Things You Should Do When Getting Pharmaceutical Supplies

The health industry is one of the most sensitive. It is supposed to extend solutions to improve health and the slightest overlook could be the thin line between life and death. Pharmaceutical supplies are important and they should be handled with the seriousness they deserve. If you are a supplier you will only manage to create a good reputation in the market only with quality products that are approved by the right bodies.

This is something that you should be able to do by taking the right measures when getting your supplies, especially when dealing with manufacturers offering the supplies online. There is more emphasis on checking out the credibility of the manufacturer or supplier before trusting them with your orders and any other medical supply needs you may have.

Find out whether the manufacturer adheres to good manufacturing practice

There are set standards when it comes to manufacturing pharmaceutical products and your manufacturer should be compliant in every sense. The GMP requirements should not only be met in the manufacturing plant, but also with the products that the company produces. With such requirements being met, you at least have assurance that you can trust in the quality of your products.

Find out whether the manufacturer works with a product line you are interested in

Health products are numerous and come in different categories. Whether you are looking for specific drugs, supplements or steroids and hormonal products, you want to be sure that your manufacturer does produce them and can meet with your requirements. Some manufacturers may specialize in one category, whereas others may deal with more than one product. Choose a manufacturer you can trust with your current supply needs as well as any future needs that you may have.

Ensure the products are cleared and approved by the relevant health bodies

FDA seems to be the most recognized body and only high quality products that meet global standards are approved and cleared. It is actually very important even for consumers to ensure that they buy only health products that have been approved by this body or any other relevant body depending on where they are located. You do not want to put the health of others at risk by getting products whose quality is unknown.

Make queries about the product you are about to buy

Finding out as much as you can about a product is important, especially if it is a product you are not very familiar with. From the information given by the supplier or manufacturer, you will be able to make an informed decision that you won’t regret. You should also not forget to check dates, especially the expiry date so you know the shelf-life of the products you are buying. If you are a patient trying to buy your products directly from manufacturers it is best that you get some insight from your doctor. Doctors are among the first to know about new health care products and may prove beneficial guiding you to the right ones.

Healthy Eating – Four Reasons to Take Probiotics

If you are someone who is interested in maximizing your health, one thing you might be considering is your intake of probiotics. These healthy bacteria live in the stomach and help keep your immune system strong, promote optimal digestion, and keep your entire body working in proper order.

While everyone needs to be consuming a healthy dose of probiotics on a regular basis, there are particular times when you need to increase your dose.

Let’s take a closer look at the main times when serving yourself a little extra dose of probiotics is a wise move…

1. When You Are Ill. Because probiotics play a vital role in keeping your immune system in top shape, it is important you focus on consuming these probiotics when you are struggling with your health.

If you are currently ill, an extra dose can give you the power your body needs to fend off whatever it is fighting: helping you get back to optimal health. When you have a common cold or the flu, as well as when you are struggling with a health issue, an additional dose could be helpful.

2. After You Have Completed The Prescribed Antibiotics. While you are sick and need antibiotics, they can be useful. What they won’t be good for is your gut health. Antibiotics will kill any harmful bacteria currently residing in your system. However, they will also take out all the “good” bacteria.

Serving yourself an extra dose of probiotics during this time can help bring your gut environment back to optimal, ensuring your immune system stays strong.

3. Before And During Travel. The next time it is a smart move to add a few extra probiotics to your daily menu is before and during travel. Before travel, the goal is to make your immune system as healthy as possible, which will help fend off any viruses present in the area you are going.

During the traveling period, taking the probiotics will help keep your system as healthy as possible, and help you avoid any digestive woes that may occur due to eating foods, not your typical dining choices. If you are all about trying local cuisine when you travel, your taste buds may enjoy this, but your stomach may feel otherwise. Using a probiotic may help prevent unwanted issues from occurring.

4. Throughout Pregnancy. Finally, the last time to make sure a probiotic is present in your life is throughout pregnancy. Keeping your body extra healthy at this point is important, and a good quality probiotic may help to reduce your risk of suffering from birth-related complications such as Gestational diabetes.

As you can see, a probiotic is not something you want to slough off and take lightly. It is a must-have in any diet plan aiming to keep you as healthy as possible.

Utilizing Nutrition And Diet Therapy

It’s no secret that the relationship between nutrition and overall health is recognized as legitimate and fundamental. The food we choose to put into our bodies has a profound and lasting impact on our weight, our health, and, ultimately, our longevity. A poor diet can mean a lifetime of illness and disease. But sadly, most people do not heed the advice of experts until they are facing a health crisis; at which time they embark upon nutrition and diet therapy to help put their bodies back into balance.

Nutrition and diet therapy works to eliminate those poor nutritional choices from the diet and replace them with choices focused on whole, natural foods. In some cases, it can be an overhaul in lifestyle; significantly minimizing or even eliminating foods that are fried, processed, or high in salt, sugar, or saturated fats. Nutrition and diet therapy will instead ask you to include fresh fruits, green leafy vegetables, whole grains, lean protein, and low-fat diary products as the staples in your diet.

This is by no means an easy lifestyle change for someone who is used to canned or boxed products and a steady stream of fast food. But it is a necessary change if you want to live a life of optimum health. In addition to the obvious advantages of implementing this lifestyle is the fact the payoff is immediate in terms of how you feel. You’ll immediately begin to feel healthier and more energized.

Apart from choosing the right kinds of food as a part of nutrition and diet therapy, there is also choosing the right amount of food. If most people would practice simple portion control, they could limit their calories enough to make a major impact on their weight and overall health.

Another part of nutrition and diet therapy is the flushing of your system. It is imperative that you drink at least eight glasses of water on a daily basis. Water acts as a natural appetite suppressant, hydrates and flushes the body, speeds the metabolism, and aids digestion.

Nutrition and diet therapy works to put your body back in line with what it needs to be healthy and efficient. If you are having difficulty making the right choices, work with a nutritionist to help develop a meal plan that works for you.

Keep the Kids Entertained This Summer

School’s out in just a few more weeks. Are you geared up for three stable months home with the youngsters? Here are some thoughts to preserve them entertained – and also you sane – all summer season lengthy.

Enroll your kiddos in a network summer season pastime application. Most cities have at the least one, and that they run everywhere from every week to a month. Drop the youngsters of at nine, and get 4 hours to your self for house responsibilities, errands, or lunch with the ladies even as your offspring play outside, create crafts tasks, and move on educational area trips. The fee is only a couple hundred bucks, however the cost is priceless.
Take benefit of your nearby library. Whether you’ve got babies or teenagers, your region public library gives a selection of packages and activities to assist them socialize and increase their minds inside the air-conditioned hallowed halls of “that place with all of the books.” Reading challenges will guarantee you some peace and pretty at the same time as they are trying to get via extra books than their sibling/cousin/excellent buddy and win the prize. And don’t forget to test out adult programs on the library, too!
Surprise the own family with inexpensive day trips. If you’re something like me, you live close to a ton of historic or otherwise exciting sights that you’ve never visited. Check out the county museum or the hollow-in-the wall art gallery down on Main Street. Hop within the vehicle and head to the closest town or cultural middle for a matinee theatre performance.

There are likely dozens of activities and points of interest for your region that you in no way consider due to the fact, hey, you stay there, but they’re really worth sorting out with the youngsters – and they could make for a amusing and inexpensive date, too!

Outdoor Recreation Items

Every summertime we ferreted the inflatable pool out of the shed and set it up within the back lawn inside the solar. Then we stuffed it with water, put it inside the solar and let the children play in it. The kids loved it. One heard testimonies of children drowning in inches of water, so one always saved an eye fixed on them. What it did do, was construct a confidence in them about being inside the water. They got their heads wet, went underwater and opened their eyes, and generally simply loved themselves.

Later this led to them wanting to learn how to swim. The school provided swimming classes, however most mother and father can inspire their youngsters to swim with the aid of stepping into the pool with them and displaying them how, protecting them, encouraging them to kick, and so on, all of which builds up confidence and enjoyment.

Some kids hate getting their faces moist, and dunking their entire head inside the water is distress certainly. Help them to now not be afraid, by way of encouraging them early directly to revel in the water.

After the stupid days of iciness, catching a chunk of loose Vitamin D from the sunshine in summer season is another consideration. Our skin absorbs daylight and our metabolism turns this into vitamin D, assisting to construct calcium within the bloodstream and so forming robust bones. (It is still advocated that you use a UV barrier cream whilst you are exterior – and put on a hat as nicely)

There are many one-of-a-kind varieties of out of doors leisure gadgets. A lot of out of doors recreational items assist youngsters to develop their motor abilties. Of direction, there is additionally a extensive variety of outdoor recreational gadgets for humans of all ages to revel in, they may be not at all limited to youngsters.

Where can you go to experience your self in summer with these objects? A vicinity to begin might be ‘indoorwaterparks dot internet’. It is a directory of waterparks in the USA, listed by nation.

There is something for all of us in out of doors pastime. From infants to grandparents. Everyone can revel in their day out, specially if care is taken to prepare nicely ahead.

Many exceptional organizations manufacturer out of doors leisure objects. (Most of these are inflatables). For example there may be Poolmaster, Swimline, Sunsmart, International Leisure, Coleman, Sevylor, Excalibur, Sportstuff, Banzai and Intex. Skamper manufactures ramps for animals which assist them get out of the water. Zoggs makes a speciality of ear plugs, nose clips and goggles.

The Use of Software Programs to Manage Business Contacts

Organizations and organizations encounter numerous issues. On the off chance that they can take care of these issues, at that point it prompts the change of their present state, in this manner accomplishing achievement. One of these issues is to oversee business contacts. They think that its difficult to deal with and deal with the rundown of individuals that are pertinent and critical for their business. That is the reason distinctive projects and virtual products are created to enable organizations and organizations to adapt to this confounding issue. The most vital thing to comprehend is that there are two unique sorts of programming projects: one that is downloaded as a PC program and another that seems to be “in the cloud”. Presently you might ask yourself, “sounds awesome, however what the hell is the cloud?” and that is a decent inquiry. It essentially implies that you don’t have to introduce any product or have an IT professional enable you to associate it to any extravagant servers or system your PCs together. Everything, the greater part of your business contacts, are overseen online from a site. You basically login and can get to your data from any gadget anyplace on the planet at whenever. We should observe the significance of programming for overseeing business contacts.

Simple Access to Your Contacts

When you have a product to oversee business gets in touch with, it will be significantly more helpful for you to get to the rundown of your contacts at whenever and even in a hurry. Every one of the communications you have made, for example, telephone calls and messages, will be plainly appeared there. On the off chance that you have been called shockingly by a customer and you couldn’t see, the fundamental data about the customer will be put away so you can reply back with the pertinent data (subsequent to pulling up their records to perceive what you last talked about). The data and information contained in the telephone calls and messages are likewise put away empowering you to better comprehend the topics.

Enhanced Customer Service

As you have moment access to all contact data, exercises, criticisms, and inquiries of clients, you will have the capacity to react quicker, making your clients inspired by your productivity. This can help your organization to hold your present customers and furthermore to acquire. You’ll doubtlessly perceive how programming programs that oversee business contacts enhance the client administration of your organization.

Spare Time via Searching for Information

One reason why you have to utilize programming that oversee business contacts is to end up more productive and in addition sorted out. The product that you can utilize has different alternatives and instruments that can extraordinarily enable you to arrange data about customers, discussions with customers, exercises in deals and advertising, and support for clients. In actuality, this will enhance the general profitability of your organization’s day by day routine and spare you bunches of time!

Lessen Expenses

Since your organization can oversee business contacts with the utilization of programming, you will have the capacity to make clients fulfilled and even surpass their necessities. This will prompt the decrease of uses expected to advance consumer loyalty and additionally the time it takes for your workers to browse messages and discover more about every customer.

Special Education Or Summer Recreation Program

Under the Individuals with Disabilities Education Act (IDEA), extended faculty 12 months needs to receive to a toddler, in the event that they require it to obtain a free suitable public schooling (FAPE). A court case Reusch vs Fountain got here up with several elements that want to be saved in thoughts, when determining if a toddler wishes ESY offerings. These factors are; regression and recoupment, nature and severity of your toddler’s incapacity, abilties which might be simply being learned (rising skills), whether the kid’s behavior interferes with their mastering, and any unique occasions that relate for your baby.

Here are a few things to maintain in mind approximately ESY and a pastime software:

1. Some faculty districts are now not providing ESY, as is required through IDEA. Instead they’re imparting to pay for non-public summer time activity programs. If your toddler needs ESY, and has a number of the above elements, they’re to acquire it out of your faculty district, freed from fee, although you may should fight for it.

2. Most summer pastime packages do now not offer instructional remediation. If they do, check it out carefully! The software may not learn via a certified unique schooling instructor, so it can no longer be appropriate for your infant. Academic remediation is a good motive to ask for ESY, in case your child desires it.

Three. Even if the summer season undertaking application is for youngsters with a incapacity, it could now not be appropriate for all children. Check out the daily schedule, speak to the group of workers, test on body of workers-baby ratio. Find out if quite a few sitting is required. This can be irrelevant for a kid with ADHD or autism.

Four. Be careful when signing up your baby for a summer undertaking program, if your infant has behavioral difficulty. Years ago, my daughter attended a special pastime camp whose personnel became not trained in handling irrelevant conduct. Ask plenty of questions, see if a fine behavioral machine may be put in place on your toddler. Also discuss how workforce will deal with irrelevant behavior.

Five. Summer activity programs have a tendency to be unstructured. Some youngsters with disabilities do no longer do nicely in an unstructured environment, so be cautious. Again, ask a variety of questions, test on the schedule and so on.

6. If your baby wishes life skills or practical schooling, ESY can offer that education. If your child wishes it, carry it up at their annual IEP assembly, and make certain that it is in writing.

By keeping this stuff in thoughts, you may be able to make the precise selection in your toddler about extended school year offerings or a exercise program.

Managing Business Data – Putting Information to Work

So you consider yourself an extremist business person. The person with the huge dreams, the vision, breathing flame and brimstone, enthusiastically driving troops starting with one wander then onto the next! Wake up, buddy. Your work area is flooding with new reports, the hard drive on your PC can take no more information and your quirky superstar IT administrator has given you such an intricate deals refresh, even Einstein would discover it a challenge….

Have you noticed the incongruity of life? How regularly have you wished you had more data on which to base pivotal business choices, yet can’t manage the information you as of now have. Overseeing business information is a BIG test, an undertaking of Herculean extents. In any case, not surprisingly, we will make it less demanding for you.

Business information comes in unending assortment! Regardless of whether it’s casual market knowledge gathered by a venturesome deals official, a gut feel for something in light of past understanding, or hard information conveniently organized into spreadsheets of a gazillion megabytes – it’s all worth nothing unless dealt with the correct way. We mean the information ought to be in the correct shape, opportune place in the correct hands at the perfect time! You’re believing that is a unimaginable dream? Try not to wager against it, we say.

We should begin toward the start. What do we mean by the expression “overseeing business information”? How about we avoid the language this time, and come to the heart of the matter. Overseeing business information basically alludes to arranging and controlling it such that it progresses toward becoming “data” – that which is equipped for creating understanding. Consider information the crude fixing, data as the handled item.

The initial step to overseeing business information is to accumulate and sort out it. In past times worth remembering you most likely utilized an ordering or documenting framework, now you utilize databases. Database administration programming causes you organize the crude information into perfect little tables, which makes ensuing access and refreshing simpler, as well as empowers de-duplication. Databases are magnificent things – you can question, sort and even perform estimations utilizing them. There’s not really a region where a database can’t be put to great utilize – stock records, client information, deals and income numbers….even climate data! The immense thing about overseeing business information utilizing these devices is that they help to associate data that may originate from various sources – for instance, a solitary generation work number can be utilized to connect input crude material, work in advance and additionally things prepared for dispatch.

Obviously, the structure of the database is immeasurably critical, and that is the reason one needs unique ability to hit the nail on the head. Luckily, there are a lot of devices accessible to help you. Visit PrimaSoft’s site to see a few cases.

Pathological Eating Disorders and Poly-Behavioral Addiction

When considering that pathological eating disorders and their related diseases now afflict more people globally than malnutrition, some experts in the medical field are presently purporting that the world’s number one health problem is no longer heart disease or cancer, but obesity. According to the World Health Organization (June, 2005), “obesity has reached epidemic proportions globally, with more than 1 billion adults overweight – at least 300 million of them clinically obese – and is a major contributor to the global burden of chronic disease and disability. Often coexisting in developing countries with under-nutrition, obesity is a complex condition, with serious social and psychological dimensions, affecting virtually all ages and socioeconomic groups.” The U.S. Centers for Disease Control and Prevention (June, 2005), reports that “during the past 20 years, obesity among adults has risen significantly in the United States. The latest data from the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older – over 60 million people – are obese. This increase is not limited to adults. The percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are considered overweight.”

Morbid obesity is a condition that is described as being 100lbs. or more above ideal weight, or having a Body Mass Index (BMI) equal to or greater than 30. Being obese alone puts one at a much greater risk of suffering from a combination of several other metabolic factors such as having high blood pressure, being insulin resistant, and/ or having abnormal cholesterol levels that are all related to a poor diet and a lack of exercise. The sum is greater than the parts. Each metabolic problem is a risk for other diseases separately, but together they multiply the chances of life-threatening illness such as heart disease, cancer, diabetes, and stroke, etc. Up to 30.5% of our Nations’ adults suffer from morbid obesity, and two thirds or 66% of adults are overweight measured by having a Body Mass Index (BMI) greater than 25. Considering that the U.S. population is now over 290,000,000, some estimate that up to 73,000,000 Americans could benefit from some type of education awareness and/ or treatment for a pathological eating disorder or food addiction. Typically, eating patterns are considered pathological problems when issues concerning weight and/ or eating habits, (e.g., overeating, under eating, binging, purging, and/ or obsessing over diets and calories, etc.) become the focus of a persons’ life, causing them to feel shame, guilt, and embarrassment with related symptoms of depression and anxiety that cause significant maladaptive social and/ or occupational impairment in functioning.

We must consider that some people develop dependencies on certain life-functioning activities such as eating that can be just as life threatening as drug addiction and just as socially and psychologically damaging as alcoholism. Some do suffer from hormonal or metabolic disorders, but most obese individuals simply consume more calories than they burn due to an out of control overeating Food Addiction. Hyper-obesity resulting from gross, habitual overeating is considered to be more like the problems found in those ingrained personality disorders that involve loss of control over appetite of some kind (Orford, 1985). Binge-eating Disorder episodes are characterized in part by a feeling that one cannot stop or control how much or what one is eating (DSM-IV-TR, 2000). Lienard and Vamecq (2004) have proposed an “auto-addictive” hypothesis for pathological eating disorders. They report that, “eating disorders are associated with abnormal levels of endorphins and share clinical similarities with psychoactive drug abuse. The key role of endorphins has recently been demonstrated in animals with regard to certain aspects of normal, pathological and experimental eating habits (food restriction combined with stress, loco-motor hyperactivity).” They report that the “pathological management of eating disorders may lead to two extreme situations: the absence of ingestion (anorexia) and excessive ingestion (bulimia).”

Co-morbidity & Mortality

Addictions and other mental disorders as a rule do not develop in isolation. The National Co-morbidity Survey (NCS) that sampled the entire U.S. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), roughly 50% had a diagnosable Axis I mental disorder at some time in their lives. This survey’s results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a mental disorder diagnosis, and nearly 25% of women will have qualified for a serious mood disorder (mostly major depression). A significant finding of note from the NCS study was the widespread occurrence of co-morbidity among diagnosed disorders. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more additional disorders. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. population, or some 43 million people (Kessler, 1994).

McGinnis and Foege, (1994) report that, “the most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400,000 deaths), diet and activity patterns (300,000), alcohol (100,000), microbial agents (90,000), toxic agents (60,000), firearms (35,000), sexual behavior (30,000), motor vehicles (25,000), and illicit use of drugs (20,000). Acknowledging that the leading cause of preventable morbidity and mortality was risky behavior lifestyles, the U.S. Prevention Services Task Force set out to research behavioral counseling interventions in health care settings (Williams & Wilkins, 1996).

Poor Prognosis

We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. But why do 47% of patients treated in private treatment programs (for example) relapse within the first year following treatment (Gorski,T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients with multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions?

Diagnostic Delineation

Thus far, the DSM-IV-TR has not delineated a diagnosis for the complexity of multiple behavioral and substance addictions. It has reserved the Poly-substance Dependence diagnosis for a person who is repeatedly using at least three groups of substances during the same 12-month period, but the criteria for this diagnosis do not involve any behavioral addiction symptoms. In the Psychological Factors Affecting Medical Condition’s section (DSM-IV-TR, 2000); maladaptive health behaviors (e.g., overeating, unsafe sexual practices, excessive alcohol and drug use, etc.) may be listed on Axis I only if they are significantly affecting the course of treatment of a medical or mental condition.

Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field, when the latest DSM-IV-TR does not even include a diagnosis for multiple addictive behavioral disorders. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictive and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals’ life, and the desired performance outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable.

New Proposed Diagnosis

To assist in resolving the limited DSM-IV-TRs’ diagnostic capability, a multidimensional diagnosis of “Poly-behavioral Addiction,” is proposed for more accurate diagnosis leading to more effective treatment planning. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging – psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences.

Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 – month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J., 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances – nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously.

New Proposed Theory

The Addictions Recovery Measurement System’s (ARMS) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co-morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions.

The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension.

The ARMS acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an individual to accept assistance with changing their lifestyles. The Stages of Change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. The ARMS theory supports the constructs of self-efficacy and social networking as outcome predictors of future behavior across a wide variety of lifestyle risk factors (Bandura, 1977). The Relapse Prevention cognitive-behavioral approach (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the ARMS theory.

The ARMS continues to promote Twelve Step Recovery Groups such as Food Addicts and Alcoholics Anonymous along with spiritual and religious recovery activities as a necessary means to maintain outcome effectiveness. The beneficial effects of AA may be attributable in part to the replacement of the participant’s social network of drinking friends with a fellowship of AA members who can provide motivation and support for maintaining abstinence (Humphreys, K.; Mankowski, E.S, 1999) and (Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M., 1997). In addition, AA’s approach often results in the development of coping skills, many of which are similar to those taught in more structured psychosocial treatment settings, thereby leading to reductions in alcohol consumption (NIAAA, June 2005).

Treatment Progress Dimensions

The American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the Treatment of Substance-Related Disorders, 3rd Edition”, has set the standard in the field of addiction treatment for recognizing the totality of the individual in his or her life situation. This includes the internal interconnection of multiple dimensions from biomedical to spiritual, as well as external relationships of the individual to the family and larger social groups. Life-style addictions may affect many domains of an individual’s functioning and frequently require multi-modal treatment. Real progress however, requires appropriate interventions and motivating strategies for every dimension of an individual’s life.

The Addictions Recovery Measurement System (ARMS) has identified the following seven treatment progress areas (dimensions) in an effort to: (1) assist clinicians with identifying additional motivational techniques that can increase an individual’s awareness to make progress: (2) measure within treatment progress, and (3) measure after treatment outcome effectiveness:

PD- 1. Abstinence/ Relapse: Progress Dimension

PD- 2. Bio-medical/ Physical: Progress Dimension

PD- 3. Mental/ Emotional: Progress Dimension

PD- 4. Social/ Cultural: Progress Dimension

PD- 5. Educational/ Occupational: Progress Dimension

PD- 6. Attitude/ Behavioral: Progress Dimension

PD- 7. Spirituality/ Religious: Progress Dimension

Considering that addictions involve unbalanced life-styles operating within semi-stable equilibrium force fields, the ARMS philosophy promotes that positive treatment effectiveness and successful outcomes are the result of a synergistic relationship with “The Higher Power,” that spiritually elevates and connects an individuals’ multiple life functioning dimensions by reducing chaos and increasing resilience to bring an individual harmony, wellness, and productivity.

Addictions Recovery Measurement – Subsystems

Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed – how should we effectively manage poly-behavioral addiction?

The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual’s comprehensive life-functioning progress dimensions. The “ARMS”- systematically, methodically, interactively, & spiritually combines the following five versatile subsystems that may be utilized individually or incorporated together:

1) The Prognostication System – composed of twelve screening instruments developed to evaluate an individual’s total life-functioning dimensions for a comprehensive bio-psychosocial assessment for an objective 5-Axis diagnosis with a point-based Global Assessment of Functioning score;

2) The Target Intervention System – that includes the Target Intervention Measure (TIM) and Target Progress Reports (A) & (B), for individualized goal-specific treatment planning;

3) The Progress Point System – a standardized performance-based motivational recovery point system utilized to produce in-treatment progress reports on six life-functioning individual dimensions;

4) The Multidimensional Tracking System – with its Tracking Team Surveys (A) & (B), along with the ARMS Discharge criteria guidelines utilizes a multidisciplinary tracking team to assist with discharge planning; and

5) The Treatment Outcome Measurement System – that utilizes the following two measurement instruments: (a) The Treatment Outcome Measure (TOM); and (b) the Global Assessment of Progress (GAP), to assist with aftercare treatment planning.

National Movement

With the end of the Cold War, the threat of a world nuclear war has diminished considerably. It may be hard to imagine that in the end, comedians may be exploiting the humor in the fact that it wasn’t nuclear warheads, but “French fries” that annihilated the human race. On a more serious note, lifestyle diseases and addictions are the leading cause of preventable morbidity and mortality, yet brief preventive behavioral assessments and counseling interventions are under-utilized in health care settings (Whitlock, 2002).

The U.S. Preventive Services Task Force concluded that effective behavioral counseling interventions that address personal health practices hold greater promise for improving overall health than many secondary preventive measures, such as routine screening for early disease (USPSTF, 1996). Common health-promoting behaviors include healthy diet, regular physical exercise, smoking cessation, appropriate alcohol/ medication use, and responsible sexual practices to include use of condoms and contraceptives.

350 national organizations and 250 State public health, mental health, substance abuse, and environmental agencies support the U.S. Department of Health and Human Services, “Healthy People 2010” program. This national initiative recommends that primary care clinicians utilize clinical preventive assessments and brief behavioral counseling for early detection, prevention, and treatment of lifestyle disease and addiction indicators for all patients’ upon every healthcare visit.

Partnerships and coordination among service providers, government departments, and community organizations in providing treatment programs are a necessity in addressing the multi-task solution to poly-behavioral addiction. I encourage you to support the mental health and addiction programs in America, and hope that the (ARMS) resources can assist you to personally fight the War on pathological eating disorders within poly-behavioral addiction.

For more info see:

Poly-Behavioral Addiction and the Addictions Recovery Measurement System,

By James Slobodzien, Psy.D., CSAC at:

[http://www.geocities.com/drslbdzn/Behavioral-Addictions.html]

Food Addicts Anonymous: http://www.foodaddictsanonymous.org/

Alcoholics Anonymous: http://www.alcoholics-anonymous.org/

References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition,

Text Revision. Washington, DC, American Psychiatric Association, 2000, p. 787 & p. 731.

American Society of Addiction Medicine’s (2003), “Patient Placement Criteria for the

Treatment of Substance-Related Disorders, 3rd Edition,. Retrieved, June 18, 2005, from:

http://www.asam.org/

Bandura, A. (1977), Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review,

84, 191-215.

Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist, 41, 765-782.

Centers for Disease Control and Prevention (CDC). Retrieved June 18, 2005, from: http://www.cdc.gov/nccdphp/dnpa/obesity/

Gorski, T. (2001), Relapse Prevention In The Managed Care Environment. GORSKI-CENAPS Web

Healthy People 2010. Retrieved June 20, 2005, from: http://www.healthypeople.gov/

Publications. Retrieved June 20, 2005, from: http://www.tgorski.com

Lienard, J. & Vamecq, J. (2004), Presse Med, Oct 23;33(18 Suppl):33-40.

Marlatt, G. A. (1985). Relapse prevention: Theoretical rationale and overview of the model. In G. A.

Marlatt & J. R. Gordon (Eds.), Relapse prevention (pp. 250-280). New York: Guilford Press.

McGinnis JM, Foege WH (1994). Actual causes of death in the United States. US Department of Health and Human Services, Washington, DC 20201

Humphreys, K.; Mankowski, E.S.; Moos, R.H.; and Finney, J.W (1999). Do enhanced friendship networks and active coping mediate the effect of self-help groups on substance abuse? Ann Behav Med 21(1):54-60.

Kessler, R.C., McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H. H,-U, & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United

States: Results from the national co morbidity survey. Arch. Gen. Psychiat., 51, 8-19.

Morgenstern, J.; Labouvie, E.; McCrady, B.S.; Kahler, C.W.; and Frey, R.M (1997). Affiliation with Alcoholics Anonymous after treatment: A study of its therapeutic effects and mechanisms of action. J Consult Clin Psychol 65(5):768-777.

Orford, J. (1985). Excessive appetites: A psychological view of addiction. New York: Wiley.

Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the boundaries of therapy. Malabar, FL: Krieger.

Slobodzien, J. (2005). Poly-behavioral Addiction and the Addictions Recovery Measurement System (ARMS), Booklocker.com, Inc., p. 5.

Whitlock, E.P. (1996). Evaluating Primary Care Behavioral Counseling Interventions: An Evidence-based Approach. Am J Prev Med 2002;22(4): 267-84.Williams & Wilkins. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed. Alexandria, VA.

U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition). Washington, DC: U.S. Government Printing Office; 2000.

World Health Organization, (WHO). Retrieved June 18, 2005, from: http://www.who.int/topics/obesity/en/