Spending time alone in nature is good for your mental and emotional health – CWEB.com

Brad Daniel, Montreat College; Andrew Bobilya, Western Carolina University, and Ken Kalisch, Montreat College

Today Americans live in a world that thrives on being busy, productive and overscheduled. Further, they have developed the technological means to be constantly connected to others and to vast options for information and entertainment through social media. For many, smartphones demand their attention day and night with constant notifications.

As a result, naturally occurring periods of solitude and silence that were once commonplace have been squeezed out of their lives. Music, reality TV shows, YouTube, video games, tweeting and texting are displacing quiet and solitary spaces. Silence and solitude are increasingly viewed as “dead” or “unproductive” time, and being alone makes many Americans uncomfortable and anxious.

But while some equate solitude with loneliness, there is a big difference between being lonely and being alone. The latter is essential for mental health and effective leadership.

We study and teach outdoor education and related fields at several colleges and organizations in North Carolina, through and with other scholars at 2nd Nature TREC, LLC, a training, research, education and consulting firm. We became interested in the broader implications of alone time after studying intentionally designed solitude experiences during wilderness programs, such as those run by Outward Bound. Our findings reveal that time alone in nature is beneficial for many participants in a variety of ways, and is something they wish they had more of in their daily life.

Reflection and challenge

We have conducted research for almost two decades on Outward Bound and undergraduate wilderness programs at Montreat College in North Carolina and Wheaton College in Illinois. For each program, we studied participants’ experiences using multiple methods, including written surveys, focus group interviews, one-on-one interviews and field notes. In some cases, we asked subjects years later to look back and reflect on how the programs had affected them. Among other questions, our research looked at participant perceptions of the value of solo time outdoors.

Our studies showed that people who took part in these programs benefited both from the outdoor settings and from the experience of being alone. These findings build on previous research that has clearly demonstrated the value of spending time in nature.

Scholars in fields including wilderness therapy and environmental psychology have shown that time outdoors benefits our lives in many ways. It has a therapeutic effect, relieves stress and restores attention. Alone time in nature can have a calming effect on the mind because it occurs in beautiful, natural and inspirational settings.

Nature also provides challenges that spur individuals to creative problem-solving and increased self-confidence. For example, some find that being alone in the outdoors, particularly at night, is a challenging situation. Mental, physical and emotional challenges in moderation encourage personal growth that is manifested in an increased comfort with one’s self in the absence of others.

Being alone also can have great value. It can allow issues to surface that people spend energy holding at bay, and offer an opportunity to clarify thoughts, hopes, dreams and desires. It provides time and space for people to step back, evaluate their lives and learn from their experiences. Spending time this way prepares them to re-engage with their community relationships and full work schedules.

Putting it together: The outdoor solo

Participants in programmed wilderness expeditions often experience a component known as “Solo,” a time of intentional solitude lasting approximately 24-72 hours. Extensive research has been conducted on solitude in the outdoors because many wilderness education programs have embraced the educational value of solitude and silence.

Solo often emerges as one of the most significant parts of wilderness programs, for a variety of reasons. Alone time creates a contrasting experience to normal living that enriches people mentally, physically and emotionally. As they examine themselves in relation to nature, others, and in some cases, God, people become more attuned to the important matters in their lives and in the world of which they are part.

Solitary reflection enhances recognition and appreciation of key personal relationships, encourages reorganization of life priorities, and increases appreciation for alone time, silence, and reflection. People learn lessons they want to transfer to their daily living, because they have had the opportunity to clarify, evaluate and redirect themselves by setting goals for the future.

For some participants, time alone outdoors provides opportunity to consider the spiritual and/or religious dimension of life. Reflective time, especially in nature, often enhances spiritual awareness and makes people feel closer to God. Further, it encourages their increased faith and trust in God. This often occurs through providing ample opportunities for prayer, meditation, fasting, Scripture-reading, journaling and reflection time.

[youtube https://www.youtube.com/watch?v=9TXBP1t2rUc&w=560&h=315]

Retreating to lead

As Thomas Carlyle has written, “In (solitary) silence, great things fashion themselves together.” Whether these escapes are called alone time, solitude or Solo, it seems clear that humans experience many benefits when they retreat from the “rat race” to a place apart and gather their thoughts in quietness.

In order to live and lead effectively, it is important to be intentional about taking the time for solitary reflection. Otherwise, gaps in schedules will always fill up, and even people with the best intentions may never fully realize the life-giving value of being alone.

Brad Daniel, Professor of Outdoor Education, Montreat College; Andrew Bobilya, Associate Professor and Program Director of Parks and Recreation Management, Western Carolina University, and Ken Kalisch, Associate Professor of Outdoor Education, Montreat College

This article was originally published on The Conversation.

Only 1 in 4 women who have been sexually harassed tell their employers. Here’s why they’re afraid – CWEB.com

Margaret E. Johnson, University of Baltimore

On May 30, a grand jury indicted Harvey Weinstein on charges he raped one woman and forced another to perform oral sex on him. And new allegations and lawsuits against the movie producer continue to pile up.

Since the earliest reports of his abuse came out in October, scores of women in Hollywood have taken to social media and shared their own stories of sexual assault and harassment by Weinstein. And thanks to the #MeToo movement, women in a range of professions have also found their voices heard, helping topple dozens of other once-powerful men in entertainment, media, sports, business, politics and the judiciary.

But a question #MeToo has been asking since the beginning is how will this affect the lives of women far from the high-powered worlds of Hollywood and Washington. Is this making it any easier for a low or mid-wage worker in middle America to rid her workplace of a sexual harasser?

One important way of doing this is by making an official complaint to the employer. But while women will often complain to family or even on social media, most don’t tell their companies of the misconduct. In fact, barely 1 in 4 ever do.

How come?

Based on experience litigating sexual harassment cases as well as my research, I have determined there are three legal barriers that stand in the way of workers filing complaints — a critical step to rooting out harassment and protecting employees.

Few formally complain

About 30 percent of U.S. workers who experience sexual harassment informally talk about it with someone at the company, such as a manager or union representative, while far fewer lodge formal complaints, according to a 2016 Equal Employment Opportunity Commission report. In addition, 75 percent of those who do formally complain say they face retaliation.

This is one reason for the success of #MeToo. It’s providing the kind of effective sexual harassment complaint forum that employees do not believe they have in their workplace.

Besides a fear of reprisal, the EEOC report cites several other reasons why employees usually don’t come forward, such as concern that they won’t be believed or the company training manual didn’t explain how to properly identify or address sexual harassment.

This is a big problem because if employees who have been sexually harassed don’t file formal complaints with their companies — without suffering retaliation — it is nearly impossible for employers to take action against the harasser or protect the worker. Furthermore, it becomes hard to hold an employer legally responsible if it fails to do either.

So while it’s positive that more women are sharing their own stories on social media and elsewhere, it can’t replace the formal employee complaint process.

Three barriers

Courts have erected three legal hurdles that discourage employees from filing complaints about sexual harassment.

One barrier is that courts have too narrowly defined sexual harassment when it involves a hostile work environment under Title VII of the Civil Rights Act of 1964. It’s only deemed illegal when it involves unwelcome sexual conduct sufficiently “severe or pervasive” to alter the employee’s employment conditions.

Employees often don’t complain because they fear they won’t be believed that the harassment was sufficiently “severe or pervasive” enough to be legally actionable.

And who can blame them. One court found that a manager rubbing the shoulders, back and hand of an employee, accusing her of not wanting to be “one of my girls” while physically grabbing her, calling her “baby doll” and telling her she should be in bed with him were not sufficiently “severe or pervasive.”

These actions can be harmful and place women as subordinate in the workplace and, unregulated, lead to even more harmful actions. As such, I believe courts need to stop finding such misconduct as “ordinary” or “de minimus” — a legal term meaning too trivial or minor to merit consideration.

Another hurdle is that employers have been largely shielded from liability when an employee complains of a hostile work environment that fosters sexual harassment. That’s because in 1998 the U.S. Supreme Court gave employers a powerful defense in such cases.

Specifically, if a company “exercised reasonable care to prevent and promptly correct any sexually harassing behavior” and the employee “unreasonably failed to take advantage of any preventive or corrective opportunities,” the employer would not be liable even though the worker was, in fact, sexually harassed.

Under this defense, courts have found that if an employer has an anti-sexual harassment policy, and the employee doesn’t complain, the employer generally won’t be found liable. This sounds reasonable, right?

Unfortunately, some employer policies meet the bare legal requirements while doing little to eradicate sexual harassment or encourage complaints by workers. And without effective training about sexual harassment and how to complain about it, employers’ policies stating “zero tolerance” for sexual harassment are meaningless.

Finally, I believe the laws punishing retaliation are not strong enough.

Taking sexual harassment seriously means employers should not fire, demote or ostracize a worker who complains about sexual harassment as they often do. And while the law on the books purportedly protects complainants, courts have told workers that the protection is only for those who reasonably believe they were illegally sexually harassed.

This puts women back in the gray area of determining what is “severe or pervasive.” As I noted above, a manager rubbed an employee’s body, called her “baby doll” and expressed a desire to have sex with her. If that’s not deemed to be sexual harassment, how can employees complain with confidence that they will be protected?

It’s time to toughen laws

What can be done about this?

The good news is that Congress is already considering changes to sexual harassment law.

For example, Sens. Kirsten Gillibrand and Lindsey Graham have introduced a bill to permit sexually harassed workers to litigate their cases in open court rather than be bound by private arbitration. The laudatory bill would prevent employers from keeping harassment or harassers secret from other workers.

But I believe lawmakers should go further by amending Title VII to expand and clarify what sexual harassment really is beyond “severe or pervasive,” strengthen worker protections against retaliation and require employers to create more effective policies and training.

[youtube https://www.youtube.com/watch?v=9TXBP1t2rUc&w=560&h=315]

The EEOC and other researchers have identified innovative methods to address sexual harassment, such as a reward system for increased complaints, promoting more women, bystander intervention and civility training. Congress should pay attention and encourage these methods while also toughening existing law.

Inspired by #MeToo, Congress could help eradicate sexual harassment.

Margaret E. Johnson, Professor of Law and Co-Director, Center on Applied Feminism, University of Baltimore

This article was originally published on The Conversation.

22% of men without college degrees don’t have jobs. Here’s why they’re being left behind – CWEB.com

Erin Wolcott, Middlebury College

The unemployment rate has plunged to about the lowest level in half a century. Yet at least one group of Americans is being left behind: men who didn’t go to college.

Just 78 percent of men aged 25-54 who never went to college were employed in 2016, the latest year for which data are available in the American Community Survey. That contrasts with about 90 percent for those who have at least one year of college and is a big change from the 1950s, when employment rates for college and non-college men were the same.

What’s driving the employment gap, which has been with us for decades?

Economists have traditionally pointed the finger at what are known as demand-side factors, such as jobs moving out of the U.S. or robots. More recently, economists have been blaming the supply side, such as growing welfare payments and better video games that glue more men to their couches.

Supply side just means that the explanation has to do with the individual — the supplier of labor – as opposed to something related to a company — the demand.

My research attempts to get to the bottom of why non-college men aren’t working in hopes that it can suggest the right solutions to turn this around.

Employment vs. unemployment

One of the most important measures of an economy is the number of jobs it’s creating, typically measured by the unemployment rate. The latest jobs report, which came out on June 1, showed that the rate dipped to 3.8 percent in May, the lowest since 2000. If it falls any more, it’ll be the lowest since 1969.

But the unemployment rate doesn’t tell the full story because it only includes people actively looking for work. People who report not having looked for work in the previous four weeks are completely left out of this number. The employment rate, which is the share who are actually employed, captures the full picture.

And the numbers are stark. Back in the 1950s, there was no education-based gap in employment. About 90 percent of men aged 25-54 — regardless of whether they went to college — were employed. That began to change in the 70s and 80s as non-college men left the workforce.

The Great Recession was particularly painful for men without any college. By 2010, only 74 percent had a job, compared with 87 percent of those with a year or more of college.

In other words, employment rates diverged over 10 percentage points in just half a century.

The gap extends to the wages of those who actually had jobs as well. As recently as 1980, real hourly wages for the two groups were nearly identical at about US$13. In 2015, men with at least a little college saw their wages soar 65 percent to over $22 an hour. Meanwhile, pay for those who never attended plunged by almost half to less than $8.

Modeling the economy

In fact, wages reveal the answer to this puzzle.

In my analysis, which I’m planning to publish, I wanted to determine whether the widening employment rate gap was caused by factors related to the supply of workers – video games and welfare – or demand – trade and robots.

So I built and calibrated an economic model aimed at finding the answer. Just as an architect builds a model city to test out ideas, economists build model economies out of math. Models allow architects and economists alike to push aside the gory details of reality and cut to the gist of things.

They also allow us to run experiments on what would otherwise be untestable hypotheses. An architect might ask: If I build a balcony, will that compromise the building’s structural integrity? I asked: If the only things that changed since the 1970s were supply-side factors, what would have happened to employment rates?

To answer this question, I plugged employment, wage and other relevant data into my model so that it replicates the real world. I then ran different analyses on the model to try to learn things, such as the underlying causes of the fall in employment for non-college men.

The intuition is like this: If a significant part of the reason non-college men dropped out of the workforce was because of supply-side factors that allowed them to remain home yet still afford their lifestyles, companies would have had to pay them more to entice them to join the labor market. On the other hand, demand-side factors would have put downward pressure on wages.

That’s exactly what my model helped me identify, suggesting that all the blame goes to demand-side factors like trade and automation, not video games.

An important caveat with my analysis – and economic research in general – is that our models are not reality. Economists have to make tough judgment calls in hopes of approximating reality and teasing out underlying truths that are otherwise difficult to ascertain.

Work wanted

All the same, I think my work reveals some important truths.

While it is true that many non-college men are home playing video games, collecting welfare payments and, unfortunately, addicted to opioids, it’s by and large not because they are choosing these over a job. Rather, sadly, it’s because they couldn’t find a job in the first place.

The takeaway is if the government wants to get more of these men back into the workforce, it should focus on stimulating demand or helping people learn new skills.

Even though we know what the problem is, we still have a lot of work ahead to solve it and get these men back into the workforce.

Erin Wolcott, Assistant Professor of Economics, Middlebury College

This article was originally published on The Conversation.

[youtube https://www.youtube.com/watch?v=9TXBP1t2rUc&w=560&h=315]

Why Neovasc Inc Is A Very Dangerous Stock — CWEB.Com

Neovasc Inc (NASDAQ, TSX: NVCN) a specialty medical device company, develops, manufactures, and markets cardiovascular devices worldwide. Its products include the Tiara technology for the transcatheter treatment of mitral valve disease; and the Neovasc Reducer for the treatment of refractory angina. The company also provides Peripatch tissue products. The company was formerly known as Medical Ventures Corp. and changed its name to Neovasc Inc. in July 2008.

Legal actions are still not settled and may impede future cash flows.

Projections of net income losses bring into question liquidity problems.

Industry competitiveness and consolidation will bring on a new set of challenges.

“Remaining on the Nasdaq Capital Market (“Nasdaq”) is a critical piece of the Company’s turnaround strategy,” commented Fred Colen , Neovasc’s President and Chief Executive Officer. “Without reaching a minimum bid price above US$1.00 for a minimum of 10 consecutive days before July 2, 2018

Consequences of a failure to effect a reverse stock split and remain on the Nasdaq
Management believes a failure to approve a reverse stock split and remain on the Nasdaq could have a material adverse effect on the Company and its stakeholders for several reasons, including the following:

• Liquidity in the trading of common shares of the Company (the “Common Shares”) will be significantly reduced, as the Nasdaq is the Company’s primary trading market, thereby putting downward pressure on the share price of the Common Shares.
• It will be more difficult for the Company to raise additional capital on reasonable terms from the majority of U.S. based institutional funds that require or want the Company to be listed on a major U.S. exchange in order to make an investment.
• The Company’s US$28,575,000 aggregate amount of outstanding senior secured convertible notes (the “Notes”) require the Company to be listed on the Nasdaq or a similar major U.S. exchange. Should the Company default on this requirement, the interest payable on the Notes will jump from 0% to 15% per annum, and holders of the Notes will receive a redemption right with a premium of 118% multiplied by the greatest closing price of the Common Shares during the period commencing on the date of delisting until the date such redemption payment is made.

Revenues decreased 77% to $339,922 for the three months ended March 31, 2018, compared to revenues of $1,481,360 for the same period in 2017. In December 2017, the Company closed its contract manufacturing and consulting services business and is now focused on the commercialization of its own product, the Reducer.

Selling expenses for the three months ended March 31, 2018 were $286,938, compared to $187,168 for the same period in 2017, representing an increase of $99,770, or 53%. The increase in selling expenses for the three months ended March 31, 2018 compared to the same period in 2017 reflects an increase in costs incurred for commercialization activities related to the Reducer.

The other loss for the three months ended March 31, 2018 was $48,324,003 compared to income of $28,299 for the same period in 2017, an increase in other loss of $48,352,302. The increase in the other loss can be substantially explained by the accounting treatment of the November 2017 financings, which resulted in a $49,277,477 increase in net loss between the periods.

Neovasc finances its operations and capital expenditures with cash generated from operations and equity and debt financings. As at March 31, 2018, the Company had cash and cash equivalents of $12,261,559 compared to cash and cash equivalents of $17,507,157 as at December 31, 2017. The Company will require significant additional financing in order to continue to operate its business. Given the current nature of the Company’s capital structure, there can be no assurance that such financing will be available on favorable terms, or at all.

The Company is in a negative working capital position of $1,275,879, with current assets of $14,036,460 and current liabilities of $15,312,339.

Neovasc holds several negative signals and is within a very wide and falling trend, so we believe it will still perform weakly in the next couple of months or a year. We therefore hold a negative evaluation of this stock.

CWEB Analyst’s have initiated a Sell Rating for  Neovasc Inc (NASDAQ, TSX: NVCN)    

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The rise and fall of Theranos: so many lessons in a drop of blood – CWEB.com

Norman A. Paradis, Dartmouth College

The last few months have witnessed the unraveling of the remarkable life sciences company Theranos, culminating in the latest news that federal regulators may ban founder Elizabeth Holmes from the blood-testing industry for at least two years. The company is also facing a federal criminal investigation into whether it misled investors about its technology and company operations.

How has this widely acclaimed biomedical innovator fallen so far, so fast?

Theranos’ revolutionary claim that won over investors was that it could accurately run tests using a small amount of blood taken from a poke in the patient’s finger, instead of a syringe full from a needle stuck in a vein. The idea was that dozens of tests, such as cholesterol and thyroid hormone levels, could be run on a single, tiny blood sample.

Theranos has had medical laboratory experts — including me — scratching their heads for some time. Having worked quite a bit in development of innovative medical tests, I knew what the company was promising just didn’t make a lot of sense.

Theranos’ much-hyped blood-testing technology

Theranos wowed investors, journalists and even groups like the Cleveland Clinic and Walgreens with what you might call an “iMedicine” vision of blood testing.

Basically, the idea was this. A few drops of blood from a fingertip are collected into a “nanotainer” collection tube and analyzed on the company’s proprietary machine, named after famed inventor Thomas Edison. How exactly the Edison devices work is unknown. But the claim was that many — possibly dozens — of tests could be run on those few drops of blood.

From a clinical perspective, this was always concerning, as such a shotgun approach to medical testing is actually very bad medicine. It is well-known that running numerous tests without symptoms or signs of disease invariably leads to false positive results.

Questions about the company’s technology came to a head in October. The Wall Street Journal alleged that Theranos might actually be performing the majority of its tests using traditional machines, the kind already in use in labs across the country, instead of its own much touted Edison devices. And then the FDA called the nanotainer an “uncleared medical device.” The company stopped using its signature collection tube, except in the single test that had been cleared by the FDA.

And, by the way, a machine capable of measuring many molecules on a drop of blood might seem like a breakthrough, unless you are someone familiar enough with life sciences technology to know that such capability has been invented numerous times. For instance, in my laboratory, we have a small handheld analyzer called an I-STAT. It can do 25 different tests on very small amounts of blood. It was developed more than 20 years ago and is commonplace today.

Blood from a finger isn’t same as blood from a vein

Let’s leave the technical issues aside for a moment and focus on those drops of blood from a fingertip.

The vast majority of FDA-approved medically important laboratory tests are based on blood taken from a vein, not from the finger. In fact, the package inserts for medical tests cleared by the FDA say something like “blood should be collected using standard venous blood collection techniques.”

To understand why that matters, let’s start with some simple physiology. The human body can be considered a series of compartments; the concentration of any given molecule in blood or tissue fluid may vary from one compartment to the next.

A small molecule, such as glucose, can move easily between these compartments, and any bodily fluid can generally be used to test its concentration. This is why testing blood sugar with a finger prick works.

But large, medically important molecules like proteins and lipids are not always found in uniform concentrations throughout the body. The composition of blood from finger pricks from the same person can vary, a problem that doesn’t happen in blood taken from a vein.

When you lance a fingertip, you get both blood and tissue fluid, and this means that the concentration of molecules may be different than if the blood sample comes from a vein.

The point is that blood taken from a finger would be considered another bodily fluid by the FDA, and any tests using finger prick blood would need to cleared by the FDA. According to news reports, at one time Theranos was seeking FDA clearances for as many as 120 tests. Even if its technology actually works, hundreds of FDA clearances would have required hundreds of clinical trials, a process that would have taken years to complete.

Theranos has gotten only one test cleared by the FDA. That test — for Herpes infection — is for the detection of antibodies, not a measurement of their concentration. Tests for the presence or absence of a molecule are much simpler than those that quantify its concentration.

In March, researchers at the Mount Sinai School of Medicine published a secret shopper study comparing Theranos to Quest and LabCorp, two major medical testing companies. Overall, more of the results from Theranos were outside the normal range, indicating a need for further medical testing. This is a worrisome result because the secret shoppers were healthy adults. But it’s also difficult to interpret because we don’t know if Theranos used its Edison machines or ran diluted samples on conventional analyzers.

Millions invested without any proof?

Why didn’t investors and journalists dig more deeply, such as by demanding a head-to-head comparison of Theranos’ Edison machine to standard chemistry analyzers?

Part of the problem seems to have been the secrecy surrounding these types of startups. Theranos always asserted that it had to operate in “stealth mode” to protect its lead in breakthrough technology, which means that there was literally no peer-reviewed information out there about its technology.

But the leading explanation seems to be that they were enthralled by the company’s charismatic young founder. Laudatory magazine cover articles about Holmes have been so numerous that the phenomenon has itself been a topic of discussion.

Theranos’ board of directors also lacked anyone with expertise in laboratory testing or medical diagnostics. This should have been a warning sign.

Show me the data

Just a few weeks before regulators proposed banning Holmes and Theranos President Sunny Balwani from the blood-testing industry, the company tried to remedy this by bulking up its medical advisor board with well-qualified experts in chemistry, pathology and clinical chemistry.

It’s hard to imagine these experts would have signed on amid all the bad publicity and allegations without demanding proof that the technology works, but who knows?

[youtube https://www.youtube.com/watch?v=9TXBP1t2rUc&w=560&h=315]

It still remains possible that Theranos has discovered a breakthrough technology that can do hundreds of lab tests on a drop of fluid from a patient’s finger. But even if this increasingly unlikely prospect is a reality, Holmes’ erstwhile acolytes need to remember the lessons learned from the pantheon of past pied pipers and summed up by statistician W. Edwards Deming:

In God we trust; all others must bring data.

Norman A. Paradis, Professor of Medicine, Dartmouth College

This article was originally published on The Conversation.

Eating disorders are hard to overcome, but ditching diets is crucial – CWEB.com

Catherine Gillespie, Drake University

Eating disorders affect at least 30 million Americans and have the highest mortality rates of any mental disorder. Those who survive eating disorders often have a long, difficult journey ahead of them.

Eating disorders are classified as mental illnesses characterized by severe disruptions in eating behaviors. In our diet-focused culture, many people may not realize that eating disorders still take a huge toll. Toward the goal of raising awareness and providing help to those who struggle, June 2, 2018 has been recognized as World Eating Disorder Action Day.

As someone who has conducted extensive research and writing in the field of eating disorder recovery, and who has ongoing personal experience in eating disorder recovery, I have found that although full recovery from an eating disorder is possible, it can take time and often requires much action. There can be many causes of eating disorders, including genetics, personality, trauma, or often a combination of causes. But by the time a person gets diagnosed by a doctor or therapist, the immediate causes are less relevant than how to recover. Consistent healthy habits are helpful in the recovery process.

Ditch the diet

The most important action that a person can take to recover from eating disorders is to stop dieting. Weight loss dieting is the number one cause of eating disorders, binge eating, body dissatisfaction and low self-esteem. In contrast, weight-neutral self-care approaches — that is, focusing on maintaining one’s current weight — have been found to assist in eating disorder recovery.

But ditching the diet is only the first step. It is necessary to investigate and address factors that maintain eating disorders.

Let go of safety behaviors

Many people in partial recovery from eating disorders still rely on behaviors that help them feel safe, or less anxious, about their weight or appearance. These so-called safety behaviors can vary but might include monitoring food intake, monitoring weight, double-checking nutritional values, being very careful about food ingredients, and avoiding eating in social situations.

The short-term anxiety-reducing benefits of safety behaviors are part of what makes them so hard to eliminate. Unfortunately, safety behaviors create a distraction and leave the eating disorder itself unchallenged.

In order to stop engaging in the safety behaviors that serve to maintain eating disorders, it is important to find alternate ways of thinking and acting around food, eating, body and weight. Strategies to reach full eating disorder recovery include letting go of safety behaviors and engaging in more self-trust and self-care.

Self-weighing is a safety behavior that maintains the overvaluation of weight, which is part of the American Psychiatric Association’s definition of eating disorders. Continued concern with weight or shape at the end of treatment has been found to be a strong predictor of relapse back into an eating disorder. A powerful strategy to reduce overvaluation of weight is to consider a personal 30-day “no weigh” experiment.

Other safety behaviors that aim at gaining information about one’s shape or size — such as mirror checking, pinching the fat on one’s torso, feeling muscles or bone, engaging in social size comparison, and seeking reassurance from others about one’s body — all have to be considered for elimination. Each one of these examples can be a safety behavior that serves to maintain undue concern with one’s weight and shape, and in turn, keeps the eating disorder alive.

Practice self-trust

Practicing self-trust around eating means giving oneself unconditional permission to eat when hungry, whatever foods are desired, in the amount desired. Research has shown that unconditional permission to eat is the exact opposite of an eating disorder. It can be anxiety-producing to give oneself unconditional permission to eat, but it turns out that any kind of food rules, including limits on when, what and how much to eat, led research participants to be more preoccupied with food. Food rules prompted participants to have a much higher tendency to overindulge, especially when they broke one of their food rules. On the other hand, research participants who allowed themselves to eat when hungry and to choose foods and amounts they desired had a lower tendency to overindulge or engage in binge eating.

Trusting one’s body to direct eating choices is one aspect of self-trust. Self-trust also extends to many other self-care practices.

Engage in self-care

A person’s individual relationship with their own body is the “doorway to pathology”, meaning if that relationship is not a positive one, a person is at risk of developing an eating disorder. In order to fully recover from an eating disorder, this doorway must be filled with positive self-care practices. People in recovery can learn to engage in self-care practices that do not contain any elements of self-harm.

Overindulgence in food contains both elements of self-care and self-harm. Self-care involves tuning in and listening to body signals and responding in helpful ways. For instance, being “tired” could elicit telling yourself to “rest a bit” or “turn off the light and go to sleep now.” The feeling of being “very uncomfortable” could signal it’s “time to change this situation,” and the feeling of being “overwhelmed” could mean it’s “time to take a break” or “time to make a list,” depending on the situation.

These responses are all dependent on the assumption of self-trust. One has to trust that the body does not lie. Our bodies tell us what we need to know and responding to their messages can help us to fully recover from eating disorders

Take some risks

It can feel scary to let go of safety behaviors and to replace them with self-care based on self-trust. Change is inherently risky. But for positive change to occur, it is necessary to take some risks. And it is worth it, because full recovery involves more than just letting go of eating disorder and safety behaviors. It also involves feeling better about oneself.

[youtube https://www.youtube.com/watch?v=9TXBP1t2rUc&w=560&h=315]

Research participants who had reached full eating disorder recovery had positive self-concepts. Those who were fully recovered from eating disorders showed higher levels of self-esteem, self-efficacy, or a person’s belief in his or her ability to succeed at a task, and self-directedness than those who were not in recovery or those who were in partial recovery. Another research study showed that the more positive ways that participants were able to think about themselves, the less likely they were to drop out of eating disorder treatment.

Taking risks to trust one’s body and to engage in responsive self-care are almost guaranteed to lead to an improved self-concept. Taking these risks can be anxiety-producing in the short run but worth it, to reach full eating disorder recovery.

Catherine Gillespie, Associate Dean, School of Education, Drake University

This article was originally published on The Conversation.

What’s at stake in the tariff negotiations between the US and China – CWEB.com

Yixiao Zhou, Curtin University and Rod Tyers, University of Western Australia

The United States and China have put on hold plans to place tariffs on exports, in an effort to avoid a trade war. Our analysis shows just how important these negotiations are, with the impact of trade wars adversely affecting both economies and others like Australia.

The threat of a trade war started when US President Donald Trump announced 25% tariffs on Chinese imported electronics, aerospace products, and machinery. China retaliated hours later and announced 25% tariffs on US exports to China.

Read more:
The China-U.S. conflict is about much more than trade

Now both sides are agreeing to take “measures to substantially reduce the United States trade deficit in goods with China” and to work on expanding trade and protecting intellectual property.

We modelled a number of scenarios showing all increases in US or Chinese protection would cause international trade, and the global economy more generally, to shrink. We also find interest rates would rise everywhere and the Australian dollar would depreciate.

China and US trade would then fall by between a quarter and a third, depending on whether the tariffs are hiked unilaterally or bilaterally. Australia’s lucrative exports to China would also fall as US demand for China’s goods fall and China requires smaller quantities of Australian goods to produce them.

Because Australia is a small, open economy that is strongly influenced by developments abroad, the impacts of rising protectionism can be as large here as they are in the US and China.

We found if US imposed tariffs but there was no retaliation abroad, the rise in tariff revenue would provide relief for the US economy and that this would raise the after-tax incomes of Americans even though US GDP would fall. However, we found after-tax incomes would fall everywhere else.

If China retaliated to the tariffs, all countries and regions would suffer losses, with Australia’s net loss among the largest, in per capita terms. The effects on China would be the largest, relative to their current disposable income. Because China would suffer the largest proportional loss of welfare, their government would have the strongest incentive to negotiate.

We expect any initial effects of tariffs on both sides to be slight, in small part this is because it will cause trade to be diverted to and through other countries. Because trade is likely to leak around the new protectionist barriers, the US and China could choose to impose the protection on imports from all countries.

If this were the case global losses would be very much larger, and they would be borne primarily by third countries, including Europe and Australia.

One possible silver lining of this scenario for central banks would be inflation in the advanced economies like Australia, causing interest rates to rise. This would take pressure off the central banks, which have been struggling to prevent costly deflation.

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While the US President continues to bring up a trade deficit with China as a concern, most economists agree that trade imbalances depend most on differences in saving rates.

Read more:
Why China can’t meet Trump’s $200 billion trade demand

The US is threatened by the continuing rapid expansion of the Chinese economy and because US firms have to relinquish intellectual property in order to enter the large and growing Chinese market. The US also fears China’s move toward more sophisticated manufacturing and services under the “Made in China 2025” plan.

Whether or not China and the US are successful in negotiating out of a trade war and restoring the integrated global economy, there will still be strategic tensions between the nations. These will create political pressure for stronger trade interventions in the future and will place countries like Australia at risk of substantial economic losses.

Yixiao Zhou, Lecturer in Economics, Curtin University and Rod Tyers, Winthrop Professor of Economics, University of Western Australia

This article was originally published on The Conversation.

What’s behind Italy’s crisis and why it matters – CWEB.com

Bruno Pellegrino, University of California, Los Angeles

Editor’s note: Italy managed to form a government after briefly slipping into political crisis, which sent markets around the world into a panic as investors fretted about the fate of the European Union. The crisis began on May 27 when the political party that won the most seats in March elections initially failed to form a government.

Economist Bruno Pellegrino, who has previously written on Italy’s economy, explains what’s going on and why it matters.

1. What’s driving the political chaos?

The March 4 election dramatically tilted the balance of power in the country.

It was a true political earthquake: The Italian electorate resoundingly rejected the political establishment that has held power since the mid-90s in favor of populism, as happened in the 2016 U.S. presidential election. The biggest issues were growing concerns over the euro and immigration. That’s in part because Italy is a major hub for migrants from Africa, an issue that has been a major challenge for the EU.

Behind these problems, however, lies an economy that has barely grown in decades. A third of 20- to 34-year-olds are unemployed, and Italy’s debt is at over 130 percent of GDP, which is extraordinarily high.

The big winners of the election were the populist Five Star Movement and the nationalist Northern League. Neither party had previously held significant power. Five Star, which alone snared a third of the vote, has been in opposition since forming in 2009. And the anti-immigrant Northern League was mostly just a minority shareholder in the center-right coalition.

Although none of the three major coalitions managed to win an outright majority, Five Star and the Northern League were allowed to try to form a government. Italian president, Sergio Mattarella, has the power to reject cabinet appointees and opted to veto proposed Finance Minister Paolo Savona, prompting the crisis.

2. Why did Mattarella torpedo the would-be government?

Savona, a professor who called Italy’s adoption of the euro a “historic error,” is seen as sympathetic to the idea of leaving the common currency.

In explaining his veto decision, Mattarella argued such a move was not brought up during the electoral campaign. Moreover, the draft of a “government contract” between the Five Star Movement and the Northern League was leaked to the press. The document proposed canceling some of the Italian debt currently held by the European Central Bank, which shook financial markets because it’s basically telling banks and other lenders that they might not get their money back.

As a result, some commentators began sounding the alarm over a potential debt crisis for Italy — which would also reignite the sovereign debt crisis that has rattled Europe since 2008.

While I believe it was inopportune and extremely premature to talk about a debt crisis before the new government was even formed, that was enough to send the yield on Italian bonds skyrocketing to a four-year high.

Mattarella has come under a lot of fire for this decision, but it is probably unfair to blame him for trying to prevent a debt crisis. He found himself in a “damned if you do, damned if you don’t” type of situation.

3. What’s at stake?

The political situation basically pits democracy against debt.

The president denied the two parties that got the most votes a chance to lead on their own terms. At the same time, talk of leaving the euro and canceling debt puts Italy’s position as a reliable debtor into question, which could have severe repercussions.

Italy bond price developments in the final days of the talks clearly indicate that investors are uncomfortable holding Italy’s debt while a government is in power with an agenda of renegotiating Italy’s debt, leaving the euro or both. Hence, Italy faces the bleak dilemma of either becoming insolvent or giving up democratic representation. That’s the conundrum President Mattarella had to face.

To complicate things further, there are few safety nets available for Italy: It holds the most public debt in the eurozone — and the third-most in the world, behind the U.S. and Japan. If Italy finds itself unable to refinance its debt, a rescue would require a coordinated effort of the International Monetary Fund, the EU and possibly Europe’s central bank. That would probably come with harsh conditions.

4. What’s next?

Events are unfolding rapidly.

After the veto, Mattarella gave a former IMF official and euro-supporter a mandate to form a temporary government — which was resisted by virtually all political parties. But now leaders from Five Star and North League are again set to lead a coalition government, with the little-known lawyer and academic Giuseppe Conte at its helm, after backing down and agreeing to a more euro-friendly choice for the Finance Ministry.

The new government faces an extremely arduous task. Italy desperately needs a government that can devise an ambitious long-term strategy to tackle its large public debt, sluggish productivity growth and high youth unemployment.

Bruno Pellegrino, PhD Candidate in Business Economics, University of California, Los Angeles

This article was originally published on The Conversation.

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Teenage depression: If a parent doesn’t get treatment for a child, is that abuse? – CWEB.com

Michael Shapiro, University of Florida

Hospital visits for kids in the U.S. who have contemplated or thought about suicide have risen sharply.

As a child and adolescent psychiatrist, I am not surprised. For years, I ran a child psychiatric hospital, where we treat kids after they attempt suicide. Usually, by the time I diagnose a teenager with depression, it is almost too late. Almost. It’s estimated that one in five teens will have depression, but two-thirds of them will go undiagnosed.

Lack of screening for depression is one part of the problem in children’s mental health, and efforts are underway to improve screening and detection for depression. Access to care is another problem, as there is a severe shortage of child psychiatrists in our country. Parents may also not see symptoms of a mental health problem or not be aware of how severe the problem is, due to lack of knowledge or understanding of depression in children.

These are several barriers to treatment, which are unfortunate. However, one barrier that is rarely addressed is when parents ignore obvious signs of depression or just don’t want help. Studies have noted that between 12-26 percent of parents reported not wanting or needing help, or being unwilling to seek help for a child’s depression.

I authored a paper, published May 31, in which I ask: Would it be considered child abuse for a parent to not get medical help for their depressed teen?

A serious illness, often experienced in loneliness

In my experience, teens experience depression for much longer than their parents are aware. There are several reasons for this, including the stigma of mental illness, and teens not being forthcoming because they blame themselves for feeling depressed and don’t want to upset their parents.

In fact, feeling like things are your fault is one of the symptoms of depression. We are lucky if a teen tells their parent they are feeling depressed or a parent sees warning signs and brings their child for an evaluation, because the depression is likely far more severe than the parent realizes. Sometimes, we’re not as lucky.

In my experience, many children who attempt suicide never have been evaluated or treated for depression before. After a child attempts suicide and a parent starts to understand and learn about depression, most parents are willing to do anything to help their child. But in some cases, this doesn’t happen.

This is incredibly hurtful to teens who ask for treatment and the message they get is their suffering is not important enough to treat.

Depression is the deadliest disease of childhood

Depression and its worst risk, suicide, are serious and common problems in children and teens. Suicide is the second leading cause of death in U.S. teens, resulting in more deaths than from cancer or any other disease or illness.

In addition to deaths by suicide, depression can cause progressively worsening brain changes, according to new research. And yet, even after a trained mental health professional diagnoses a child with depression, some parents refuse treatment. This can occur despite these teens wanting and asking for treatment.

Some do not want their children to take antidepressants. Antidepressants carry the FDA black-box label warning on thoughts of suicide in young people. But the consensus in the field is that benefits outweigh risks with careful monitoring. Also, a recent study reported the clinical trials used to form the FDA black-box warning excluded patients who were already at “significant risk of suicide,” which means this risk-benefit analysis was formed without patients who were the most depressed and at the most risk. Evidence-based psychotherapy also treats depression, but some families don’t commit the time or resources to ensure their children have frequent appointments.

In most states, teens under 18 require a parent’s permission to receive treatment for depression. There are some exceptions, but in most cases, a child cannot get treatment on their own.

Mental health can be neglected

One possible way to overcome this is to view a deliberate lack of providing treatment for depression as a form of child abuse. The term “medical neglect” refers to a child being harmed due to a lack of medical care.

In the criteria outlined by the American Academy of Pediatrics, medical neglect occurs when parents understand the medical advice given, the recommended treatment would have significant benefit for the child’s health and be accessible by the family, and the parent or caregiver still denies or refuses treatment or access to care. Another way for neglect to occur is to ignore obvious signs of illness.

While these criteria are usually applied to chronic physical illnesses like HIV or asthma, it appears to be rarely applied to mental illnesses. If I told you that a teenager was hospitalized multiple times due to a chronic life-threatening illness, and that teenager’s parent refused to bring the child for doctor’s appointments or allow them to take medication for the illness, what would you think should be done?

My guess is if the illness was HIV, diabetes or asthma, the answer would be to ensure the child is allowed to take their medication and attend doctor’s appointments. But that was not the answer I got with one teen with depression and multiple suicide attempts.

The law in Florida, where I teach and practice, is that only when children reach age 18 years can they consent to treating their own depression with medication or with ongoing therapy. I was told this teen would have to “wait” until he or she reached 18 to get treatment since the parent was refusing.

Depression is hard to diagnose because it is not always obvious. Parents may not believe in an illness they don’t see.

The Practice Parameter for Treating Depression by the American Academy of Child and Adolescent Psychiatry (AACAP) acknowledges that families “may not wish to participate in psychotherapy or may object to taking any medications.” However, if these are the two evidence-based treatments being recommended and they are available, what are our options for ensuring these children receive appropriate care? Once a professional does make the diagnosis, and if severe enough, why are we allowed to let it go untreated?

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When we — children, parents and physicians — view depression like other illnesses, more people will be helped. We as physicians should be working to prevent neglect from occurring by talking to parents about depression and treatment, providing education and addressing their concerns.

Parents need to be educated that some illnesses still exist and cause suffering even if they can’t always see it. Parents should also know we physicians are not blaming them for their child’s illness, but they are responsible for getting their child appropriate treatment. If they don’t, I believe that is neglect.

Michael Shapiro, Associate Professor, Psychiatry, University of Florida

This article was originally published on The Conversation.

Groupon Still The King of Daily Deals – CWEB.com

By: Leslie Cohen
Managing Editor

Strong growth in platform initiatives raises full-year 2018 adjusted EBITDA outlook with a gross profit of $324.9 million. net loss from continuing operations of $2.8 million adjusted EBITDA of $52.6 million GAAP loss per diluted share of $0.01.

61.90% of Groupon Shares are owned by institutional investors. Strong institutional ownership indicates big money managers and hedge funds believe that a company is poised for long-term growth. The number of shares currently selling short amount to 8.6% of shares outstanding with an uptick of 3.23% last month. Groupon is down 6.08 this year, but Wall Street is bullish on the stock. Analysts coveringGroupon have a buy equivalent rating on the stock. Analysts are suggesting a 17-point percentage game recent close. Vanguard Group Inc., which owns 34,432,805 shares of the stock are valued at $159.77 million. The third largest holder is Alibaba Group Holding Ltd, which currently holds $152.99 million worth of Groupon’s stock.

Groupon’s (NASDAQ: GRPN) makes headway when it announced it will place strategic planning for local businesses. Groupon continues to add items to its menu to attract new customers and attract new ones.   You can order food from Grubhub within the Groupon App. Customers have access to GrubHub (NYSE: GRUB) full array of restaurants that offer fast and convenient food delivery. GrubHub is the nation’s leading online and mobile delivery marketplace for on-demand food delivery services.

In May 2018 Groupon acquired UK-based Cloud Savings Company, the parent company of online discount code platform Vouchercloud and Giftcloud,   the brand loyalty provider Gift Cloud   Enterprise is valued at 65 million dollars.

Vouchercloud is one of the United Kingdom’s voucher platforms.   Vouchercloud was the first of Europe’s discount deals app that was started in 2010. People have downloaded the app more than 10 million times. The website has   55 million annual visitors. 12,000 retailers discount campaigns are listed in their exchange. Giftcloud is a gifting app for consumers. It allows users to buy and use digital gift cards which provide businesses with digital rewards and loyalty solutions.

UPS has rolled out the My Choice Deals program for its 43 million-plus customers letting them access hundreds of deals from department stores and other vendors that participate in the program.   For example, if you’re receiving something from Macy’s you’ll receive an additional deal alert that lets you know that there’s another available deal for you at that store. The alerts are set up when you’re getting your tracking information in your account about your delivery.

Groupon is still the king of daily deals. The company continues to foray into acquisitions,   bringing more features and services for its huge customer base. CWEB has a   buy rating on the stock.