while 67 percent would do so after being involved in a serious medical error.  Another 67 percent of the physicians were willing to seek help for substance abuse issues, while 62 percent were open to seeking medical help for physical illness.  Tellingly, only half (50 percent) of the physicians indicated that they would seek help for mental illness, and an equally small number also indicated that they would be open to assistance regarding serious interpersonal conflicts at work.

When asked about barriers to seeking help, 89 percent of the doctors indicated that they did not have time to get help with the causes of their distress, while 69 percent also responded that they were either uncertain about how to get help or that they had experienced difficulty in obtaining assistance.  A total of 68 percent of the physicians also cited lack of confidentiality, a potentially negative impact on their career, and the stigma associated with seeking help as barriers.

Regarding the most likely sources of support that they would be willing to seek, 88 percent expressed a preference for their physician colleagues, while only 48 percent were willing to be seen by mental health professionals, and only 29 percent were open to participating in employee assistance programs.

 

 

The findings of this study are hardly surprising.   The prevalence of major distress and mental health issues among physicians continues to be very high, relative to the general population.  At the same time, only half of the physicians participating in this study indicated a willingness to seek help for mental health problems.  Similarly, only half of these doctors would be willing to seek help for serious interpersonal difficulties (a common marker for certain psychological and personality disorders) in the workplace.  Among the most often cited reasons for not seeking help were “lack of time” and uncertainty about how to obtain help.  Additionally, the physicians who participated in this confidential study expressed serious concerns regarding confidentiality, the potential for negative career impact, and the perceived stigma associated with asking for help for mental health issues.

 

 

From my own experience as a physician over the past 23 years, I can honestly say that these disturbing statistics and findings regarding physician stress, distress, and mental health problems are, if anything, most likely understated.  Within the medical profession, it is no secret that the true incidence of depression, bipolar disorder, personality disorders, interpersonal strife, marital duress, domestic abuse, and divorce is very high among physicians, in comparison to the general population.  Ironically, and unfortunately, however, as bad as the stigma associated with mental illness is in the general public, it is even more severe within the medical profession.

Over the years, I have known numerous physicians with various forms of mental illness and personality disorders, and I cannot recall a single one of them ever voluntarily reaching out to mental health professionals for help.  Sadly, in view of the strong aversion on the part of physicians with mental illness towards seeking help from mental health professionals,  proactive and progressive steps to eliminate the perceived stigma of mental health problems within the medical profession, as well as removing the potentially punitive sanctions that many physicians would otherwise be subjected to if they sought professional help, will be necessary before troubled or impaired physicians can begin to feel free to seek help and support for the problems that torment them.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-Million,Vroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month. (More than 1.2 million health-conscious people visited Weekly Health Update in 2010!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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Job and Workplace Stress

 

Welcome to Weekly Health Update



“A critical weekly review of important new research findings for health-conscious readers”


JOB AND WORKPLACE STRESS

 

The global economy remains in the doldrums, unemployment remains at historically high levels around much of the world, and many people are feeling stressed in both their professional and personal lives.  In today’s highly competitive job market, many employees are feeling increasingly vulnerable.  There is also the perception among many workers that the poor job market has given employers the upper hand when it comes to the workplace environment.  Employees are working longer hours (and often without traditional overtime pay, and the other economic incentives of the pre-recession era), taking more work home with them, and in general, are feeling a great deal more stress and insecurity than they experienced before the economy took a nose-dive in 2008.

Increased levels of chronic stress have been linked to a variety of health problems, including cardiovascular disease, depression, obesity, increased drug use (including tobacco, alcohol, and illicit drugs), domestic abuse, interpersonal conflicts (at home and at work), and some cancers.  With no end in sight to this second-worst economic downturn in modern history, the odds remain relatively high that many employees will continue to face increased demands in the workplace, increased difficulty in finding a reasonable work-home life balance, and will continue to feel vulnerable and anxious about the stability of their jobs.  Many employers recognize that treating their employees fairly, and helping them to feel secure and appreciated in their jobs, is a “win-win” for everyone.  Employees who are treated fairly, and who come to work each day knowing that their workplace environment is both supportive and free of unnecessary strife, are more efficient and more productive, and tend to take fewer days of sick leave.  On the other hand, employees who feel that they are not being treated fairly, or that they are being taken advantage of, or that their jobs are at risk for reasons other than their performance, are less productive, more prone to interpersonal conflicts, and take more days of sick leave than employees who enjoy a healthy workplace climate.  While some employers may see the current economic downturn as an opportunity to take advantage of their employees, and to exploit and mistreat their employees at a time when many workers already feel insecure and vulnerable, most employers understand that when their employees look forward to coming to work in a healthy, supportive, and fair workplace climate, both employer and employees are more likely to thrive.

 

 

Two newly published public health studies, which appear in the current issue of the Journal of Occupational & Environmental Medicine, offer both employees and employers important insights into creating a healthier, more productive, and more collegial work environment. 

 

The first study was a long-term longitudinal, prospective occupational health study of 326 men and 338 women who originally enrolled in this research study in 1980 (while between the ages of 9 and 18 years).  These children and adolescents were then followed for an impressive 27 years, until 2007.  This study found that the now adult workers who had engaged in frequent leisure-time exercise, and effort-intensive sports, during childhood and adolescence were significantly less likely to complain of chronic workplace stress after they reached adulthood (i.e., when compared to employees who had rarely engaged in exercise or sports during their youth).  Interestingly, after being tested for cardiovascular fitness during adulthood, this study found that a high level of physical fitness in adulthood only partially explained the apparent benefit of increased physical activity during late childhood and adolescence on perceived workplace stress.   In addition to engaging in regular exercise and sports, having a “Type A” personality also appeared to be predictive of less workplace-associated stress.  (People with “Type A” personality traits are highly goal-oriented, performance-oriented, “take charge” people, as opposed to people with so-called “Type B” traits.  “Type B” people tend to feel more comfortable in delegating tasks, are less confrontational than Type A” folks, and also do not feel the sense of task-oriented urgency that their “Type A” peers constantly experience.)

While we probably cannot change our basic personality type, we can all increase our levels of physical activity, starting in childhood and continuing through adulthood, as a means of coping with the increased levels of chronic stress that many of us are feeling these days.  (Importantly, there are many clinical research studies that have demonstrated a strong correlation between regular exercise and a decrease in the incidence of stress-related physical and mental illnesses.)

 

 

The findings of the second occupational health study should serve as a wake-up call to those employers that take advantage of hard economic times to exploit their workers, as well as those employers that permit an unhealthy or unfair work environment to persist.  In this study, 2,763 randomly selected employees from the general population were interviewed and evaluated with respect to their workplace environment and their satisfaction with their jobs.  A second group of 3,044 employees who appeared on their companies’ sick lists for more than 14 days, over a 2 month period, were similarly evaluated.

Among the women employees, a perceived unhealthy or unfair workplace environment was associated with an 80 percent increase in the likelihood that these female employees would end up on chronic sick lists.  The impact of a toxic workplace environment on the male employees was even more profound, as men who complained of an unhealthy or unfair workplace climate were 174 percent more likely to chronically call in sick when compared to the men who were generally satisfied with their workplace environment and their jobs.  (Interestingly, increased workload alone, in the absence of an unhealthy workplace environment, increased the risk of absenteeism among women, but not among men.)

 

 

In summary, these are tough times for many, many people.  Most employers treat their employees in a fair and ethical manner, knowing that happy and secure employees are more efficient, more productive, more reliable, easier to get along with, and less likely to take excessive sick leave.  Unfortunately, there are also employers who, sensing the insecurity of their employees during difficult economic times, exploit their employees through excessive and unfair workloads, and through their permissiveness in allowing unhealthy or unfair workplace environments to persist.  For employees who must navigate these uncertain times, regular and frequent exercise can be a very important coping mechanism, and can pay important dividends in both one’s personal and professional lives (including a reduction in the risk of stress-related physical and mental ailments).  For the minority of employers who take advantage of their anxious employees, or who turn a blind eye towards unhealthy or unfair workplace environments, such employers not only betray their responsibilities to their employees (and their responsibilities to society, in general), but their unethical treatment of their employees may also be detrimental to the overall success of these organizations, as disaffected employees often respond to such treatment with passive-aggressive work-avoidance behaviors, increased absenteeism, and in some cases, with litigation. 

In time, we will emerge from this terrible global recession.  When that happens, companies that have treated their employees fairly, and according to high ethical standards, during the worst of times will have an inherent advantage over those companies that took the low road.  High levels of productivity, excellent employee morale and loyalty, and low levels of absenteeism and workforce turnover, will improve the competitiveness, stability, and productivity of the companies that treated their employees well during tough economic times (while the companies that did not treat their employees well are more likely to face increased employee turnover as the economy improves, as their disenfranchised employees seek better opportunities within an improving employment marketplace). 

  

HAPPY HOLIDAYS TO OUR MANY HEALTH-CONSCIOUS

WEEKLY HEALTH UPDATE” READERS AROUND THE WORLD!

 

PEACE, LOVE, AND GOOD HEALTH TO ALL OF YOU!

 

 

For a complete discussion of the role of stress on cancer risk, and important evidence-based approaches to cancer prevention (including exercise), order your copy of my new book, A Cancer Prevention Guide for the Human Race, now!  For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, in both paperback and e-book formats, and begin living an evidence-based cancer prevention lifestyle today!

  

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GIVE  THE  GIFT  OF  HEALTH  THIS  HOLIDAY  SEASON!  For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores! 

On Thanksgiving Day, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com Top 100 Bestseller’s List for Kindle e-books!




Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author



For a different perspective on Dr. Wascher, please click on the following YouTube link: 

Texas Blues Jam



I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month.  (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!)  As always, I enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 

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Vitamin D and Depression

 

Welcome to Weekly Health Update



“A critical weekly review of important new research findings for health-conscious readers”


VITAMIN D AND DEPRESSION

Regular readers of this column already know that Vitamin D, which functions more as a hormone than a vitamin, has been linked to multiple potential health benefits.  These include a decreased risk of cardiovascular disease, improved strength and balance in older men and women, and a decreased risk of certain cancers.  In a newly published clinical research study, which appears in the current issue of the International Archives of Internal Medicine, increased blood levels of this hormone-like vitamin also appear to be associated with a significantly decreased level of risk for depression.

This large public health study assessed 7,970 research volunteers between the ages of 15 and 39 years in the United States.  All of these young study volunteers had blood Vitamin D levels measured, and this group of nearly 8,000 adolescents and young adults was also assessed for depression using a validated mental health survey.  The findings of this large clinical study were impressive:  After adjusting for other factors known to be linked with depression, this very large study found that people who were deficient in Vitamin D (blood levels less than or equal to 50 nmol/L) were 85 percent more likely to be clinically depressed when compared to people with normal Vitamin D blood levels (greater than or equal to 75 nmol/L).

Although this clinical research study identified a strong and significant association between the risk of depression and levels of Vitamin D in the blood, the findings of this study cannot prove that low levels of Vitamin D in the blood directly cause depression.  There could be other explanations for this finding, including decreased exposure to sunlight which is, itself, linked to depression (the majority of the Vitamin D in our bodies is manufactured in our skin, following exposure to sunlight).  However, recent research has also demonstrated that cellular receptors for Vitamin D are present within the brain, including those areas of the brain that regulate mood, and which are also thought to be the areas of the brain responsible for mood disorders like depression.  Therefore, it is certainly possible that Vitamin D, like multiple other hormones and neurotransmitters, may also play a direct role in the modulation of our moods.

As always, I strongly recommend that readers consult with their physician prior to taking supplements of Vitamin D, as serious health side effects can occur after taking large doses of this essential nutrient, particularly in patients with kidney or parathyroid gland disorders.

 

For a complete discussion of the important role of Vitamin D in cancer prevention, order your copy of my new book, A Cancer Prevention Guide for the Human Race, now!

  

 

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GIVE THE GIFT OF HEALTH THIS HOLIDAY SEASON!  For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores! 

On Thanksgiving Day, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com Top 100 Bestseller’s List for Kindle e-books!



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


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I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month.  (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!)  As always, I enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 

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