Head and Brain Injuries Induce Early Onset of Death

By Penelope Chuah

Yesterday, BBC published an article highlighting the fatal effects of post-head injuries. The analysis supports the fact that “injuries to the head can leave victims susceptible to early death” leading to a three times greater risk of death compared to people who did not suffer any damage to the brain (BBC).

Damage to certain brain areas can cause severe impairment to fundamental physical and mental body controls, some of which include motor function, memory function, executive function, and regions involved in personality formation. The frontal lobe, for example, is a region that specializes in memory function, executive function, and personality formation. When the frontal lobe undergoes damage from a concussion or repeated forceful strikes to the area, completing cognitive tasks becomes difficult, as well as initiating behavior and organizing tasks becomes impaired (Jagust). Furthermore, the frontal lobe is the area that involves personality formation. When this region is affected, preservation and inappropriate behavior with feelings of agitation develop. Among damage to these functional areas, The BBC article concludes that “common causes of premature death among those who had suffered previous brain injury included suicide, being a victim of assault or suffering fatal injuries, for example in a car crash” (BBC). Overall, brain and head injury commonly cause a change in potentially fatal mental and physical behavior. Punch-Drunk Syndrome exemplifies the effects of head injuries and the likelihood of the onset of premature death. This syndrome is common in boxers or those who are taking constant impact to the head. This eventually leads to cognitive and behavioral alterations that include personality changes and depression, accompanied with motor weakness. Problems in the brain lower the reserve and increase the potential of having problems with amyloid plaques and neurofibrillary tangles, a type of protein and fiber, respectively, that contribute to the onset of Alzheimer’s disease through neuronal degradation (Jagust).

Traumatic injuries to the brain can trigger a series of neuronal degradation that is particularly destructive to brain and bodily function, causing a higher risk of death. The brain, with all its intricacies and production of complex output, is a lot more fragile than people expect and require a lot more protection than given.

Sources:

Brain blow leaves life-long dangers. (2014, January 15). BBC News. Retrieved January 16, 2014, from http://www.bbc.co.uk/news/health-25747704

Dr. William Jagust, UC Berkeley, Public Health/Cognitive Science 129

Taking the First Step with Walk with a Doc

By Mint Bhetraratana

Four months ago, I found myself at the helm of a flip camera, a device that I was less than comfortable using, despite being a part of the tech-savvy generation. I was volunteering at a health conference in Oakland and was assigned to videotape the day’s events and interview some of the guest speakers. Everyone that I met was a health professional of some sort, having already found their calling and belonging to an organization that worked to better the community through public health means, while I, a Berkeley student on the brink of graduation, was simply there to help out and explore.

Little did I know that by the end of the day, I would find something to be a part of, too.

One of the guest speakers that I spoke with was Dr. David Sabgir, a physician from Columbus, Ohio who had flown all the way from his hometown to talk about his non-profit called Walk with a Doc.

“Hmm,” I thought the first time he told me and which I soon would realize is a common mistake people make, “Walk with a Dog.”

Of course, Walk with a Doc has nothing to do with this 4-legged creature (although we do encourage man’s best friend to walk with us!), but instead, is about encouraging the community to do the very simple act of walking.

Walking, as is often dismissed as just a necessary means of getting from one place to another, has a lot of health benefits. By walking 30 minutes a day, you are effectively lowering your blood pressure and cholesterol levels, reducing your risk of obesity, improving your immune system, and decreasing stress – thus making you a healthier, happier person!

With this in mind, Dr. Sabgir sought out a way, as a cardiologist, to help his patients prevent the onset of hypertension and cardiovascular disease (which to this day, is the number one cause of death in America) by encouraging them to be more physically active…and to do it with them.

So, in 2005, he founded Walk with a Doc, an organization that not only hosts monthly 2-mile walks with a leading physician, but which also provides free blood pressure screenings, healthy snacks, and giveaways like shirts, pedometers, and water bottles to encourage community members to continue walking long after the culmination of the event.

It was a simple idea – the merging of clinical medicine with a doctor’s advice and public health practice with a blood pressure check and a walk in the park.

I mulled over the concept in my head and concluded that, as someone who grew up playing tennis and soccer and even coached others in these sports, and as someone who learned about the obesity epidemic in public health classes, I wanted to be a part of this growing movement. (And indeed, Walk with a Doc is growing – with over 100 walks in the U.S., Australia, and Russia!)

After reconnecting with Dr. Sabgir after the conference and expressing my interest in getting involved with a Bay Area chapter of Walk with a Doc, he introduced me to the program’s director, Liz Mace. To my surprise, she told me that there wasn’t a Walk with a Doc chapter here, but that she would help me to start one.

I took some time to think about the task ahead of me: would I be up to the challenge of creating a chapter of a non-profit, something that I had no experience doing before? Would I be ready to take on a commitment that I knew would require much of my free time and energy?

I wasn’t sure what the answers were to these questions yet, but I decided that I would test the waters and find out.

And so began my journey with Walk with a Doc, which would involve several hours of sending and receiving e-mails, maintaining an Excel sheet that documented my every decision, talks with local physicians, visits to cafes and businesses for donations, and other tasks that I won’t go into detail here. I will however, share with you a few things that I’ve learned thus far while working on this project.

1. I have to pick myself up when the going gets tough.

It’s an unfortunate reality that there will be obstacles in the way of planning an event –whether it be a cynical opinion or a schedule that doesn’t hold up. It’s easy to allow these road bumps to add up until the point when you start doubting yourself. But when that happens, it’s important to remind yourself why you got involved in the first place; it’s an opportunity to reinforce your passion and commitment for a project. For me, I like to take a look at pictures from past Walk with a Doc events and remember the important message that this organization is getting across to thousands of people. I think of the impact that an event like this can have on a community and also consider that:

2. If I surround myself with supportive people, the obstacles can be conquered.

There are times when an individual can do a task, and there are times when a team of people can do it better. For public health initiatives, the latter is the better option. It’s crucial to interact with people who are supportive of the cause and of you. I was fortunate to come across with and connect with individuals from The City of Berkeley, Lifelong Medical Center, and Walk with a Doc, as well as the many business sponsors who believed in this program and who believed in me. Their relentless support truly helped me maintain the foundation for which I alone could not support.

Taking the time to reflect about Walk with a Doc has allowed me to think back to when I first heard about this program and which brings me to another lesson that I learned:

3. Do not discount the little things because if you let them grow, they can lead to greater opportunities.

Four months ago, I would not have thought that volunteering to take pictures at a health conference would have led me to creating a Walk with a Doc chapter in Berkeley. Had I not done the seemingly minor task of taking footage that day, I probably would not be writing this very essay. The bottom line is – take notice of everything that is going around you and the opportunities that may come your way. And if they don’t come, take notice of the things that you are doing and forge your own path to create something that you feel there is a need for in your community.

With that said, I invite you to come walk with us on Saturday, October 19^th in San Pablo Park in Berkeley. Dr. Janet Berreman will be speaking about the importance of physical activity and nutrition and Heart 2 Heart will be providing blood pressure screenings. In addition, we have invited Thalassemia Outreach at Children’s Hospital, Diabetes and Sports Health Camp (DASH), and 10x10 Wellness for Alameda County to speak to walkers about their respective health organizations. If you would like to volunteer or would like more information about this event and Walk with a Doc, feel free to e-mail me at wwad.berkeley@gmail.com. 

Stigma: “A mark of disgrace or infamy”

The impact of stigmatization in preventing the HIV/AIDS epidemic in Sub-Saharan Africa

By Michelle Tsui

Permissions  granted from Youth Challenge Institute  www.yci.org 

HIV began its well-recorded spread through Sub-Saharan Africa in 1959 when the earliest known HIV infection was found in what is now the Democratic Republic of the Congo.  Fifty years later, HIV has grown into a global epidemic infecting more than 33.3 million individuals worldwide according to the World Health Organization, 22.4 million of whom call Sub-Saharan Africa their home.

The HIV/AIDS epidemic began in Sub-Saharan Africa in the late 1970s, soon after the African independence movements brought displaced refugees, civil wars and poverty. This created an ideal setting for the sexually transmitted disease to spread. Since then, Sub-Saharan Africa has remained at the top of the charts in terms of the HIV infected population for reasons including forced prostitution for income, transmission of HIV from mother to child, the concept of concurrency, and most importantly, the social stigma against HIV that effectively counters the attempts of prevention and treatment.   

In almost any nation around the world, the HIV/AIDS infection is associated with some level of stigma, or “mark of disgrace or infamy”. United Nations Secretary-General Ban Ki Moon states, “Stigma remains the single most important barrier to public action. It is a main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. It helps make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions.”

Especially in certain parts of Sub-Saharan Africa, HIV/AIDS is taboo due to its association with physically promiscuous activities, and stigmatization toward infected individuals has become normalized and infused in those communities. As a result, individuals that are known to be living with the HIV/AIDS infection face prejudice, maltreatment, abuse, and discrimination even from their friends and family. Two specific cases of stigmatization were reported in the International Quarterly of Community Health Education (2009) when a boy named Nkosi Johnson was refused entrance to school and when a woman named Gugu Dlamini was murdered in South Africa by a mob that found out she was HIV positive.

HIV/AIDS-related social stigma, often cause individuals often shy away from treatment, medication, and care, even if such things may well increase their life expectancy. The overpowering fear of discrimination and condemnation from loved ones makes it difficult for people to come to terms with and manage the disease personally. However, this personal attitude becomes a problem for the entire nation when people refuse to get tested or disclose their infected condition to their romantic partners, causing the epidemic’s continuation.

In a recent study performed by the Africa-UCSF HIV/AIDS Stigma Project (2009), stigma was quantitatively measured in five different African countries using a series of surveys completed by people living with HIV and nurses treating HIV patients. The survey asked questions such as “In the past three months, how often did the following event happen because of your HIV status?” and determined the frequency of stigma-related occurrences. The results showed that 64.2% of all HIV infected individuals and 83.7% of nurses reported experiencing one or more HIV stigma events in a period of 3 months in all five African countries. Fortunately, the study also showed that in all five countries, stigma incidents decreased in the HIV infected over the time of the study; however, further study is needed to determine exactly why this is the case.

The most obvious solution for stopping stigma’s affects on the epidemic would be to break the myths and educate the community about disease prevention and availability of treatment. The World Health Organization states, “As HIV/AIDS becomes a disease that can be both prevented and treated, attitudes will change, and denial, stigma and discrimination will rapidly be reduced.” According to a related study conducted in Botswana, “stigmatizing attitudes had lessened three years after the national program providing universal access to treatment was introduced.” However, increased access to treatment will not by any means eliminate the social stigma the HIV infection brings.

 To address the social stigma, countries are creatively promoting awareness of the ability to live a normal life even with HIV/AIDS. The documentary Miss HIV depicts the true stories of everyday citizens in Sub-Saharan Africa who are battling stigma in unique ways. In Botswana, the Miss HIV Stigma-Free beauty pageant strives to show the community that women with HIV are still human beings and should be treated with respect. In Uganda, college students rally together in order to break the stigma surrounding sexual abstinence, as well as to collect interviews from people that that have chosen to publicly admit their HIV positive status and encourage those infected to get medicine as soon as possible. The winner of the Miss HIV Stigma-Free beauty pageant, Ms. Ntsepe proclaims, “I'm going around the country to talk to people to say that (being) an HIV positive person does not mean you have done something wrong. You are still who you are."

Getting rid of social stigma in Sub-Saharan Africa may seem like impossibility, but it can be done. Ban Ki Moon believes, “We can fight stigma. Enlightened laws and policies are key. But it begins with openness, the courage to speak out.” HIV education and awareness needs promotion so that people will seek treatment, get tested, and take measures toward HIV prevention. Once myths are destroyed, fear is eliminated, and the “mark of disgrace or infamy” erased, the HIV epidemic will be one giant step closer to elimination.  

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Author Bio:

Michelle Tsui is a first year intended public health major planning to pursue the fields of epidemiology and infectious disease. In her free time she loves reading, outdoor activities, and playing board games with friends.