All posts by Mike Schadone

Academia, Society

The Nature of Truth

Truth transcends knowledge, and knowledge transcends belief. Too many people invert these values to claim that their beliefs are true. In order to understand truth, it makes sense to first explore knowledge and belief and how, as humans, we use these constructs.

In the search for truth and knowledge, we as humans develop a belief structure based on observation over time. As this belief system develops, we start to draw correlations and presume conclusions based on the perceived degree of believability for each new belief, a system of fuzzy logic (Hajek, 2009), and how each relates to another. It is only when beliefs correlate well with other beliefs regarding the same subject do we get to claim knowledge.

I define knowledge as the agreement of beliefs within the study of interrelated subjects. Science is the process used to attain knowledge (“Science”, 2010). However, science can be wrong. This has been proven throughout history, time and time again. Science can only prove “provisional truths[, or] answers that are the best explanation for things at the present time” (Jackson, 2006, 1). It is these provisional truths that I regard as knowledge.

Truth, in the ultimate terms, cannot be false to any degree. It is easy to create truth from knowledge by applying conditions confining it. Ergo, the belief that dogs are dangerous is not true, nor is it knowledge, though there is truth in the statement that some dogs can be dangerous. Likewise, any other broad and sweeping generalization could create a false, but widely held belief. It is much more difficult to attain a universal, or absolute, truth, such as the God of Christianity is the architect and creator of the universe and all life within it, or that life is just a natural process and has no dependent relationship with any singular intelligent being.

Some absolute truths, however, can be attained. One such truth is that mortal existence ceases upon death. Death, in fact, is the definition of the end of mortal existence. This definition has been formed by observation, the creation of beliefs, and acceptance of these beliefs as knowledge. Though, if our beliefs and knowledge about death were different, as they once were, it would not negate the truth.

Another absolute truth is that life is revolutionary, or cyclical. Otherwise, what is the point of attaining knowledge and understanding truth if it cannot be used to our benefit?

References

Hajek, P. (2009). Fuzzy Logic. In Edward N. Zalta (Ed.), The Stanford Encyclopedia of Philosophy [Spring ed.]. Retrieved from http://plato.stanford.edu/archives/spr2009/entries/logic-fuzzy/

Jackson, J. (2006). Science has been wrong before. UK-Skeptics. Retrieved from http://www.skeptics.org.uk/article.php?dir=articles&article=science_has_been_wrong_ before.php

Science. (2010). Merriam-Webster Online Dictionary. Retrieved from http://www.merriam-webster.com/dictionary/science

Academia, Health Care, Public Health

The Impact of Stages of Life on Health

During our lifetimes, we are met with all kinds of obstacles to overcome, whether in business, society, or in moral dilemmas. None as true as in our health and wellness. During each major stage of life, there are many health challenges and risks that must be met and overcome. The importance of identifying challenges in each developmental stage of life is crucial to the promotion and adoption of healthy changes in behavior (Green, 1984). I will explore how lifestyle and behavioral choices, as well as social determinants of health, can impact these health risks and challenges as they relate to the various life-stages. Kolbe (as cited in Green, 1984) indicates a number of “health-related types of behaviors” (p.218), some of which I will address for each life-stage and transition between life-stages. As we transcend each stage of our lives, new and evolving concerns obstruct our path to wellness. We tend to approach our health from the present, the here and now, but it starts before our birth and, with genetics, possibly before conception.

Once we are conceived, we are locked into the care of our parents to be. Whether a mother and father, a single working parent, a single drug-addicted parent, caring grandparents, foster care, the State, or a host of other possibilities, each is suggestive of the environment to which we will be born and/or raised. This environment will surely shape our health from within the womb and health professionals are tasked with providing directed education to the parents-to-be to give the child the best chance of a healthy development.

The importance of maternal health to the fetus has become a focus in public health over the last century, but emerging research is showing how best to approach this topic. “Two principal threats to infant health are low birth weight and congenital disorders including birth defects” (Green, 1984). Though technological advances are proving helpful in high-risk pregnancies (Blincoe, 2007), prevention and education is still key. A recent literature review (Slama et al., 2008) has identified some links between environmental toxins and neonatal health, calling for more specialized research in this area. Exposure by pregnant women to toxins, such as that from pharmaceuticals, cigarette smoke, and contaminated fish, pose significant threats to the fetus (Gwiazda, Campbell, & Smith, 2005; Landrigan, Kimmel, Correa, & Eskenazi, 2004). Family violence towards the mother-to-be also serves a significant threat to children in utero. A study by Amaro, Fried, Cabral and Zuckerman (1990) reveals that women who have a poor support structure, a history of depression, and current alcohol and illicit drug abuse are more prone to be victims of violence, which threatens the pregnancy.

Infancy is the most crucial of the developmental stages for cognitive, social, and emotional development (Centers for Disease Control, 2009). The environment in which the infant development takes place is a key determinant to the level of neonatal and infant health. Lead, as well as other environmental toxins and notwithstanding comprehensive abatement programs, still threatens the development of infants and young children (Gwiazda et al., 2005; Landrigan et al., 2004). As infants develop into toddlers and young children, the threat focus shifts from indirect toxin exposure to direct accidental poisoning and physical trauma.

As children start to walk and gain enough strength and ingenuity to open doors and containers, there is an increased risk of accidental poisoning by household goods (Hockey, Reith, & Miles, 2000). Though accidental poisoning has been mitigated to a degree by the “Mr. Yuck” campaign (Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, 1971/2009) and the introduction of childproof containers, many poisonings still occur, some being purposeful by loved ones (Davis et al., 1998) but most are accidental. Poisoning included, trauma remains the leading cause of childhood death (Green, 1984, p. 225; Harkins, 2009).

The transition into puberty comes with a change in physiology, both in the body and in the brain. Adolescents must contend with a new found, and usually intense, libido. With this, the adolescent faces the threat of early pregnancy and a host of sexually transmitted diseases. Though public health education efforts seem to be effective on some levels, teenage pregnancy and STD’s remain a constant concern.

Green (1984) also finds that teenagers also find themselves expanding and exploring their environments with their increased autonomy. Increased risk-taking attitudes typically lead to a high likelihood of trauma, which, as is true for younger children, remains the leading cause of death for adolescents, though the associated poisoning is attributed more to recreational and experimental illicit drug use and abuse.

Transitioning into adulthood, the health focus begins to shift towards disease processes and away from trauma, except for, perhaps, motor vehicle and occupational incidents. Green (1984) supposes that this is from a “curtailed freedom [and] increased responsibility for lifestyle” along with “reduced parenting roles, changing bodily functions, [and] reduced activity” (Table 3). It is within these years that other responsibilities can seem to outweigh those of health, probably attributable to a high sense of health as active teenagers and a perceived need to be successful within their personal economy. This loss of health focus can certainly lead to disease processes, such as atherosclerosis, hypertension, and obesity, which can, in turn, lead to an early stroke or heart attack. It makes sense to consider that behavioral health changes within the early adult years can impact the later adult and senior adult years.

As we age towards our retirement, our picture of health tends to become more obvious. Many of us will suffer from hypertension, coronary artery disease, diabetes, and elevated cholesterol levels. Some of us will have already suffered a heart attack or stroke, and some others might soon. At this point in life, it is imperative to have frequent check ups with a physician who will probably attempt to control most of the underlying risk factor diseases mentioned above with pharmaceuticals. Though we can try to adopt healthier behaviors, by the time we reach our senior years, most of the physiologic damage is irreparable. There is some promise, however, as “the elderly are found in evaluative research studies to be as much if not more responsive to behavioral change supports than younger patients or subjects” (as cited in Green, 1984, p. 228).

One of these changes is osteoporosis, or a weakening of the calcium bone matrix. As we grow through childhood, our bones are formative and calcium is readily bonded within the bone structure providing the skeletal framework for the rest of our lives. The elderly suffer the most from any calcium deficiency, as the threat of simple fall can lead to a catastrophic injury requiring surgery for correction or a permanent fracture if the person does not have strong enough bones. This will most certainly result in the loss of the person’s ability to maintain his or her activities of daily living which can result in having to rely on residential nursing care. A lifetime of cigarette smoking, heart disease, or generally poor health can lead to the same degree of disability requiring the same type of care.

Skilled nursing facilities, though important for the continual care or rehabilitation of the elderly and infirm, have risks for the in-patient just as any other treatment might. Skilled nursing facilities are a vector of a number of nosocomial infections, usually medically resistant, which can and often does lead to a serious condition known as sepsis, a life-threatening infectious condition that overcomes the bodies ability to self-regulate. Sepsis is largely fatal. Confinement in a nursing facility is also associated with an increased incidence of depression and loss of constitution (Green, 1984).

As we have discussed some of the more prominent challenges that we face at each stage of our lives, we need to understand some of the determinants that affect our health. So long as we are aware of these, we can change our lifestyle and behaviors to minimize the impact of some of the negative determinants. In my opinion, the most important determinant of health is the availability of clean water, then perhaps, the availability of whole food and decent shelter. I feel that these are most important because they are the most difficult to correct as an individual. Following these, I feel that the availability of comprehensive health care is important.

This paper is based on research conducted primarily in developed Western society; therefore, it does not address the problem of extreme poverty and other determinants of health attributed to it. One example of this is provided by Kiapa-Iwa and Hart (2004) who show an increase risk of health with a prevalence of high-risk pregnancy and STD’s in the impoverished region of Uganda. Whether we are discussing Britain’s Liverpool, the Mid-west United States, or Uganda, we must admit that a focus on education and prevention, such as safe-sex programs, safe storage of medications and firearms, defensive driving, and others, seem to be the most effective means of mitigating some of the more controllable health determinants for parents and children, as well as adolescents. Older adults and seniors need to have a comprehensive program directed by their physician, including a healthy diet, exercise, and controlling medical problems such as hypertension and diabetes to increase their health status.

References

Amaro, H., Fried, L. E., Cabral, H., & Zuckerman, B. (1990). Violence during pregnancy and substance use [Abstract]. American Journal of Public Health, 80(5), 575-579. doi:10.2105/AJPH.80.5.575

Blincoe, A. J. (2007, October). Doppler sonography: Improving outcome in high risk pregnancy. British Journal of Midwifery, 15(10), 650-653. Retrieved from http://www.britishjournalofmidwifery.com/

Centers for Disease Control. (2009, May 7). Child development. Retrieved from http://www.cdc.gov/ncbddd/child/default.htm

Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center. (1971/2009). About Mr. Yuck. Retrieved from http://www.upmc.com/Services/poisoncenter/Pages/about-mryuk.aspx

Davis, P., McClure, R. J., Rolfe, K., Chessman, N., Pearson, S., Sibert, J. R., Meadow, R. (1998). Procedures, placement, and risks of further abuse after Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Archives of Disease in Childhood, 78, 217-221. doi:10.1136/adc.78.3.217

Green, L. W. (1984). Modifying and developing health behavior. Annual Review of Public Health, 5, 215-236. doi:10.1146/annurev.pu.05.050184.001243

Gwiazda, R., Campbell, C., & Smith, D. (2005, January). A noninvasive isotopic approach to estimate the bone lead contribution to blood in children: Implications for assessing the efficacy of lead abatement. Environmental Health Perspectives, 113(1), 104-110. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1253718/pdf/ehp0113-000104.pdf

Hockey, R., Reith, D., Miles, E. (2000, July). Injury bulletin: Childhood poisoning and ingestion [Injury Bulletin No. 60]. Queensland Injury Surveillance Unit. Retrieved from http://www.qisu.org.au/modcore/PreviousBulliten/backend/upload_file/issue060.pdf

Harkins, D., (2009). Pediatric trauma in the spotlight. Journal of Trauma Nursing, 16(3), 123-125. Retrieved from http://content.ebscohost.com/pdf23_24/pdf/2009/39B/01Jul09/ 44454466.pdf

Kiapi-Iwa, L., & Hart, G. J. (2004). The sexual and reproductive health of young people in Adjumani district, Uganda: Qualitative study of the role of formal, informal and traditional health providers. AIDS Care, 16(3), 339-347. doi:10.1080/09540120410001665349

Landrigan, P. J., Kimmel, C. A., Correa, A., & Eskenazi, B. (2004, February). Children’s health and the environment: public health issues and challenges for risk assessment. Environmental Health Perspectives, 112(2), 257-265. doi:10.1289/ehp.6115

Slama, R., Darrow, L., Parker, J., Woodruff, T. J., Strickland, M., Nieuwenhuijsen, M., …Ritz, B. (2008). Meeting report: Atmospheric pollution and human reproduction. Environmental Health Perspectives, 1161(61), 791-798. doi:10.1289/ehp.11074

Academia, Health Care, Public Health, Society, Technology

Direct To Consumer Advertising: Patient Education

Today, we are familiar with mass-media marketing of prescription drugs not only to physicians but to patients as well, known as direct-to-consumer advertising (DTCA). Though, many argue that a better informed patient allows for more autonomy in physcian-directed care (Buckley, 2004; Lyles, 2002; Sumpradit, Fors, & McCormick, 2002), “the evidence for DTCA’s increase in pharmaceutical sales is as impressive as is the lack of evidence concerning its impact on the health of the public” (Lyles, 2002, p. 73). Concerns abound regarding the ability of the physician to direct the care of a patient driven by DTCA. Many researcher’s, including Buckley (2004) and Green (2007) believe that many physicians prescribe medications solely on the request of the patient without providing guidance or education to the patient.

As a paramedic, I hear the concerns of patient’s regarding physician refusals to prescribe name-brand drugs to patients. These patients are almost militant about their beliefs of their illness and that the physician should honor the requests of their patients. While these patients never seem to find a resolution, I also see many people who trust in their physicians’ role and, with education, discuss with their physicians the possibilities and concerns of advertised medications. As one secondary data analysis (Sumpradit et al, 2002) suggests, though there is no demographic difference in the propensity of patients to ask their doctor for a medication based on DTCA alone versus seeking more information from their doctor, those with chronic conditions and who have poorer perception of health status tend to engage their physicians more often to clarify information garnered from DTCA’s.

I feel that DTCA is can be an empowering tool for the patient as long as it is educational, honest, and forthcoming. Empowering the patient to take an active role in his or her medical care is very important, but this empowerment comes with responsibility to be as fully educated as possible, allowing the physician his or her role in the relationship as the ultimate patient advocate, which some physicians lack.

References

Buckley, J. (2004). Pharmaceutical marketing: Time for change. Electronic Journal of Business Ethics and Organization Studies, 9(2), 4-11.

Green, J. A. (2007). Pharmaceutical Marketing Research and the Prescribing Physician. Annals of Internal Medicine, 146(10), 742-748.

Lyles, A. (2002). Direct marketing of pharmaceuticals to consumers [Abstract]. Annual Review of Public Health, 23, 73-91.

Sumpradit, N., Fors, S. W., McCormick, L. (2002). Consumers’ attitudes and behavior toward prescription drug advertising. American Journal of Health Behavior, 26(1), 68-75.

Academia, Society

The Problem of Evil

There is a boding question about the “evils” of the world, and many people need to justify the necessity of evil through faith. I define faith as deduction, induction, or hope. With this definition, it only makes sense to me that so many people in the world, and throughout history, have faith in a supreme being and a just and rewarding afterlife. Solomon and Higgins (2010) present the discussion of evil in contrast to the goodness and how it relates to God. Chafee (2009), like Solomon and Higgins (2010), examines only the religious concepts of evil, but he does state one important truth, “the existence of evil in the world poses a serious threat to religion in general, and the concept of an all-loving, all-powerful God in particular” (p. 391). The argument that if evil exists then there can be no omnibenevolent, omnipotent, and omniscient God acknowledges the existence of evil and denies the existence of God. To me, the word evil seems to have too many religious connotations for academic consideration, as for those that do not believe in God, this contrast between good and bad loses meaning and application. For this same reason, it is difficult for me, I admit, to discuss evil in the context of God and religion. To do so would mean that I have suspended my faith and beliefs.

To discuss evil, I must remove the religious connotations and define it in acceptable terms. The word evil embodies all that is harmful, but what is harmful for one might be curative for another. For there to be good in the world, there must be equal bad to contrast, essentially giving the good its value in comparison to the bad. One might argue that good gives value to bad, also. This is commonly referred to as “the Contrast View” and is in direct disagreement with Martin Buber’s (1981) view of evil as inattention to moral ways. Things that have no morals (e.g. nature) can be perceived as evil, thereby providing an argument to Buber, though I believe that Buber’s views are that of some of the humanistic causes of evil.

Evil, or the bad in the world, is simply a lack of good, just as black is a lack of white, and cold, a lack of heat. Consider, though, that an unfortunate event can be viewed as evil to one person and can prove fortunate to another. Therefore, I consider evil to only be a perception of an individual grading fortune and misfortune on a scale of good and bad.

References

Buber, M. (1981). Good and evil. Upper Saddle River, N.J.: Prentice Hall.

Chafee, J. (2009). The philosopher’s way: Thinking critically about profound ideas (2nd ed.). Upper Saddle River, N.J.: Pearson Prentice Hall.

Solomon, R. C., & Higgins, K. M. (2010). The big questions: A short introduction to philosophy (8th ed.). Belmont, C.A.: Wadsworth, Cengage Learning.

Academia, Society

Perception is Reality

For Peyton Farquhar, belief acquiesed to knowledge the moment that he felt his neck break, the last of his mortal feelings (Bierce, 1909/1966, Chapter 3). While reading “An Occurence at Owl Creek Bridge”, I was taken in by the author’s use of the omniscient narrator’s descriptions of Farquhar’s perceptions. And, as I have stated before, perception is reality. In order to contrast what is real and what is not, we must acknowledge that there are separate realities for each perceiver, and each perception must be that of consequence. The old rhetoric asks, “If a tree falls in the wood and there is no one around to hear it, does it make a sound?” My reply is, “How do you know that the tree fell?” This, however, does not answer the question, but it starts us on a journey to find the meaning of reality and which reality we are defining.

In the question about the tree in the wood, there is a consequence of the falling action, which is a transfer of energy to the vegetation and ground which it strikes. There is also the vibration of the air around the tree agitated by the sudden separation. The question here is if it made a sound. Very simply, these vibrations are perceived as sound by using the ear as an antenna, the ear drum as a modulator, and the brain as a filter and recorder. If there is neither any living thing in audible proximity to the fall, nor an analog recording device capable of reproducing the sound as testimony, then I argue that the tree did not make a sound. Further, one could argue that only the brain makes the sound by interpretting the vibrations; therefore, falling trees do not make any sound and any recording is only a recording of vibrations of air. Is this just semantics? Because this argument depends largely on how “sound” is defined, I believe it is. The same is true for color.

By my statement that perception is reality, I mean that our reality is defined by our perceptions, though it does not mean that what is real to me must be real to anyone else. One could also say that life is defined through experiences, but again, it is truly the individual perception of these experiences that matter, nothing else. “A philosophy is the expression of a man’s intimate character, and all definitions of the universe are but the deliberately adopted reactions of human characters upon it” (James, 1909, p. 20).

In Bierce (1909/1966), Peyton Farquhar perceived an ordeal where he was spared a hanging because of chance. Consider my theory, both metaphysically and astrophysically, that the Universe is infinite and, thereby, everything that can happen does happen. The term “Universe” here is a misnomer. I am actually describing a Multiverse with an infinite number of Universes, each a separate and distinct realm based on a choice, decision, and consequence. Picture an infinite number of Universes that are, initially, exactly the same, then there comes a choice to be made: option A or option B. Half of the Universes take on the consequences of option A while the remaining half take on option B, then there is another choice to be made, and the Multiverse splits infinitely in half based on the infinite choices that are made. This theory would promote realms where the choices not made in our Universe may or may not be consequent. Did Peyton Farquhar get a glimpse of an alternate reality in which the supply sergeant failed to care for the rope appropriately? Though it might be possible, it does not matter. Peyton Farquhar perceived his death immediately after, subsequently defining his reality, and for a split second, giving him knowledge. Though, if he continued the experience of escaping his death even after his death is witnessed by the executioner and his peers, one could argue that reality had split and though Peyton was dead, perhaps he lived on in another reality. This, I believe, is the basis of the religious context of Heaven and Hell. You can believe in Heaven, Hell, or nothing in particular; until you experience it, you have no knowledge of it.

If we can never glimpse the alternate realities, then we cannot perceive them; therefore, they are not real.

References

Bierce, A. (1966). An occurrence at Owl Creek Bridge. The collected works of Ambrose Bierce (Vol. 2, pp. 27-45). Retrieved from Project Gutenberg: http://www.gutenberg.org/files/13334/13334-h/13334-h.htm (Original work published 1909)

James, W. (1909). A pluralistic universe. Retrieved from http://books.google.com/books

Academia, Culture, Emergency Management, Emergency Medical Services, Health Care, Technology

Improving Traffic Safety for Emergency Responders

The Emergency Medical Services (EMS) is an occupational field wrought with opportunities for workers to become ill, injured, or succumb to death while performing the functions of their job (Maguire, Hunting, Smith, & Levick, 2002). In the mid-1980’s, Iglewicz, Rosenman, Iglewicz, O’Leary, and Hockmeier (1984) were among the first to perform research into the occupational health of EMS workers by uncovering unhealthy carbon monoxide levels in the work area. This appears to have been the impetus for further research into uncovering some of the causes and contributing factors of illness and injury incidents, as well as safer alternatives to current work practices.

One of the more recent efforts to protect EMS workers relates to traffic-related injuries and fatalities of EMS workers while responding to calls and working on the scenes of traffic accidents. As important it is for the EMS workers to be able to get to the scene of an emergency and work without threat of injury, the safety of the community is important to consider. Solomon (1990) realized the need to improve safety in this area and recommended changing the paint color of emergency apparatus to more visible lime-green. Emergency workers were continuing to fall victim to “secondary incidents” at roadway scenes (Cumberland Valley Volunteer Firemen’s Association, 1999). An analysis of EMS worker fatalities between 1992 and 1997 reveals an occupational fatality rate that continues to exceed that of the general population (Maguire, Hunting, Smith, & Levick, 2002).

Across the pond, in the United Kingdom, efforts were also underway to improve the visibility of police vehicles by considering various paint design schemes, including the Battenburg design: alternating blocks of contrasting colour (Harrison, 2004). Harrison concluded that the half-Battenburg design showed promise as it increased visibility and recognition of police cars in the United Kingdom, and the United States National Institute of Justice was considering research on the efficacy of the Battenburg design here in the United States to promote officer safety. EMS administrations are known for paying special attention to the bandwagon, that is they frequently make changes based on inconclusive and sporadic evidence. This is the case with recent ambulance designs.

Many ambulances in the New England, as well as other parts of the country, are being designed with the half-Battenburg markings applied to the sides of the vehicles in attempts to improve the safety of EMS workers. Unfortunately, we may find that these markings might have an unintended effect of confusing other drivers and causing more problems. A recent study found that Harrison (2004) was correct in that the Battenburg design assisted British drivers in quickly identifying British police vehicles, but the “effectiveness of the ‘Battenburg’ pattern in the UK appears primarily related to its association with police vehicles in that country” (Federal Emergency Management Agency, Department of Homeland Security, 2009, p. 6) having little effect on the recognition potential of American drivers.

Perhaps with the evolving data, we can begin using an evidence-based approach at helping the EMS worker perform his or her job safely at traffic scenes.

References

Cumberland Valley Volunteer Firemen’s Association. (1999). Protecting Emergency Responders on the Highways: A White Paper. Emmitsburg, MD: United States Fire Administration.

Federal Emergency Management Agency, Department of Homeland Security. (2009). Emergency vehicle visibility and conspicuity study [Catalog No. FEMA FA-323]. Emmittsburg, MD: United States Fire Administration.

Harrison, P. (2004). High-conspicuity livery for police vehicles [Publication No. 14/04]. Hertfordshire, U.K.: Home Office, Police Scientific Development Branch. Retrieved from http://scienceandresearch.homeoffice.gov.uk/hosdb/publications/road-policing-publications/14-04-High-Conspicuity-Li12835.pdf

Iglewicz, R., Rosenman, K.D., Iglewicz, B., O’Leary, K., & Hockmeier, R. (1984). Elevated levels of carbon monoxide in the patient compartment of ambulances. American Journal of Public Health, 74(5).

Maguire, B.J., Hunting, K.L., Smith, G.S., and Levick, N.R. (2002). Occupational fatalities in emergency medical services: A hidden crisis. Annals of Emergency Medicine, 40(6), 625-632. doi: 10.1067/mem.2002.128681

Solomon, S.S. (1990). Lime-yellow color as related to reduction of serious fire apparatus accidents: The case for visibility in emergency vehicle accident avoidance. Journal of the American Optometric Association, 61, 827-831.

Academia, Culture, Emergency Management, Emergency Medical Services, Health Care, Public Health, Society

Volunteerism

Living in such a small community as I do, there is little need for grassroots organizations to assist in the health and welfare of the community. Most of the organizations that are available in my community are business-based, healthcare focused institutions.

Day-Kimball Hospital (http://www.daykimball.org) is the center of healthcare and wellness in Northeastern Connecticut. Partnering with the community, Day-Kimball Hospital provides a host of services through its many facilities to provide outreach programs which help to make a healthier community. Employment and volunteer opportunities are available within the hospital for those with a desire to help promote health and wellness within the community.

There are two other local agencies, United Services (http://www.unitedservicesct.org) and Quinebaug Valley Youth and Family Services, which have partnered to provide a community-centered approach to the psychological welfare of adults, adolescents, youths, and their families. United Services, Inc. also provides employee assistance programs to workers of participating local businesses. Providing psychiatric consultation services for addiction and recovery, family violence, and family structure support, these agencies promote social change as both entities themselves and through their contact with members of our community.

The town of Killingly, Connecticut, also offers a Little League program where children can learn to play baseball and softball while learning the values of sportsmanship, loyalty, courage, and commitment. This program helps to promote social change through encouraging positive mentor relationships at a young and impressionable age. Little League is also an outlet where interested parties can help through sponsorships, umpiring, coaching, or just attending games and showing support for the program and the kids.

I have volunteered most of my life through the volunteer fire departments in my area, and I still do. I am an active member of the South Killingly Fire Department where I serve as a mentor and instructor in Emergency Medical Services. As an experienced paramedic, the least that I can do for my community is to ensure that those who will come after me are trained appropriately and to a high standard. Though my full-time job requires me to provide the same service in the same area, I enjoy a different role with South Killingly Fire Department which allows me the freedom to help others in a different manner than usual within the same occupational field.

Volunteering with others instills teamwork, dedication, and other core values that lend especially well to the promotion of positive social change. I am glad to help.

Academia, Emergency Management, Health Care, Public Health, Writing

Summary – Public Health Theory: Social Cognitive Theory

Building on Social Learning Theory, Social Cognitive Theory (SCT) (as cited in Bandura, 1989; U.S. Health and Human Services, National Institutes of Health, National Cancer Institute, 2005) has been a mainstay in psychology since 1986 when Albert Bandura explored the relationship between the individual, his or her personal traits, the physical environment, and society, and how each of theses factors impact and influence the others. Since this time, SCT has shown to have increasing applicability across the spectrum of health education. Using SCT to focus on these relationships, the health practitioner can understand that individuals are able to overcome obstacles to their health with an increased sense of responsibility, motivation, and control (U.S. Health and Human Services, National Institutes of Health, National Cancer Institute, 2005). By allowing an individual to understand that they can shape their environment just as their environment shapes them, the individual regains their locus of control, motivation, and sense of self.

A dynamic process, SCT has been used successfully to assess treatment techniques, improving on areas lacking in benefit. Brand and Nyland (2009) identify that 30-35% of patients with anterior cruciate ligament repair do not recover to their preinjury level of activity participation; however, they have identified that, using SCT, bolstering pre- and postoperative self-efficacy levels could ultimately improve a patient’s return to the preinjury activity level. Analyzing and identifying psychological factors which inhibit a sense of self-efficacy, allow the health practitioner more opportunity to improve overall success in surgery and rehabilitation.

In recent years, innovative researchers have been exploring other positive roles where SCT may be employed, including the creation of internet-based grief counseling programs. Dominick et al., (2009) show that identification of an individual’s grieving style can assist with forming adaptive cognitive therapies which, even provided in an online format, can assist the uncomplicated griever by positively affecting attitude, self-efficacy, and increasing knowledge about their personal grieving style.

SCT’s adaptive and dynamic nature allows for the health practitioner to analyze a problem and apply the theory’s constructs to change as much or as little as necessary for the development of a working solution with specific focus and control. In this way, SCT allows program development to follow a structured and informed methodology allowing a higher percentage of success.

References

Bandura, A. (1989). Social cognitive theory. In R. Vasta (Ed.), six theories of child development. Annals of child development, 6, 1-60. Greenwich, CT: JAI Press.

Brand, E. & Nyland, J. (2009, May). In D. L. Johnson (Ed.), patient outcomes following anterior cruciate ligament reconstruction: the influence of psychological factors. Orthopedics, 32(5), 335-340.

Dominick, S. A., Irvine, A. B., Beauchamp, N., Seeley, J. R., Nolen-Hoeksema, S., Doka, K. J., Bonanno, G. A. (2009). An internet tool to normalize grief. Omega: Journal of Death & Dying, 60(1), 71-87. doi:10.2190/OM.60.1.d

U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. (2005, September). Theory at a Glance: A Guide for Health Promotion Practice (NIH Publication No. 05-3896). Retrieved from http://www.cancer.gov/PDF/481f5d53-63df-41bc-bfaf-5aa48ee1da4d/TAAG3.pdf

Academia, Society, Writing

Comma-dy, Tragedy: Small Writing Improvements in Academia

Writers of academic research need to adhere to a standard of language to improve the readability of their content and ensure the readers’ understanding of the author’s intent. The importance cannot be understated. As some constructs may be useful in the writing of a novel or screenplay, the same constructs can be detracting in the professional and academic domains.

Through primary and secondary school, I have always been a creative writer, and I have always been confident in my creative writing skills. My academic writing skills, I found, are not as effective. Recently, I had to take a college-level course concentrating on scholarly writing. Two things bothered me: the 16 years it has been since high school and the 13 years that I have been relegated to writing medical reports with no hint of grammar in sight. Though I have written some technical documents during this time, academic writing has never been a focus. I will describe my challenges in style and grammar as it pertains to scholarly writing.

Grammatic Fanatic

Comma Chameleon

Readers of my previous works may find the comma to be quite an elusive device. I have always tried to use clauses that relate in both meaning and flow, and this had allowed me to make stylistic considerations in the use of the comma. Even now, after having this shortcoming identified, I find difficulty in full and proper use of the comma.

Aaron (2007) describes strict comma usage with clauses such as dates and time, insignificant or nonessential phrases, and lists of three or more items, but she admits that stylistic considerations can be made for readability, especially in the case of brief but equally important phrases. It is apparent that I have taken this as license to defer appropriate comma usage, but I now have the tools and motivation to pay close attention to the punctuation in my future writing. I do need to ensure that I do not overcompensate for this shortcoming by including unwarranted punctuation.

Colloquialism Speaks Volumes

Converse to my lack of comma usage, I have realized that I rely heavily on colloquial speech, perhaps, as a means of presenting a contemporary, pertinent, and assured demeanor. Though the use of colloquial speech can add flair to an otherwise lifeless discourse, continual use should be avoided. Standard American English is the accepted standard language used in academic writing, following standard conventions and vocabulary and allowing “distance between writer and reader” with an “authoritative and neutral” voice (Aaron, 2007, p. 73). The Publication Manual of the American Psychological Association (2010) addresses this by wholly restricting “expressions… which diffuse meaning” (p. 68).

More importantly, I have recognized the need to avoid anthropomorphisms and the use of the passive voice, specifically. Though these constructs are prolific in colloquial speech, their use can impact the readability of the work and can negatively influence the readers’ perceptions of the author.

Reflection

Applying the writing skills that I have learned previously, I feel that I now have a fairly good understanding of the concepts in academic, scholarly writing. As I progress in my academic career, I will have frequent opportunities to improve my writing and explore more useful stylistic methods. I want to have a near-perfect use of the grammar before expanding my writings to more poignant subjects. Upon matriculation into a graduate program, my writing ability will prove pivotal to my success in academia. My writing skill must be of the same quality as my peers; therefore, my skills must improve as I proceed in my studies.

References

Aaron, J. E. (2007). The little, brown compact handbook (6th ed.). New York, NY: Pearson Education, Inc.

American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

Academia, Technology

Growing Up Einstein:

 A Look at the Controversies Surrounding Gravity

Newton’s Universal Law of Gravity has been the impetus of many significant advances in physics. Similarly, Einstein’s theories of relativity enabled the creation of a school of science, cosmology, and maintains a symbiotic relationship with the study of quantum mechanics, though quantum gravity proves elusive (“Relativity and the quantum,” n.d.). Einstein’s General Relativity (GR) theory is the accepted standard for modeling gravity, today. Until recently, anyone refuting Einstein was sure to find his or her claim subject to acute skepticism, if not complete dismissal. In fact, controversial claims have been made, and until as late as 2004, one unfortunate observation was made:

Supporters of the big bang theory may retort that these theories do not explain every cosmological observation. But that is scarcely surprising, as their development has been severely hampered by a complete lack of funding. Indeed, such questions and alternatives cannot even now be freely discussed and examined. An open exchange of ideas is lacking in most mainstream conferences. Whereas Richard Feynman could say that “science is the culture of doubt”, in cosmology today doubt and dissent are not tolerated, and young scientists learn to remain silent if they have something negative to say about the standard big bang model. Those who doubt the big bang fear that saying so will cost them their funding. (Alternative Cosmology Group, 2004, para. 5)

Two variant theories have surfaced with promise of becoming accepted, or at least considered: Modified Newtonian Dynamics (MOND) and Tensor-Vector-Scalar (TeVeS). The question remains, will these theories be heard?

Background

Isaac Newton first introduced the concept of gravity in 1686 in his work Principia. Expanding on the ballistics work of Galileo and using the Pythagorean theorem, Newton explained the known observations of the moon’s orbital path around the Earth (Fowler, 2008). This work “led Newton to his famous inverse square law: the force of gravitational attraction between two bodies decreases with increasing distance between them as the inverse of the square of that distance, so if the distance is doubled, the force is down by a factor of four” (“The Moon is Falling,” para. 9) and, hence, extrapolated to the creation of Newton’s Universal Law of Gravity.

Newton’s Universal Law of Gravity states that the force of gravity between two objects is equal to the product of the masses of the two objects divided by the square of the distance between the objects multiplied by the universal gravitational constant. This is a very simplistic explanation of gravity, and though it proves true when considering objects closely related, it fails to explain the observed effects of gravity at both extremely long and intimately short distances (Skordis, 2009 ; Stacey & Tuck, 1981).

Einstein’s work on space-time in the early 1900’s was at odds with the classical notion of gravity. He spent some time reconsidering this impact and devised his GR theory. GR, though expanding the Newtonian law of gravity with the concept of curvatures in space-time to predict the existence of gravitational waves, gravitational lensing, and black holes, according to Skordis (2009), is still lacking and fails to explain the observed distribution of matter throughout the universe. GR requires mathematical adjustment to remain valid in some circumstances, introducing obscure concepts, such as dark energy and dark matter. The combination of dark matter and dark energy is told to comprise more than 95% of all mass in the universe (Filippini, 2005). Yet, this matter has never been observed. This situation presented cosmologists with an opportunity to devise a more complete and elegant solution to explain the effects of gravity. The problem: acceptance.

The Controversy, Itself

“There are significant discrepancies between the visible masses of galaxies and clusters of galaxies and their masses as inferred from Newtonian dynamics” (Sagi & Bekenstein, 2008). Proponents of GR and Newtonian Dynamics present the existence of dark matter and dark energy to provide explanations for these discrepancies. Some researchers did not accept this as a viable solution to the missing mass problem. Instead, they struggled to find a better solution. As earlier researchers presented their work, they were met with arrogance and contempt (Alternative Cosmology Group, 2004). This attitude has dissuaded others from questioning the conventional theories, at least without a sound theory that could hold up to scrutiny.

Modified Newtonian Dynamics (MOND) was probably one of the first contemporary proposals to identify a respectable solution to the quandaries of GR. Though, as Bekenstein and Sanders (2005) describes, it answered the questions of perigalactic gas clouds and some galaxy clustering without the need for dark matter, it failed with its incompatibility to the laws of conservation. The aquadratic lagrangian (AQUAL) theory emerged from MOND to address these shortcomings, though it, too, was flawed as it was a nonrelativistic solution to the problem. Relativistic AQUAL (RAQUAL) was introduced soon after. Being a relativistic version of AQUAL, RAQUAL does not negate AQUAL, and therefore, stays true to the MONDian theory, also. RAQUAL is not without its problems, however, as “it permits superluminal propagation of φ waves (B&M). And it is unable to give an account of gravitational lensing in agreement with the basic observation that lensing by galaxy clusters is anomalously strong compared to what was to be expected in view of their galaxies and gas content” (p. 24). Another problem is that RAQUAL is not covariant and actually “weaken[s] gravitational lensing, rather than enhancing it as intended” (p. 24). The introduction of a constant vector field to the equation both provides a solution and suggests the approach of the Tensor-Vector-Scalar (TeVeS) covariant field theory.

TeVeS is actually a combination of MOND, Newtonian, and Einstein’s GR, with two metrics to interact with the fields in the theory. “Many aspects of TeVeS have been investigated extensively, proving the theory to be faring quite well in view of the huge challenges it was designed to meet” (Sagi, 2009). TeVeS may provide ground-breaking advances in cosmology, and perhaps, in quantum physics.

The controversy surrounding TeVeS and its sound consideration probably stems from the shortcomings of its precursors. This is not a respectable position. Looking through the history of science, rarely is there a major step forward without, first, smaller and error-laden advances. Any new theory that answers real observations should be given an opportunity to mature with greater study and more observational constraint.

Science and Society

This controversy has been raging for the better part of a century. Not until recently has there been a proposed solution that both agrees with GR and Newtonian Dynamics at the same time that it furthers the understanding of gravity where GR fails. Many of the major technological advances in the last century were a direct result of Einstein’s breakthrough contributions to Newtonian physics. One would think that more people would be paying attention, but the general media has not. Perhaps, many of the reporters feel this issue is outside of the realm and scope of their readership’s ability to understand, or maybe, the media just does not realize the import of such discoveries. Unfortunately (or, perhaps, fortunately), the discussion remains technical, equation-laden, and lackluster, helping to keep the influences of the ignorant out of the discussion. Regardless, the limited mainstream coverage limits the controversy to the experts of astrophysics and cosmology.

Society should certainly pay more attention to science; it would serve society well to be an active participant in contemporary scientific discourse. A strong social commitment to science is needed in order to progress responsibly, and though society can prove to be collectively ignorant, it is no marker of overall intelligence. Can society give back to science?

What is (Not) Science?

In a recent Time magazine article (Cray, 2006), Francis Collins, in a debate with Richard Dawkins, attempts to justify his rigor as a scientist with his spiritual beliefs as a Christian. Science is knowledge. Science is neither philosophy nor religion. In the quest for understanding, cosmology is seeking answers to the beginning and hints of the end of time, the self-stated realm of religion. As of this writing, quantum physicists are sifting through anti-matter to glimpse the elusive God particle.

Scientific breakthroughs, though insightful, do not provide testimony against the existence of a Creator, just as uncovering a religious artifact does not negate the latest scientific conclusion. While religion strives to provide an explanation of the beginning of mankind, science is willing to explore the physical boundaries that religion is said to transcend. It would do both camps well to isolate themselves from one another. Cosmology is fraught with opportunity to infringe on religion, especially in the study of gravity. The separation of virtue from knowledge, while allowing them to coexist, is paramount. As we increase our understanding of the macro- and microscopic world around us, especially in the fields of cosmology and quantum physics, the sciences need to maintain a focused and unbiased search for knowledge. This discretion, alone, will limit many of these controversies from arising.

A Changing of the Guard

It appears from the amount of emerging research that there is a renewed vigor among cosmologists to rectify the problems of GR. With the amount of research being submitted to scholarly journals, detractors can no longer deny the need to seriously examine the potential solutions. Additionally, perhaps, the pool of experts have changed, and the conventional mindset has changed with them. Regardless, it appears as though a dearth of research is being completed in the study of universal gravity, and the research is, now, being considered as valid.

This controversy illustrates the need for scientists and field experts to approach emerging solutions with an open mind, though remaining vigilant and skeptical. As a society, we cannot afford having a potential scientific breakthrough remain secreted by virtue of conventionalism, alone. Our knowledge is too important for us to fail in nurturing it.

References

Alternative Cosmology Group. (2004, May 22). Open letter on cosmology. Retrieved from http://www.cosmology.info

Bekenstein, J. D. & Sanders, R. H. (2005). A primer to relativistic MOND theory. In G. Mamon, F. Combes, C. Deffayet & B. Fort (Eds.), EAS Publications Series (Vol. 20, pp. 225-230). doi:10.1051/eas:2006075

Cray, D. (2006, November 5). God vs. science. Time. Retrieved from http://www.time.com

Filippini, J. (2005, August). Why dark matter? Cosmology Group, University of California, Berkley. Retrieved from http://cosmology.berkeley.edu/Education/CosmologyEssays/ Why_Dark_Matter.html

Fowler, M. (2008, November 13). Isaac Newton. Physics Department, University of Virginia. Retrieved from http://galileoandeinstein.physics.virginia.edu/lectures/newton.pdf

Relativity and the quantum. (n.d.). Einstein-Online. Retrieved from http://www.einstein-online.info/en/elementary/quantum/index.html

Sagi, E. (2009, August 15). Preferred frame parameters in the tensor-vector-scalar theory of gravity and its generalization. Physical Review D, 80(4), 44032-44047. doi:10.1103/PhysRevD.80.044032

Sagi, E. & Bekenstein, J. D. (2008, February 1). Black holes in the TeVeS theory of gravity and their thermodynamics. Physical Review D, 77, 024010-024021. doi:10.1103/PhysRevD.77.024010

Skordis, C. (2009, March 21). The Tensor-Vector-Scalar theory and its cosmology. Class.Quant.Grav., 26, 143001-143044. doi:10.1088/0264-9381/26/14/143001

Stacey, F. D. & Tuck, G. J. (1981, July 16). Geophysical evidence for non-newtonian gravity. Nature, 292, 230-232. doi:10.1038/292230a0