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Suicide is a serious public health problem that causes immeasurable
pain, suffering, and loss to individuals, families, and communities
nationwide. Many people may be surprised to learn that suicide was
one of the top 10 causes of death in the United States in 2009. And
death is only the tip of the iceberg. For every person who dies by
suicide, more than 30 others attempt suicide. Every suicide attempt
and death affects countless other individuals. Family members,
friends, coworkers, and others in the community all suffer the
long-lasting consequences of suicidal behaviors. Suicide places a
heavy burden on the nation in terms of the emotional suffering that
families and communities experience as well as the economic costs
associated with medical care and lost productivity. And yet
suicidal behaviors often continue to be met with silence and shame.
These attitudes can be formidable barriers to providing care and
support to individuals in crisis and to those who have lost a loved
one to suicide. More than a decade has passed since Surgeon General
David Satcher broke the silence surrounding suicide in the United
States by issuing The Surgeon General's Call to Action to Prevent
Suicide. Published in 1999, this landmark document introduced a
blueprint for suicide prevention and guided the development of the
National Strategy for Suicide Prevention (National Strategy).
Released in 2001, the National Strategy set forth an ambitious
national agenda for suicide prevention consisting of 11 goals and
68 objectives. The revised National Strategy is a call to action
that is intended to guide suicide prevention actions in the United
States over the next decade. The National Strategy includes 13
goals and 60 objectives that have been updated to reflect advances
in suicide prevention knowledge, research, and practice, as well as
broader changes in society and health care delivery that have
created new opportunities for suicide prevention. Some of the major
developments addressed in the revised National Strategy include: A
better understanding of how suicide is related to mental illness,
substance abuse, trauma, violence, and other related issues; New
information on groups that may be at an increased risk for suicidal
behaviors; Increased knowledge of the types of interventions that
may be most effective for suicide prevention; and An increased
recognition of the importance of implementing suicide prevention
efforts in a comprehensive and coordinated way. Because suicide is
closely linked with mental illness, in the past, suicide prevention
was often viewed as an issue that mental health agencies and
systems should address. However, the vast majority of persons who
may have a mental disorder do not engage in suicidal behaviors.
Moreover, mental health is only one of many factors that can
influence suicide risk. For example, enhancing connectedness to
others has been identified as a strategy for preventing suicidal
behaviors and other problems. All of us can play a role in helping
to make this protective factor more widely available. Suicide
prevention is not exclusively a mental health issue. It is a health
issue that must be addressed at many levels by different groups
working together in a coordinated and synergistic way. Federal,
state, tribal, and local governments; health care systems,
insurers, and clinicians; businesses; educational institutions;
community-based organizations; and family members, friends, and
others-all have a role to play in suicide prevention. The revised
National Strategy reflects this understanding. Suicide prevention
efforts must involve a wide range of partners and draw on a diverse
set of resources and tools. The National Strategy seeks to do so by
integrating suicide prevention into the mission, vision, and work
of a wide range of organizations and programs in a comprehensive
and coordinated way.
An estimated 97 million adults in the United States are overweight
or obese, a condition that substantially raises their risk of
morbidity from hypertension, dyslipidemia, type 2 diabetes,
coronary heart disease, stroke, gallbladder disease,
osteoarthritis, sleep apnea and respiratory problems, and
endometrial, breast, prostate, and colon cancers. Higher body
weights are also associated with increases in all-cause mortality.
Obese individuals may also suffer from social stigmatization and
discrimination. As a major contributor to preventive death in the
United States today, overweight and obesity pose a major public
health challenge. Overweight is here defined as a body mass index
(BMI) of 25 to 29.9 kg/m and obesity as a BMI of 30 kg/m or
greater. However, overweight and obesity are not mutually
exclusive, since obese persons are also overweight. A BMI of 30 is
about 30 lb. overweight and equivalent to 221 lb. in a 6'0" person
and to 186 lb. in one 5'6." The number of overweight and obese men
and women has risen since 1960; in the last decade the percentage
of people in these categories has increased to 54.9 percent of
adults age 20 years or older. Overweight and obesity are especially
evident in some minority groups, as well as in those with lower
incomes and less education. Obesity is a complex multifactorial
chronic disease that develops from an interaction of genotype and
the environment. Our understanding of how and why obesity develops
is incomplete, but involves the integration of social, behavioral,
cultural, physiological, metabolic and genetic factors. While there
is agreement about the health risks of overweight and obesity,
there is less agreement about their management. Some have argued
against treating obesity because of the difficulty in maintaining
long-term weight loss and of potentially negative consequences of
the frequently seen pattern of weight cycling in obese subjects.
Others argue that the potential hazards of treatment do not
outweigh the known hazards of being obese. The intent of these
guidelines is to provide evidence for the effects of treatment on
overweight and obesity. The guidelines focus on the role of the
primary care practitioner in treating overweight and obesity.
This National Institutes of Health Publication 11-5755, "What I
Need to Know About Celiac Disease," provides information from
understanding what Celiac Disease is, what the symptoms are, and
obtaining the proper treatment and proper nutrition for Celiac
Disease. Celiac disease is an immune disease in which people can't
eat gluten because it will damage their small intestine. Gluten is
a protein found in wheat, rye, and barley. Gluten may also be used
in products such as vitamin and nutrient supplements, lip balms,
and some medicines. Other names for celiac disease are celiac sprue
and gluten intolerance. Your body's natural defense system, called
the immune system, keeps you healthy by fighting against things
that can make you sick, such as bacteria and viruses. When people
with celiac disease eat gluten their body's immune system reacts to
the gluten by attacking the lining of the small intestine. The
immune system's reaction to gluten damages small, fingerlike
growths called villi. When the villi are damaged, the body cannot
get the nutrients it needs.
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