Suicide Prevention

     

    

  In a time such as we are in now, with work never ending, bills to pay and life moving at 100 miles per hour, it is either no surprise the suicide rate is high or a modern mystery of how people have the time to think about the act. In reality, suicide is no new subject. Since before the time of Jesus, historical records have indicated the incidence of suicide. The biggest celebrity of 30 B.C. Egypt, Cleopatra, tragically took her own life when her forces could not defeat an army. One does not have to have the weight of a failed army over their shoulders to be suicidal, however. According to the World Health Organization, nearly one million people lose their lives from suicide every year. That equates to about one death every 40 seconds. One million people is a scary statistic, and it is even more tragic that those deaths were preventable. For everyone one person who succeeds in their suicide, 20 people have attempted suicide. Here, just in the United States, suicide is the 6^th leading cause of death and the 3^rd leading cause for 15 to 24 year olds. With such a large number of people suffering enough to feel the need to end their life, it is natural to want to do something for them. Everyone can become informed with the common signs and symptoms a suicidal person may display and possibly save a life. More often than not, a suicidal person suffers from fairly severe depression, and many of the signs and symptoms of suicide coincide with symptoms of depression.  These include a bad or poor mood that persists, strong pessimism, hopelessness, insomnia, rage not typical to their temperament, desperation, risky behaviors, impulsiveness and increased alcohol and/or drug consumption. Something that is noteworthy to look out for are signs of preparation. This could be giving away possessions, writing a suicide plan, or even purchasing weapons or tools that could kill a person.  Again, it is often hard to know if someone is suicidal or if they are just going through a rough time. However, if there is any chance that you believe they may take their own life, make no hesitations. You will regret your doubt if you are wrong. If you believe a person is at very high risk of killing themselves, do not leave them alone. Be with them at all times until a medical professional can be available. It is acceptable to bring a suicidal person to the nearest emergency room as they can be observed and their depression issues can be treated.  If you have someone who you strongly believe is not so serious of a case, the American Foundation for Suicide Prevention suggests you do not say things such as, ‘You have so much to live for,” or arguing down suicide as an option. The best way to confront an individual whom you believe may be suicidal is through direct questions such as, “Are you thinking about ending your life?” “Have you made a suicide plan?” It may seem nerve racking or scary to the individual asking the questions, but a funny thing often happens with the depressed person.  In more cases than not, the unstable person seemingly wanted to be asked the question.  It is as if a private barrier has been lifted and they finally have been granted permission to verbalize their internal pain. However, some do react strongly and deny and repel the seemingly accusatory questions.  It is often worth the risk. For those that realize their own battle and want to seek help, there are numerous resources available. For example, most cities have support groups for depressed people and people who have attempted suicide in the past. There are also many free suicide hotlines in which you can call in and talk to someone anonymously. One of the largest hotlines that is open 24 hours per day is the National Suicide Prevention Lifeline (1-800-273-TALK).

            When it comes down to it, life is hard, unfair, infuriating, and the hardest thing you will ever do. However, it is simultaneously the craziest, most beautiful phenomenon. For you to be able to preserve your own life, or keep someone from taking their own is an incredibly heroic feat. Be a super hero. Save a life.

Facts from blog pulled from:

http://www.fijitimes.com/story.aspx?id=182096

http://www.kplctv.com/story/15568620/youth-suicide-prevention-conference-underway

http://www.tribune.com.ng/sun/crime-features/5082-world-suicide-prevention-day-why-suicide-has-been-on-the-increase-clerics

http://www.medicinenet.com/suicide/article.htm

http://www.newstrib.com/articles/news/local/default.asp?article=29663&aname=Suicide+prevention+walk+Sept.+25+at+Baker+Lake

Healthy Habits

Food choices are influenced by many factors, personal likes, family influences, peer influences and cultural influences. Although the main purpose of food is to nourish the body, food means far more than that to many people, especially Americans. It can symbolize much of whom and what we are.


Knox County, a small Northeast Missouri community, is a prime example of a unhealthy population. Knox County has a population of 4, 131 residents (QuickFacts Knox co. census, 2011). The 2007 statistics showed 38% of Knox County residents were overweight and 30% were obese. When surveyed about their overall health problems, 24% of residents in Knox County believed they had fair or poor health status. Twenty one percent of Knox County residents have hypertension and 24% high cholesterol. As if obesity, hypertension and high cholesterol was not already negatively affecting their health, 22% smoke cigarettes. The residents of Knox County need to seek care for these health problems, however; 25% of the residents are without health care coverage (Health & preventative practices for Knox county adults, 2007). Better dietary choices along with an increase in physical activity would improve the health status of Knox County residents tremendously.

About half of the population in Knox County is in the workforce, a total of 1,982 residents (ACS profile report, 2009). Because half of the population is employed, stress of the residents work and personal lives can get in the way of healthy living. Stress related eating is an unhealthy coping strategy brought on by depression or anxiety (HealthTeacher). Diverting oneself with a walk in the park or office rather than a bag of greasy potato chips might prevent emotional eating. When the need to eat happens, eat something healthy. Lack of time management is also a factor that prevents people from nutritious eating. Parents have to work, pick up kids and drive to and from practice. They use the excuse “I went through the drive through because I did not have time to make anything today”. Suggestions for avoiding the fast food restaurants are shopping for groceries as a family, selecting foods low in fat and sugar, planning meals and snacks before leaving home and attempt to eat around the dinner table as a family. It is crucial for people know how to fit proper nutrition into their stressful and busy lives (HealthTeacher).

Unhealthy nutrition habits, paired with physical inactivity, have become a major reason of health problems not only in Knox County, but also in the United States. Poor eating behaviors and physical inactivity contribute to cardiovascular disease, type 2 diabetes, hypertension, osteoporosis, and certain cancers. These health problems can result in an energy imbalance (more calories are eaten than are burned off in physical activity) has become the most important factor contributing to the increase in overweight and obesity in this country (MyPlate.gov).

Fruits and vegetables, as a part of a healthy diet, are vital for optimal child growth, weight management and chronic disease prevention (National Action Guide). The national Healthy People 2010 fruit and vegetable objective reported that only 32% of Americans are eating the recommended dose of fruits and vegetables. An astounding 8% of Missourians are eating both fruits and vegetables (State Indicator Report). According to the CDC, supporting increased fruits and vegetables access, availability, and reduced price are key strategies to help increase fruits and vegetable consumption and thus improve nutrition.

Mayo clinic states that

Although most Americans get too many calories, they don't get enough health-enhancing and disease-preventing nutrients. To address this problem, energy-dense foods — especially foods high in SoFAS — should be replaced with lower calorie, nutrient-rich vegetables, fruits, whole grains, and fat-free or low-fat dairy products.

Calories are burned in the three ways: BMR, Physical Activity and Thermic Effect (Physical activity and health: adults, 1999). The metabolic rate that elevates while exercising continues to function at a higher level for an additional two hours once finished, thus resulting in extra burned calories, therefore one of the many benefits of exercise (HealthTeacher.com). Combined with adequate daily physical activity, following a nutritious diet that does not provide excess calories and follows the 2010 Dietary Guidelines should improve the health of most individuals (Mayo Clinic).

Adolescents are easily influenced by their peers and may influence each others food choices. Parents need to educate their children that not everyone is built the same way. People in general metabolize food at a different rate. A school lunch consisting of french fries, cheeseburger, cookie and large soda may make a teenager gain a pound, yet another teenager same age gender is not affected. The USDA recommends that children and adults engage in at least 60 minutes of physical activity everyday in order to maintain average body weight. Children of obese parents have a 25-30% chance of becoming obese themselves, primarily due to poor eating habits rather than genetics (CDC). The USDA also recommends that overweight children increase their physical activity and consume fewer calories while under the care of a physician (MyPlate.gov).

There are many benefits to living a healthy lifestyle. The Knox County Community Center will promote, educate and enable its members embrace a healthy and active lifestyle. The Knox County Community Center is a place where health, education and community meet.

Works Cited

"Fruits & Veggies Matter: Health Professionals: Research
CDC." Fruits & Veggies Matter: Home: Eat a Colorful Variety of Fruits and Vegetables Every Day for Better Health
CDC. CDC and DHHS, 2009. Web. 23 Nov. 2011. .

2008 Physical Activity Guidelines for Americans. (2009, July). Retrieved September 21, 2011, from CDC Fact Sheet for Health Professionals on Physical Activity Guidelines for Adults: http://www.cdc.gov/nccdphp/dnps/physical/prf/PA_Fact_Sheet_Adults.pdf

County Level Estimates of Leisure-Time Physical Inactivity. (2008). Retrieved September 21, 2011, from Centers for Disease Control and Prevention: http://apps.nccd.cdc.gov/DDT_STRS2/CountyPrevalenceData.aspx?mode=PHY

Health & Preventative Practices for Knox-Scotland-Clark County Adults. (2007). Retrieved September 15, 2011, from Missouri Department of Health and Senior Services: http://health.mo.gov/data/mica/CLS_Compare/header.php?cnty=103&profile_type=1 chkBox=C

"HealthTeacher :: Barriers to Making Healthy Food Choices." HealthTeacher :: Welcome. HealthTeacher, July 2011. Web. 12 Oct. 2011. .

Mayo Clinic Staff. "New Dietary Guidelines: How to Make Smart Choices." Mayo Clinic: Health Information. Mayo Clinic, 2 Feb. 2011. Web. 10 Nov. 2011. .

Physical Activity and Health Adults. (1999). Retrieved September 21, 2011, from Centers for Disease Contro QuickFacts Knox Co. Census. (2011, June 2). Retrieved September 15, 2011, from U.S. Census Bureau: http://quickfacts.census.gov/qfd/states/29/29103.html

State Indicator Report on Fruits and Vegetables. Rep. CDC, 2009. Web. 23 Oct. 2011. .

"Tips and Resources." USDA's MyPlate - Home Page. United States Department of Agriculture, 30 Sept. 2011. Web. 14 Oct. 2011. .

Work and Jobs in Knox County, Missouri. (2010). Retrieved October 12, 2011, from City-Data : http://www.city-data.com/work/work-Knox-City-Missouri.htmll and Prevention: http://www.cdc.gov/nccdphp/sgr/adults.htm

Physical Activity for the Family

The evidence is overwhelming. With nearly two thirds of the population overweight, Americans today are heavier than ever before. Fast food, frozen dinners, computers, television, and a constant need to be “on the go” bolster poor eating habits and sedentary lifestyles. These are the primary contributing factors to this major public health epidemic. An article written by the American Medical Association (2004) states, “If doctors could prescribe only one treatment to ensure a long, healthy life, it would be exercise” (p. 45). Physical activity holds numerous benefits both physically and mentally, and reduces risk factors that often lead to disease and premature death.  Environment has much to do with an active lifestyle, and children learn these behaviors early from their parents, peers, and teachers. Promoting healthy habits within the whole family can not only be enjoyable, but also will decrease the risk of common chronic illnesses and prevent obesity.

There are an infinite number of ways to promote fitness within the family. A major factor is reducing the amount of time children and parents spend watching television, working or playing at the computer, and playing video games. The National Institutes of Health suggests discouraging sedentary time by limiting screen usage to two hours or less per day (2005). Setting an established and agreed upon limit in the family, leads to clear expectations and discourages using television and computer as easy ways to cure boredom. It will force everyone to be more creative and come up with other activities (Dreisbach, 2011). Their input should be considered when brainstorming physical activities and ideas (National Institutes of Health, 2005). It is important that the pursuits of the family are geared towards the passions and interests of the children as this keeps them excited and engaged in the activities. Lastly, encourage the family to try new activities (Dreisbach, 2011). Finding new hobbies and sports for the family to enjoy will keep physical activity entertaining and enjoyable! 

References

American medical association (2004).Exercise, fitness, and health. American Medical Association Family Medical Guide (45-50). John Wiley & Sons, Inc. 

Dreisbach, S. (2011). Family fitness makeover. Parenting School Years.  Retrieved from http://www.parenting.com

National Institutes of Health (2005). We can! Retrieved from http://wecan.nhlbi.nih.gov

 

 

 

 

Community Center Coming to Knox County

Knox County is home to 1,110 residents. Those residents have faced many challenges when it comes to getting regular physical activity. Because there is currently no indoor facility to utilize, residents have been influenced by weather, air quality, and time. Weather in Knox County follows general seasonal patterns; however temperatures from November to March are typically too cold for outdoor exercise. Snowfall also hinders outdoor physical activity during these winter months. On the other hand, temperatures have the potential to reach too high of a level during the months of June, July, and August for it to be considered safe to exercise outdoors. Air quality across Knox County does not fall below state levels, but because three of the largest industries in the area include construction, transportation, and warehousing, air quality could be a concern in areas near these industries. Outdoor exercise in these areas could be detrimental to health and would not be advisable. Knox County’s rural location has an effect on the amount of time residents have to exercise as well. Residents must spend a considerable amount of their day traveling to work, in fact, 36% of residents have a commute of 50 minutes or more. When this much time is spent being sedentary in a vehicle, it is difficult to make time to commit to physical activity. These are just a few reasons why Knox County is the perfect location for this new community center (Onboard Informatics, 2011).

            Once Knox County Community Center is built and open, residents will have access to high quality fitness equipment, including both cardiovascular machines and weight training machines. Residents will gain many benefits from having this equipment readily available. First, exercise controls weight, and since 30% of Knox County’s population is considered to be obese, this has the potential to really influence overall county health. Exercise also helps combat diseases such as diabetes, which Knox County has a higher rate than the state of. Exercise also improves mood, boosts energy, promotes better sleep and can even jumpstart a person’s sexual drive. The fitness portion will be open to all members of the community center and families will be encouraged to develop healthy habits as a unit (Mayo Foundation, 2011).

            Nutrition is also an area of health that the community center is hoping to target. The conference room will include a kitchen component in order to accommodate nutritious cooking lessons. Through nutrition promotion, residents will gain the education they need in order to reap the benefits of good nutrition. Benefits include having the fuel necessary to perform daily activities, providing nutrients for the body’s cells, growing and repairing tissue, reinforcing the immune system, preventing chronic diseases of lifestyle, maintaining good mental health, and ensuring healthy teeth and bones (Rooyen, 2007).

Knox County Community Center also plans to target worksite health as part of their comprehensive health campaign. Prior to the grand opening of the center, businesses and organizations in Knox County will be asked to partner with the community center. These partnerships will include a discounted membership to employees of contracted worksites. As a result of the partnerships, health insurance costs will be negotiated as well as breaks and lunch policies to accommodate daily workout times. By targeting worksites, many residents who may not have originally considered becoming a member will be influenced to examine the option (Tarek, 2009).

The final goal of the Knox County Community Center is to build community relationships in an effort to unite the residents. Seasonal competitions involving fitness goals will be facilitated through the community center and patrons will be encouraged to work out as a family unit or with friends. The conference room will be available for organizations to hold meetings and develop further ideas to benefit the community. The conference room will also be available for rent by individuals seeking a space to host a birthday party, reception, reunion, etc.

Knox County is very fortunate to be faced with an opportunity as beneficial as this. Through various goals, Knox County has the potential to become a healthier and happier community through the unity of health, education, and community.
References: 

Mayo Foundation. (2011, August 02). Fitness. Retrieved from http://www.mayoclinic.com/health/exercise/HQ01676/NSECTIONGROUP=2

Onboard Informatics. (2011, March). Knox county, mo. Retrieved from http://www.city-  data.com/city/Edina-Missouri.html

Rooyen, C. (2007, August). The benefits of good nutrition. Retrieved from             http://www.health24.com/dietnfood/Diet_basics/15-1168-1173,34569.asp

Tarek, L. (2009, November). Worksite health promotion. Retrieved from     http://citationmachine.net/index2.php?lastName[1]=Rooyen&firstName[1]=C.&lastNam            e2=&firstName2=&lastName3=&firstName3=&lastName4=&firstName4=&lastName5=            &firstName5=&monthPublished=August&dayPublished=&yearPublished=2007&titleW            ork=The+benefits+of+good+nutrition&specialDiscriptors=&description=&url=http%3A   %2F%2Fwww.health24.com%2Fdietnfood%2FDiet_basics%2F15-1168- 1173%2C34569.asp&doi=&more=yes&reqsrcid=APAWebPage&reqstyleid=2&nameCnt            =1&mode=form

Adair County Substance Abuse Problem

Adair County is located in the Northeast Missouri region and has a population of 25,607 (Behavioral Health Profile for Adair County, 2011, p. 1).  It is 1 of Missouri’s 114 counties and is ranked 42^nd in terms of population (Behavioral Health Profile for Adair County, 2011, p. 1).  Adair County is not considered a primary healthcare shortage area but is considered a mental health professional shortage area by the Health Resources and Services Administration.  In Adair County, 50.98% of youth believe that it would be easy to get cigarettes and 41.78% have friends who smoke (Behavioral Health Profile for Adair County, 2011, p. 1).  One of the objectives in Healthy People 2020 is to reduce tobacco initiation and use by adolescents and adults.  An estimated 60.59% of youth in Adair County believe that it would be easy to get alcohol and 53.24% have friends who drink alcohol (Behavioral Health Profile for Adair County, 2011, p. 1).  Youth who use alcohol are at greater risk of developing abuse problems later on in life due to chronic abuse in early years of life.  In Adair County, 29.34% of youth believe that it would be easy to get marijuana and 17.58% of youth believe that it would be easy to get other drugs such as cocaine, methamphetamine, and ecstasy (Behavioral Health Profile for Adair County, 2011, p. 1).  Missouri youth tend to perceive marijuana as being safer than other illegal drugs and safer than tobacco (Behavioral Health Profile for Adair County, 2011, p. 1).

Current Substance Use for Grades 6 through 12

Substance	Adair County %	Missouri %
Cigarettes	18.1	13.7
Chewing Tobacco	5.93	6.1
Alcohol	19.3	19.8
Binge Drinking	14.33	11.40
Marijuana	5.34	9.4
Inhalants	3.24	3.0
Prescription drugs not prescribed for student	4.47	6.70
Over the counter drugs	4.63	4.80

               

                   In Central Missouri, an estimated 6.93% of residents age 12 and over use illegal drugs and 7.65% are abusing alcohol (Behavioral Health Profile for Adair County, 2011, p. 1).  Public safety, health care, crime, and public assistance are among the areas impacted by substance abuse.  In 2009, Adair County had 24 alcohol-related traffic crashes, a higher rate than the previous year (Behavioral Health Profile for Adair County, 2011, p. 1).  Of the 2009 alcohol-related crashes, 1 crash resulted in the loss of life and 7 resulted in injuries (Behavioral Health Profile for Adair County, 2011, p. 1).  Alcohol-related crashes are more likely to produce fatalities and injuries compared to non-alcohol-related crashes.

                In 2009, Adair County had 137 DUI arrests, 160 liquor law violations, 131 drug arrests and 24 methamphetamine laboratory seizures in 2009 (Behavioral Health Profile for Adair County, 2011, p. 1).  The manufacture of methamphetamine has been particularly problematic for rural Missouri.  Missouri is the number one state in the country for methamphetamine trafficking.  In 2002, one of every six methamphetamine labs confiscated in the United States was Missouri (Gundy, 2006, p. 7).  According to the Kirksville Police Department, methamphetamine is their number one crime problem.  This high prevalence of methamphetamine abuse leads to 40% of school dropouts in Adair County (Gundy, 2006, p. 7).

                In state fiscal year 2010, 229 Adair County residents were admitted to substance abuse treatment at publicly-funded facilities.  Perceptions, attitudes, and community norms of students, parents, and community members about substance abuse and violence were recently surveyed community-wide.  In Northeast Missouri and statewide, alcohol and marijuana are the most common substance abuse problems presenting for treatment. In Northeast Missouri, the next most common drug problem is methamphetamine (Behavioral Health Profile for Adair County, 2011, p. 2).  Peer pressure was felt to be a primary reason for substance abuse for students in the middle and high school schools (Behavioral Health Profile for Adair County, 2011, p. 2).


References:

Behavioral Health Profile for Adair County (2011, July 1). In Missouri Department of Mental Health.

Retrieved October 16, 2011, from http://dmh.mo.gov/ada/countylinks/adair_link.htm

Gundy, K.V. (2006). Substance Abuse in Rural and Small Town America [Electronic Version].  Reports on

                Rural America, 1(2), 7-10. 

Sip Smart

Introduction:

The amount of overweight or obese citizens of Missouri has been steadily increasing. One culprit behind the gain in weight may be sugary drinks. They can range from soda, sweetened teas, to fruit juices. A typical 12 ounce can of soda has about 150 calories. To put this into perspective, if a person were to drink one can of soda per day, they would gain about 1.2 pounds a month, or over 14 pounds a year. In Missouri, the percentage of citizens that are either overweight or obese is 65.8 (1). This rate exceeds the overweight or obese rate of the United States, which is at 63.8 percent. Someone who is overweight or obese has an increase risk of developing many problems including: heart disease, stroke, high blood pressure, and diabetes (3). For these reasons, it is important to reduce the occurrence of overweight and obese individuals in the state of Missouri. One way to achieve this goal is to ban sugary drinks.

Risks of consuming sugary drinks:

The Nurses’ Health Study conducted a prospective cohort study which examined approximately 91,000 women, initially diabetes free, over 8 years. After the study, the researchers analyzed the data and found that the women who consumed one or more sugary drinks per day were twice as likely to develop type II diabetes as those who consumed less than one drink per month. Here is a short overview of how diabetes works:

Prolonged consumption of sugary drinks may lead to type II diabetes. Diets high in simple sugars, the same sugars present in sugary drinks, can cause desensitivity to insulin receptors. In turn, the body will not be able to absorb insulin as efficiently. This condition is known as type II diabetes. However, there are two main ways to prevent diabetes, exercise and nutrition. In the long term, exercise can increase your body's sensitivity to insulin (4). Exercise can also decrease the amount of body fat. This is important because adipose tissue, or fat cells, release a hormone called leptin. Leptin decreases your body's sensitivity to insulin, thus making you more likely to develop type II diabetes (9). 

In addition to diabetes, sugary drinks may also increase the risk of developing heart disease. According to the CDC, more than one in four Missourians die from heart disease every year (2). The Nurses’ Health Study also conducted research on heart disease and sugary drinks. They found that the women who drank more than two servings of sugary drinks a day had a 40 percent higher risk of developing heart disease than those who rarely drank them. Now, the researchers knew that it was likely that the women who consumed more than two sugary drinks a day probably did not have the best diets and did not exercise regularly. So, the researchers took these problems into consideration. They then found that even with regular exercise and a clean diet, the risk of developing heart disease only decreased slightly (3).

In a meta-analysis of 88 studies, drinking soda correlates with a decrease in milk consumption along with the vitamin D, vitamin B6, vitamin B12, calcium, protein and other micronutrients (3). Phosphorus, a micronutrient, can be found cola-type beverages, but there may be a risk in consuming too much (3). Phosphorus and calcium are used in the body to create calcium-phosphate, which is the main component of bone. However, the combination of too much phosphorus with too little calcium in the body can lead to a degeneration of bone mass (3).

Finally, since there are so many risks associated with soft drink consumption, people should strive to take these drinks out of their diet or at least consume them in moderation. However, sometimes this is not enough and the next step would be to ban soft drinks from vending machines in areas such as schools and workplaces to ensure that people are cutting down. The ban should start with only a few cities and eventually spread to more and more cities once support is gained and the statistics agree that obesity is dropping. But this is not an easy task because citizens must put together a petition so that the policy change can be put on a ballot for voting. To aid this process along, community leaders from each city should be gathered to help persuade voters to pass the change.

References

(1)   "BRFSS | Health & Senior Services." Home | Missouri Department of Health & Senior Services.  .

(2)   "CDC - Health Effects - Heart Disease - Smoking & Tobacco Use." Centers for Disease Control and Prevention. Web. 28 Nov. 2011. .

(3)   "Sugary Drinks or Diet Drinks: What's the Best Choice? - Healthy Drinks - The Nutrition Source - Harvard School of Public Health." Harvard School of Public Health - HSPH. .

(4)   Backx, K., McCann, A., Wasley, D., Dunseath, G., Luzio, S., & Owens, D. (2011). The effect of a supported exercise programme in patients with newly diagnosed Type 2 diabetes: A pilot study. Journal of Sports Sciences, 29(6), 579-586. doi:10.1080/02640414.2010.544666

(5)   Brown, E. W. (1998). Healthy Gums and Heart Disease. Medical Update, 22(2), 5. Retrieved from EBSCOhost.

(6)   Burgos-Ramos, E., Chowen, J. A., Arilla-Ferreiro, E., Canelles, S., Argente, J., & Barrios, V. (2011). Chronic central leptin infusion modifies the response to acute central insulin injection by reducing the interaction of the insulin receptor with IRS2 and increasing its association with SOCS3. Journal of Neurochemistry, 117(1), 175-185. doi:10.1111/j.1471-4159.2011.07191.x

(7)   Daily Flossing Is Essential. (2003). Nutrition Health Review: The Consumer's Medical Journal, (86), 4. Retrieved from EBSCOhost.

(8)   Larkin, M. (2002). Can flossing teeth foil heart disease?. Lancet, 360(9327), 147. Retrieved from EBSCOhost.

(9)   Marino, J. S., Xu, Y., & Hill, J. W. (2011). Central insulin and leptin-mediated autonomic control of glucose homeostasis.Trends in Endocrinology & Metabolism, 22(7), 275-285. doi:10.1016/j.tem.2011.03.001