A New Government Curfew is Now In Effect

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For your own protection, a new government curfew is in effect in Queensland as of July first 2016.

> No adult in the state may purchase a shot of alcohol after 11:59pm.
> All bars must close alcohol service by 3am in government “entertainment districts”
> All bars must otherwise close alcohol service by 2am state wide: in preparation for the 1am curfew to begin in February next year.

30 minutes is to be allowed for customers to swiftly finish drinks already purchased.

Casinos are to be exempted.

These measures appear to fly in the face of data showing Australia, especially Brisbane, to have a near zero violent crime and global homicide rate – which is already on a further downward trend.

This also appears to defy research which, when adjusted for the reduction in jobs and foot traffic, clearly show government curfews such as these:

1. Increase illicit drug use;

2. Disperse crime to the suburbs, away from policing centres;

3. And tend to leave violent crime rates steady overall, but increase violent crime in the exempt casino districts.

However, it is also rumored that illicit money, channeled via casinos and unions, to political parties is the true inspiration for this government intervention.

As a hypothetical thought experiment, when this is taken in to account: can a minority government really be blamed for doing whatever they can to hold power?

Ultimately, at a time of higher youth voter turn out than ever before, and with youth and shift workers reminded of the impact of this legislation at least weekly: it is highly probable these measures will single-handedly bring about a one term Premiership for the Queensland Labor party.

For now, no one will be stumbling home laughing, as the sun comes up, with a group of their mates. Nor a hot hook-up from the night before. There will be no ‘Hens’ or ‘Bucks’ nights out on the town till dawn, to farewell bachelorhood.

These represent yet more experiences now not a possibility for the millennial generation.

In the interim: House-Party anyone?

JJR

*JJR is the psychiatry, malpractice and research science investigator for the Chronicle.

[+++] Research Blog Marker

JJR (2016). A New Government Curfew is Now In Effect. JChronLettSc, 01607 (01), Ed5.

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Australian Chamber of Commerce And Industry. “Australian Chamber: Trends In Youth Under Employment”. Acci.asn.au. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/2djgpu9

Australian Studies. “Youth Gambling In Australia – ACYS”. Acys.info. N.p., 2016. Web. 3 June 2016: http://acys.info/resources/gambling/youth-gambling-australia-snapshot/

Barry, M. “Would The Last Person In Sydney Please Turn The Lights Out?”. N.p., 2016. Web. 3 June 2016. http://tinyurl.com/zveytny

de Andrade, Dominique, Ross Homel, and Michael Townsley. “Trouble In Paradise: The Crime And Health Outcomes Of The Surfers Paradise Licensed Venue Lockout”. Drug and Alcohol Review (2016): Web. 2 June 2016.http://tinyurl.com/zrwkg2x

“Fatal Flaw In Lockout Laws”. Couriermail.com.au. N.p., 2016. Web. 3 June 2016. http://www.couriermail.com.au/news/queensland/queensland-government/queensland-lockout-laws-griffith-university-finds-preloading-among-revellers/news-story/81cdd8b82c2c51dc77a641c760d76445

Fitterer, Jessica L., Trisalyn A. Nelson, and Timothy Stockwell. “A Review Of Existing Studies Reporting The Negative Effects Of Alcohol Access And Positive Effects Of Alcohol Control Policies On Interpersonal Violence”. Frontiers in Public Health 3 (2015): n. pag. Web. 2 June 2016. http://tinyurl.com/zem5urv

Palk, Gavan R. and Davey, Jeremy D. and Freeman, James E. (2007) Policing and preventing alcohol-related violence in and around licensed premises. In Proceedings 14th International Police Executive Symposium, Dubai.http://tinyurl.com/bvd3wu

Jeffin, Lubuna. “Fight Serious Organised Crime In Queensland | I LOVE QLD”. Iloveqld.com. N.p., 2016. Web. 2 June 2016.

Justice and Community Safety Directorate,. “ISSUES PAPER ADDRESSING ALCOHOL – RELATED HARM”. ACT.Gov. N.p., 2015. Web. 2 June 2016.http://tinyurl.com/hhecc38

“Labor Forms Minority Government In Queensland”. ABC News. N.p., 2016. Web. 3 June 2016. http://tinyurl.com/jjeezq5

“Lockout Laws On A Path To Failure | Daniel Huigsloot”. Centrethought. N.p., 2016. Web. 3 June 2016. http://tinyurl.com/h2f3pba

Mack, E. “NSW Bureau Of Crime Stats Director Says Mike Baird Used Dodgy Data To Plug The Lockouts – Music Feeds”. Music Feeds. N.p., 2016. Web. 3 June 2016. http://tinyurl.com/jo2dcwd

Mirum. “PEST Analysis”. Competitive-intelligence.mirum.net. N.p., 2016. Web. 2 June 2016.

Plant, Matt. “Liquor Law Review”. Justice.NSW.Gov. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/jyymyjk

Price, M. (2016) “Alone In The Crowd”. APA 42(6)p46. 2016. Web 3 June 2016: http://www.apa.org/monitor/2011/06/social-networking.aspx

Queensland Police Department. “Annual Statistical Review 2014/15”. QPS ISSN 1441-4589. N.p., 2015. Web. 2 June 2016. http://tinyurl.com/z37s4up

QPS,. “Reported Crime Trend Data”. Police.qld.gov.au. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/j94ms8p

“Queensland Government Rejects Petition For A New Police Facility In Brisbane’S South East”. True Blue Line. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/gvost7c

QLD Office of Premier And Cabinet. “Joint Statement”. Statements.qld.gov.au. N.p., 2016. Web. 3 June 2016. http://tinyurl.com/hzja4p6

QPS. “Finances: Transparency Service Delivery Statement”. Police.qld.gov.au. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/grbe2gt

“Queensland Mps To Sit Four-Year Terms After Referendum Declared”. ABC News. N.p., 2016. Web. 3 June 2016. http://www.abc.net.au/news/2016-04-05/four-year-fixed-parliamentary-term-referendum-declared-yes-ecq/7299386

Queensland Police Service,. “2015-16 Queensland Budget Papers”. Queensland Police Service. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/gl59zlp

Quilter, Julia Ann. “One-Punch Laws, Mandatory Minimums And ‘Alcohol-Fuelled’ As An Aggravating Factor: Implications For NSW Criminal Law”. Int J for Crime, Justice & Social Democracy 3.1 (2014): n. pag. Web. 2 June 2016. http://tinyurl.com/qyt5mqf

Saul, Stephanie. “Raped At Off-Campus Frat Houses, Students Say, And Ignored By College”. Nytimes.com. N.p., 2016. Web. 3 June 2016. http://tinyurl.com/gqzsvpd

Tackling Alcohol-fuelled Violence Legislation Amendment Bill 2015. Report No. 20 , 55 Th Parliament Legal Affairs And Community Safety Committee February 2016. 1st ed. Brisbane: QLDGov, 2016. Web. 3 June 2016. http://tinyurl.com/zouyl8d

“The Facts | Problem Gambling”. Problemgambling.gov.au. N.p., 2016. Web. 3 June 2016: http://www.problemgambling.gov.au/facts/ http://tinyurl.com/lv6xsuk

The Courier Mail (Online),. “Quick Guide To The Lockout Laws”. Couriermail.com.au. N.p., 2016. Web. 2 June 2016. http://tinyurl.com/zra2tfg

UNODC (2011). “Criminal Intelligence Manual For Managers”. UNITED NATIONS OFFICE ON DRUGS AND CRIME, Vienna. N.p., 2011. Web. 3 June 2016. http://tinyurl.com/hzce886

Art:  http://tinyurl.com/hpp8qth

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Cognitive Enhancing Drugs & Students

 Cognitive Enhancing Drugs & Students

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Every year, at exam time, I get questions about cognitive enhancers.

Also, inevitably, about ADHD, and often there will be an addle minded mention of ethics at some point as well.

So, if you are the kind of person who prefers the answers to your questions to be spat at you, in strings of scarcely linked bullet points dressed as paragraphs; well, welcome home!

This brevem investigates the new world of cognitive enhancers (CE).

Ethics

There is a large literature on this now, though arguably unnecessarilyi. Is it ethical to graduate tens of thousands of dollars in debt? To not get to choose your parents? To lose/gain a full grade of your “academic ability” for attendance – and do you really think things like this would be required if attendance contained its own benefits? Will you pay for my internet? Is it ethical children and the hungry made the device you are reading this on?

Is it moral to have a bureaucracy to deal with, after being diagnosed with sarcoma young? Or the same scenario at any age – is that OK? What about just born poorer? And the rest.

Am I “Good“?!

Life requires many skills. At times problems require networking prowess, akin to knowing who to meet at the back of the library stacks. Other times knowing how to build probes that will fry your left pre frontal cortex  just enough. Or the ability to convince your friend to try it first, may sometimes be what is called for. But you must be your own self reflective arbiter!

“If it harm none (and one practices self honesty and ownership), then” . . . look, just get off my page.

Well-Being

As to is ADHD real, well it is not really a valid question. But in a word – yes. Really, we are all here to talk about well-being. It is as simple as that. One of the few things social bio-psychiatry and neuro/clinical psychology have got right is talking to the patient. Is there an unwelcome impact on your social, study/vocational, or intra-personal life? If yes, you require intervention. If no, I still have to bill you for the full hour. Sorry.

Always the strongest position is not having to reach outside of the self. Unfortunately, the world reaches in, and will eventually kill you and everyone you think you love – that is a mere fact. A multifaceted approach to well-being is, thus, of best benefit. Always practice clear-focused and system unified cognition, alongside life path re-enforcing behaviour sets. Continue this in conjunction with all clinical intervention. Be creative with self defined interventions. But prescription medication, where available, certainly has a role to play in life. And we will all be on them at some point; so you better learn how to make good choices from data. And own your choices.

Applied meditation and cognitive techniques, as well as aligning to a healthy environment, and a life path you can likely enjoy (as supposed from your current position) is criticalii. No medication can give you these. Most medications do not even do close to what they are suppose to – by a real lot – and are almost always addictive (defined as marked physiological distress on cessation), despite what you are told. Physicians are use to never being questioned, this does not mean that in the past they were actually always right. I will skip malpractice and iatrogenics hereiiiivv. To suffice it to say, it is you who must own your decisions. People in every profession can be annoying, but not a single one of them will live your life. And we all only have a best guess at the likely possible future. But medication can work with you, if you prepare properly, choose wisely, do not confuse your doctors for scientists, and take responsibility for your own choices and investigation.

Nothing can give you well-being. And death is impending. It is a coin toss as to how much we (the extended health community) can assist in the latter, and how you deal with it. However, we can ensure you find resources to better align to path, and do not lose your job, or drop out of school (or worse) in the interim.

Tech

Do not implant, or attach, radiation devices to your head, of any kind (and there are a lot), at this time. This is deserving of its own piece. But do not do it. With Electro Convulsive Therapies (ECT), like nearly all medical procedures, the real risk is likely in the anesthetic. However, this does not account for more permanent memory loss and other deficits (most likely); that’ll be your more classic “brain damage” (not that this is necessarily a bad thing).

Though I am quite partial to memory loss being part of the therapeutic effect (some meditations I practice rely on this as technique), and I am not even against the idea of some form of neural regeneration triggered from the insult: Still, there is a reason we treat epileptic seizures, not just count it as a blessing and control the muscles. It should almost go without saying that ECT is not by default an enhancer. It is a last resort, and not for exam blocks. Now, do we know as much about it as most of the drugs? Unfortunately, arguably yes. But, like the antidepressants, any positive effects would take too long to be seen. Do not count on shock regeneration to assist with encoding.

Implants and trans-cranial (and supra cranial) similarly face too many risks via application techniques or poorly directed specificity in procedure. Decline until further notice. Though nanite enhancement seems robust, depending on the quality of your supplier. However, do not drive with active nanites, and do not partake in nanotech that goes beyond exam block, ie remaining active, except at a sub optimal function charge: enough only to assist in auto-removal relocation/positioning.

Do not use alcohol (as CE). This is a controversial one, and I could make an argument – but just off the shelf and for the general population: of the non prescription drugs, it is the worst on too many dimensions to mention, would be my answer. And, just generally, do not use any prescription drugs, except as a last resort, after all the other strategies are in place as well as they (honestly) can be.

Then definitely use prescription drugs.

CE

Finding personal balance that matches societal expectation is requisite in life. Non medical CE will not be covered here, as research is sparse. Besides – it is too personal to be otherwise. However, all compounds equally rely on how you personally respond, and if you can apply them reliably. Coffee, it is being assumed, finds ubiquitous use among readers. Caffeine is supported at this time (within personal limits up to 500mg/day)vi. Nicotine is a well established memory and focus CEvii. Non cigarette nicotine is being supported at this time. “Vaping” and gum are potential answersviiiix. Smoke in lungs is not an answer, anymore than sticking your head in a chimney isx. Remember state dependent learningxixii. And stay in the state where you remember to remember it during exam time.

None of the sedative/hypnotics can be strongly enough recommended at this timexiii. This is not a simplistic amnesic fallacy, rather it is the feeling of JChron that these classes (though we loathe to treat them as classes. ed.) would fail to surpass caffeine in efficacy amongst most of the population, in most circumstances – though there are additional reasons for concernxiv. The only general exception would be arousal issues under Yerkes-Dodsonxv – though this is too patient specific to comment on verily at this time.

Of the hormones, androgens – especially testosterone – have some work behind them (though can run into similar problems as the benzodiazepines in some cases.)

Similarly, analgesics and antimicrobials (antibiotics/antivirals/antifungals) are not recommended at this time; though there are some application potentials, just sub threshold at this time, and particularly in environmental/situational poly use they do offer obvious benefit (eg if unwell). Further, despite some possible class broad, and other likely unique effects observed under, somewhat strict, task conditionals for at least one drug in every class (eg arguably: aspirin; marijuana; Zolpidum; certain antibiotics et al. ed.) – they are not recommended at this time. This is as the domains are too limited and side effect profiles too high in trade.

Antipsychotics/antidepressants (many of which should arguably be illegalxvi xvii) are also not recommended at this time; this includes so called NERI/Atyps/5HTNERI/Tricycs et al. Though there is an argument for some antidepressants, after acclimatisation (especially the older, if sedation is balanced): the input/output likely benefit ratio is far too dangerously unbalanced. Doubly so during the stress of exam block. If already taking medication do not stop taking it during exam block. And almost universally, do not start one to take exams either.

And just so there is no confusion, let it be reiterated: despite limited and specific cognitive enhancement (in a near useless and highly specialised amount, and at great deficit cost) – marijuana is not recommended at this timexviii.

Stimulants likely do not need to be covered in much depth (especially methylphenidate & damph etal). They are generally effective reasonably short term – unless primarily listed as an antidepressant, have an atypical sedative effect, or are not titrated correctlyxix. Though there are some dangers, of course, and idiosyncratic and drug interactions must always be consideredxx. And they are not magicxxi – quality of work is organised, and focused: but it is never miraculously more than you would have done anyway. And work will still suffer on sleep deprivation; though more control of when deprivation will set in is their most potent power. They are non addictive (defined as marked physiological distress on cessation); and certainly not likely to be a problem for single use or short period, all things being equalxxii.

Novel use off label drugs like modafinil and duromine (and to a lesser degree Atomoxetinexxiii, Khat xxiv and othersxxv) fall into this category as well xxvi. Each appear, at this stage, to enhance different kinds of cognitive ability; even when the mechanism is unknown (or thought to be near identical to other compounds), and each carry correspondingly different risksxxvii. Examples of specific measurable enhancements seen include items such as: memory encoding (longer term); memory recall (medium term); speed encoding (short term); spacial manipulation; mathematical ability; social intelligence; and vigilance – among others (like pseudoephidrine/ephidrine/hypericin/hyperforin – though vigilance above caffeine not demonstrated, and limited if any effect on recall) xxviii. .

For the first time, compounds may have to be task matched for subject field requirements. This is a trend in CE that seems set to continue – even among the brain frying (literally) technology due to be next off the line 30 31 32 33 34 35. In the independent search for novel compounds, a good rule of thumb is to see if said compounds are listed as used by pilots and the militaryxxix, shift workers (especially medical), Alzheimer treatments (and dopamine/norepinephrine precursors), or by older mothers to lose weight; if so, then they likely benefit from further investigationxxx xxxi.

Long-term

Long-term treatment efficacy for enhancement methods (ie in ADHD/shift workers/as antidepressant adjuncts/and in the “normal” population ect) is a far more difficult question to answer. Though it is certainly becoming more common in adults, with the addition of more inclusive diagnostic criteria (rightly so; cf Well-Being), the advent of longer acting preparationsxxxii and less mental health stigma xxxiii.

It is also difficult to find reliable, unbiased (as possible) cohort or longitudinal data on these compounds/technologies. Even with the older ones, this is the case. Hopefully these data will soon be forthcoming, though, or so the chatter in the academy goes.

And there have been some breaking of old dogmas, including ones that made it taboo to highlight any protective effects of stimulants against psychiatric illnessxxxiv (including preventative impacts on, and strategic treatment with, co morbid substance abuse disordersxxxv). And there is a sound case for more wide spread use.

We’ve had some of these drugs a long time. And literally every other clinical class is inferior (re tollerability and efficacy), as well as being closer to entirely ineffective in these domains, even outside of direct comparison xxxvi. With medical data; it tends to be the older the betterxxxvii. Do not be the first if you can help it. These older compounds do have minimal risk, no addiction (defined as clinically significant distress on cessation): but do have personality, plasticity, and neurodepletion with natural decline, genuine philosophical concerns still to considerxxxviii. Cardiovascular concerns, despite the mix in the literature, are almost certainly a concern as well.

As such, the question seems to be: are the ultimate long term quality of life concerns serious enough, and genuine enough, that the impact of no “domain X” success will effectively be the greater risk of “killing you quicker”. Further, that these issues are not amenable to being solved readily by alternate means. It is a decision that can not be made for this “now”; but critically, one has to compute likely future possibilities – with some stark truth to self.

However, the same is true with absolutely every daily medication; prescription or bottle-shop. But especially prescription. This is as public science literacy, and genuine knowledge of selfness, is so abysmal among the general population (cf section on well-being).

Fin

You are always better off having nothing. It is the most powerful position. But it is equally true that society requires you contribute via work or study as best you can with what your environment provides. This is one such option set for some. Nothing is likely to harm you in a single (or rare) use.

Never take anything everyday if it can easily be avoided. If not – do not ever skip a dose, so that the body may adjust for better long term safety. Check there is no evidence for cumulative toxicity. If benefit ceases – stop. But even if there is no withdrawal risk listed (even if it is a technology); always stop properly. Thoughtfully. Always expect at least temporary reversion, or even increased, re-emergence of the symptoms originally being treated on cessation. Always be on a dose in the upper mid-range. Never be on a new drug or technology. Never be on an upper limit of even an approved dose. Avoid polypharmacy with extra vigilance, as far as is reasonably possible.

But do not treat drugs as other than individual. And the same goes for brains and regions. That is to say, if/when polypharmacy and/or technology is required (defined as >5-7+ medications/interventions in some corners of the literaturexxxix – but even more generally); do not fall for “whole classes” or “combinations” being placeholders for specific drug target or region “supposed” outcome effects. There are no guarantees. It is never up and down, on or off. Ever. Certainly not in poly.

And, as always, investigate new claims of harm (relevant to your situation) as they arise. Otherwise, you’ll be fine. Now, count backwards from one hundred, while you just sign here.

JJR

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*JJR is the psychiatry, malpractice and research science investigator for the Chronicle.

[+++] Research Blog Marker

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JJR (2015). Cognitive Enhancing Drugs & Students. JChronLettSc, 01516(11), Ed3.

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v Hayward, R. A., & Hofer, T. P. (2001). Estimating Hospital Deaths Due to Medical Errors: Preventability Is in the Eye of the Reviewer. JAMA, 286(4), 415. http://doi.org/10.1001/jama.286.4.415

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viii Bostrom, N., & Sandberg, A. (2009). Cognitive Enhancement: Methods, Ethics, Regulatory Challenges. Science and Engineering Ethics, 15(3), 311–341. http://doi.org/10.1007/s11948-009-9142-

ix Palazzolo, D. L. (2013). Electronic Cigarettes and Vaping: A New Challenge in Clinical Medicine and Public Health. A Literature Review. Frontiers in Public Health, 1. http://doi.org/10.3389/fpubh.2013.00056

x Sood, A. (2012). Indoor Fuel Exposure and the Lung in Both Developing and Developed Countries. Clinics in Chest Medicine, 33(4), 649–665. http://doi.org/10.1016/j.ccm.2012.08.003

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xiv Stewart, S. A. (2005). The effects of benzodiazepines on cognition. The Journal of Clinical Psychiatry, 66 Suppl 2, 9–13.

xv Diamond, D. (2005). Cognitive, Endocrine and Mechanistic Perspectives On Non-linear Relationships Between Arousal and Brain Function. Nonlinearity in Biology, Toxicology, and Medicine, 3(1), 1–7. http://doi.org/10.2201/nonlin.003.01.001

xvi Youtube.com,. ‘*Critical Psychiatry, Medicine & Methods* – Youtube’. N.p., 2015. Web. 15 Nov. 2015. http://tinyurl.com/nk7wnzu

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xviii Crean, R. D., Crane, N. A., & Mason, B. J. (2011). An Evidence-Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions: Journal of Addiction Medicine, 5(1), 1–8. http://doi.org/10.1097/ADM.0b013e31820c23fa

xix Ilieva, I. P., & Farah, M. J. (2013). Enhancement stimulants: perceived motivational and cognitive advantages. Frontiers in Neuroscience, 7. http://doi.org/10.3389/fnins.2013.00198

xx Pringsheim, T., & Steeves, T. (2012). Cochrane Review: Pharmacological treatment for Attention Deficit Hyperactivity Disorder (ADHD) in children with comorbid tic disorders. Evidence-Based Child Health: A Cochrane Review Journal, 7(4), 1196–1230. http://doi.org/10.1002/ebch.1861

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xxiv Hoffman, R., & Al’Absi, M. (2010). Khat use and neurobehavioral functions: Suggestions for future studies. Journal of Ethnopharmacology, 132(3), 554–563. http://doi.org/10.1016/j.jep.2010.05.033

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xxvii Urban, K. R., & Gao, W.-J. (2014). Performance enhancement at the cost of potential brain plasticity: neural ramifications of nootropic drugs in the healthy developing brain. Frontiers in Systems Neuroscience, 8. http://doi.org/10.3389/fnsys.2014.00038

xxviii Urban, K. R., & Gao, W.-J. (2014). Performance enhancement at the cost of potential brain plasticity: neural ramifications of nootropic drugs in the healthy developing brain. Frontiers in Systems Neuroscience, 8. http://doi.org/10.3389/fnsys.2014.00038

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xxxi Mehlman, M. J. (2004). Cognition-Enhancing Drugs. The Milbank Quarterly, 82(3), 483–506. http://doi.org/10.1111/j.0887-378X.2004.00319.x

xxxii Adams, Jared. ‘Cochrane For Clinicians: Immediate-Release Methylphenidate For The Treatment Of ADHD In Adults – American Family Physician’. Aafp.org. N.p., 2015. Web. 15 Nov. 2015.

xxxiii van den Ban, Els et al. ‘Less Discontinuation Of ADHD Drug Use Since The Availability Of Long-Acting ADHD Medication In Children, Adolescents And Adults Under The Age Of 45 Years In The Netherlands’. ADHD Attention Deficit and Hyperactivity Disorders 2.4 (2010): 213-220. Web. 15 Nov. 2015.

xxxiv Biederman, J., Monuteaux, M. C., Spencer, T., Wilens, T. E., & Faraone, S. V. (2009). Do Stimulants Protect Against Psychiatric Disorders in Youth With ADHD? A 10-Year Follow-up Study. PEDIATRICS, 124(1), 71–78. http://doi.org/10.1542/peds.2008-3347

xxxv Bihlar Muld, B., Jokinen, J., Bölte, S., & Hirvikoski, T. (2015). Long-Term Outcomes of Pharmacologically Treated Versus Non-Treated Adults with ADHD and Substance Use Disorder: A Naturalistic Study. Journal of Substance Abuse Treatment, 51, 82–90. http://doi.org/10.1016/j.jsat.2014.11.005

xxxvi Sikirica, V., Lu, M., Greven, P., Zhong, Y., Qin, P., Xie, J., & Gajria, K. (2014). Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review. Neuropsychiatric Disease and Treatment, 1543. http://doi.org/10.2147/NDT.S65721

xxxvii Castells, Xavier et al. ‘Amphetamines For Attention Deficit Hyperactivity Disorder (ADHD) In Adults’. Cochrane Database of Systematic Reviews (1996): n. pag. Web. 15 Nov. 2015.

xxxviii Wang, G.-J., Volkow, N. D., Wigal, T., Kollins, S. H., Newcorn, J. H., Telang, F., … Swanson, J. M. (2013). Long-Term Stimulant Treatment Affects Brain Dopamine Transporter Level in Patients with Attention Deficit Hyperactive Disorder. PLoS ONE, 8(5), e63023. http://doi.org/10.1371/journal.pone.0063023

xxxix Skinner, M. (2015). A literature review: Polypharmacy protocol for primary care. Geriatric Nursing, 36(5), 367–371.e4. http://doi.org/10.1016/j.gerinurse.2015.05.003

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MRI Radio-Pornographers May Now Use Your Images

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MRI Radiographer & Radiologist Pornographers have overcome the “Movement Artifact Problem” that had long plagued their art form.

In what has been hailed by some as a likely:

“Boon for the Magnetic Resonance pornographic industry as a whole; akin to when Renaissance art was replaced by cartoons”.

A glimpse of what we can expect from the future of erotic magnetophilla has been unearthed, and is linked below.

But not all are greeting the discovery as a “win” for humanity.

One doctor wrote to the chronicle earlier today, stating:

As with all technological breakthroughs, it comes with drawbacks as well as contributions”

They went on to warn:

“[one]…just had better be really careful what you are filmed doing in those scanners from now on”.

And the alarm may yet be justified.

“Underground MRPR’s (Magnetic Resonance Porn Rings) are scheduled to begin popping up all around the country by mid September: using YOUR personal medical MRI scan images, probably”

– unnamed official sources claim.

But will it really be as bad as all that?

Or is this just the latest form of “technophobia” rearing its ugly head?

This investigator, for one, has no doubt that it will indeed be as bad as some warn: If not worse.

The researchers went on to claim the Nobel Prize for Medicine* shortly after their original work was first published in BMJ, 1999.

And society has arguably been in a steady decline ever since.

(*Ig)

JJR

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*JJR is the psychiatry and research science investigator for the Chronicle LS.

[+++] Research Blog Marker

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JJR (2015). MRI Radio-Pornographers May Now Use Your Images, JChronLettSc, 01517(8), Ed4.

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Missing Person Profiling: The Private Contractor Perspective

det

Missing Person Profiling:

Location, Repatriation, and Assistance Of – The Private Contractor Perspective

This year’s conference topic, following the lead of the Federal Police (AFP) and national missing person co-ordination centre (NMPCC), is “Follow Your Instincts” (i).

There are five general headings that I am going to cover in today’s talk:

1) Beyond the First 48h-7days

2) On National Licensing to Avoid Conflicts of Interest

3) Who Is The Client: Target Long Term Welfare vs Contract Holder Interests vs The State

4) OS Intelligence & Data Mining Software For Licensed Inquiry Agents: GSI’s Approach

5) The Final Review of the “Footprint” Program Findings

Further outlines can be found below.

Brief Introduction:

Over a hundred people are reported missing every week in the more populous states of Australia (6); a figure the Bureau of Criminal Intelligence (BCI) independent report estimates to be as high as some 35’000 people reported missing nationally every year – with an associated search cost of approximately $2’500 of public money per case (~$70 million PA)(ii).

The conference title this year is apt, as missing persons (MiPs) rarely, if ever, go missing in a vacuum (6). Rather, disappearance is far more often the final symptom of an underlying, tumultuous, socio-psychic environment of the subject. This is able to be noticed by those around them, if they are open: both felt on “instinct”, and seen in their behaviours, leading up to, even an initial, exodus event (6 iii).

This “instinct” has been found to be especially apparent if the person in question is in danger; be it personal or otherwise (6 iv). This is known from case comparisons (where appropriate) of initial likely reported cause of the exodus event, given by significant others at t0 (“time zero”), and the motivation reported by the subject on relocation.

Though the vast majority of cases resolve, through either active location, or the subject returning home safely of their own accord, within the first 24 hours to seven days – accounting for approximately 86% (6); there are, of course, the remaining percentage of people whose cases are not so easily resolved.

Of these remaining few thousand people per year, special attention is required for location, repatriation, and/or assistance.

It is at this juncture private contractors will most often be brought in; so that the real police can get on with real police business, at least until something new of merit develops with the case.

And it is the perspective of the private firm contracted inquiry agent, in 2015, that I have been asked to speak from today.

When Is a Missing Person “Missing”?

Arguably the most harmful misconception to come from American television (and there are many to choose from), is the idea that a subject must be missing for 48 hours before a formal report can be filed.

In Australia – anyone who is “missing”, is “missing” right now! Especially if “instinct” informs you that something is “not right” (v).

Furthermore, swift reporting of missing persons see’s them returned safely more often than not before the day is out, and certainly long before private contract inquiry agents are sought (6).

For youth, a mixture of genuine safety concerns (ie accident, injury, suicide ect), or rebellion against authority for less serious concerns, make up the majority of cases – with mental health reasons accounting for the remainder (6).

This remains the case with subjects missing beyond the initial seven days. For this reason, it can be argued, too much of initial missing persons profiling is focused on potential reasons for criminal risk (6).

Functional personality profiling, from the start, would be of great benefit for; location, and local environmental reconstruction, as well as intervention design, to prevent future events after MiPs are returned to the initial environment; to locate likely possible target locations in surrounding states if subject did not want to be found; to identify personal psychological and victimological risk factors to determine more quickly if foul play is likely, or if dual investigative streams should be engaged with equal vigor – among other factors (vi vii).

The research area is dramatically underfunded. However, for the most part, MiPs investigation tends to be tiered: after the federal investigators (AFP), and affiliates, are comfortable enough to classify a given case as “likely outside of the realms of foul play”; location of subjects all too often falls to private contractors from this second tier point; with the rehabilitation components left in the hands of community support groups at a distant third tier (viii).

In truth, the best results would always be from a three pronged approach; making use of resources across all three tiers from the moment the case is opened ix.

Though my work has been focused largely on mitigating career burnout, and better utilization of community resources (until Footprint was flagged for cancellation, sighting funding reasons): I do still have a lot of time for MiPs locator profiling. Especially making use of psychological, field interstate, and cyber tools.

In many cases, international cases in particular; the client(s) often just want to know that the subject is OK. Once target confirmation has been acquired and assessed: often that is enough. The final report on a subject’s location, associates, and activities brings closure for the client. This is what is meant when it is said that the “moderate level harm” of “not knowing” is what requires satiation in certain cases (x).

This is a complicated topic. However, it is further obscured by certain issues relating only to private contractors, dealing with longer term cold cases.

It is these issues I would like to briefly touch on now, and then I’ll take questions.

1) Beyond the First 48h-7days

The affordability of private contractors is beyond many families, and this is, in turn, a cost to the community at large. The argument for a certain amount of federal funding being made available for cases that meet certain criteria shall be made (xi xii).

The co-ordination centres (NMPCC et al) (xiii) do a great job in reconnecting and rebuilding where they can; but we are all only as good as our funding, and the theory driven research that underpins strategic and operational deployment of the limited resource set available (…and its funding. Sorry, couldn’t resist).

2) On National Licensing to Avoid Conflicts of Interest

The merits of a federally required registration system for investigators and inquiry agents, rather than the state and territory clearance system being independent to international licensing, currently in use, will be prosecuted.

As an Officer of the Supreme Court, even as a Notary, in one state; but an Inquiry Agent based in another – I know I have run into some murky, perhaps not illegal, but at the very least “ethically challenging” waters on occasion as to which cases I can accept, and how I may proceed with them.

This is certainly so where interstate (which nearly all are) and (especially) international contracts are concerned.

Further, I have colleagues who occupy various dual roles in public and private practice, across disciplines, that have encountered situations which have seen them removed from the field component of some cases entirely, if not removed from a principle investigation altogether; despite them being the best team member for a given case in that district.

Even with larger multi-state firms, human skill sets in a given location are of a premium.

A lot of these issues can be remedied with a unified national set of legislation/registration/dual role guidelines above and beyond those implemented by private firms themselves.

3) Who Is The Client: “Target” Long Term Welfare vs Contract Holder Interests vs The State

This is a very interesting topic, worthy of an hour on its own. The art of grey areas, and the rights and obligations of inquiry agents:

> Cases of when to return information to a client. If the home environment is “unsavory”, but not illegal – does the private inquiry agent have the right to legally cancel a contract after the fact (the answer – “it depends”);

> If the subject is merely “happier” in the new state – should resources be offered to help establish them there, if, for example, they are in stable work and accommodation, but technically still a minor? Or if they simply give valid, but not legally binding, reasons as to why they do not want to be found: The inquiry agent, and qualified team, as mediator will be explored;

> Reporting obligations of past illegal activities, or minor parole breaches/outstanding warrant notification if not serving in the capacity as an officer of the court (not as cut and dry as you may think).

The final point being that you can not compel a subject to remain in an environment they do not wish to in a cost effective manner – nor is it always necessarily in the best interests of said MiPs, or society more broadly.

It is from this longer term perspective that these ethical issues shall be explored. It shall be argued that early onset offenders of only minor crime, and those who are not criminally engaged, deserve a more target specific, case specific, approach when executing their repatriation options.

4) Open Source Intelligence & Data Mining Tools For Licensed Inquiry Agents: GSI’s Approach

As a field generalist for GSI, in addition to a research adjunct under a QCC code, I believe there are some key areas that the labs and network tech just “miss” (even my own), that real life application highlight as insufficient. Mixed method approaches are always best.

That is not to say cyber tools are less than invaluable – they are invaluable. And there are many items now known to be reasonably consistent to general MiP profiles once the first week has passed, that are all too often overlooked in general investigation practice, but can work well with certain mixed cyber/IRL tactics.

From my own work, it will be posited that the vast majority of post seven day, both criminal and non criminal, MiPs are interstate runaways (xiv). Concentration on crowd locus interstate events from the missing subject’s home profile, and recruiting of public security at said events, will be argued for.

Though this program is focused on non criminal and teenage/young adult cases – some trajectory based theory for early intervention for the most efficient use of public and private resource funding will also be discussed.

This is especially applicable to teenage and young adults at 6 month+ cold case (as most of my work is teenage and young adult cold case); however, with some tweaking, the techniques do have wider applications to MiPs more generally that will be further elucidated.

5) Final Review of the “Footprint” Program Findings

The final round up of what has been gleaned from the “Footprint” project shall be discussed.

Significant findings will be outlined, along with their relevant limitations and implications.

The successes of the program will be heralded.

And the begging for more money will ensue shortly there after.

JJR

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*JJR is the psychiatry and research science investigator for the Chronicle LS.

[+++] Research Blog Marker

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JJR (2015). Ethics and Investigation Conference, JChronLettSc, 015(8), AUG16, Ed4.

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i AFP/NMPCC.(a2015). ‘Missing Persons : National Missing Persons Week 2015: Follow Your Instincts’. Web: Missingpersons.gov.au, 15 Aug. 2015.

ii Henderson, M., Henderson, P., Kiernan, C., & Australian Institute of Criminology. (2000). Missing persons: incidence, issues and impacts. Canberra: Australian Institute of Criminology.

iii Foy, S. (2006). Profiling Missing Persons Within New South Wales. PhD [Summary]. Retrieved from http://www.missingpersons.gov.au/~/media/mp/file/pdfs/profiling%20missing%20persons%20within%20nsw.pdf

iv Foy, S. (2007). Profiling Missing Persons Within New South Wales. PhD [Full].

v AFP. (2015). Australian Federal Police: “Follow Your Instincts”. Retrieved from http://www.missingpersons.gov.au/~/media/mp/files/mini%20brochure%20pdfs/missingmythsminibrochure.pdf

vi Fyfe, N. R., Stevenson, O., & Woolnough, P. (2015). Missing persons: the processes and challenges of police investigation. Policing and Society, 25(4), 409–425. http://doi.org/10.1080/10439463.2014.881812

vii Evans,K. (2011). The missing. College & Research Libraries News. 72(6). http://tinyurl.com/nqayt8g

viii NMPCC. (a2015). MP. Myths of the Missing. Retrieved from http://tinyurl.com/pzmc6yt

ix J.J.R. [A01-3/G] (2015). QCC/GSI Footprint Program Joint Report [Chap4], Canberra, QCC-ANU Press.

x Quinet, K. (2012). The Problem of Missing Persons. Center for Problem Oriented Policing, (66). Retrieved from http://tinyurl.com/oakogul

xi International Committee of the Red Cross. (2013). ACCOMPANYING THE FAMILIES OF MISSING PERSONS. ICRC. Retrieved from http://tinyurl.com/neumyda

xii Grampion (a2015). Intelligence Led Investigation. Missing: Understanding. Planning. Responding.  Retrieved from http://tinyurl.com/q2djpk8

xiii Reconnect – Dept. Social Services. (2015). AusGovtDSS. Retrieved from http://tinyurl.com/o6nqgwz

xiv J.J.R. [A01-3/G] (2015). QCC/GSI Footprint Program Joint Report [SUMMARY], Canberra, QCC-ANU Press.

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Princeton Nobel Mathematician John Nash Has Died

✩✩✩JJR✩✩✩_(@Jaii_Raph)_Twitter_-_2015-05-25_01.33.47

An automobile accident, involving a taxi cab in New Jersey, has claimed the life of Princeton Nobel mathematician Prof John Forbes Nash, Jr, and that of his wife Alicia Nash, police say. (1)

Nash, best known for his contributions to economics and game theory, won the Nobel Prize in Economic sciences in 1994.

Nash was further brought to the public eye via the biopic film “A Beautiful Mind”.

The film received four academy awards, which included Russel Crowe, who played the mathematician, taking home the best actor Oscar for the role. Best supporting actor went to Jennifer Connelly, who played his wife Alicia Nash.

Regarding the tragedy, Russel Crowe Tweeted:

Russell_Crowe_on_Twitter_Stunned...my_heart_goes_out_to_John_&_Alicia_&_family._An_amazing_partnership._Beautiful_minds,_beautiful_hearts._t.co_XF4V9MBwU4_-_2015-05-25_01.42.24

Nash and his wife Alicia were staunch mental health advocates; outspoken on all manner of patient’s rights issues. Both Nash himself, and his son, have spoken openly about having suffered from variant forms of the schizophrenias. (2)

In a 2004 interview, conducted at the 1st Meeting of Laureates in Economic Sciences in Lindau, Germany (3), Nash talked about his illness.

When asked how a man, who had devoted his life to advanced theory of reason, could possibly hold such delusional beliefs, including that aliens were communicating with him; Nash soberly replied:

Well, the ideas came to me the same way my mathematical ideas came to me: so I believed them”

Both John Nash and his wife Alicia will be dearly missed.

JJR

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*JJR is the psychiatry and research science investigator for the Chronicle LS.

[+++] Research Blog Marker

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JJR (2015) Princeton Nobel Mathematician John Nash Has Died, CoL, MAY24.

REFER

I) “Famed ‘A Beautiful Mind’ Mathematician John Nash, Wife, Killed in N.J. Turnpike Crash | NJ.com.” Accessed May 24, 2015. http://www.nj.com/middlesex/index.ssf/2015/05/famed_a_beautiful_mind_mathematician_wife_killed_in_taxi_crash_police_say.html.

II) “The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 1994.” Accessed May 24, 2015. http://www.nobelprize.org/nobel_prizes/economic-sciences/laureates/1994/.

III) “A Beautiful Mind (2001) – IMDb.” Accessed May 24, 2015. http://www.imdb.com/title/tt0268978/.

IV) “Interview With John Nash’s Schizophrenic Son – YouTube.” Accessed May 24, 2015. https://www.youtube.com/watch?v=SizS1nOOeJg.

V) “Dr. John Nash – A Nobel Prize Talking – YouTube.” Accessed May 24, 2015. https://www.youtube.com/watch?v=ZY9tZyueZj4.

VI) “Russell Crowe on Twitter: ‘Stunned…my Heart Goes out to John & Alicia & Family. An Amazing Partnership. Beautiful Minds, Beautiful Hearts. https://t.co/XF4V9MBwU4.’” Accessed May 24, 2015. https://twitter.com/russellcrowe/status/602468781911183360.

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Malpractice & Abuse In Psychiatry (Reply: Early Onset Bipolar Medical Briefing)

cute pink hair blod
Arguably, among the biggest names in Bi-Polar Disorder (BiPD) research came together this year, for the 2014 “8th Annual Ryan Licht Sang Bipolar Foundation” medical briefing to discuss early-onset BiPD. (1)
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They toted great success and, though admit much (*much) remains unknown, and that the tests for BiPD are clinical observation only “not a blood test” (1). None the less; the data somehow suggest diagnosis (?) and pretreatment before clinical observation is possible. Miraculous!
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They further go on to express how the children they have recruited for their pretreatment study have all been uncharacteristically treatment compliant for BiPD – and it is expected either these kids will not develop BiPD or, if they do, that the pretreatment will have mitigated the disorder.
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That is, either the treatment works, or else you just do not understand how bad it would have been – thank and pay them all the same.
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The sideshow continues as we are regaled by a tale, expertly delivered, by the crying mother of a conspicuously absent child who, we are assured, had been horribly afflicted by BiPD, but was now living the fulfilling life style of a sales representative of some variety – employee of the month, or some such thing. All as irrelevant, as it was touching; if not more so.
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And all thanks to this wonderful intervention program, despite him not being a candidate for it. Or taking part in it. That is one explanation.
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However, a contrary explanation to elucidate most, if not all, of their study results is ready at hand. Try and follow me here: might it just be that the treatment group do not have BiPD at all, and were never going to develop it? That would explain a lot. But these are professionals, and what are the odds of that?
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Well, I can tell you: the global lifetime prevalence for BiPD1 – 000.6% (2). That is right, serious disorder represents a fraction of a percent worldwide. The whole globe over. So, what does one say to such “research” as was presented today? How about “what a pile of irresponsible malpractice this pretreatment protocol appears to be?”. That might be a start.
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 Literature and lecture summary:
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Diagnosis
You are not sick. Even if you were, we wouldn’t really know what was going on. Or a lot of the time, again, if you even really were sick at all. And even say you had “something”, right; then sick with “what”  precisely, really we just . . .  *shrugs*. And even if we all agreed what was going on with the illness – well, we never know specifically, anymore than we do how treatments are suppose to work, but anyway – if we agreed on a name I mean – . . .
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Pre-Treatment Protocol
. . . look, lets just get started with medications and interventions, that we also don’t understand (especially early in life or long-term), but for some of their horrible, potentially fatal, side effects – we know about those – um. . . hmmm. . . right-o, so, let’s just go ahead and get amongst it, yeah?
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Rationale
(Psst, quickly now; while you still have no appreciable symptoms whatsoever, to treat a condition only diagnosable by the symptoms you are not yet showing, and may never show: and then we can run around declaring treatment success, sound good to you?)
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And why not? It sounds very good indeed. If I may address the researchers directly: Hey, you have little choice but to back your own research, no one else will.
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Can’t give the grant money back. It is pretty fool proof, as a scam. Though I, like any good Jewish lad, do hope you all end up in court. Good talk though. No patients saying it has helped them, sure. But good audio. Clear recording.
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One of the highlights for me included the mother’s emotive portrait of possible “success” that her son had achieved (*for all she knows). Success was to be measured by a bland television criteria that doesn’t call on quality of life (*this patient was also absent, which was smart); and all this “success” in an already diagnosed case with standard care nothing to do with the research: and post psychotic break. Well fantastic, tell us more you miracle workers! It is like Christ has returned on Galen’s birthday, after stealing Hippocrates’ wallet, while  riding on Chiron’s back!
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Then to fear-monger further, to children no less; children that almost certainly, by the sheer numbers, will not ever have BiPD – brilliant. To initiate pretreatment: and then act surprised they are doing fine? That treatment compliance is uncharacteristically good? Cycling not observable? Zero reported manic or hypo-manic progression? Well of course not!
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You treated asymptomatic healthy children, who you scared into an unnecessary compliance regime that will DEFINITELY impact their life path, in exchange for a PLETHORA of, fingers-crossed, promised maybes. And then you seem to call that some kind of success? You don’t mean “medical success”, surely? Do you?!
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Nice work. . . doctors?
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Though, to be fair; I think you’ll have to agree that treating the healthy has always been that little bit easier than healing the sick.
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I know research is hard. And the bad cases of BiPD are really bad – I know that too. But this is some, if not evil, at the very least particularly bad science.
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Though you all spoke very clearly, I’ll give you that. The performances were good. Great even! Two words: “Broad” and “Way”.
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But when you don’t know what you are treating. . . or what the drugs do across the life span (well, we both know some of the bad things, but you know what I mean). . .
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And when the interventions do happen to “work”, with a patient who actually displays pathological maladies that ask for treatment intervention: it is still idiosyncratically “patchy”, with no agreed criteria for efficacy as to what “working” actually constitutes, even then. . .
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AND we still don’t know why they even “work” in such a case, no matter which one (*each with a different mechanism) is used: it just begs asking. Treat the ill, absolutely; but is the case you present really cause to rush in and treat healthy youth?
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What possible motivation?
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We may never know. (3 , 5 , 6)
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Glaxo Smith Kline (GSK) is a maker of many BiPD treatment medications, as well as being a large funder of precisely this kind of medical research. I’m not saying that kind of thing could be related, that is just trivia. A lot of big companies do.
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Interestingly, the resulting comparison trials see the drug made by the investor company out perform its competitors 9/10 time (3). For example, if GSK put up the cash, their drug works best, but if Phizer put up more cash: suddenly their drug starts working! Pharmacology sure is complex. But that is not why I mentioned GSK.
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See, GSK also recently settled out of court for, yet another, sum of somewhere around ~$490 million; this time in China (4) . Only this case is a little bit different. Because it is only this time, I believe, that has seen two people involved in the scandal, not only drop a large pile of cash, but also end up seeing the inside of a jail cell (4, 5).
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Again, it is probably not related.
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However, should I turn out to be wrong, and this study does indeed reveal itself, in time, to be a similar situation to the one described above; there may be some skin in the game for all players. Because, money aside, when the long arm of the law reaches into the doctor’s clinic this time, it will be backed with a precedent of tough justice.
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And international or not: I suspect a precedent like that would not be conducive for sound sleeping, were I involved in such research abuses. But you do not have to worry about it for one instant longer – because I’m not.
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Distinguished dais – thank you for your presentation.
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*JJR is the psychiatry and research science investigator for the Chronicle LS.
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[+++] Research Blog Marker
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JJR (2014). Reply: Early Onset Bipolar Medical Briefing. JChron.LettSci, OCT (20), Ed7.
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1- Early Onset Bipolar Medical Briefing (BiPDFndn AUG2014) http://tinyurl.com/levxuus
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2 – Merikangas, R., et al (2012) Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative. Arch Gen Psychiatry. Mar 2011; 68(3): 241–251. doi:  10.1001/archgenpsychiatry
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3 – Atypical Suicide: Psychiatric Research Abuse at the University of Minnesota (Elliott 2014)http://tinyurl.com/k8j5ww6
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4 – China fines GSK $492 million in Xanax & Valium No Longer To Be Sold In Australia (2014)- http://tinyurl.com/melw7fb
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5 – Jail Time in Doctor GSK Case (AP 2014) – http://tinyurl.com/qg5g8lu
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6- Pfizer Inc : Corporate Crimes – http://tinyurl.com/oja9u7n
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I Do Not Believe In Ebola

Awesom lady reaches for Ebola help

Ebola is in Australia! Turn out the lights and call the cops!

And yet in June of 2014 in Liberia, Africa, “I don’t believe in Ebola” was not only a common view, even among many medical professionals; it was the number one hit songi.

Little did the news team know, what Vice investigator Larsen was reporting on, in those mere months prior to the formal “mega outbreak”, was a far cry from what was to follow.

Vice investigator, Gold, would find, for his dispatches, a picture that was exceedingly more grim when he returned to Liberia in October of 2014ii.

The bodies were piled high and the emergency services overwhelmed. The situation so chaotic, that one medical team took a body for cremation; only to discover on arrival that the patient was still aliveiii.

But how did it come to this? Thousands of US boots on the groundiv; quarantine zonesv; confirmed US cases, one now dead, being sent home when returning from disease stricken Africa vi; according to the World Health Organization (WHO) an “unavoidable” continued spread in Europe being underway vii; and even four suspected cases in Australia: Perth, Melbourne, Gold Coast and, most recently, Cairns viii. Is this new disease the beginning of the end for us all?

Well, probably not.

First of all, the haemorrhagic viruses of the Ebola family are quite well understood ix. This is something that has been persistently reinforced, since the outbreak became internationally unwieldy, by lectures at UC Berkeley x; Stoneybrook in New Yorkxi; and grand rounds at Texas Statexii, where the US Ebola fatality occurred, to name but a few. Even the medical arms of the military, including the notorious Fort Detrick xiii, and Africa Command (AfriCom) xiv, along with the Centers for Disease Control (CDC)xv, have gone out of their way to make this information available.

Ebola is a delicate virus that only requires standard available hospital contact precautionsxvi xvii. This is not to say the deaths are not real; however, the outbreak can be controlled – no different to any other infectious disease faced in any hospital around the world every day. According to a letter in Lancet this month: This remains the case, despite the over the top precautions all too often shown in news reports xviii. Indeed, the greatest risk of infection appears to be in the incorrect removal of personal protective equipment (PPE) by medical staffxix.

The real problem is the lack of facilities in African nations becoming over burdened, and poor contact precaution procedure enforcement in developed world hospital settingsxx xxi. Which is something we always live with xxii xxiii xxiv xxv.

The African cases have been genetically and spatially mapped, according to Science xxvi xxvii, and through this, as well as CDC contact tracing xxviii, a geo-spacial time line of the 2014 outbreak has already been formed all the way to a likely “patient zero” in a 2 year old boy xxix. Additionally, the virus has been around, in one form or another, since at least 1976 xxx. Arguably, even in backwater Australia, we know quite a lot, is the point xxxi xxxii.

So why all the hype? Why is special training required to take a medical history xxxiii 29? Why are actors dressing up as Ebola patients in New York xxxiv? Why are medical staff refusing to be quarantined, if it is so dangerousxxxv? Why is the military doing something altogether differentxxxvi? In short: Why is Ebola death on every channel?

One reason is the actual death.

WHO figures have the current African death toll approaching a “likely highly under reported” ~5’000 dead xxxvii. That alarming figure, however, does not adequately communicate the risk – or lack thereof. That being said, it seems all but certain the novel tobacco derived antiviral “ZMapp” will still make a killing; whether or not it is needed or even works xxxviii. And don’t worry, along with companies in Russia promising several vaccines xxxix, the “reputable” giant Glaxo Smith Kline (GSK) is on the case – this being perhaps more concerning news than anything Ebola could hope to threaten alone xl xli xlii xliii xliv xlv.

Another glaring question is: How did Africa go from, not even believing in Ebola in June, to ~5’000+ dead in September 1 11 xlvi?!

Ebola in its current form is thought to come from eating African wild game meat4. However, the reason so many in Liberia were in disbelief for so long, was due to the fact that, if cooked at ~60 degrees Celsius; Ebola is destroyed xlvii. As such, with cooking, no one was sicker than usual – and everyone was eating the meat 1.

Add to that the (arguably deserved 1 2) distrusted reputation of the US and Liberian governments, and the large number of other fatal diseases still in Africa: Why would they worry about another disease? One being told to them no less; that required they give up one of their, very limited, food sources; and that they saw no evidence for? Under the circumstances, it could be argued, a belief in Ebola, especially in those early days, would not have been the most prudent position to maintain for the average African.

And cooking is not one’s only Ebola defense. It is worthy of note; Ebola virus is also destroyed by bleach, time, sunlight, boiling water for 5 minutes – indeed, by pretty much anything 44. And all of the key items are found in the hospitals of developed countries. And most households. And, quite honestly, in most public restrooms.

The issue is infection control protocols and adherence. As it was before Ebola ever made the stage xlviii xlix 3.

It is further worthy of note that all Ebola case scares in Australia, thus far, have not in fact resulted in a sweeping outbreak of the disease in this country. In fact; they have amounted to nothing at all – and even that is arguably too much. This is the trouble with “news” media hype.

Although it is true the vectors are technically unknown, and the disease is technically untreatable, but for supportive care 17 4 : to worry about Ebola is no different to worrying about every other horrible, and more contagious, disease that you have, as yet, never even heard of.

And believe me, there are a lot of them l li lii.

The best thing you can do to protect yourself, and your family, right now – is turn off your TV.

J.J.R.

[+++] Research Blog Marker

*JJR is the psychiatry & research science investigator for the Chronicle LS.

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J(J)R (2014). I Don’t Believe In Ebola. JChronLettSci. (10), OCT, Ed16.

iMonkey Meat and the Ebola Outbreak in Liberia – Vice Dispatch.” Accessed October 30, 2014. https://www.youtube.com/watch?v=XasTcDsDfMg.

iiThe Fight Against Ebola (Part 1/3) – Vice News.” Accessed October 30, 2014. https://www.youtube.com/watch?v=4AZidJ36nA0&list=PLw613M86o5o7q1cjb26MfCgdxJtshvRZ-&index=4.

iiiEbola Burial Team Take Body Away for Cremation, Realise Man Is Actually Still Alive – Africa – World – The Independent.” Accessed October 30, 2014. http://www.independent.co.uk/news/world/africa/ebola-burial-team-take-body-away-for-cremation-realise-man-is-actually-still-alive—9773565.html.

ivDefense Department Briefing | Pentagon| C-SPAN.org.” Accessed October 30, 2014. http://www.c-span.org/video/?321789-1/defense-department-briefing.

vCDC Briefing First Ebola Case US | C-SPAN.org.” Accessed October 30, 2014. http://www.c-span.org/video/?321812-1/cdc-briefing-first-ebola-case-us.

viEbola Patient Dies in Texas; Five U.S. Airports to Screen for Fever | Reuters.” Accessed October 30, 2014. http://www.reuters.com/article/2014/10/08/us-health-ebola-usa-idUSKCN0HX1OK20141008.

viiEbola Outbreak: Spread of Deadly Disease across Europe Is ‘Unavoidable’, Warns WHO Chief – Europe – World – The Independent.” Accessed October 30, 2014. http://www.independent.co.uk/news/world/europe/ebola-outbreak-husband-of-spanish-nurse-placed-in-quarantine-as-22-contacts-identified-9779682.html.

ixThe Structural Basis of Ebola Viral Pathogenesis – NIH.” Accessed October 30, 2014. https://www.youtube.com/watch?v=H8IFC8GQvNE&index=4&list=WL. “AHPPC-Statement.pdf.” Accessed October 30, 2014.

xThe 2014 Ebola Outbreak: Update on an Unprecedented Public Health Event – Berkeley.” Accessed October 30, 2014. https://www.youtube.com/watch?v=WCM3HWsIbDE&list=WL&index=1.

xiPresidential Lecture: ‘Ebola – Risks of Emerging Infections’ – Stoney-Brook.” Accessed October 30, 2014. https://www.youtube.com/watch?v=LBQdzp0YGZ0.

xiiEbola Virus Disease Preparedness for Health Care Workers – TexusU.” Accessed October 30, 2014. https://www.youtube.com/watch?v=WvTJY0_tsLQ.

xiiiBiological Warfare – Experiments on the American People – Institute for Molecular Medicine.” Accessed October 30, 2014. https://www.youtube.com/watch?v=1QJo3XuYp-M.

xivFirst Shipment of the Ramped Up U.S. Military Response to Ebola Arrives in Liberia | United States Africa Command.” Accessed October 31, 2014. http://www.africom.mil/newsroom/article/23586/first-shipment-of-the-ramped-up-u-s-military-response-to-ebola-arrives-in-liberia.

xvEbola and Contact Tracing – CDC.” Accessed October 30, 2014. https://www.youtube.com/watch?v=rwdkVenedZQ&feature=youtu.be.

xviDefense Department Briefing | Pentagon| C-SPAN.org.” Accessed October 30, 2014. http://www.c-span.org/video/?321789-1/defense-department-briefing.

xvii “Ebolavirus – Pathogen Safety Data Sheets.” Accessed October 31, 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php.

xviiiRyschon, Timothy W. “Ebola Control Measures and Inadequate Responses.” The Lancet 384, no. 9949 (September 2014): 1181–82. doi:10.1016/S0140-6736(14)61346-5.

xixEdmond, Michael B., Daniel J. Diekema, and Eli N. Perencevich. “Ebola Virus Disease and the Need for New Personal Protective Equipment.” JAMA, October 28, 2014. doi:10.1001/jama.2014.15497.

xxMonkey Meat and the Ebola Outbreak in Liberia – Vice Dispatch.” Accessed October 30, 2014. https://www.youtube.com/watch?v=XasTcDsDfMg.

xxiTowner, J. S., P. E. Rollin, D. G. Bausch, A. Sanchez, S. M. Crary, M. Vincent, W. F. Lee, et al. “Rapid Diagnosis of Ebola Hemorrhagic Fever by Reverse Transcription-PCR in an Outbreak Setting and Assessment of Patient Viral Load as a Predictor of Outcome.” Journal of Virology 78, no. 8 (April 15, 2004): 4330–41. doi:10.1128/JVI.78.8.4330-4341.2004.

xxiiWiener-Well, Yonit, Margalit Galuty, Bernard Rudensky, Yechiel Schlesinger, Denise Attias, and Amos M. Yinnon. “Nursing and Physician Attire as Possible Source of Nosocomial Infections.” American Journal of Infection Control 39, no. 7 (September 2011): 555–59. doi:10.1016/j.ajic.2010.12.016.

xxiii Sadsad, Rosemarie, Vitali Sintchenko, Geoff D. McDonnell, and Gwendolyn L. Gilbert. “Effectiveness of Hospital-Wide Methicillin-ResistantStaphylococcus Aureus (MRSA) Infection Control Policies Differs by Ward Specialty.” Edited by Jan Kluytmans. PLoS ONE 8, no. 12 (December 10, 2013): e83099. doi:10.1371/journal.pone.0083099.

xxiv“Infection Control, Ethics and Accountability | Medical Journal of Australia.” Accessed October 30, 2014. https://www.mja.com.au/journal/2009/190/12/infection-control-ethics-and-accountability.

xxvCohen, J. “Ebola Vaccine: Little and Late.” Science 345, no. 6203 (September 19, 2014): 1441–42. doi:10.1126/science.345.6203.1441.

xxviGire, S. K., A. Goba, K. G. Andersen, R. S. G. Sealfon, D. J. Park, L. Kanneh, S. Jalloh, et al. “Genomic Surveillance Elucidates Ebola Virus Origin and Transmission during the 2014 Outbreak.” Science 345, no. 6202 (September 12, 2014): 1369–72. doi:10.1126/science.1259657.

xxviiRasmussen, A. L., A. Okumura, M. T. Ferris, R. Green, F. Feldmann, S. M. Kelly, D. P. Scott, et al. “Host Genetic Diversity Enables Ebola Hemorrhagic Fever Pathogenesis and Resistance.” Science, October 30, 2014. doi:10.1126/science.1259595.

xxviiiContact-Tracing. 2014. Ebook. 1st ed. CDC: Centers for Disease Control and Prevention. http://www.cdc.gov/vhf/ebola/pdf/contact-tracing.pdf.

xxixEbola Outbreak: A Timeline of the Worst Epidemic of the Virulent Disease in History – ABC News (Australian Broadcasting Corporation).” Accessed October 31, 2014. http://www.abc.net.au/news/2014-10-22/ebola-timeline-worst-outbreak-in-history/5831876.

xxxOutbreaks Chronology: Ebola Virus Disease | Ebola Hemorrhagic Fever | CDC.” Accessed October 31, 2014. http://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html.

xxxiEbola Virus Disease (EVD) Outbreaks in West Africa – Ebola-Clinicians.pdf.” Accessed October 30, 2014. http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-ebola.htm//$File/ebola-clinicians.pdf.

xxxii“Ebolavirus – Pathogen Safety Data Sheets.” Accessed October 31, 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php.

xxxiii“Review of Human-to-Human Transmission of Ebola Virus | Ebola Hemorrhagic Fever | CDC.” Accessed October 31, 2014. http://www.cdc.gov/vhf/ebola/transmission/human-transmission.html.

xxxivHospitals Secretly Send in Actors to Fake Symptoms, Test Staff.” Accessed October 31, 2014. http://www.firstcoastnews.com/story/news/health/ebola/2014/10/09/hospitals-secretly-send-actors-fake-symptoms/16959621/.

xxxv“Kaci Hickox, Nurse Under Ebola Quarantine, Returns to Her Maine Home – WSJ – WSJ.” Accessed October 31, 2014. http://online.wsj.com/articles/nurse-being-held-under-ebola-quarantine-at-newark-hospital-will-be-discharged-1414418399.

xxxvi“Remarks by the President on Ebola | The White House.” Accessed October 31, 2014. http://www.whitehouse.gov/the-press-office/2014/10/28/remarks-president-ebola.

xxxvii“2014 Ebola Outbreak in West Africa | Ebola Hemorrhagic Fever | CDC.” Accessed October 31, 2014. http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html.

xxxviiiCohen, J. “Ebola Vaccine: Little and Late.” Science 345, no. 6203 (September 19, 2014): 1441–42. doi:10.1126/science.345.6203.1441.

xxxixRussian Scientists Develop New Vaccine to Fight Ebola Virus | News | The Moscow Times.” Accessed October 31, 2014. http://www.themoscowtimes.com/news/article/russian-scientists-develop-new-vaccine-to-fight-ebola-virus/505967.html.

xlVaccine-Makers and Ebola: Giving It a Shot | The Economist.” Accessed October 31, 2014. http://www.economist.com/news/business/21629399-drugmakers-bet-vaccines-will-help-fight-against-ebola-giving-it-shot.

xliEbola Vaccine Trials Fast-Tracked by International Consortium | GSK.” Accessed October 31, 2014. http://www.gsk.com/en-gb/media/press-releases/2014/ebola-vaccine-trials-fast-tracked-by-international-consortium/.

xlii“Avandia Lawsuit – Current Lawsuits, Settlements & Help With Your Claim.” Accessed October 31, 2014. http://www.drugwatch.com/avandia/lawsuit.php.

xliii“Paxil Lawsuit – Lawyers, Legal Claims Against GlaxoSmithKline.” Accessed October 31, 2014. http://www.drugwatch.com/paxil/lawsuit.php.

xliv“GlaxoSmithKline Agrees to Pay $3 Billion in Fraud Settlement – NYTimes.com.” Accessed October 31, 2014. http://www.nytimes.com/2012/07/03/business/glaxosmithkline-agrees-to-pay-3-billion-in-fraud-settlement.html?pagewanted=all.

xlv“GSK To Pay $229 Million To Settle Avandia, Drug Lawsuits By 8 State Attorneys General.” Accessed October 31, 2014. http://www.lexisnexis.com/legalnewsroom/litigation/b/litigation-blog/archive/2013/07/25/gsk-to-pay-229-million-to-settle-avandia-drug-lawsuits-by-8-state-attorneys-general.aspx.

xlviGreen, Andrew. “West Africa Struggles to Contain Ebola Outbreak.” The Lancet 383, no. 9924 (April 2014): 1196. doi:10.1016/S0140-6736(14)60579-1.

xlviiEbolavirus – Pathogen Safety Data Sheets.” Accessed October 31, 2014. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php.

xlviiiSydnor, E. R. M., and T. M. Perl. “Hospital Epidemiology and Infection Control in Acute-Care Settings.” Clinical Microbiology Reviews 24, no. 1 (January 1, 2011): 141–73. doi:10.1128/CMR.00027-10.

xlixData and Statistics | HAI | CDC.” Accessed October 31, 2014. http://www.cdc.gov/hai/surveillance/.

lMahy, B. W. J, and M. H. V Van Regenmortel. Desk Encyclopedia of Human and Medical Virology. Oxford: Academic, 2010.

liInstitute of Medicine (U.S.). The Infectious Etiology of Chronic Diseases: Defining the Relationship, Enhancing the Research, and Mitigating the Effects: Workshop Summary. Edited by Stacey Knobler. Washington, D.C: National Academies Press, 2004.

liiCook, G. C, Alimuddin Zumla, and Patrick Manson. Manson’s Tropical Diseases. [Edinburgh]: Saunders, 2009.

 

 

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True Love: By The Numbers

cute anime gif

Gladwelli has suggested that we can only find mastery, of any subject or skill, if 10 thousand hours are devoted to the mastery of the task.

However, if it truly takes 10 thousandii hours to master anything; that has some serious implications, across lifespan, which have thus far been overlooked. Most apparently: It means that, after sleep, one has units of time with which to achieve mastery (Mu) for approximately only 50 itemsiii, before likely deathiv.

That is including relationships of merit.

Let us assume no death tomorrow (which we best not, but are gonna…), and give all a full life (by the numbers).

And let us further assume a contemplative focus brought to bear on only every other moment, which is generous. Add an inclusion in that of 50% of the Mu, mastery potential units, spent in unfocused revelry or misspent on lost endeavors.

That leaves 25 Mu items (+-5 for conservative error).

1 Mu for standard schooling (and a few of the above misspent items, perhaps). 1 Mu to become practiced at your work, x 5 Mu for life time career changes. 1 Mu for being sick or burnt out for a while, at least. 5 Mu or more for family. 1 Mu for guitar or something similar (we all do at least one). 1 Mu or more for higher study, depending on level of specialty (& a few more of the above misspent items, almost certainly).

Depending on how you scored on the above measures – that leaves between 11 opportunities to master honest relationships of merit, in a LIFETIME, at the HIGH end; and only 6 or so opportunities otherwise.

Three Mu for the first half of life, three Mu for the second.

And it is further requisite that the people you invest in are matching your own contemplative investment focus, on said friendship, at that particular time.

Even if you find out relatively early on that they are not so devoted – you do not get that time back. And every moment you let pass without such a dynamic unfolding, equates to having less chance again of ever achieving love; just by virtue of running out of time.

And this assumes one is never sick longer term, such that attention and possibility further falter.

And that none of the Mu opportunities over your life, that you are actively working with, ever die.

And that no Mu’s are half spent – if it takes 10 thousand hours, you simply couldn’t quite make it work on a partial Mu; even with “the one”.

It also presumes you are actively onto it at age “0″. This is arguably overly demanding, despite it being so important a task.

None the less.

Be all that as it may: is there in existence a sole sober agent, of reason and sound wits, that dare say unto me, verily, that the active pursuit of such a lofty, idealistic social contract is incorrect? The wrong position from which to begin to explore the nature of the other?

Or, conversely, that following the normative draw into a wedding, that takes 10 years to get out of, and adds an ineptly planned for child or two* (*not that we do not love them), is ever objectively correct?

Or, more completely, that assuming one’s base print for anything is correct! Surely it is best that each view taught to us be challenged, and quickly! As can following any norm be a reasonable investment, before they have been questioned and explored to satisfaction of self? And an ever changing self at that!

I am no longer certain if this position gives us more power over our own destiny, or less! It is difficult to call either way. We can not know where we are up to on our Mu’s, that still seems correct. But this position does square up some best case realities, somewhat, and that may impact other decisions.

People have an intense desire to feel they have selected things for themselves, without influence vi vii. Well, never have I seen someone scratch their head and say in response to a suggestion:

“hmm. Yep, that seems right-er than what I was doing”

At least not in under a 3 year time-frame: and even then they pretend it is their idea. OK, that is just a personal observation.

But something that it appears applies to us all, is that there is so little time. Even if we are guaranteed a full life expectancy which, dare I remind the reader; we are not.

Thus, targeting allies must be done carefully. Blocks must either be activated immediately for confrontation, or avoided entirely and approached subaurally (surreptitiously).

Life requires reflective and active thought if one is to achieve. And achievement can only be measured by one’s own standards: if it is to be “your” achievement, that much is evident. Despite this, however, most refuse to recognize, with any great haste, what their own behaviors will readily announce. Their life is not being self-honestly lived.

Once again, life requires reflective and active thought if one is to achieve. And this is neither manipulative nor a “bad” thing for one to be consistently engaged in actively.

True enough, sometimes one simply runs out of Mu. Little can be done about that.

However; any who fall, coming from a position less thoughtful and active, deserve the salt from every tear. Because, truly, they did not ever even try.

JJR

*JJR is the psychiatry and research science investigator for the Chronicle LS.

[+++] Research Blog Marker

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J(J)R (2014) True Love: By The Numbers. JChronLettSc(CoL), NOV, (7), Ed11.

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i Gladwell, Malcolm. 2008. Outliers: The Story of Success. 1st ed. New York: Little, Brown and Co.

ii “The 10,000 Hour Rule.” 2014. Accessed October 30. http://gladwell.com/outliers/the-10000-hour-rule/.

iii *All cause mortality 75% percentile rounded down with approximately 1/3 (*21.6 units) assumed for sleep.

iv “3303.0 – Causes of Death, Australia, 2012.” 2014. Accessed November 6. http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/3303.0main+features100002012.

v Dumitriu, Constanţa, Iulia Cristina Timofti, Elena Nechita, and Gheorghe Dumitriu. 2014. “The Influence of the Locus of Control and Decision-Making Capacity upon the Leadership Style.” Procedia – Social and Behavioral Sciences 141 (August): 494–99. doi:10.1016/j.sbspro.2014.05.086.

vi Życińska, Jolanta, Alicja Kuciej, and Joanna Syska-Sumińska. 2012. “The Relationship between General and Specific Self-Efficacy during the Decision-Making Process Considering Treatment.” Polish Psychological Bulletin 43 (4). doi:10.2478/v10059-012-0031-4.

vii “Locus of Control and Decision Making for Posthospital Care.” 2014. Accessed November 6. http://gerontologist.oxfordjournals.org/content/29/5/627.abstract.

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On Teen Suicide (An Australian Perspective)

Fin Life Sucks Gif

It best not be forgotten that suicide is a top 10 killer in Australia (1a). Age is, of course, the most important risk factor and, as many of you will know, the age bracket most at risk is . . . the 85 years and older (1a*, 1).

Further, as you will no doubt also be aware, the safest group to be in, going by the sheer numbers, where they actually count the bodies, is . . . teenagers.

Huh. I’ll just double check my numbers here; ok teen suicide, age 15-19 years, yes: the least likely to actually self harm resulting in death. How about that?

Yep. Least. Of the entire population. Let that sink in. Just as you thought hey?

The “women and children first bias”.

Well, no, actually.

Men account for 75% of the suicides, the median age of onset is ~45 years old, and the 7 year survival rate for successfully completed suicide in this bracket is, understandably, prognostically quite poor (4).

Before you ask, the most common way to die is hanging, or a hanging variant. Yeah, the majority. Overdose is next, but three to four fold less common.  I know. Blew my mind as well. And these people are suppose to have lived? 8.5% by alcohol/car exhaust. Guns are at 7%. But get this – jumping off something is grouped with “and other“: that is how rare it is (5). Who knew. And in a male dominated sport no less: few cars, less guns, and almost no jumping off high stuff. There isn’t always truth in stereotypes apparently; is that the lesson?

Yes.

I genuinely had a “Mulan moment”: where I had to make sure they didn’t send me the stats for daughters, when I asked for sons. Legit.

The second sex comes in second place, (yawn), again: accounting for only 25% of the deaths by suicide. Probably couldn’t choose an outfit. What? It is not me; the report only comments on those two anchor points on the gender spectrum (4). Real prejudice is subtle.

“Women”, to their credit, do tend to get in a little bit earlier (well, the men are still alive at that point aren’t they? The great motivators. I can’t prove that is related. Kids are probably still alive too. What? I’m just noting some raw factoids. I’m just saying probs. They are probs alive. And it is probably not even related >> . . . I wouldn’t worry about it hey).

It is worth remarking, however, that the median age of female suicide is also ~45 years. About on pa. So if suicide is decimating the elderly, and is frequent for those in midlife: why the gosh darn heck (yeah, I said heck) have I even heard the word pairing teen suicide like it is a “thing”? And then they are the least likely! I tell ya’, it is that mari-ju-anna, saps the motivation. Commit suicide? Pfft, please. Teens can’t commit to anything.

Of course, we don’t write “death by suicide” on the main table; this is a Christian country. We put it on a separate graph in the appendix. We aren’t monsters after all; we’re medical professionals. But you are more than welcome to check my numbers against the 3303.0 report that came out at the end of this past March (2014) (1).

Consider for a moment what might be going on here.

Nah, I’ll just tell you. Quicker.

This is an extension of what professor Carlin calls “Child Worship” in his 2008 critique on Social and Health Policy (published under the title “It’s Bad for Ya”) (6).

We idolize life in the form of youth as a vicarious pseudo immortality fount. That, or we don’t (we do).  Fear guided funding at its most abstract. We are so collectively afraid of death that we legislate and fund the fear. Or not. But suicide is illegal.  In truth, I was just shocked to learn not all depressed teens were hot; TV lied to me again (ABS report really doesn’t pull any punches this year).

The point is: I could be turning 70 soon, for all I know; and the idea of my kids surviving me in a “World War Z” type scenario, based on some argument of intrinsic value, makes me sick to my stomach. Listen, there are plenty more Hitlers than Mozarts; believe you me. And I’m not excluding my brats from that either:

I’ve got a better idea; I’ll go with the nice colonel to the UN command carrier away from the zombies – but you can keep the golf mug and pair of socks. Still wrapped, how bout that? Hey, kids, it is literally the least I could do. Do you know how small the bunks and lockers are on these UN command carriers? Gotta travel light.”

The number 1 killer, by far, is cardiac ischemia et al vascular disease (2). Again. Always wins hands down. Top two spots actually.

This is why I particularly love it when a doctor asks:

“…is there a history of cardiac disease in your family?

Why yes doctor, now that you mention it, I am a human being . . . you studied for how many.  . . look, is there, um, anyone else I could . . . you know what: it’s fine.

Use that information as well as you can. Don’t let the fact that whoever comes in here, unless their parents are immortal like my own (*you shut your mouth, that women is a saint and will never die NEVER -_-), will likely answer “yes” to that question. Or that, If they don’t know, you should probably just assume it anyway, you know, if it helps. Better than flipping a coin? Who knows.

Existential threat is wasted on the young and healthy (but oh too terrifying to consider clearly later). The truth is, you can slice up the WHO data a lot of interesting ways (7).

But on suicide, if you want my advice, spare any sympathy you had for whiny teens. Give it to the real high risk groups:

1. The ~45 year olds who are stuck actually dealing with legitimate problems in the too teen addled world, and;
2. The over 85 year olds who have watched their friends and family die, while a debilitating, but slow working, disease devours their body from the inside; such to match their moth-eaten-by-life, long time tormented, hole ridden, soul. (1b*,1c*).

J(J)R

*JJR is the psychiatry & research science investigator for the Chronicle LS.


J(J)R (2014). On Teen Suicide (An Australian Perspective), JchronLettSc: Col, 7(4). Ed7.

[+++] Research Blog Marker
1a* In males only is suicide a top 10 killer. Female 14th.
1b* Hyperbole; soul not confirmed by 3303.0 data set.
1c* Also, people can live to 120 years relatively as healthy as any other time in their life: and you never know where you are on the spectrum. And neither do specialists. At all. In fact especially specialists. Ask them.
(1)(ABS 3303.0, Released March, 2014) – http://tinyurl.com/pxdjbfv
(2) 3303.0 Overall Mortality – http://tinyurl.com/o97broc
(3) 3303.0 Key characteristics – http://tinyurl.com/mgey8ab
(4) 3303.0 Age – http://tinyurl.com/o2vnbnx
(5) 3303.0 Method – http://tinyurl.com/pk5659c
(6) Carlin (2008) – http://tinyurl.com/o99y3zc
(7) WHO Methods for Divining Cause of Death, WHO Bulletin v(84, 4, 297) (ac2014) ~ http://tinyurl.com/ldfbnuy
(8) Criminal Code 28-291-311/2, QLD, (1899) – http://tinyurl.com/o8eznnc
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Youtube suicide

Crisis helplines

Lifeline: 13 11 14

Suicide Call Back Service – 1300 659 467

Kids Helpline(for young people aged 5 to 25 years): 1800 55 1800

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~ Strategies for the End of the Journey ~ [EV-I]

end_of_line_by_marc_mebarak-d3857p9

When God closes a door, he opens a window.

True enough, if there are gays who can marry in your city; outside may be a plague of spiders or a tsunami  – but this piece isn’t about the immutable external reality of the first mover, but rather the seemingly alterable internal world that makes up the “us-ness” architecture: more specifically relating to cognitive applications in abstinence.

This will call on the literature, but also informed by opinion, it may or may not hit the threshold for the RB (research blog) search engine; we’ll let the review board decide.

However, in quitting anything, from illegal narcotics;  to sex; to cigarettes; to alcohol: there will be many strategies that are core – that simply apply to everyone. And almost as many which are purely personal, of course.

The personal must be discovered.

However, why not arm yourself with the core?

The core contains removing behavioural cues; medications to reduce withdrawal or craving; treating underlying conditions; and improving cognitive architecture so that craving can be resisted and executive power restored. This will include “mindfulness” style techniques in this piece. But also some of the more traditional strategies, only stripped back.

Forgiveness” and “acceptance” are another set of terms that are, perhaps, more “soft”; but very important concepts. This piece will focus on alcohol, but will apply more broadly.

To begin; there is no stigma in therapy or medication anymore. We could all benefit in having a paid sounding board to assist us, indeed, there was a time when every person had their analyst. If you are living in a country where access to healthcare is available to you; it is all but criminal not to accept this assistance. Many places are not so lucky.

~The First Step Therapies~

In the case of alcohol, I would argue there is a causal relationship between violence (that is stronger than Meth in some studies), depression and anxiety. Even presuming there is no initial hidden condition being “self medicated” – there is almost certainly a chemical component that needs to be addressed in treatment on substance abuse cessation. As far as medication  goes; a general assistant such as escitalompram and a long acting benzodiazapine, at first, like diazepam, is a good genuine first step.

Moderate to high dose Mirtazapine (30-45+) has a unique and well rounded mechanism set, and Sertraline I am a fan of as well. Though escitalopram does have the best combined profile for actually working and being quickly tolerable.

Regarding “tolerable”; they all have an “upset stomach/flu” period at the beginning, and end, of treatments; though Mirtazapine does have weight gain of ~5kg and extreme lethargy in some cases (*both H1 mediated, I imagine, both at the lower doses too, and likely impacted by time of day taken as well as depression sub type: but I can’t prove any of that). Also, the afore mentioned medications are all nowhere near as addictive as something like Venlafaxine.

Venlafaxine will work; it has the beauty of leaving open the option to keep increasing the does until a new mechanism additionally kicks in. It is reasonably unique in this. Vfax, however, is the most like trading one addiction for another. It works the best and the fastest on paper, but is another thing you will perhaps have to concentrate on in order to get off of at a later date. The ones listed above have mitigation options. The company says 95% have no trouble changing dose with Vfax – I doubt any less than 50% of people find significant trouble. But it may be worth the trade.

A final thing on this topic, since medications have been addressed elsewhere [link crux]; drug expectations must be realistic. The above medications are “background drugs” – you are not supposed to “feel them working”. I consider them more like “shields”, a piece of equipment you are fortunate to have access to that can assist you in dealing with withdrawal, and the period of readjustment. Or as a more adaptive addiction at worst.

I think with drinkers in particular this is never quite explained. It is not like pouring a drink, it is like taking a vitamin (*which reminds me, also take thiamine when you stop alcohol, it would take too long to explain : but have a little faith; this is the internet, after all, what could possibly go wrong?).

The point is medications are an important part of any treatment regime. If you are in a country where you can access them, it is silly not to. Think about it; you already use potent daily drugs to get by, right? Just do not think they are “not working” if after the initial one-ish weeks of headaches and tummy aches you “don’t feel any different”. That is very likely not the case.

Also, with some you will not have reached the effective dose yet. Again, the medications listed above can usually be started on what is considered the “effective” dose level, or it can be quickly reached. Your doctor will (hopefully) tell you all this, in the 15 minutes it takes to diagnose you with the computer check boxes and write you a script/hand you a sample. And do not be scared by hand outs: they must list every possible thing to protect against legal liability. The sample group these have been tested on now is LARGE.

(*If you would like an opinion on a compound not listed, contact me.)

But in general, remember two things: 1) There may be an underlying reason why the addiction took hold in the first place that you are unaware of; and 2) There is a chemical component that needs to be addressed now regardless.

Would you attempt to stop smoking without nicotine gum and/or patches? Of course not, who would. And if you did try, the odds are you probably would not do so and be successful (the average is the forth attempt, with assistance). And quitting smoking won’t kill you. The same can not be said for alcohol.

Similar to nicotine, alcohol base craving must be reduced in this manner, and the imbalance created by dependence moderately mediated.

Drugs like Bupropion are effective, though essentially only prescribed for cigarette cessation in Australia, rarely (if ever) as monotherapy for the depressive illnesses. There are also a range of negative reinforcing compounds for alcohol that could fill their own piece. To suffice it to say, avoid them.

Cigarettes have an inhaler, a delivery system to mimic the action of the initial addiction. Alcohol requires a replacement habit as well. And this is where one benefits from being personally focused and creative in planning out a personal arsenal of responses for both boredom and craving.

One mindfulness technique, that I have named here “snap-back”, is key to not buying that drink. Whenever you find your mind dwells in that direction; observe, rationally dispute (ie forcefully say to your systems ‘NO’, as neural retraining) and then “snap” your attention back to silence. Or to your music, to your TV program. It does not matter what you snap back too; but this is a universal application technique. And you will use it a lot.

Do not blame yourself if this happens often, especially at first. Even every other second. It is the “go to” circuit that is being retrained here; it would be stranger if this was not a frequent occurrence.

You don’t actually “want a drink” per se; rather you have set up a “when this, activate that” system. That is what you are feeling, it is mislabelled. You can highjack other systems, like by drinking a glass of water or orange juice, because all of these circuits interact. You would switch off parts of the craving, through back doors (drinking muscles active, stomach distension…others). Soon you would “crave” orange juice. It is a behavioural conditioning exercise. We killed a lot of horses to work this stuff out; have some respect for the dead already.

Forgive yourself for indiscretions. There is little benefit in the alternative. Indeed, “disappointment” and “guilt” are likely along some of the very same artificially up-regulated depressive affect circuits we are trying to by-pass, apoptose and rewrite. There is a literal retraining going on of neural pathways. This is why “snap-back” works best when it is militant in its application.

Your brain must know you are serious before it will seek out alternate routes for that connection, without requiring the substance. Once this is done, craving will decrease to removal.

Replacement substitution can help. There is always a reason for relapse, every single day. The presentations of such circumstances will be more salient. Spiritually, if you believe in such things, this occurs because the universe likes to test you; you asked it too. This, anecdotally, will often be 3 times, with increasing difficulty – the 4th and final the “most reasonable” and most difficult.

Resist.

Neurologically, your brain is seeking the drug input and so makes salient the cues that preceded intake in the past; especially whenever doubt or resistance was encountered. You will see every minute problem, you will see them stack up, and they will appear worse than ever. It will be darkest in the death throws; just before the alternate pathway is reset.

Resist.

It is always darkest before dawn.

And like when training a child (I don’t have kids): to reinforce the drug pathway at all means that, essentially, you’ve told the system it need only reach a more desperate point than the one previous, and drug intake will be achieved. The command is that this is the new system you want put in place. This is a poor lessen to teach any enemy, be they child or circuit.

Forgive yourself and your brain for this repetitive behaviour. But definitely meet head on any “snap-back” challenge. When you hear demands such as “craving” being made, remember it is not what it appears.

At every “snap-back”, you can replace/substitute with anything. Silence works for some. If you have the will to quit. It will still happen a lot.

Forgive frustration.

If in the earlier stages, or if quitting “for someone else” (which is also really always for you, but no more is likely needed on that point); replacement behaviours are even more useful. Anything, preferably something you can feel however. Do 11 push ups, for example. Or eat something high in sugar. Moving from one habit to another, in a weening process, has many benefits. Sure, there are those that would say, yes, more of the exercise is fine but not sugar: have some celery or a carrot stick.

As I say, anything can work, but sugar does allow a reward firing. Though I do like crunchy things. But we aren’t here to talk about me. Gum is another good one, as it can always be on hand. Train your mindfulness “peace space” (*talk to your therapist or Guru) to be related to the behaviour, ie as you have the gum, each and every time, relax all muscles, breathe deeply once, and forgive everything. That may sound a little bit hippie, and I hate hippies; but it works. Again, strong gum works better. So you can feel it.

It is all part of neural retraining. Compared to how long your brain has been trained to operate only with the drug; it actually works quite quickly.

Therapy and social replacement will be examined more completely in the next section.

DocJA (R), hc. (2013). Escape Velocity I. J Chron Lett Sc, Ed7. (19).

TA-73/3A-A-01/3-D

*Escape Velocity [EVII]

**Image: Deviant Art – ‘End of the Line’ by Marc Mebarak

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~ Escape Velocity ~ [EV II]

Escape_velocity_with_Supernova_by_Juggernaught9900

If only we could all afford psychotherapy all the time, we would all be better off. Luckily, if you have a recognised condition and live in a first world country with a universal healthcare system, you can likely get a full compliment of treatment focused sessions bulk billed.

So lucky.

Removing self blame, being prepared for the whole undertaking to be difficult, and managing the biology side, are certainly the core things. Knowing about salience neuroscience. Knowing about things seeming worse, as your brain distorts inputs (as it was trained to do by you). All in order to seek drug input. And, on occasion, there is a kind of “culture shock” as you begin to see life and “choices” more clearly. Just being aware that this occurs for everyone is important.

But supportive therapy is another worthwhile option. If you are not familiar with behavioural techniques like relaxation, avoiding cues and mindfulness; these are worth learning. As are cognitive techniques for self work in observation; changing language use to alter brain firing patterns; identifying independently wired cognitive distortions outside of addiction; and disputing techniques. Invaluable. And you can’t throw a stone (no matter how hard) without hitting a CBT therapist. And a compact therapy treatment course is covered by Medicare.

There are, however, too many amazing explorative techniques and experiences out there that find themselves (unfairly) eclipsed by CBT (important though it is). These may also be of benefit. But these will likely cost more. But probably not much, it depends on what and how serious you are. Try them all if you can, why not.

There are a range of supportive motivational techniques, where there is simply a place outside of your regular life you can go to talk about anything. Or not talk, just go. Most importantly, this breaks patterns. This is why any therapy will help. Never give up on anything too soon either, it is all retraining pathways. But finding a form of self work that “clicks” with you is important.

There is benefit in having the journey be for you alone first. Alcohol, in particular, is difficult because of the enormous and unyielding social components centred around it; no matter where you go. This must be planned for.

And you must somehow locate 3 activities outside of the house that bring some reward. This is a midterm strategic plan that becomes important for the overall picture. In the immediate, complete each task one thing at a time. Including planning these 3 activities, and getting to them. Get up. Clean your teeth. Dress. Be in transit. It is all another task accomplished, and each is actually another reward firing to assist in rewiring. These are the tactical concerns explored in the previous piece, and are some of what will be honed with your therapist.

The tactical is the moment to moment, but the strategic consideration includes things like getting or keeping a job or beginning or continuing and completing study. But it all hinges on the three activities. You must leave the house. You must break patterns.

You may (very likely) find you must force your self to do these, like a robot. And, as usual, do not expect them to be miracles in and of themselves either. However, your system will be seeking input. It almost doesn’t matter what they are; if you can complete these elements, the input will assist of its own accord. It is another one of those biological things. We are socially wired.

There are data describing these underpinning bio-social elements in primates going back to nearly the earliest records of biological research. It is an important part of self mastery that I think many people miss in their operational therapy plan, one that may account for relapse in some cases.

Speaking in operational terms is always the hardest, because “quitting” is never really the aim; taking an alternate path which allows greater opportunity for higher level hedonic dividends is the actual aim. Always.

We do not ever really know what that operational path “is” in its entirety from the “bird’s eye view”; not while on it. It forms beneath ones feet while walking. Thus, it is important not to be discouraged if you can not picture what that future looks like from where you currently are. This is normal. Indeed, at least in part, almost a necessity. Your predictive faculties have not been honestly and clearly directed to draw such a picture in a very long time.

This is also why the 3 moderate term strategic “experiences” out of your normal routine can be almost anything: it is in large part exploration. Socio-biological input and strategic exploration to colour in the picture of what the ultimate operational landscape will be. A new arsenal of what is requisite for such a world will also be collected along this journey. You will have what you need when you get there.

But do not worry about that, concentrate on now. Let your focus fall on now. Your goals know themselves. The future takes care of itself. Time does that.

It is in the tactical application of daily self-work to counter, whatever it is you consider to be, maladaptive behaviours and cognitions; as well as strategically responding to “surprise” life stressors and boredom; and in the effortless paving of the new operational ground work for the next chapter in your life, through seeking input outside of your former life path pattern: that will be where the challenges and answers are found.

And both will be yours alone. But the challenges do not have to be faced alone. Not entirely.

This is why the first step is always recruiting. A GP to address the biological. A therapist to assist in the psychological. And courage, with commitment, to alter daily patterns that have, across time, been given your permission to become “automatic’ and have for too long been allowed to operate unchecked.

The journey only seems far standing on this side of it. But, to borrow from the hippies again; “the journey of a thousand miles begins with a single step”. It was Jesus who said that. Probably. Or Ghandi, maybe Buddha, look, it doesn’t matter alright; the point is it is inherently true.

If you keep going that way, you know where you will end up. If you want to change direction, you have to actually physically put effort in to point a foot in a different direction. It is physics. Well, I mean, most things are. And then you have to actually take a step.

And that first step is always to begin to map, with honest foresight, your strategically focused and tactically rich, path forward; following a recruitment phase (ie see a generalist (GP)).

And never be afraid of doctors. If you don’t like what they have to say, you can keep door knocking until you find someone who does have ideas which appeal to you.

Medicine is not a science, after all.

But do remember, this is a daily and integral part of your life you are replacing with something else; it is no small task. This is why the techniques are many, and you benefit most in taking advantage of them all. If you do things in halves, you may not ever reach “escape velocity”.

And a final truism – if you do nothing at all: you will go nowhere.

DocJA (R), hc. (2013). Escape Velocity II. J Chron Lett Sc, Ed5. (19).

TA-73/3A-A-01/3-D

*Strategies for the End Times [EVI]

**Image: “Escape Velocity with Supernova” by Juggernaught9900

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Huntsman Cause Majority of Severe Spider Bites in Australia

imageimageimage

Surprise! Yep, afraid so.

The results are in: If you are going to get a severe spider bite, the odds are it is going to be from a huntsman.

That is simply what the data say.

Hows ‘bout that? They are responsible for more bites than any other spider.

And that comes from the Oxford International Journal of Medicine:

This is the only large study of spider bite with prospective data collection, follow‐up and expert identification of spiders, and so provides the most accurate information on spider bite published to date. It gives comprehensive information on Australian spider bite as well as on the clinical effects and circumstances of bites by important groups of spiders that also occur worldwide…the commonest family to cause bites was that of the huntsman spiders

and, considering the majority are, specialist confirmed,  “harmless” huntsman bites, it is curious that:

Pain or discomfort occurred in ALL750 definite spider bites…moderate in 544 cases (63%) and severe in 205 cases (27%).

Severe pain for more than 24hrs in nearly a third of cases? How do these people define harmless? Red back was the worst, but only accounted for ~5%, funnel web <1%. ~6%? Hmmmm let me do the math here, and, yep, *carry the 1*, hey yeah : That means the MAJORITY of SEVERE spider bites in this country are estimated to come from HUNTSMAN.

We get lied to all day.

So you can add “huntsman are harmless” to the list of ignorant things people say, everyday, just because someone else said it to them once.

And there is no other rigorous study. Zero. None. One other real major one in scope, but not as rigorous. Harmless, pfft.

Bites occurred to all parts of the body, with 49% distal (hand or foot), 27% on the proximal limb, 16% on the trunk, 7% on the head/neck and 1% on multiple regionspuncture marks or localized initial bleeding occurred in 33% of bites…swelling occurred in 13%… a red mark in 69% of cases… Systemic effects occurred in 13% of all spider bites.”

9 new sub-genus of huntsman spider found since 2012: some with no eyes at all.

Maybe that is species not genus, whatevs, that’s still a lot; too many, I say. What kind of creature has no eyes anyhow? Communist, probably.

Say what you will about creepy things, politics and genocide: at least bats have the decency to have eyes. Same goes for Mao and Stalin.

Ohhhhh, they so have changed the genus as well! It is Heteropodidae, it was formally Sparassidae.

See? They’re sneaky too. Never play cards with them.

Apart from this study, there is virtually no information on spider bites, for any species, ever; because there is no expert identification almost ever. Obviously, when you think about it.

You have to rely on the patients’ memory, after the fact.

Of the few big studies attempted, most were done here (more spiders); 80% of injuries reported as “spider bite” by the treating physician where not actually at all. With the exception of some redbacks, where they actually did use antivenom a bit, and the funnel web- Most bites that are “bites” in the ED/AE, turned out to be from insects when examined by a specialist.

You can’t just milk spiders and inject people with the venom, apparently, so you have to trust patients looking at mug shots.

Do you know how many species in a single genus there are that live in just this country alone?

Yeah, the mug shot system was never going to work.

Plus, spiders do tend to look a bit different in those magnified close ups, to how they look whilst waving your arms in the air screaming:

“Get it off me! Get it off me! I’m too young, oh God I believe I believe, just get it off me!”.

Which was the conclusion the researchers came to as well.

Hence why we only have one decent study. And it says huntsman.

image

And when do most bites occur? All the time. Just, all the time. But they really start to pick up again around September/October. Yep, right now.

And I’m telling you, the females are coming in here following my pheromones. You think I’m joking? I’m not.

I bet I could induce mating barking if a female huntsman spider was exposed to my sweat during mating season. Hell, anytime. Hell, any species for that matter. No, but I’m serious. Get me some grant money.

No one is interested in inter species breeding anymore. Thank you VERY much human genome project.

But, anyway, otherwise we don’t know what bites have what effects. Period. Bloody science.

They even lost practically hundreds of samples in the only controlled study too. Even the good study. LOST. These people caught the spider, for the study, while dialing an ambulance with the other hand. The lab lost 180 of the samples.

So dead or alive; those people were not included. Odds are they were probably Huntsman bites though.

They live in colonies, that’s why there is a sudden rush of them. And their main predators are birds, and there are very few birds in my room. I’m diligent with that.

And when huntsman engage in cannibalism, they rarely eat direct kin, if they can help it, cause they are a social spider: one of the only ones. That’s from the J of Zoology. Well, how about that? That’s nice. It is also why there are so many different kinds of them we had to change genus.

I’d like to think Id eat my siblings only as a last resort…but deep down I know all it would take is a late pizza guy and handy plastic spork.

Huntsman are considered the largest spider in Queensland, 20cm from leg to leg in some cases. Consider the 30cm high school ruler. 20cms! “Draw blood if they bite you, on occasion”, well I’m not surprised: they’re 20 cm long. They could probably draw blood if they kicked you.

Especially all 8 legs in, with a jump kick. And they do jump at you too. Because they are “aggressive”. But not “aggressive and harmless”, “aggressive and severely harmful”. So slight mis-characterisation there. Changes the picture just a tad.

They are nocturnal, that is why I see more of them.

They live communally and bring 1/3 of food back to the hive-gaggle to feed younger siblings (unless they grow to be the same size, then they’ll kill them).

There is a single pregnant queen. So if you see an egg sack carrier – kill that with extreme prejudice. And always 2 there are – the master and the apprentice. They hunt in packs, usually pairs.

If you kill one, there will be another roaming with it: possibly bigger, possibly smaller. They are paired as master/apprentice, so hope you killed the older one first …and LOOK OUT BEHIND YOU!

And they probably eat people too, for all we know. It would explain why they run at you. Hasn’t that ever seemed curious to anyone else? I am still quite a bit bigger than them. Most of them. Were creatures smaller in the past? That is not what the fossil record appears to indicate. There is no reason for these spiders to behave the way they do. No reason.

Something like 13% of bites occur in your sleep, one study said. What a bastard of a spider.

Here is one on the keyboard:
image

Here is one sitting on the toilet roll:

image
They’re just a’holes. Perverts too, apparently.

Look at him glaring. You’re sitting there all vulnerable, staring back at the most aggressive spider in the whole country, the one that causes more severely painful bites than any other; and then it speaks:

…wipe…slower…” it seems to say with it’s eyes (if it has them) in its cross-species gravelly pur of a look.

And that’s when you notice you can only see 7 legs. Dirty bastards. At almost the same moment you feel a fury paw caress your inner thigh, coming from INSIDE the toilet bowl.

Oh yeah, very “social” spider, the huntsman. Why won’t this soap make me clean?

The controlled study recruited people at random, had aracologists in emergency rooms, followed people for 2 years, gave them equipment to catch the spiders. There is no other good research.

Positive predictive values of spider species identification at over 0.95 with 95%CI of ±0.02. You better gosh darn believe it folks.

The results are in: If you are going to get a severe spider bite, the odds are it is going to be from a huntsman. That is simply what the data say.

So next time a hippie tells you not to kill one, or someone says “they’re harmless” and hands you a Tupperware container; hand it straight back and say that you just “got a feeling” mother earth wants them to personally handle this one.

Then just pray like hell that they are one of the ones that gets severely bitten.

Oh, man how I hate hippies.

J.J.R. (2013). Huntsman Cause Majority of Severe Spider Bites in Australia. Chronicle of Letters. Oct. Ed 8, (13).

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Novel Corrective Brain Surgery for GD & Homosexuality (2013)

DBS Orange in Electric Blue Skull

We have had these techniques for quite some time, if I may refer to what we learned from the Harvard, and other, military experiments of the late 20th and 21st centuries.

Although, let it be said from the beginning; I do agree with detractors in saying that I find the use of military personnel, or occasionally civilians, for experimentation, especially without their explicit consent, to be a morally ambiguous practice.

I do, however, find medical consent to be an ambiguous construct at the best of times; especially given the reality [REDACTED]. Furthermore, military personnel do sign their lives over to the service of the country quite legally and, for all intents and purposes, of their own free will – with their “eyes wide open”, so to speak.  At least to a certain inarguable degree.

This “understanding” in the case of the service member constitutes a level of consent that, I would argue, one would be hard pressed finding up on the wards of a civilian hospital for almost any given procedure.

In any event; despite qualms a reviewer may hold regarding the internal moral or over arching ethical standing of these ongoing practices – such views are, objectively speaking, clinically irrelevant. Indeed, such hang-ups hardly invalidate reliable, replicated, statistically significant results.

If Heidigger has taught us even one thing in the behavioural sciences (one that does not require we learn a second English within English, or German within German); surely, the separation of the common ethic and intellectual advance, is that lesson.

Following this line of reasoning, and quite unclassified, is the work of Dr E Moniz. Dr Moniz’s work on the human frontal lobes was among the best of his era; work which saw him claim no less than the Nobel Prize in medicine, lest we forget.

Similarly, Yale emeritus professor of physiology & psychiatry Dr. Delgado’s (et al) human experimentation series examining affective behaviour were both unique and instructive. Especially for those who have seen the footage; it is undeniable that these investigations uncovered an impressive set of results (Tarth-US(CD)MORI).

Yet his work on rDBS (stimoceiver) still remains largely uncapitalised in the mainstream.

Let it be posited here that to withhold a treatment, despite its origins, when there is a high probability said treatment could help some patients find peace; is to place oneself in a position that faces moral and ethical questions of its own.

Such an action would be akin to denying phenomenology due to a personal distaste for Heidegger’s self promotion policies.

And the rDBS evidence, for these maladies in particular, does indeed exist.

Even only taking from what has been declassified for Australia (FOIA-MORI), for example, the literature show that in both a 14 year old and 11-year old set of patients, gender identity and sexuality could be altered with minor stereotactic surgery.

Indeed, one 11yr old boy underwent identity change via rDBS of the superior temporal convolution which “… induced confusion about his sexual identity … [the] effects were specific, reliable, and statistically significant”. Among other things, the patient can be quoted as saying “I was thinking whether I was a boy or a girl,’ and ‘I’d like to be a girl“.

There were also many marriage proposals, across patients, reliably induced via more temporally mediated targets.

We have local access to the requisite materials within district; both in terms of candidates and skilled hands. Furthermore, under remit [REDACTED]. Indeed, I use to assist in similar work at [REDACTED] War Memorial Hospital, [REDACTED] Children’s, and [REDACTED] Uniting  Private Hospital in Brisbane city. I use to assist in bolting the slab cage into the patients’ skulls, with the head shaving and placement of fiducial markers, and in lining up scanner mapping lasers for regional location targeting.

Specialists remain on campus as of 2013.

We used non-r DBS for parkinsonism with great success (internationally renowned), and for depression as well (less publicised).

Surgical talent are skills tested and within GSI extended rank.

And since the loss of the CAST contract, alongside the removal of [REDACTED] and St John in June of 2013, MISO project DSTO funding can be more readily secured via current contract extension through CRC without requiring QCC additional approval (DMTC-GSI-Ext-lscJJR-TBR**).

As indicated by cardiologist/geneticist Dr Eric Topol (of NSAID et al Cox2 Inh JAMA research fame, leading to rofecoxib recall); bio-medico-cyber interventions are already in use across the full spectrum of disease.

Despite the selective bias of TED previously examined by Chronicle editors, Dr Topol has provided the TED corporation a brief, but supportive, summary along these lines.

It is true that a lot of his work focuses on obs type data for medicine. None the less, it remains a truism to say that interventions such as DBS; spinal stimulators; insulin pumps; pacemakers; and even cardio-pulmonary artificial compression devices, are far from novel interventions at this time.

Nor are they set to become any rarer in their applications in the coming days.

Both QCC and GSI would be remiss in passing up such an opportunity to support the field team in taking up a leadership role on this matter. Picking up the psycho-biological slack, and assisting one of their own in moving the behavioural sciences forward (as project PI), can only be of benefit to all involved.

As the long failed epoch of psychiatric medications comes to a close; truly there is an argument to be made for this type of minor neurosurgical application to be given the opportunity to further prove itself in the field.

Candidate names have been provided for trial use in treating resistant GD patients, as well as for use in individuals who find themselves similarly clinically distressed by their homoerotic tendencies.

There is reason to believe such techniques may be vindicated as both more theoretically sound, and more specifically targeting of symptoms, in these populations.

Thus, said treatments could conceivably be of greater benefit to the patient, with more predictable satisfaction outcomes, and with far fewer side effects than the current treatment options provide.

Following the publication of 134 peer reviewed papers, 500 general scholarly articles and 6 books on the topic (Blackwell, 2005), Prof Delgado concluded “[targeting] specific brain areas…[is] scientifically superior to oral administration of drugs… whose effects [are] mitigated by liver metabolism, the blood brain barrier and uncertain distribution” (SciAm, 2005).

Certainly, if such an approach proved itself to be as directive as early trials have indicated it will be; then this treatment plan is surely more humane than the barbaric use of gross systemic hormones, other chemicals, and surgical reassignment:- where, despite years of clinical application, our hands are quite simply not yet adequately adept, and the supportive research literature itself far less theoretically robust.

J.J., LSC (2013). Novel Corrective Brain Surgery for GD & Homosexuality. J. Chron Lett. Sci. Sept. Ed10, (25).

[+++] Research Blog Marker

**Cnslt. Maj. S.G. (Fmr FCO-H-GSI-A01-3) queries #D4 notice breach review.

Reply to Dr J.J.R., hc ~ Chron Lett. “GD: Another Look Under the Hood”. *Awaiting confirmation.

Refer:-

Blackwell (2011) ID:f9da6400-ea5f-4b24-990e-6c259d48eca4.

JAMA (2005)-doi:10.1001/jama.286.8.954.

J AppNeuroPhys (1978)- doi:10.1159/000102436.

J NvsMtDis Oct (4) (1968)- PID5683678.

J Em&CritCMed May (2013)- doi.org/10.1097/CCM.0b013e31828a24e3.

SciAm (2005)-doi:  10.1038/scientificamerican1005-66.

MapConv Spring (2) (2001)- http://cabinetmagazine.org/issues/2/psychcivilization.php

PhysContMind (1969)- ISBN 0-06-090208-6.

Nobel Pize Medicine (1949):-http://is.gd/9pnmtG

SUNY (Acc 2013)- http://is.gd/xVfKdH

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TED is Evil ~ Well, That Sucks

TED Pleb

To my vast disappointment I recently learned that TED talks are evil.

They are engaged in extreme censorship.

And that would be bad enough, but they also act like a cult. “Scientology summer camp“, one former TED fellow described the experience. Cult psychology is one of my specialties, usually for its application to military recruit indoctrination. At least I can still have an interest in TED for the purposes of a case study.

I may even get a paper out of it.  And a libel suit.

But I doubt, however, I’ll ever be allowed to give a TED talk on corporate influence or faceless ivory tower censorship.

The story goes thus:-

As of 2013, I have just learned TED removed talks by Sarah Silverman; Dr Rupert Sheldrake (ironically talking on dogmatic science); lawyer, entrepreneur and Vice journalist Eddie Huang; and a drug taking hippie named Graham Hancock. I am sure there are others I do not know about.

The censored talks, that I have identified above, can now be found online; though often with the TED logo blurred out. And the release of the material at all did not come easily.

Now, I have no time for drug culture; especially the South American “hallucinogen’s will fix the world, so stop trying to take responsibility for your actions and go get high – with a Shamanic context to justify a break from habits (that you obviously already know are unwelcome in your life), since you lack the internal constitution to do so on your own without an alter present and some ritual” approach to life.

But that doesn’t mean I do not want to hear about it. Parts of it are actually quite fascinating.

For as much as I dislike too much hippie nonsense; I dislike censorship far more.

TED has had other drug talks. So that is a false reason for removal. They also knew Hancock’s caper when they invited him. The first line of his Wiki says something akin to “Hancock is a sociologist and writer who specialises in unconventional theories”.

So either TED is incompetent, unable to research even as far as Wiki; or TED is not TED anymore. Which, frankly, seems more likely to be the case.

TED has had talks about people catching poems “by the tail” and, thus, having to write them backwards for crying out loud!

They’ve had people who have severe brain damage, following a stroke, who make claims about finding God via spiritual thrombosis. But that was apparently OK.

And, actually, it is a great talk. I’m glad it wasn’t censored; but had it been described to me I certainly would not have sought it out.

And that would have been my loss.

Luckily, it came up in the TED search one day. Something the above videos could never have done; since they were removed from the search even once public pressure compelled them to be returned online.

Why is a guy, whose only deal is the “unconventional”, suddenly a problem for talking about using shamanic mysticism to quit weed? Especially when there is research for psychedelics currently underway looking at this, and similar, clinical applications in mainstream schools as of 2013.

Hancock gave what was, essentially, a short and very basic anthropology lecture with a personal touch. After all, it is only 20mins? It was already recorded? YOU invited HIM! This is a problem now?

The only answer can be that TED has become corrupted by sponsorship.

TED is beholden to big money, not sharing ideas. Not anymore.

These lecturers were selected. Approached. This was done because of interest already identified.

Should the talks be of no value, people will get a glimpse into how some other people think, at the very least. Then not pass them on if they do not like them, like most TED talks. Not watch them again, this kind of thing. That is part of sharing ideas, one could be forgiven for thinking. Seeing differences in opinion.

And bear in mind; I hate this hippie crap.

But there are bigger ideals at stake here. Or must everything be censored in America now? Just all the time?

There are no TED accidents. Even the audience tickets include no equity. But we’ll get to that.

These speakers have already been selected, for reason of interest, and they aren’t being paid for their time.

Eddie Huang pointed out some of the bizarre behaviour that goes on at TED conferences after his REQUESTS to travel a few suburbs to record a pre-booked radio show, or see to his partner on his birthday, which fell during the conference, WERE DENIED.

And pause for a moment to consider how completely controlling it is that TED invited these speakers, pays them nothing, makes such high demands of these people (like ~15hrs per day for 7 days); only to then remove the speakers’ presentations post hoc.

But this they did. They either refused to post them at all, or took down their presentations after some much needed “censorship reflection time”.

Then, after people (accurately) cried “censorship”, TED pretended “oh no, that whole event was cancelled”. O_0.

When that flimsy excuse fell over, since the other lectures from the event were posted, TED re-posted the talks; but removed them from the search so they could not be found without scrolling through the whole webpage; ie one would need to already be on a mission to find them. Talk about spreading ideas. One would have to know they were there before searching.

They also changed the page code so they could not be embedded or shared or downloaded: only for the “marked” videos at that conference.

And it gets weirder. As mentioned, one former TED fellow described the whole experience as “Scientology summer camp…you [even] share a room with someone assigned to you”, “…your own partner is not allowed to stay with you” (in this case even for their birthday), “you are forbidden to hire your own Hotel room”, and “YOU ARE FORBIDDEN TO LEAVE. The conference is a week.

You are expected to give a week of your time where they schedule your every activity for ~15hrs a day.

Again, YOU ARE FORBIDDEN TO LEAVE. If you value your TEDness.

Even for the audience there is no equity.

There is an application process to even be allowed to buy a ticket.

For the lucky and chosen few: you are then “allowed to pay US$8’000 per person. Yes, that is thousand.

In the 2’000 seat auditorium: that is US$16 Million dollars just on tickets sales, and remember: no speaker is getting paid.

But why should they, TED talks are for the people after all. And TED have costs. Overhead. And to speak at TED, why, it is a public service, right?

Well, I mean, sure; they do have some sponsors.

Only companies, for example, like “Sony”; “Samsung”; “Gucci”; “Intel”; “Target”; “American Express” and “GE”: real Ma and Pa, grassroots style companies who are barely scraping by following the financial crisis (*they helped cause).

Another banned talk, by millionaire Nick Hanauer, was on the dire need for taxing the wealthy. Nothing suspect regarding censorship there, given the sponsors. The claim was that it is having people to spend money in the middle class that creates jobs – that if the rich were really job creators, since the rich are currently richer than ever before – where are all the jobs?

Where indeed.

Correct or flawed; it is an interesting thought problem none the less. And one that is sure to spark an interesting and informative debate.

Or, to use TED speak; *DELETE*.

This is not about the sharing of ideas, as it was when TED first began to gain in popularity. The very reason TED became what it did, is no more. The soul has been stripped from TED, and been replaced with “TED inc”.

TED needs to be replaced in its entirety.

TED no longer allows the spreading of novel ideas for our consideration; the consideration comes first. And then again later. And again if need be. And again after that, this time more surreptitiously.

It seems unlikely an accident that all the banned talks just happened to say “question orthodoxy” in one form or another, as all those who moved us forward in science have done in the past. On paper, this is a cornerstone of science. But it is not a cornerstone of TED science.

Sheldrake was interesting. The kind of talk that inspires you to think outside of the box, if only for a brief moment. To see what might be possible. Isn’t that what TED was suppose to be all about?

But no artist or scientist appreciates having their thoughts pre-thought for them.

Therefore, TED is no longer for artists or scientists.

JJR (2013). TED is Evil. J. Chron. Lett. Sci, 2(7), Sept. Ed8.

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Humour Ethnographic Observational Pilot

Humour Ethnographic Observational Pilot Preparation Code: 3.00/12=9 Where: Club Environment (L1)/ External location (LxA).

Transcription 1

INTRODUCTION

Open space, few pillars blocking stage and overall quite impressive. First time in attendance. Professional comic [01] remarked many pub stages in Australia are set up with a bar of similar size, which remains open during performance, and where food service continues; only as one moves to theaters is a more formal environment introduced.

The open bar was successful and not distracting from the show.

Agencies pushing all talent, even when specific artist is asked for by name, was reported. This is in line with anecdotal stories at large, Sarah Silverman comes to mind as an example. The artist remained with this agent at this time.

Comedy club houses talent nearby and arranges transport to and from airport. Staff appear to be connected with the club directly, as an impending public holiday threatened to impede this service.

[01] made reference to the presence of security and handlers on larger/longer tours who ensure arrangements and deal with other practicalities (eg assemble of stage backing). These personnel travel with the tour. As expected, anecdotal evidence of many comics’ personalities being a mismatch to public persona were recounted.

It was pointed out that the bar is where most club finance comes from in these venues. One retelling painted a venue with a bar right next to the stage which was identified as a lesser design.

Show begins with an up beat music stab and strobes of coloured light on the stage, to draw attention of the audience. Audience are seated around and above at dining tables. The format begins with junior performers showcasing material guided by an MC.

Class H and Class K members identified. MC displayed impressive crowd control fluency. An inclusion technique disarmed audience members who where a heckler risk. This appeared to be instinct and is perhaps the consistent job of the MC.

MODEL FIT AND NOVEL OBSERVATIONS

HOPSMI appeared to predict methods most akin to mirth induction (as measured by laughter expression). Headliner performers used more of the RM’s predicted to be stronger, apparently on instinct. All closing lines employed a strong technique. This is perhaps explained by the techniques being observed from comic masters in both instances, if intrinsically.

It is apparent that later acts hold an advantage with regard to a better lubricated crowd, in addition to more developed material. It is predicted that at later night venues, this plying effect of the social lubricant would plateau and perhaps even reverse its beneficial effects. This may be especially so in cases where artists employ more cerebral and/or subtle styling alone.

Indeed; the low energy subtleties, but solid material, of the final act appeared to meet resistance at points very possibly due to this effect. By contrast, the exuberance and energetic nature of the headliner traversed both the apparently more sober and later more inebriated crowd with ease. By a similar token: the opening performances with weaker material (or perhaps less structured to be fluent) have a particularly difficult task.

Field notes would benefit from 1) A more structured pre journal format for an average number of (or room for all perhaps) RM’s and forms tally. 2) A highlighted rule for forms and methods when they are apparent wo tally (3) Power crosses for method demonstration which require attention beyond that of the TC. Since tally is semi arbitrary in count as a rough descriptor of current focus and by show; the cross may ultimately be a very important predictor of the development streams that a comic who continues to be successful may build upon.

Complete heckler handle map.

Inclusion of comic industry staff beyond performer alone may be of benefit for further direction. Robustness from an ‘in’ out group.

Also, tyring effects of researcher can not be ignored as potential confound. Grounded theory categories require no further sorting at this stage.

The most interesting comment was an observation [01] has had regarding the taming of the comic scene with “tea drinkers”. An observation supported anecdotally by veteran comedian peers. One tour [01] was the only traveler who partook in alcohol. However, upon further investigation, the presence of other substances was confirmed in all cases leading to an inadvertent support of H2 where as it opened as a potential block. It is further posited that future “tea drinkers” may be divided into ‘reformed’ and ‘medicated’. This is, of course, only a theory and has limitations in that such broad categories could indeed include all society. As such more development is needed. This may benefit from further targeted investigation in semi structured interview.

C-3pi not formally applied. Unstructured interview conducted in part at venue and continued at [01] apartment. As a case study, Hx performance, family performance Hx, safe affluent home with assistance given and ability to return at will, Kathy Griffin listed as a first response inspiration. Also Fiona O’lachlan. Cursory informal does not support H1 but does support H3.

PERFORMANCE ANALYSIS

This is not a review with hierarchy but rather an analysis of content. Though personal bias must be acknowledged on some call lines; the ultimate categories are not higher or lower than one another. Instead, they merely categorise for reference purposes in this research and the rest is up to personal taste. Even the bias calls are within limits that, it is the aim, will not be ultimately evident in a way that will effect test ret test reliability between investigators. This will be born out in the data.

[01] Form: SubC(G) Lead: PR/ST/Pols/SubC(G/P)/Wit Flank OG-Rel/Sport; ShkMnr SNS*PLANE

[A1] Form: S/U (C) Lead: Wit-r Flank: PolsMnr (Male Yth/Short Set)

[B1] Form: S/U (C) Lead: Pols-r/SelfDep Flank: Sk-r/ Wit-r/123/Obs/GP+PH/ST(poor response to some good concepts: no obvious cause)

[B2-SH] Form: S/U (C) Lead: Wit/Shk 123 Flank: 123(457)/Sk-r/

[LH] Form: DP/Ch/RF Lead: Wit/ QP/123 Flank: Silence/lm-Strngh (new use)/PH-Walk Thru/Obs (some undeveloped with intent for neural build unappreciated. Word play not for the late slot perhaps. )

H(x) – Hypothesised research questions being examined for further investigation.

Audience subclasses identify potential problems to the fluency of an act.

Class K – Celebration of birth or work function that is not a signature event (ie not 21st/30th ect).

Class H – Hens night.

[01] Is an A(2)-(1) with years of industry experience playing venues country wide.

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THE CRUX

This gallery contains 8 photos.

Originally posted on Journey Chronicle in Letters and Science:
How Do I Choose a Medication – The Crux Medications are treatment assistants; they are not treatments. They are shield generators, helpful because humans are biologically wired toward the depressive emotions.…

Gallery | Leave a comment

Everything is fucked: The syllabus

The Hardest Science

PSY 607: Everything is Fucked
Prof. Sanjay Srivastava
Class meetings: Mondays 9:00 – 10:50 in 257 Straub
Office hours: Held on Twitter at your convenience (@hardsci)

In a much-discussed article at Slate, social psychologist Michael Inzlicht told a reporter, “Meta-analyses are fucked” (Engber, 2016). What does it mean, in science, for something to be fucked? Fucked needs to mean more than that something is complicated or must be undertaken with thought and care, as that would be trivially true of everything in science. In this class we will go a step further and say that something is fucked if it presents hard conceptual challenges to which implementable, real-world solutions for working scientists are either not available or routinely ignored in practice.

The format of this seminar is as follows: Each week we will read and discuss 1-2 papers that raise the question of whether something is fucked. Our focus…

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This Australian Grandmother’s Inspirational Story With Medical Cannabis, Oils & Natural Dentistry

the-wisdom-of-the-crone

ALTHOUGH it has served me well, I have not needed medical cannabis for a long while now and I am using essential oils in its stead.

I will start by saying that Cannabis is NOT inert and needs to be treated with respect. Everything one buys from the street will be TOXIC. It’s ALL impregnated with pesticide and other toxic additives and will cause you great harm!

You can overuse it and that will cause a kind of serotonin syndrome that is extremely frightening and unpleasant. I don’t believe it’s life threatening; however it can be terrifying. I have experienced it on three occasions.

That said, I do not believe moderate use is dangerous or addictive. I did find it habit forming and, as with any pain or emotional relief, desirable. Restraint was needed until I came to a workable dosage.

I also found I built a tolerance to it and no longer felt the effects of being “stoned,” which is good as I needed to function, including study. But in my experience not increasing the dose does not lessen the positive effect as in pain relief. A short break of one or two days will reset tolerance levels back too if one needs to “feel” the effect. Any medication that requires upping the dose to maintain its efficacy is a cause for concern. Being able to stop and start cannabis with ease with very limited effects is one of its advantages.

I went cold turkey after 12 years of daily use and kept detailed notes of my experiences as if conducting my own clinical trial. The withdrawals were minor compared to pharmaceuticals I had been previously prescribed and used for a matter of months.

Upon cessation, for 48 hours there was nothing notable at all. Then by day three, I was a bit moody and had a couple of nights bad sleep as my routine was disrupted. I did notice changes taking place in my mind and body for at least a month after ceasing. Memory improved, typing speed back, my passive lucid dreams became very colorful and vivid for two weeks (one nightmare) and my appetite came back with a vengeance. That too normalized after a couple of weeks. So far I have not suffered pain rebound, long term sleep problems or anxiety, but I did use essential oils during the process.

I now have an essential oil routine that I use through the day, and another before bed as I experience the most discomfort at the end of the day. I am also using the oils for gum disease that has occurred due the result of dry mouth that is caused by some medication, including cannabis.

I messed up badly on this one, I didn’t see this coming and at 62 I value my teeth and thought I exercised great oral hygiene, we need to know more.

Would love to oil pull for my teeth, but I gag. Still just adding clove bud oil to the cleanser on my tooth brush, doing the odd swish with Manuka honey and several of colloidal silver or salt and oregano oil rinses a day. That alone, in three days has reduced the halo ulcers in my receding gums around my teeth line and the gum is noticeably healing.

Although my dentist tells me I have gum disease (and I believe him because my gums are receding) I have no signs of infection, no bad breath, no bleeding. My gums are pink and firm etc. I now understand how dry mouth causes plaque to build more aggressively enhancing bacteria activity. Apparently when saliva flow is reduced the various organisms and structures within the biofilm undergo changes that often lead to inflammatory changes in the supporting tissues and bone.

I will be having my gums and teeth treated two weeks. I am afraid as it is very intrusive and I don’t like it, however I am excited to hear my dentist’s comments at the vast improvement in my gums in just two weeks, with no antibiotics.

Using cannabis as a medicine has its challenges, some due to the fact that most doctors are not prepared to discuss it or are not informed enough in its regard. Even my neurologist admitted she had only read one (1) paper involving one minor clinical trial? Apart from that her knowledge was poor to nil.

Lack of specialized support and the legal status of cannabis makes dosage hit and miss for a while, and quality/organic is almost impossible to get unless you grow your own. That has psychological disadvantages as it is just another stress. For me that was always very unpleasant but preferable to the unpredictable negative long term side effects of untested pharmaceuticals and street cannabis.

I self-medicated daily for 12 years under my own council but with a lot of research. My clinical diagnoses were, PTSD, clinical depression, chronic insomnia, rheumatoid arthritis, oesto arthritis, fibromyalgia, multi painful lypomas, chemical sensitivities, food allergies and sensitives to EMR, the list goes on.

I also managed my own business and studied at university during that time. However if I had a practitioners assistance, could have avoided such things as cyclic vomiting (which is very cruel and by definition, reoccurring), chronic cough and gum disease. All associated with the use of medical cannabis.

Long term use also causes disinterest in all food, low motivation, chronic short term memory loss, driving restrictions as it stays in your system for at least a month after you stop. It can reduce your social life and, with some, ability to work.

I have found all these are reversible once one discontinues the treatment; however my research suggests that this is only applicable if you are older. The damage done to young smokers brains – it seems is not reversible (ie 20 years and under).

Short term memory loss caused by cannabis can be stressful, however for me was a God send. I used it as part of my treatment. It hijacked obsessive thought and let joy in. It allowed me to re-frame horror into logical chunks of data that I could analyse, devoid of emotion. It helped me understand my place in it all in a very safe way and illuminated the idea that all things are transient and this too will pass. It freed me from guilt and those positive feelings have remained after ceasing its use. I seem to have re-set the emotions surrounding my memories of very painful events; they are no longer overwhelming or consuming.

I had been treated for PTSD and have tried most treatment programs and medications over 30 years. None worked like cannabis and I was 50 years old when I discovered its medical use. Pity it could not have been in a more clinical setting, perhaps it would have been required as a treatment only for 1 year, instead of 12.

I used the disinterest in food to manage my weight and introduce new foods for gut health. And by only choosing an array of organic, healthy and nutritionally dense foods, and only eating until full, I have changed my lifestyle. As I had no appetite or food preferences it made good food choices and quantity so easy. And a new healthy habit is formed.🙂

Like any medication, I believe cannabis should be considered short term and be teamed with a good organic diet and exercise. Its origin and quality is paramount and I feel it’s very important to have someone qualified to work with you during your healing process. Please keep in mind its affect is both physical and emotional, and at times touches on the spiritual.

There can also be negative effects such as a kind of serotonin syndrome (street name “Green Out”). Very nasty and not without danger.

Find someone you trust to share/listen during this process, if you choose cannabis for healing.

LRH.

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*LRH is the Alternative Medicine, Counseling  and Food-As-Medicine Writer for the Chronicle.
..

LRH (2016). This Grandmothers Inspirational Story With Medical Cannabis, Oils & Natural Dentistry. JChronLettSc, 01607 (13), Ed3.

 

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Emperor Palaszczuk & (AttGen) D’Ath’s Side of Labor’s Pro Gambling Laws – Labor Wants Your Kids Addicted To Gambling And Selling Drugs

4533956-wars1500

In a surprise move to stem Queensland’s falling crime rate, the Labor government has acted to bring in harsh new liquor laws, set to give the criminal underworld a boost.

In the words of one local unnamed criminal source:

From forcing young revelers to turn to “pre-load binging” on alcohol before clubbing; to sculling alcohol in the car on the way out; and in inspiring young people to turn to recreational street drugs, both as an alcohol replacement (many of whom may never have tried drugs otherwise), and for employment opportunities, as thousands of predominantly youth held jobs are set to be lost state wide from the hospitality industries – the Labor government appears to be taking a multi faceted approach to this crime boosting initiative, and that, in our view, is really quite commendable”

Another criminal added:

“Yeah … [It’s] really great to see. Hopefully it opens up whole ‘frat’ districts of young new customers, like it did in the United States: pushing crime so that it can be more liberally spread all over the suburbs. I’m not saying we can match the US crime figures, but under this government we can at least give it the old college try”.

Then a third criminal emerged from the shadows behind me, further elaborating:

“… cause, it is frannkly a bit of a hassle having to go where the customers are, you know? Like, when they are all concentrated where police forces can, not only better manage any incidents that occur, but where the Queensland police in particular have seen violent and drug crime rates drop in recent history – I mean, the number of youth offenders (10-19 year olds) decreased by 4% in 2013-14. It makes us a criminal laughing stock. Tourists will want to come here! But that was under previous governments with, like, more common sense initiatives? Spreading police forces thinner and increasing youth unemployment really gives us an “in” to expand”.

Assistant Commissioner Tony Wright, in the Queensland South Police Statistic report, only seemed to confirm what the felons I spoke with had been saying:

“Armed robbery is down by 16.3 percent … property crime down by 5.2 percent…[s]exual offences were reduced by 1.7 percent. There was a 1.2 percent decrease in rape and attempted rape offences and a 1.8 percent decrease in other sexual offences…a fall in property offences…break ins to homes across the region have dropped by 22.3 percent while unlawful entry of shops has fallen by 37.8 percent”

But never fear, Palaszczuk is here! And the Palaszczuk government seems set not to disappoint.

Using legislation packed with all the tried and tested techniques of 1am lockouts“, or “early last drinks“, and “no shots after midnight” restrictions, there is good reason to believe all of the same things that occurred in ever other place similar mechanisms were put in place will now happen to Queensland as well.

Nick Braban, secretary of Our Nightlife Queensland (ONQ), pointed out it may be difficult, starting from such a low crime rate, citing the fact that “assault rates in Queensland are already 63% lower than Newcastle and 86% lower than Sydney” adding, in reference to Queensland’s premier violence hot spot, “[w]e’re only talking about five assaults per weekend in [Brisbane’s] Fortitude Valley“!

Though, what Mr Braban seems to misunderstand, Premier Palaszczuk pointed out to me in an off the record interview earlier this week, is that over a Friday, Saturday and Sunday night (and day); crime rates like that could equally be represented by numbers as high as one and a bit (ie 1.6) assaults per day! Adding that “the Palaszczukian Utopia Project” was not going to stand for number* (*nearly numbers) like that.

Premier Palaszczuk went on to say that Braban was blinded by his arrogance, that he underestimated the power of (AttGen) D’Ath’s side of the argument. Palaszczuk continued that it was reasonable for the force to redouble their efforts, moving towards a lower target crime rate of no less than a magnitude order of 0.066, that the state created criminals would be the new police force, under D’Ath, and also something about “Braban paying a price for his lack of vision“… or something of that sentiment. It was difficult to hear over the lightning bolts crackling from her fingertips, striking an intern who had admitted to a glass of champagne with their lunch.

And the reaction from industry seems equally convinced that the government plan to reduce tax revenue and increase youth unemployment will have the above stated effects. Nightclubs Queensland chairman Sarosh Mehta stated to the riotous applause of government onlookers:

lockouts had not worked in Queensland [or] in southern states…[i]t is a proven fact that …lockouts have never worked. They have never worked…[t]hey have never proven… there is no evidence what so ever the lockout has ever done any good for the industry or for the community for that matter

But it is not only selling drugs, to try and pay their way through university, while picking up chemical addictions, that the Palaszczuk government has in store for our kids.

When asked about the benefits of new legislation, that would be imposing some of the harshest laws anywhere in the world, on a state with one of the lowest, and still falling, violent crime rates anywhere in the world; a senior Palaszczuk Government minister added:

“[I]f they are looking for something to do after [lockout]…you can have a coffee, you can have a water, you can have a soft-drink…[and] you can have a flutter on the pokies[!]”

Gambling Addiction Advocates Australasian Headquarters (GAAAH) have welcomed this move. GAAAH have further supported additional Palaszczuk government plans to add exceptions for casinos from the new legislation.

Queensland Attorney-General Yvette D’Ath is also in favour of laws that would force people to stay home, or (more realistically) to congregate in unsupervised party houses with no security and delayed police access, rather than go out into an entertainment precinct.

Personal safety must be paramount she wittily quipped, tongue firmly pressed into her cheek, going on to add:

“The community is telling us it’s time to act, to keep people safe…I would rather – as a member of the Palaszczuk Government – explain to someone why at 2:30 in the morning they can’t have another alcoholic drink, than explain to their parents why they’re not coming home”

Joked the Attorney-General.

Of course, she would not have to do any of those things under any circumstances.

And, of course, this legislation means the opposite. When they do not come home, if they are “the one” of the 1.6 unlucky victims of (non fatal) crime (which occurs on the weekend while out in a “violence hot spot“) in this state: we will now have no security footage; our children will have no access to cabs; or security; or police, and as such we would not even know where to start looking, or have good evidence to press charges where necessary. See? That’s the joke.  I mean it must be.

Or maybe I am joking.

As, in all honestly, what could be safer than being unemployed and drinking alone, at home, in your parent’s garage? Or living in a doss house in some dank suburb, as a forced employee of some well armed drug dealers, after dropping out of medical school when you lost your part-time/casual job in that inner city bar? Where could be safer than that?

Arguably, the Palaszczuk Government seems to want you to believe, no-where.

Incidentally, the same place this legislation is heading if the government has any sense.

JJR

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*JJR is the psychiatry, malpractice and research science investigator for the Chronicle.

[+++] Research Blog Marker

JJR (2016). Labor Wants Your Kids Addicted To Gambling And Selling Drugs. JChronLettSc, 01604 (01), Ed1.

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  1. ABC: “Revised lockout laws will curb alcohol-fuelled violence, Queensland A-G says” – http://tinyurl.com/zwtqvsy
  2. Qld Government Set To Propose Most Confusing Lockout Laws Yet – http://tinyurl.com/hhkgtke
  3. Queensland To Face Some Of Australia’s Harshest Lockout Laws – http://tinyurl.com/hyzlsvh
  4. ABS: Youth Offenders (10-19 year olds) decreased by 4%  in 2013-14 – http://tinyurl.com/gvkd966
  5. Latest reports of Queensland’s crime rates – http://tinyurl.com/glrm834
  6. Maps show changing nature of violence in Sydney’s CBD since lock-out laws – http://tinyurl.com/hsw64th
  7.  Queensland Government Proposes Toughest Liquor Lockout – http://tinyurl.com/j93aca6
  8. UC Berkeley: The Impact of Juvenile Curfew Laws on Arrests of Youth and Adults – http://tinyurl.com/glwhnuq
  9. ABS: Homicide statistics – http://tinyurl.com/c829q73
  10. The World Bank: Intentional Crime (per 100,000 people) – http://tinyurl.com/m867kch
  11. Queensland Dropped by Two Percent- http://tinyurl.com/hmhsodc
  12. QPS: Crime Statistics – http://tinyurl.com/jnodjnc
  13. Bills: Bills of the 55th Queensland Parliament – http://tinyurl.com/h94b23n

 

 

 

 

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Why We Don’t Let Pharmacists Prescribe

the_mad_hatter_by_fayrenpickpocket

Pharmacy associations are not sending their best. They are sending people that have lots of problems with reasoning, and they are bringing those problems to us. They’re bringing drugs. And some, I assume, are good people.

But try to buy “real” Sudafed, or Panadol, or a Codiene containing product, as an adult, and one is presented with an experience that can only be described as “wanting”.

One is finally left to wonder how the pharmacy associations come up with their recommendations for drugs, and their sale, at all. Almost certainly by committee – that much seems clear.

But what one is not left wondering is why we do not let these people prescribe medications themselves.

To Protect You From Yourself

They are here to keep you safe. With no regard for personal efficacy, or criminal intent – no the “you” part is not required, in the world of the pharmacist. Patients are surplus to demand, at least the mind part is. The body part they want. The body part has the wallet. Yes; the pharmacy association wants your body. And only wants you for your body.

And not that anyone asked for this attention particularly. We did not dress hot to entice – we are febrile. No situation arose that called for their ever-so-expert “bad” touch. And yet here we are. Running a fever, running nose, and running a gauntlet of irrationality.

Codeine is dangerously addictive. Paracetamol virulently toxic. And a packet of 60mg Pseudoephidrine tablets is more sought after, on the criminal black market, than the very narcotics that the innocent looking brightly coloured boxes of breathing, are rumored to be turned into.

Or so you would be forgiven for discerning, from the way some of these “people” carry on. All the while trying to peddle products that, they themselves do not believe to work, in placei; drugs that may actually be dangerous, like phenelephrineii.

To the untrained eye it can seem all for the best, prima facie: except none of the fear mongering can be held as justifiably true. And law enforcement know it iii iv. And the AMAv knows it. And, quite frankly, most people on the street know it too.

In truth, none of these compounds are a major problem.

Drugs are Bad, Mmm…k?: Reflections Dancing with Some Data

Codeine is not dangerously addictive. We have advanced forensic tools for examining Codeine – in the living and the dead – and its transformation into Morphine in the bodyvi.

Not only is metabolism different in every patientvii, seeing the drug effectively metabolised to an active compound at a ratio of only ~10:1 in the best case: the idiosyncratic differences are such that, in as many 1 in 20 cases, Codeine is not metabolised into any desired compound at all (therefore having no effect on the patient whatsoever)viii. Hardly the dream.

As for paracetamol: no one is accidentally overdosing. Though, for the amount of alerts I get in my inbox monthly regarding this topic, one would be forgiven for thinking that people are having a single Panadol, and their heads are exploding.

So, regarding the great dangers of Panadol (Acetaminophen/Paracetamol) that fill up my in-box multiple times per week; to say they have been greatly exaggerated, would be less than a great exaggeration.

Panadol does not make the top list of deaths, or poisoning, pretty much at allix. In the poison specific portion of the ABS statistics, it ranks only among suicides and overdoses as (a likely reasonably non acute concern) single compound that was present among many – never as the cause. Though you have to read the fine print to really work that out (I know, reading *blurgh*)x. Alcohol is also never included, it is worthy of note.

So, you are looking at, at most, between 8-18 deaths (in real numbers) where Panadol was even present. No claims it was really involved, and antidepressants were still more commonly used even for suicidexi.

To put that all in perspective: even if we take those as “Panadol damage related death” (and pretend there are no suicides, and that no other drugs were involved); the actual death likelihood: ~1 in 23’000xii.

The death from radiation exposure risk is ~1 in ~12’000 xiii – not including cancers. Yet you do not see the SERT team xiv unloading clips into the sky during every electrical storm, nor shooting at the sun during the hot summer’s day, do you? And nor should you. But these pharmacy association recommendations make about as much sense.

In fact, arguably, quite a bit less sense.

However, these drugs are merely the runners up. As everyone knows; the real danger comes from the well organised, politically connected, and highly networked international criminal underworld… which also, as it happens, is entirely sustained on cold and flu medication bought by people on the way to work. I mean, obviously.

Pseudo Pseudo Ephidrine Scare Mongering

When it comes to street amphetamine, approximately 80% does not come from known sources of in-country pharmaceutical pseudoephidrine stocks, according the Federal Police xv xvi.

And of the estimated 20% amount remaining, the majority is actually thought to come from ingredients either smuggled in from fake orders to shell chemical companies, or from massive bulk raids of pharmaceutical factories xvii xviii.

Yes: somewhat surprisingly, it turns out drug syndicates do not get the bulk of their resources from elaborate chains of multi-state wide cold and flu sufferers compiling 60mg tablets at a time, edging towards a ton.

Who knew, eh?

Everyone but the Guild of Pharmacists, apparently.

If it is true that 9.5 kg of street Meth – a recorded bust from this month xix – is worth $3 million wholesale, but pseudoephedrine is worth $200k per kilo on the black market xx xxi; where is the incentive? Honestly.

That means that if you had a 15 man crew in your bike gang* (*and I am pretending you do not have to deal with other items, from bribing the pharmacist and/or security guard; to hiring a delivery driver; the cook chemist – plus we are also ignoring distribution and its costs. I mean you do have to sell the stuff, you can’t just take it into a bank… right? But pretending you could)…

Right, SO, again: If you had a 15 man crew, then that record haul would earn each of you less than the median wage for this country that year xxii. And no job stability.

You’d be far better off all going on the dole, paying a third of your payments each to have one member of your crew go to university, and open up your own legitimate pharmacy; that you all own shares in. That is where the smart money would be.

A never ending weekly supply of orders; deliveries to your door; sales representatives coming to you, and customers that can come out during the day! And not least of all: no breaking the law, and the associated problems.

The reason they do not do this, is because the vast majority of the source for the illicit drug supply simply does not come from citizens trying to alleviate the symptoms of allergies or the flu to get to work. It is not true.

And So That Is Why

So the next time it comes up that “pharmacists should prescribe”, because they have memorised our best guess at enzymatic pathways some 30 years ago. Say no.

And when they lament that even clinical and neuro psychologists get to prescribe before them, along with nurses and physician’s assistants; let it be known that this is why.

Yes, those drug sales numbers are likely inflated. But police forces have budgets and jobs to protect – what is the pharmacist’s excuse?

With the exception of hospital pharmacists, the average shampoo monger sees only relatively healthy patients anyway. They have nothing to add of value, certainly nothing that the same (identical) “medication clash alert” app, used by most physicians, does not already have covered. Thanks.

And, finally, the other fields believe in self efficacy. Personal responsibility. Patient autonomy. Criminal intent. Police and clinicians have some contact with reality.

Pharmacists do not. It may be questionable to even let some of them make recommendations, in certain cases. Perhaps the cases outlined above rank among them.

At the heart of the matter is the fact that pharmacists are, for the most part, entirely divorced from both clinical and forensic reality – and that is why we do not let them prescribe.

JJR

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*JJR is the psychiatry and research science investigator for the Chronicle LS.

[+++] Research Blog Marker

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JJR (2015).Why We Don’t Let Pharmacists Prescribe. JChronLettSc, 01518(9), Ed5.

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i Horak, F., Zieglmayer, P., Zieglmayer, R., Lemell, P., Yao, R., Staudinger, H., & Danzig, M. (2009). A placebo-controlled study of the nasal decongestant effect of phenylephrine and pseudoephedrine in the Vienna Challenge Chamber. Annals of Allergy, Asthma & Immunology, 102(2), 116–120. http://doi.org/10.1016/S1081-1206(10)60240-2

ii Meltzer, Eli O., Paul H. Ratner, and Thomas McGraw. ‘Oral Phenylephrine Hcl For Nasal Congestion In Seasonal Allergic Rhinitis: A Randomized, Open-Label, Placebo-Controlled Study’. The Journal of Allergy and Clinical Immunology: In Practice (2015): n. pag. Web.

iii Australian Federal Police, (AFP). ‘Amphetamines – Australian Federal Police’. Afp.gov.au. N.p., 2015. Web. 18 Sept. 2015.

iv Australian Federal Police, (AFP). ‘Australian Federal Police – Annual Report’. (AFP). N.p., 2013. Web. 18 Sept. 2015.

v Australian Medical Association (AMA). ‘Australian Medical Association’. Australian Medical Association. N.p., 2015. Web. 18 Sept. 2015.

vi Berg-Pedersen, R. M. et al. ‘Codeine To Morphine Concentration Ratios In Samples From Living Subjects And Autopsy Cases After Incubation’. Journal of Analytical Toxicology 38.2 (2013): 99-105. Web. 18 Sept. 2015.

vii Smith, Howard S. ‘Opioid Metabolism’. Mayo Clinic Proceedings 84.7 (2009): 613-624. Web. 18 Sept. 2015.

viii Smith, Howard S. ‘Opioid Metabolism’. Mayo Clinic Proceedings 84.7 (2009): 613-624. Web. 18 Sept. 2015.

ixABS,. ‘4102.0 – Australian Social Trends, 2001’. Abs.gov.au. N.p., 2015. Web. 18 Sept. 2015. http://tinyurl.com/oamucwc

x ABS, Poisoning. ‘4102.0 – Australian Social Trends, 2001’. Abs.gov.au. N.p., 2015. Web. 18 Sept. 2015.

xi ABS, Poisoning. ‘4102.0 – Australian Social Trends, 2001’. Abs.gov.au. N.p., 2015. Web. 18 Sept. 2015.

xiiABS,. ‘4102.0 – Australian Social Trends, 2001’. Abs.gov.au. N.p., 2015. Web. 18 Sept. 2015. http://tinyurl.com/oamucwc

xiii National Safety Council, (NSC). ‘National Safety Council – Death Hazard Ratio’. NSC. N.p., 2015. Web. 18 Sept. 2015.

xiv ‘Special Emergency Response Team (Queensland) | World Public Library – Ebooks | Read Ebooks Online’. Worldlibrary.org. N.p., 2015. Web. 18 Sept. 2015.

xv TheAustralian,. ‘Stolen Tablets Worth $10M To Speed Labs’. N.p., 2015. Web. 18 Sept. 2015.

xvi Australian Federal Police, (AFP). ‘Australian Federal Police – Annual Report’. (AFP). N.p., 2013. Web. 18 Sept. 2015.

xvii Crime Commission Joint Report (ACC) ‘4 Intelligence Operations | Australian Crime Commission’. N.p., 2015. Web. 18 Sept. 2015.

xviii TheAustralian,. ‘Stolen Tablets Worth $10M To Speed Labs’. N.p., 2015. Web. 18 Sept. 2015.

xix Australian Crime Commission. ‘Two Charged, 9.5Kg Of Meth Seized In Perth | Australian Crime Commission’. N.p., 2015. Web. 18 Sept. 2015. http://tinyurl.com/nby7zve

xx Federal Police, (AFP). ‘Amphetamines – Australian Federal Police’. Afp.gov.au. N.p., 2015. Web. 18 Sept. 2015. http://tinyurl.com/owostt3

xxi The Australian,. ‘Stolen Tablets Worth $10M To Speed Labs’. N.p., 2015. Web. 18 Sept. 2015.

xxii ABS- Earnings. ‘6302.0 – Average Weekly Earnings, Australia, May 2015’. N.p., 2015. Web. 18 Sept. 2015. http://tinyurl.com/64r3o4

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