|
Depression is the
Leading Cause of
Disability in the U.S.
and Worldwide |
Depression is a serious medical
condition. In contrast to the
normal emotional experiences of
sadness, loss, or passing mood
states, clinical depression is
persistent and can interfere
significantly with an
individual's ability to
function.
Symptoms of depression include
sad mood, loss of interest or
pleasure in activities that were
once enjoyed, change in appetite
or weight, difficulty sleeping
or oversleeping, physical
slowing or agitation, energy
loss, feelings of worthlessness
or inappropriate guilt,
difficulty thinking or
concentrating, and recurrent
thoughts of death or suicide.
Depression can be devastating to
family relationships,
friendships, and the ability to
work or go to school. Many
people still believe that the
emotional symptoms caused by
depression are "not real", and
that a person should be able to
shake off the symptoms. Because
of these inaccurate beliefs,
people with depression either
may not recognize that they have
a treatable disorder or may be
discouraged from seeking or
staying on treatment due to
feelings of shame and stigma.
Too often, untreated or
inadequately treated depression
is associated with suicide.
Brain imaging research is
revealing that in depression,
neural circuits responsible for
moods, thinking, sleep,
appetite, and behavior fail to
function properly, and that the
regulation of critical
neurotransmitters is impaired.
More than 80 percent of people
with depressive disorders
improve when they receive
appropriate treatment.
Source: the National
Institutes of Health
For more information: Click
http://health.nih.gov/quiz.asp?quiz_id=24
|
What is the 250 Yard Rule? |
The
question
of what
constitutes
"coming
to the
emergency
department"
is not
always a
simple
one to
answer.
Over the
years,
the
issue
has
arisen
in
connection
with the
transport
of
patients
by
ambulance
or by
helicopter,
the
development
of a new
emergency
condition
when a
patient
is
already
in-house,
and
similar
situations.
In 1998,
an
incident
in
Chicago
raised
this
issue in
a
striking
way.
Allegedly
because
of a
hospital
policy
prohibiting
personnel
from
leaving
the
grounds
while on
duty,
emergency
room
personnel
at
Ravenswood
Hospital
failed
to
provide
assistance
to
15-year-old
Christoper
Sercye,
who had
been
shot at
a nearby
school
playground
and
whose
friends
had
brought
him to
an alley
just off
hospital
grounds.
The boy
died
from his
wounds.
The
Clinton
administration
lost no
time in
announcing
its
intention
to
punish
the
hospital,
and
reportedly
OIG
imposed
a
$40,000
fine,
but in
truth
there
was
nothing
in the
hospital's
response
to this
tragic
situation
which
violated
the
EMTALA
rules as
they
then
existed.
(This
case
exemplifies
the fact
that
even a
hospital
fully in
compliance
may be
subject
to a
citation
and a
fine, or
worse,
if the
politics
of the
situation
are
wrong --
and
if
it
chooses
not to
contest
the
citation.
It is
only by
challenging
the
citation
that the
hospital
can
vindicate
itself
if the
CMS
action
is
erroneous.)
|
In 2000, CMS
issued new
amendments
to the rules
under 42 CFR
489.24,
expanding
the
responsibility
of the
emergency
room to
respond to
any
"presentation"
on the
hospital
campus or at
any
provider-based
off-campus
facility of
the
hospital. In
2003, these
rules were
significantly
revised.
The 250-yard
rule comes
from the
definition
of "Campus"
found at 42
CFR
413.65:
"Campus
means
the
physical
area
immediately
adjacent
to the
provider’s
main
buildings,
other
areas
and
structures
that are
not
strictly
contiguous
to the
main
buildings
but are
located
within
250
yards of
the main
buildings,
and any
other
areas
determined
on an
individual
case
basis,
by the
HCFA
regional
office,
to be
part of
the
provider’s
campus."
This
definition
comes into
play in
connection
with the
complicated
regulations
which define
"provider-based"
facilities.
The
significance
for EMTALA
under the
2000
regulations
was that
provider-based
status was
considered
to bring
some (but
not all)
off-campus
facilities
within the
sphere of
the
hospital's
responsibility.
For those
facilities,
a patient
who
presented to
a facility
requesting
treatment,
or who
appeared and
was
perceived to
be in need
of
treatment,
had to be
provided
with the
medical
screening
examination
prescribed
under
EMTALA, and
provided
with
stabilizing
medical
treatment if
an emergency
medical
condition is
found.
The 2003
revisions
provide:
A person who
presents
anywhere on
the hospital
campus and
requests
emergency
services, or
who would
appear to a
reasonably
prudent
person to be
in need of
medical
attention,
must be
handled
under
EMTALA.
Other
presentations
outside the
emergency
room do not
invoke
EMTALA.
The 250-yard
zone will
continue to
apply when
defining the
"hospital
campus".
Now,
however,
that sphere
does not
include
non-medical
businesses
(shops and
restaurants
located
close to the
hospital),
nor does it
include
physicians'
offices or
other
medical
entities
that have a
separate
Medicare
identity.
EMTALA does
not apply to
any
off-campus
facility,
regardless
of its
provider-based
status,
unless it
independently
qualifies as
a dedicated
emergency
department.
Source:
EMTALA.com
For more
info: click
http://www.emtala.com/250yard.htm
|
The Violence of
School Shootings |
School
shootings
are sobering
and tragic
events that
cause much
concern
about the
safety of
children.
Despite
these
events,
schools
remain a
very safe
place for
children to
spend their
days. In
fact, the
vast
majority of
children and
youth
homicides
occur
outside
school hours
and
property.
|
To learn
how these events may be
prevented, CDC is
conducting ongoing
research to learn more
about the nature of
school associated
violent deaths. Here are
some of the key facts
from this research:
FACTS: What has research
shown to date about
school-related violence?
To date, CDC research on
school associated
violent deaths found:
The number of children
and youth homicides that
are school-related make
up one percent of the
total number of child
and youth homicides in
the United States.
Most school associated
violent deaths occurred
during transition times
such as the start or end
of the school day, or
during the lunch period.
We have also seen
that school-associated
homicides are more
likely to occur at the
start of each semester.
Nearly 50 percent of
the homicide
perpetrators (this
includes adults,
children and youth) gave
some type of warning
signal (e.g., a threat,
a note) prior to the
event.
Among the
students who committed a
school-associated
homicide, 20% were known
to have been victims of
bullying and 12% were
known to have expressed
suicidal thoughts or
engage in suicidal
behavior.
Q: What kind of
preventive measures may
help to prevent
school-associated
violent deaths?
CDC in partnership with
the Departments of
Education and Justice is
gathering information
about school-associated
violent deaths to
identify trends that can
help schools develop
preventive measures to
protect and promote the
health, safety and
development of all
students. These
prevention measures
include:
Encouraging efforts to
reduce crowding,
increase supervision,
and institute
plans/policies to handle
disputes during
transition times that
may reduce the
likelihood of potential
conflicts and injuries.
Taking
threats seriously:
students need to know
who to go to when they
have learned of a threat
to anyone at the school,
while parents,
educators, and mentors
should be encouraged to
take an active role in
helping troubled
children and teens.
Taking
talk of suicide
seriously: it is
important to address
risk factors for
suicidal behavior when
trying to prevent
violence toward self and
others.
Promoting prevention
programs that are
designed to help
teachers and other
school staff recognize
and respond to
incidences of bullying
between students.
Ensuring at the start of
each semester that
schools’ security plans
are being enforced and
that staff are trained
and prepared to use the
plans.
Source: Center for
Disease Control - For
more information, click
hyperlink
http://www.cdc.gov/ncipc/sch-shooting.htm |
