People are often confronted with feelings of disappointment, frustration and anger as they interact with government officials, co-workers, family and even fellow commuters to people just in society. Most can control their actions to the extent that relatively few of these interactions end in a radical action like being racist to violence.

What help build a individuals feelings to turn out in a negative result (like bullying someone to protesting to worse rioting to violence or killing) is factors.

Factors being:

1. YOUR CHILDHOOD UPBRINGING. Your childhood builds the foundation of how you turn out as an adult. If you have good upbringing where there are good morals, values, ethics with limitations or rules and regulations in what you can and cannot do with mommy and daddy overlooking from a distance in watching the child’s actions/interests/who they play with/what they’re doing on the computer or watching on T.V or even listening to music will help give direction for their child to be effective in society. Including, as the child shows good choices than more independence in getting older with still guidance and direction as needed. Remember your a young adult at 17 and a full fledged adult at 21 years of age to make all decisions in your life.
2. BEING AN ADULT.   This includes accepting the turn outs of how a situation finally results; before the final result if you did everything you could legally try to reach your hope of a turn out and did reach it great, it makes you a stronger person. Now let’s say you didn’t than acceptance is necessary of what the result turned out as which also makes you a stronger person with being an asset in the community. Than your next step whether it be alone or in society overall move on without being an insult to the community where it effects the society in a negative way (like killing 2 innocent police officers just for wearing the color blue in uniform, prejudice=a radical action).   Being able to allow acceptance in your life which doesn’t always turn out the way you want it to helps you move on in life making you less out to be radical in your behavior. Take the riots (which they call protesting a radical approach from Missouri to New York) and see what their results turned out to be. Stopping people from getting to a destination point who had nothing to do with what the protestors were protesting about, to damage of property of innocent people’s business to the worse DEATH. Like this radical move did anything productive for humans in society. It obviously didn’t.

First let’s look at what turns anger into action? The answer to this is mostly cognitive control or to use a less technical term, self-control.   University of Michigan professor of social psychology, Richard Nisbett, the world’s greatest authority on intelligence, plainly said that he’d rather have his son being high in self-control than intelligence, one year ago. Self-control is the key to a well-functioning life, because our brain makes us easily [susceptible] to all sorts of influences. Watching a movie showing violent acts predisposes us to act violently. Even just listening to violent rhetoric makes us prone or more inclined to be violent. Ironically, the same mirror neurons that make us empathic make us also very vulnerable to all sorts of influences. This is why control mechanisms are so important. If you think about it, there must be control mechanisms for mirror neurons. Mirror neurons are cells that fire when you grab a cup of coffee (to give you an example) as well as when you see someone else grabbing a cup of coffee. So, how come you don’t imitate all the time? The idea is that there are systems in the brain that help us by imitating only “internally”—they dampen the activity of mirror neurons when we simply watch, so that we can still have the sort of “inner imitation” that allows us to empathize with others, without any overt imitation. The key issue is the balance of power between these control mechanisms that we call top-down—because they are all like executives that control from the top down to the employees—and bottom-up mechanisms, in the opposite direction, like mirror neurons. This is whereby perception—watching somebody making an action—influences decisions—making the same action ourselves.

Neuroscience uncovered why people behave so violently looking into the Virginia Tech Massacre in 2007 with many other like incidents also which were still a small percentage of people. What happens in these individuals is that their cognitive control mechanisms are deranged. Mind you, these individuals are not out-of-control, enraged people. They just use their cognitive control mechanisms in the service of a disturbed goal. There are probably a multitude of factors at play here. The subject is exposed to influences that lead him or her to violent acts—including, unfortunately, not only the violent political rhetoric but also the media coverage of similar acts, as we are doing here. A variety of issues, especially mental health problems that lead to social isolation, lead the subject to a mental state that alters his or her ability to exercise cognitive control in a healthy manner. Again also childhood plays a big role.   The cognitive control capacities of the subject get somewhat redirected—we don’t quite understand how—toward goals and activities that are violent in a very specific way. Not the violent outburst of somebody who has “lost it” in a bar, punching people right and left. The violence is channeled in a very specific plan, with a very specific target—generally fed by the media (like take the protesting that has gone on from Missouri to New York for a month or more with media showing every news flash each day)through some sort of rhetoric, political or otherwise—with very specific tools, in the Giffords case, a 9-millimeter Glock.

Now lets look at what are the signs of a person who is disturbed enough to take some form of action to killing.   The signs are quite visible, although difficult to interpret without a context—and unfortunately they unfold very quickly , and people can rarely witness them before the action is taken (which happened with Brinsley in New York killing officers in Brooklyn on duty just doing their job), . The action itself is a sign, a desperate form of communication from a disturbed individual (Brinsley did put on the internet a warning the day it was going to be done, Sat 12/20/14. Unfortunately, nobody was chatting with the guy when he left his final messages on Internet before getting into action. But I bet that if somebody was communicating with him before the act and saw those signs and read those messages on social network he was using, that person could have done something, could have engaged him in a sort of conversation that might have redirected his deranged plans. Indeed, by connecting with the subject, that person might have redirected some of the activity of mirror neurons toward a truly empathic behavior, rather than in the service of the deranged imitative violence leading to action.

My readers I could go on with more examples of people killing but I am sure you listen to the news or read it somehow but I tell you this information not to persecute a person, not even a race or politician but to LEARN HOW THE BRAIN WORKS.   Most importantly to PARENTS bring your children up AS A CHILD not as an adult until they reach adulthood with giving good direction and guidance as their primary mentor. You the parents make our next generation who are now children and even for future parents learn so they will have a more productive working society. For now the society in America works as a   nonproductive unit of people to all races, creeds, genders, sex preferences, & nationalities of all kinds. Especially in being compared to the 1980’s; yes they had their problems but not like today’s with people treating each other with more respect even if things didn’t go their way. Our nation went off the deep end in allowing us to have freedom of everything without limitations or better rules/regulations legally in place not followed which we are paying a good price for and will take a very long time to fix. Remember when someone or now a group of people get hurt you can forgive but healing is like a wound it takes time to heal. Example: Look at Hitler, people still haven’t forgiven him, those that did have not forgotten it and they shouldn’t. Protesting can be effective where its peaceful, quiet, and not bothering other people in the area who aren’t involved. Look at Missouri and New York City this past 6 months, MUCH DAMAGE due to not thinking first but acting out first.

“About 6 of every 10 (or 60%) of men and 5 of every 10 (or 50%) of women experience at least one trauma in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, disaster, or to witness death or injury.”

US Dept of Veteran Affairs

“PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes.”

National Institute of Mental Health (NIH)

In honor of all men and women who have served our country thank you!!

I have committed myself in caring for people as a RN over 28 years and for the commitment you have made in keeping the USA safe with any sacrifices you made from the bottom of my heart thank you!! I dedicate this article to all acting and retired veterans.

Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Many people who go through traumatic events have difficulty adjusting and coping for a while, but they don’t have PTSD — with time and good self-care, they usually get better. But if the symptoms get worse or last for months or even years and interfere with your functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

The Mayo clinic states you can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren’t sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

• Inherited mental health risks, such as an increased risk of anxiety and depression
• Life experiences, including the amount and severity of trauma you’ve gone through since early childhood
• Inherited aspects of your personality — often called your temperament
• The way your brain regulates the chemicals and hormones your body releases in response to stress.
• Posttraumatic stress disorder, or PTSD, can occur after someone goes through, sees, or learns about a traumatic event like:                                                                                                                                                          *• Combat exposure • Child sexual or physical abuse • Terrorist attack • Sexual/physical assault • Serious accident • Natural disaster, which can occur during areas of war or not.
• Most people have some stress-related reactions after a traumatic event. If your reactions don’t go away over time and they disrupt your life, you may have PTSD. During a traumatic event, you think that your life or others’ lives are in danger. You may feel afraid or feel that you have no control over what is happening around you. Most people have some stress-related reactions after a traumatic event; but, not everyone gets PTSD.
• If your reactions don’t go away over time and they disrupt your life, you may have PTSD.  What factors take impact on determining if you have PTSD. *                                                                                                -How intense the trauma was or how long it lasted*                                                                                               -If you were injured, lost a body part or lost someone important to you*                                                         -How close you were to the event*                                                                                                                          -How much help and support you got after the event* *                                                                                                                                                                                     PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.
• There are four types:
• What are the symptoms of PTSD?
• Whether or not you get PTSD depends on many things:
• Most people who go through a trauma have some symptoms at the beginning. Only some will develop PTSD over time. It isn’t clear why some people develop PTSD and others don’t.

1. Reliving the event (also called re-experiencing symptoms)
2. You may have bad memories or nightmares. You even may feel like you’re going through the event again. This is called a flashback.
3. Avoiding situations that remind you of the event
4. You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.
5. Negative changes in beliefs and feelings
6. The way you think about yourself and others may change because of the trauma. You may feel fear, guilt, or shame. Or, you may not be interested in activities you used to enjoy. This is another way to avoid memories.
7. Feeling keyed up (also called hyperarousal) People with PTSD may also have other problems. These include:
8. What other problems do people with PTSD experience?
9. You may be jittery, or always alert and on the lookout for danger. Or, you may have trouble concentrating or sleeping. This is known as hyperarousal.

• -Feelings of hopelessness, shame, or despair
• -Depression or anxiety
• -Drinking or drug problems
• -Physical symptoms or chronic pain
• -Employment problems
• -Relationship problems, including divorceFor many Veterans, memories of their wartime experiences can still be upsetting long after they served in combat. If you are an older Veteran, you may have served many years ago, but your military experience can still affect your life today.
• COMMON SIGNS AND SYMPTOMS OF PTSD: Anger and irritability, guilt, shame, or self-blame, substance abuse, feelings of mistrust and betrayal, depression and hopelessness, suicidal thoughts and feelings, feeling alienated and alone, & physical aches and pains.
• Common symptom patterns:
•                                                                                                                                                                             *Some Veterans begin to have PTSD symptoms soon after they return from war. These symptoms may last until older age. Other Veterans don’t have PTSD symptoms until later in life. *                                                                                                                                                                              *For some Veterans, PTSD symptoms can be high right after their war experience, go down over the years, and then worsen again later in life. *                                                                                                                                                                                   *Many older Veterans have functioned well since their military experience. Then later in life, they begin to think more or become more emotional about their wartime experience. As you age, it is normal to look back over your life and try to make sense of your experiences. For Veterans this process can trigger Late-Onset Stress Symptomatology (LOSS). The symptoms of LOSS are similar to symptoms of PTSD. With LOSS, though, Veterans might have fewer symptoms, less severe symptoms, or begin having symptoms later in life. *                                                                                                                                                                                       *The wars in Afghanistan and Iraq are the longest combat operations since Vietnam. Many stressors face these Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) troops. OEF/OIF service members are at risk for death or injury. They may see others hurt or killed. They may have to kill or wound others. They are on alert around the clock. These and other factors can increase their chances of having PTSD or other mental health problems. *                                                                                                                                                                                          For many service members, being away from home for long periods of time can cause problems at home or work. These problems can add to the stress. This may be even more so for National Guard and Reserve troops who had not expected to be away for so long. Almost half of those who have served in the current wars have been Guard and Reservists. Another cause of stress in Iraq and Afghanistan is military sexual trauma (MST). This is sexual assault or repeated, threatening sexual harassment that occurs in the military. It can happen to men and women. MST can occur during peacetime, training, or war.                                                                                                                                                                                                                            *MST-Military Sexual Trauma is the term used by the Department of Veterans Affairs (VA) to refer to experiences of sexual assault or repeated, threatening sexual harassment that a Veteran experienced during his or her military service.
• In many cases, treatments for PTSD will also help these other problems, because they are often related. The coping skills you learn in treatment can work for PTSD and these related problems.

Stayed tune for Part II this weekend on PTSD.

Children with Williams syndrome are extremely sensitive to sound and may overreact to unusually loud or high-pitched sounds (hyperacusis). Chronic middle ear infections (otitis media) are often present.

National Organization of Rare Disorders

“A study just published by Clinicians on patients in the West Midlands who travelled overseas to receive Living Donor transplants has found that clinical outcomes are often poor. Over 30% of the patients in the study who travelled either died within three months (17%) or lost their new kidney within a year(14%).”

National Kidney Federation

“Atrial fibrillation, or AFib, is the most common type of arrhythmia.
It is a major cause of stroke, especially in the elderly. Although the causes are diverse, hypertension is common.”

AHA (American Heart Association)

Atrial Fib with Rapid Ventricular Rate

Working of the heart:

To easily identify atrial fibrillation with RVR, it is vital to understand the working of the heart. The atrium or atria (plural) is the upper chamber of the heart, bigger in size compared to the lower chambers known as the ventricles. The atria function by gathering blood as it flows into the heart and shrinking to forward the blood into the ventricles. At the very moment, the smaller ventricle must shrink to forward the blood to all parts of the body. This rhythm of blood flow creates a heart signature voice referred to as the Sinus rhythm. It is important that the sinus rhythm is synchronized so that the atrium does not send blood into the ventricle out of cue. To achieve this, an electric signal is generated to ensure the atrium contracts. When this signal short circuits (bypasses) the atrium, atrial fibrillation with RVR occurs, and the atrium is seen to vibrate just like jelly on a flat surface.

Atrial fib with RVR refers to atrial fibrillation with rapid ventricular rate. Usually the heart is like clockwork, the top (collecting) chambers beat then the bottom (main pumping) chambers sense this and also beat, and so on, in a nice regular fashion just like a clock ticking second after second. Usually the heart beats at about 60-80 beats per minute.

In atrial fibrillation the top chamber basically goes crazy often firing off over 400 beats per minute! Atrial fibrillation with RVR (Rapid Ventricular Response) is a heart condition caused by irregular electrical activity that results in irregular contractions of the 2 top heart chambers fibrillating. This means the heart (atriums), shakes with a rapid tremulous movement or makes fine irregular twitching movements, generally referred to as fibrillating causing little control in the heart output of blood by the heart but the lower chambers called the ventricles take over.

These bottom chambers don’t allow all those impulses through but it does let every second or third one through. This can give a heart rate of 100-180 beats per minute at rest, still too many beats, known as Afib with RVR, leading to symptoms and problems with heart function. Afib does not necessarily lead to Afib with RVR however, Afib can be rate controlled, sometimes naturally, sometimes using medications and sometimes requiring procedures as discussed below.

In most people with AFib although symptoms can sometimes be unpleasant it is generally not harmful as long as the afib is controlled, meaning the heart in the afib rhythm with the pulse under 100. The main concern is stroke, but that can be treated with the use of blood thinning medications in people at risk. In Afib with RVR, basically the heart is beating too fast. Of course palpitations are the most common symptom. Other symptoms of AFib with RVR may include dizziness, lack of energy, exercise intolerance and shortness of breath. If Afib with RVR goes on for too long then this may result in heart failure and of course worsening of existing heart failure. Control of the heart rate in patients with Afib with RVR often causes these symptoms to improve, again meaning the HR is under 100 with the heart rhythm in afib.

A major indication of atrial fibrillation with RVR is a very rapid heartbeat rate, although some patients are known to have the condition without showing symptoms. Atrial fibrillation with RVR may occur when cardiac muscle cells overcome their intrinsic pacemaker’s signals and fire rapidly differently from their normal pattern spreading the abnormal activity to the ventricles. The rapid heart rate can strain the heart, developing a situation referred to as Tachycardia (meaning a pulse greater than 100). Atrial fibrillation with RVR can be detected from the various symptoms though it is important to remember that some patients have experienced the condition without symptoms.

Symptoms:

Some of the symptoms of this disease include heart palpitations (described as unnoticed skipped beats or skipped beats noticed from experienced dizziness or difficulty in breathing), shortness of breath when lying flat (orthopnea), shortness of breath (dyspnea after exertion) sudden onset of short breath during the night (also called paroxysmal nocturnal dyspnea) and gradual swelling of lower extremities. As a result of inadequate blood flow, some patients complain of light headedness and may feel like they are about to faint, a condition referred to as presyncope and may actually lose consciousness (syncope). Some patients experience respiratory distress that results in them appearing blue. A close examination of jugular veins usually reveals elevated pressure in some patients (jugular venous distention). When some patients are subjected to lung examinations, crackles and rales may be observed pointing to possible lung edema.

Importance of proper diagnosis:

A good diagnosis of the symptoms shown by patients is important to ascertain that the patient is suffering from atrial fibrillation with RVR.  This is because some forms or irregular and rapid heart rates, tachyarrhythmia, are dangerous and must be ruled out as they are life threatening – such as ventricular tachycardia. Some patients are usually placed on continuous cardio respiratory monitoring, but an electrocardiogram ECG is vital for correct diagnosis.

How is it diagnosed?

Simple, a typical 12 lead electrocardiogram (ECG). This test shows cardiac rhythms which atrial fibrillation is. Rhythms are made up of types of waves that the ECG shows which are P waves, QRS waves, T waves and U waves.

The QRS complexes should be narrow, to signify that they are being initiated by normal conduction of atrial electrical activity through the Intra-ventricular conduction system, or heart conduction system. Wide QRS complexes could point to ventricular tachycardia, although wide complexes may also be an indication of disease processes in the Intra-ventricular conduction system. The R-R internal will also likely be irregular. Meaning measuring from each R section of the QRS rhythm. It is also important to find out if there are triggering causes for the tachycardia which include dehydration, Hypovolemia – a decrease in blood volume, and more specifically decrease in blood plasma volume. You can go ahead to eliminate Acute coronary syndrome – which refers to any diseases that are directly attributed to the obstruction of coronary arteries.

WHAT IS THE TREATMENT:

A Shock

This is known as cardioversion and is used typically either when an immediate result is required or used when the Afib is of relatively recent onset or only intermittent, and so has more chance of staying in normal rhythm. In cardioversion a small shock is given using defibrillation pads. It is done under light anesthesia therefore it doesn’t hurt. The Afib may return however.

Rate Control Drugs

The biggest problem in Afib with RVR is too fast a heart rate. In a rhythm control strategy we use drugs such as beta-blockers to slow the heart rate down. These drugs typically will leave the patient in AF. For many people with AF it turns out that a rate control strategy is preferred as it is considered less risky than the rhythm control drugs used to get rid of the AF while being just as effective. In Afib with RVR rate control drugs can often slow the heart rate down fairly quickly and improve symptoms.

Rhythm Control Drugs

These medications are generally more powerful than the rate control drugs and attempt to convert the Afib back in to a normal rhythm. They are often given after a shock treatment to try and help the heart stay in normal rhythm. These drugs are also commonly used in hospitalized Afib with RVR patients. The problem with these drugs is that they may have side effects and associated risks. Many patients simply cannot tolerate Afib even if the rate is controlled and therefore require rhythm control drugs. They may be safe and effective however if used in selected patients. In cases of Afib with RVR these medications may need to be used if patients cannot tolerate other rate control medications.

Ablation Procedures

Ablation procedures are minimally invasive procedures typically done through the groin. They are typically used in patients that have tried, or cannot tolerate medicines for control of AFib. Ablation is typically not used as an emergency treatment of Afib with RVR, rather it is used for stable patients in AF, or those with intermittent AFib that wish to remain in normal rhythm. In patients that have had persistent Afib for a long time these procedures are not likely to be successful in the long term.

Pacemaker

This is typically the last throw of the dice for AF control. In some patients, drugs can either not control the rate in AFib with RVR, or the drugs can simply not be tolerated. In these patients who have no other choice, and in whom it is determined the Afib is causing harmful effects, a procedure called AV node ablation and pacemaker is done. In a relatively minor procedure, a small burn is made to the connection that connects the top and bottom chambers of the heart. A pacemaker is then inserted. This prevents Afib with RVR as although the top chambers continue to fire at a fast rate, the pacemaker now controls the bottom chamber, in a nice regular way. The downside of course is that now although the patient cannot have Afib with RVR, they have a pacemaker.

Acute afib RVR patients are more likely to be converted to Normal Sinus Rhythm (the best rhythm you could be in) as opposed to patients with chronic afib. There are complete resolutions for both kind of afib but atrial fibrillation in RVR the heart can handle for only so long and remembering the engine of our body is the heart so take good care of it for if you don’t it could allow you to die.