Author Archives: Alexandra McLeod

Talking About the Trauma

In the United States District Court of Los Angeles a case is being brought against the Compton Unified School District for failure to not adequately provide appropriate education and assistance for those students who have suffered from a “complex trauma.” The Plaintiffs assert that too often the school district turns to punishment for students who are attempting to cope with the struggles they face in their lives.

To better understand the type of trauma these students are experiencing it is important to understand the environment these children have grown up in throughout their lives. Compton is a city located south of Los Angeles and has an extremely violent reputation; last year alone the murder rate in Compton was five times the national average. These students face problems of addicted parents, homelessness, and a constant fear of violence in their everyday lives. One of the Plaintiffs said that he witnessed his first murder at the young age of eight, took a bullet to the knee, and in 2014 alone witnessed twenty shootings; another Plaintiff was mistakenly arrested at gunpoint by police at school. One plaintiff was sexually assaulted on the bus, on her way home from school. Gangs are a normal part of life and fear is something that students have to accept as a part of their lives. According to Susan Ko of the National Center for Child Traumatic Stress, exposure to violence can have a profound impact on one’s ability to learn.

The suit being brought argues that “complex trauma” should be considered a disability under the Rehabilitation Act and Americans with Disability Act. The complaint states that individuals who experience chronic or repeat trauma demonstrate physiological impairment in performing normal daily activities such as thinking, learning, reading, and concentrating. Something as simple as social interaction can cause bodily distress due to former trauma. Memories of fear can be created on multiple levels in the brain’s system because trauma triggers multiple functions of the brain. Research by Victor Carrion and Shane S. Wong of Stanford University shows that the hippocampus plays an important role in learning new information. Those who have experienced “complex trauma” have a smaller hippocampus, which makes learning more difficult. By classifying “complex trauma” as a disability the complaint asserts that these children will be able to receive the help they need to process their trauma and move forward.

A recent article said that a program implemented in the Los Angeles School District of 10 counseling sessions was effective in helping the students recover and improve their performance in school. By providing programs such as this one in low income areas teachers will receive the training necessary to: recognize trauma and seek mental health support to assist the students in coping with their trauma. These programs will allow school’s from a punishment structured system of handling student outbursts as a result of their trauma to promoting reconciliation and mediation before jumping to a suspension or expulsion.

The school district is extremely sympathetic to these children, but has to acknowledge the large costs that would have to be allocated to these programs and that there are other school districts with these same issues that do not have lawsuits pending.

While the cost may be high,is it possible that now is the time to spend more in cities and neighborhoods such as Compton to promote students getting the help they need for the trauma they have experienced throughout their lives? As a nation we should prioritize investing in children’s futures. It is important to recognize that every child deserves a chance to have a positive learning experience and feel safe in the school environment. While this occurs in places outside of Compton, maybe it is time for all states to take a look at their lower-income neighborhoods to see what they can do to help kids who are suffering from “complex trauma.” These kids deserve a chance to learn and create better lives for themselves and future generations. This transition may not be an overnight transformation, but by classifying “complex trauma” as a disability more students will be able to get the help they need.

 

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FDA Proposes Rule Setting Out Proper Consumption Levels for Added Sugar

In July 2015, the FDA proposed a rule that would update the Nutrition facts label on most food packages to include more information about how much added sugar is in a food product and what the appropriate consumption levels are. Added sugars are sugars and syrups that are added to food or beverages when they are processed or prepared.  Major sources of added sugar include soft drinks, sugars, candy, cakes, cookies, pies and fruit drinks; dairy desserts and milk products (ice cream, sweetened yogurt and sweetened milk); and other grains.

The proposed rule will require declaration of the “percent daily value” for added sugars. Presently, it is recommended that daily calories from added sugars not exceed 10 percent of a 2000-calorie diet. In a 2000-calorie-a-day diet, that works out to a daily maximum of about 200 calories a day or 12 teaspoons of added sugar. Currently, added sugar is presented in grams on nutrition fact labels. One gram of sugar contains about 4 calories. http://www.npr.org/sections/thesalt/2015/07/24/425908798/no-more-hidden-sugar-fda-proposes-new-label-rule

Food companies throughout the United States add sweeteners to their products, which increases calories but provides no nutritional value. Also, consuming too much added sugar leads to weight gain, obesity, Type 2 diabetes, and reduced heart health, and heart disease. Most Americans consume way more sugar than they realize. Sugar is one of the few major food components that doesn’t have a recommended consumption level on U.S. food labels, primarily because FDA hasn’t issued recommended consumption levels. This action by FDA will promote consumer awareness and allow Americans to make informed decisions relating to their sugar intake.

“For the past decade, consumers have been advised to reduce their intake of added sugars, and the proposed percent daily value for added sugars on the Nutrition Facts label is intended to help consumers follow that advice,” wrote Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, in an agency news release.

Currently, the FDA is taking comment on the new proposal for 75 days. Many health activists and consumer advocate groups have applauded the FDA’s efforts to inform consumers about how much added sugar they are actually consuming when they consumer processed foods and beverages. The agency will probably also hear from food companies. The Sugar Association has already weighed in, probing whether the move to constrain added sugars to no more than 10 percent of daily calories is backed by sufficient scientific evidence and studies. Moreover, food companies argue that nutrition fact labels do not influence most consumers and it will be expensive for companies to implement into their products.

This proposed rule is a part of a major overhaul by the Obama administration to modernize nutrition fact labels and inform consumers so they may lead healthier lives.

 

Written by Karina Velez–Fellow Health Law and Policy Brief Junior Blogger

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Modernizing Medicine

There is a new wave of medicine that has been sweeping across the healthcare world. Telemedicine (also known as “remote healthcare”) is the new modern wave of healthcare. Telemedicine is the use of medical information exchanged from a single site to another via electronic communications to improve a patient’s clinical health status. The original purpose of telemedicine was to extend healthcare’s reach to rural areas to allow patients from these areas to be provided access to healthcare benefits. The technology that has become available after forty years of development now extends to services using two-way video calling, smart phones, and other wireless tools to provide services to the rural population in the United States. Since telemedicine creation the original purpose has expanded to include a variety of resources to both rural and urban patients in addition to the medical community. First, telemedicine provides primary care for those individuals in rural areas that may otherwise not have access to healthcare. Second there is the ability for doctor’s to monitor those patients who live remotely and need to have blood pressure or glucose levels checked on a regular basis. Third, the telemedicine field allows consumers to obtain specialized medical information, have access to discussion groups on health diagnoses, and provides peer support groups in times of need. Finally, telehealth is giving the medical field a makeover in how it shares information because doctors are now able to access more techniques and services through these devices to grow his or her technique in a particular field of study.

There are significant benefits from the expansion of telemedicine; healthcare can now be provided to a wider range of individuals, telemedicine is more cost efficient, improved the quality that as a nation we provide, and lastly there is more patient’s want to use telemedicine because it reduces the stress and time a person has to dedicate to ensuring his or her body is in good health.

As a result of the increase in patients and doctors alike wanting to use telemedicine, Congress would like to restructure how Medicare pays for telehealth. The representatives in support of this idea have proposed the Medicare Telehealth Parity Act of 2015. The act consists of three phases that are to be implemented over a four year period expanding the coverage of telemedicine not only to the members of the rural community but also to urban areas. Phase 1 consists of expanding the rural health centers and adding centers to metropolitan areas with a population less than a 50,000; this phase also includes the expansion of specialists such as diabetes educators and speech therapists. Phase 2 encompasses expanding telehealth sites to include metropolitan areas with populations of 50,000 to 100,000 people. The third and final phase of Congress’ plan is to then extend the telemedicine services to all geographic locations regardless of population size.

Bipartisan members of Congress that support the expansion of telecommunication have tried to introduce legislation that reimburses those companies that support telehealth endeavors. Unfortunately, in both 2013 and 2014 the bills did not leave the House Energy and Commerce Subcommittee on health despite the support the bill received from the Telecommunications Industry Association and American Telemedicine Association. The representatives are now hoping that the bill will get the chance to leave the Committee and that members of the healthcare community will sponsor this bill in order to have healthcare be available to every individual that needs it. This bill is legislation that would allow medicine to be provided to a larger demographic and ultimately benefit society by having healthcare be provided a little closer to home.

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