Health And Wellness Evaluation Form Checklist: Fill & Download for Free

What's your thought on requiring a psychiatric evaluation done before the purchase of a gun?There are legal and Constitutional issues with this idea, as well as problems with positive feasible results from such a policy. The legal and Constitutional issues are for the courts to decide and are fairly clear so I won’t go into that, but the evidence is overwhelmingly clear on this topic. In short, there is no way psychological evaluations would be an effective policy to prevent violence.In 2017 there were more than 25,000,000 background checks processed, down from 27,000,000 the previous year. That means we would have to run 25,000,000 evaluations as well. If you really want to degrade the already floundering mental health system tying up clinicians with bureaucratic evaluations is one way to do it, potentially exacerbating the issues that lead to the worst crimes committed with guns. This idea is more likely to make the problem worse, not better, if reducing mass shootings is the goal.We know the evaluations would have to be fairly superficial in order to sustain the inflow of requests. The most popular method of evaluation is the informal interview. Using a superficial single method of evaluation has been shown to be ineffective,Fennig and colleagues (1994) long ago showed that diagnoses derived from clinical interviews alone agreed only about 50% of the time with diagnoses derived from multi-method assessments. In short, our reliance on using one clinician and one source of information (i.e., patient interview) to generate a diagnosis may well create an unreliable and erroneous understanding of the patient.Psychological evaluationIf you want a fairly accurate result you need to use multiple clinicians all using multiple methods. So if two clinicians each use two methods of evaluation that’s about 100,000,000 new appointments a year that serve no purpose in the overall mental health field.Even using multiple clinicians and multiple methods there are still inherent issues with evaluations in general that could lead to abuse and false positives that deny citizens their rights unduly. All ten of the fallacies outlined in this article warrant a read, but this one stands out:Confusing Retrospective & Predictive Accuracy (Switching Conditional Probabilities)Predictive accuracy begins with the individual's test results and asks: What is the likelihood, expressed as a conditional probability, that a person with these results has condition (or ability, aptitude, quality, etc.) X? Retrospective accuracy begins with the condition (or ability, aptitude, quality) X and asks: What is the likelihood, expressed as a conditional probability, that a person who has X will show these test results? Confusing the "directionality'' of the inference (e.g., the likelihood that those who score positive on a hypothetical predictor variable will fall into a specific group versus the likelihood that those in a specific group will score positive on the predictor variable) causes many errors.This mistake of confusing retrospective with predictive accuracy often resembles the affirming the consequent logical fallacy:People with condition X are overwhelmingly likely to have these specific test results.Person Y has these specific test results.Therefore: Person Y is overwhelmingly likely to have condition X.10 Fallacies in Psychological AssessmentOne huge flaw in such evaluations is how incredibly easy it is to lie. Clinicians and patients must have the same goal in mind in order for the evaluation to be effective. The data collected during the interview is completely self-reported. Anecdotally, I have an acquaintance that has a rare form of a disorder that is similar to multiple sclerosis. He has “failed” three psyche evals in order to qualify for disability benefits because he doesn’t want anyone to think he is weak, so he says he is “fine” and lies about his difficulties, something he has done his entire life. Now imagine someone wants to buy a gun. Do you really think they would self-report disqualifying information? This is only made worse with people that have certain kinds of mental illness or disorders such as multiple personality disorders and antisocial personality disorder, which some argue may be risk factors for violent behavior. From 1998 to 2012 around one million people lied intentionally or unintentionally on the background check form 4473 and were denied by the NICS system. Without an instant check of background information the form 4473 would just be a checklist with no verifiable authority. We have no such check for people undergoing a self-reported evaluation.In addition to this, even if we began to run psychiatric evaluations at the time of sale we cannot actually use the results in most states,There are an estimated 3 million living Americans who have been involuntarily committed to mental institutions. The NICS database only contains the names of about 90,000 of these individuals. There are only 17 states that provide information on involuntary commitment for inclusion in the NICS database. Many of the noncompliant states simply have not computerized their records on involuntary commitment. However, a large number of the noncompliant states are also grappling with serious health-information privacy issues and are reluctant to provide the required data to NICS before these issues are resolved.Under the federal Health Insurance Portability and Accountability Act, mental health records may only be released to medical professionals, health insurance workers and quality-control personnel. Ohio’s attorney general has not yet determined how to gain access to the medical records needed to process CCW applications. Because Ohio has a relatively new CCW law, sheriffs are being asked to assist temporarily in checking courthouse records for involuntary-commitment orders. This exercise is both time-consuming and labor-intensive. It’s also unlikely to produce all of the information needed to verify the accuracy of answers provided on Ohio CCW permit applications.Although federal and state laws establish involuntary commitment as a prohibiting factor for gun purchases, mental health professionals contend that there is no scientific basis for this prohibition.According to Dr. Paul Applebaum, vice president of the American Psychiatric Association (APA), “checking for involuntary commitments…doesn’t make sense because past mental illness does not predict future violence.”Mental Illness And Gun Ownership - Guns & AmmoBecause of HIPPA the information gathered by psychiatric evaluations cannot be used in the NICS system because only medical professionals, health insurance workers, and quality-control personnel can access this information. In addition to that, as Dr. Paul Applebaum points out, these kinds of evaluations, even if they provided accurate results, would not constitute an accurate assessment of potential violent behavior in the future.As a side note, there were 19.8 times more legal transactions processed by the NICS system in 2012 alone than denials from the beginning of the NICS system to 2012. That would point to the success rate of any psychological evaluation system being incredibly low, assuming we had an effective, verifiable psychological evaluation system.For more information on evaluation effectiveness you can see: Is it possible for a psychopath to deceive psychiatrist in order to pass psychological test and consider of being normal, no mental-disorder?Psychological evaluations tied to background checks in order to purchase a firearm would only be effective in degrading the mental health system and would not present any positive benefits.

Programs like Rushfit, Insanity and P90X aim to offer a comprehensive program that will help consumers successfully reach their health, fitness and weight-loss goals. There is no question that these are ambitious goals, particularly when you consider how many variables are involved, such as diet, exercise (activity and non-exercise activity) and behavioral change. After all, these are the foundational principles for achieving that elusive physical metamorphosis so many desire, but they must never be offered at the expense of good science and safe programming appropriateness.While each of these programs possesses both merits and drawbacks, it is important to consider the bigger picture. What happens after the immediate workout that leaves a person out of breath and lying flat on his or her back? Or after the short-term extreme diet that promotes unhealthy weight loss? How do these experiences change the way people think and feel about their health and well-being, and how will it influence their choices in the future? A program that leaves an experienced exerciser exhausted and elated at the notion that muscle soreness is merely a forthcoming adaptation means something completely different to an individual who has been told by his or her physician to get into shape. To that end, we hope this evaluation provided greater insight into the strengths and weaknesses of these popular programs. If this review helps you serve the needs and desires of your clients and the public with whom you engage in fitness dialogue more effectively, then we have accomplished our primary goal with this endeavor.The most accurate sided-by-side comparison I've found is posted on the American Council of Exercise website by Fabio Comana. It is an excellent expert lead report!P90X™, Insanity™ and Rushfit™—turn on your TV or computer, and you’ll be hard pressed to miss an infomercial from one of these products claiming that it will transform your body into the “best shape of your life.” Given their extreme popularity (and subsequent profitability), it’s no surprise that these programs have spawned sequels and imitators. Interestingly, each product includes some slick marketing educational piece demonstrating the program’s revolutionary training method for shaping your physique, whether it be through “Muscle Confusion,” “Max Interval Training” or “High Intensity Interval Training.” Hardly revolutionary, these are training modalities that are generally categorized under Metabolic Conditioning (MC). After all, years before these programs existed, renowned researcher Dr. William Kraemer, a professor of kinesiology at the University of Connecticut, Storrs, demonstrated the merits of muscle confusion (non-linear or undulating periodization), including the ability to induce greater levels of metabolic stress and adaptation upon the body. And Tabata, LaForgia and colleagues demonstrated the benefits of high-intensity interval training (H.I.I.T.) approximately 15 years ago. BeachbodyTM (which produces both Insanity and P90X) and others have successfully turned these concepts into revenue-generating goldmines. Of course, popularity is no guarantee of effectiveness, so ACE decided to put P90X, Insanity and Rushfit to the test in a head-to-head match-up to evaluate each on the basis on efficacy, science and safety.A Brief Review of Metabolic ConditioningBefore we get started, let’s briefly review the overall concept of metabolic conditioning (MC), which is defined as training that incorporates more integrated (whole-body), high work rate–type exercise sessions of moderate loads (resistance), coupled with shorter active recovery periods (activity during recovery) or even no-recovery periods. One key goal is to boost caloric expenditure during and after workouts (i.e., excess post-exercise oxygen consumption, or EPOC). This form of training is generally achieved through a combination of one or more of the following:Manipulating load (force generated) or the amount of resistanceManipulating the volume of work performed (usually quantified by the amount of sets times the number of repetitions performed in a session)Manipulating power or the rate at which work is performedThe initial strength improvements often witnessed early in a program are attributed more to neurological changes within the body as opposed to increases in muscle mass or size.Metabolic conditioning represents many different things to different individuals. To the athlete, it is specific training that mimics the demands of their sport—more specifically, the movement patterns and energy pathways needed for performance. To occupational professionals (e.g., firefighters, military servicemen or -women), tactical metabolic conditioning is task-specific, preparing them to perform their jobs successfully, efficiently and free from harm. For most people, however, MC is really just about health and fitness, with workouts designed to focus primarily upon helping individuals lose weight by increasing the number of expended calories during exercise and recovery. To a lesser extent, they also emphasize building muscle mass, which in turn increases the body’s metabolic flame (the increase in resting metabolism associated with having more muscle tissue). Contrary to many of the testimonials offered within infomercials, the reality is that while muscle conditioning (endurance, toning, etc.) is a likely outcome, most adults are lucky if they achieve significant muscle gains during these relatively short, defined program timeframes (e.g., 60, 90 days or eight weeks). While muscle typically takes four to six weeks after beginning a workout to start showing any increase in mass and size, a majority of research only shows adults gaining 2 to 4.5 pounds during studies lasting eight to 52 weeks.Initial Product ImpressionsThrough both infomercials and the Web, all three products utilize an effective marketing strategy to capture interest, especially through vicarious experience (seeing others successfully performing the workouts). Thus, after ordering each product, task number one was to review the introductory segments of each program, then take more time to review all the DVDs. Table 1 compares the costs, requirements, and overall appeal of the host and presentation of the workouts, while Table 2 details the goals, objectives and format of each program. http://www.acefitness.org/certifiednewsarticle/1443/p90x-insanity-and-rushfit-a-side-by-side/How Do the Three Programs Measure Up?The three programs are compared side-by-side for overall content, quality, training purpose(s) and strengths. A 1 to 10 scoring system (Tables 3, 4 and 5) is used for qualitative and quantitative purposes to evaluate each parameter measured, with a “1” indicating “poor” and a score of “10” indicating “excellent.”http://www.acefitness.org/certifiednewsarticle/1443/p90x-insanity-and-rushfit-a-side-by-side/Scientific Value: Evaluation, Appropriateness and SafetyRushfit: Overall Exercise Program ImpressionsTrainer Erik Owings demonstrates a solid understanding of science, exercise programming and progression. This program offers foundational instruction of key movement patterns that include squats, lunges, push-ups, sit-ups, rotations and dumbbell exercises, but he does miss some important technique cues (e.g., hip-hinging, lumbar stability) and key compensations, such as St-Pierre’s lack of mobility during squats, during which his feet fall into pronation and his heels lift during the lowering phase. This is a bit concerning given the repetitive nature and complexity of some of these exercises and movement patterns.However, Owings clearly is knowledgeable about training the body and energy systems, as evidenced by his progressions and work-to-recovery ratios (e.g., during his plyometric intervals, he incorporates appropriate work-to-recovery ratios. He also demonstrates easier exercise alternatives and modifications for many of his movements for novice exercisers.The exercise and movement patterns selected mimic various activities of daily living while also introducing a variety of basic movements and techniques needed by the MMA fighter (especially in The Fight Conditioning Workout). All the participants perform the workouts barefoot, much the way an MMA fighter trains and fights. While I personally believe we all need some form of barefoot training, not everyone should or will want to train barefoot. This does not imply that these workouts cannot be performed with shoes on, but I think some discussion on the matter would have been helpful.The workouts offer a comprehensive approach to MC training that targets a variety of the health-related parameters of fitness (endurance, strength, flexibility and cardio) and the skill-related parameters of fitness (power, agility, balance, coordination and quickness).Insanity: Overall Exercise Program ImpressionsFrom a scientific standpoint, what is most alarming about the Insanity program is the overall lack of understanding of science, programming and how to effectively train the energy pathways. This is evident from start to finish. For example, DVD #1 features a battery of eight fit tests, each challenging the exerciser to complete as many repetitions of a particular movement in 60 seconds, separated by brief 30- to 60-second recovery intervals. Given the protocols selected, sequence of testing and the work-to-recovery ratios, one must question the validity and purpose of this battery. A good test administrator recognizes the need for purposeful tests that avoid redundancy, utilizes a progressive test sequence (assessing more compound movements first) and also allows for appropriate muscle and energy pathway recovery between assessments. All of these elements are missing, as the tests induce partial fatigue with simpler movements before the more complex and challenging protocols are conducted. Additionally, it strings together a series of almost redundant jumping drills in succession before concluding with two assessments emphasizing the upper extremity. Even the most basic of circuits alternates between the upper and lower extremities to allow for appropriate recovery.Equally concerning is the intensity of the warm-ups, which last approximately 10 minutes and have the models sidelined in exhaustion. This is followed by approximately five to eight minutes of static stretching, which makes little sense given the mostly plyometric-based training that follows. On a positive note, however, a static stretching component is appropriately included in the post-exercise segment.The coaching cues and exercise instruction are poor. The introductory DVD begins with some basic instruction and a review of four basic movements that are used frequently throughout the program—jumps, squats, planks and a C-sit. Not only are most of these movements instructed incorrectly, but many of the technique instructions are simply read from a checklist, with almost no explanation or demonstration to the end-user. Additionally, on countless occasions, the trainer emphasizes a specific technique in one area while neglecting other more significant compensations (e.g., missing repeated valgus stress in the knees during jump-landing in many of the female models, while demonstrating a firm core). Most experts agree that it is not advisable to introduce jumping activities until you have successfully instructed individuals how to land correctly, a basic premise omitted with this program.While each workout features a unique (albeit similar) title, it is almost impossible to make sense of each workout’s objective or differentiators, other than simply inducing fatigue and exhaustion with repetitive exercises and to burn calories. This suggests that the trainer, Shawn T, simply devised a series of exercises (emphasizing low-to-moderate lower-extremity plyometric exercises), then randomly assigned them to different workouts without rhyme or reason.Dr. Donald Chu, a leader in plyometric training and research, has long suggested that appropriate plyometric volumes for athletes should be based upon training experience and intensity, and determined by the number of foot or upper-extremity contacts. While most of Insanity’s drills qualify as low-to-moderate intensity drills, the number of foot contacts featured in several sessions is almost double the number suggested by Chu, which raises concerns about repetitive micro-trauma or overuse.No programming philosophy appears to exist for how the workouts are sequenced during the “circuits” (e.g., alternating upper and lower extremities or push-pull movements), and DVDs labeled as “Max” are simply longer workouts. Almost every DVD involves jumping, along with static and dynamic balance drills (to a lesser extent). The “Max Interval Plyo” workout primarily targets muscular endurance and only has four true plyometric exercises. Given their complexity and increased potential for injury, plyometrics are traditionally performed early in a session.Curiously, Cardio Abs is filled with jumping activities, and the Core Cardio and Balance workout introduces three true balance exercises during the last 14 minutes of the workout. Again, balance training is traditionally positioned toward the earlier phases of a session when concentration levels are higher (e.g., during dynamic warm-ups).Exercisers are frequently asked to monitor heart rate (HR), but no information or explanation is offered regarding target HR zones or appropriate HR training intensities.While this program demonstrates popularity among competitive, athletic individuals, perhaps creating a cult-like following, it does present a myriad of concerns for the average deconditioned individual who is simply trying to improve his or her overall health and fitness. Although Insanity’s effective marketing campaign clearly states this “program is not for everyone,” part of its success is attributed to how effectively it baits one’s competitive fervor, whether conditioned or not.For the average person, Insanity’s exercise intensities, exercise selections, sequences, durations and work-to-recovery ratios are inappropriate and, at a minimum, may breed disappointment. When exercisers are encouraged to use outcome goals (e.g., complete as many reps as possible in 60 seconds) without adequate recovery, it is just a matter of time before individuals begin to perceive failure if they are unable to complete some (or even most) of the assigned drills.P90X: Overall Exercise Program ImpressionsOne of the first things that is evident from the P90X DVDs is the charisma and humor that characterizes Tony Horton’s teaching style. He possesses a strong ability to engage participants and build rapport effectively, demonstrating skill sets so critical for success when working with people. Additionally, his sense of humor certainly helps alleviate the anxieties many people possess associated with exercise. Undeniably, these traits probably account for much of the success his program has enjoyed.Metabolic or physiological stress, or “muscle confusion” as he calls it, is nothing new, but he has developed a comprehensive system that puts it into practice. His program design, while not perfect, as no program ever is, is deeply rooted in science. It is evident that he has gone to great lengths to develop his program and consider which of the various parameters of physical fitness should be included. He identifies appropriate exercise modifications for more inexperienced individuals, understands how to train muscle groups (split routines) and how to sequence exercises with appropriate recovery intervals. Although he does miss key biomechanical flaws and cues during his instruction and coaching of various exercises, he is attentive to safety and his instructional cues are generally solid.Unfortunately, one disappointing aspect of P90X is the need to make a considerable investment into ancillary equipment to complete the workouts. Unlike the other products, the muscle-strengthening focus of P90X requires resistance equipment, which may come as an unexpected surprise to many consumers. While this equipment is readily available within the confines of a commercial gym, most people intend to perform these DVD-based workouts at home. It is no surprise, then, that Beachbody offers all of the necessary equipment for purchase on its Web site. Of course, these items can also be found at most sporting-goods stores, as well.As with Insanity, exercisers are frequently asked to monitor heart rate (HR), and check target HR zones, but little explanation is offered for why this is necessary. While there is an initial cardio test that measures recovery HR, no information or explanation is offered in the program regarding target HR zones or appropriate HR training intensities.Dietary ComponentsFor most people, the impact on weight loss of a calorie-restricted diet is greater than the effects of exercise during the initial phases of a weight-loss program. When one considers initial tolerance levels for exercise intensity, duration and frequency for most deconditioned individuals, and the fact that elevated metabolic rates attributed to the addition of a few added pounds of lean mass do not occur for four to six weeks, a successful program to transform the body has to include effective dietary strategies. With that in mind, let’s take a look at how the three programs stack up in terms of nutritional and weight-loss advice.RushfitRushfit’s nutrition guide is very simple, suggesting healthier sources for the three macronutrients (carbohydrates, protein and fats) and a variety of effective dietary strategies. The program also offers pre- and post-exercise snack or meal guidelines. While the pre-workout macronutrient proportions and hydrationstrategies fall in line with recommendations from current research, the post-exercise guidelines prove somewhat questionable. The general nature of their workouts is anaerobic endurance, which utilizes carbohydrates as a primary fuel, necessitating glycogen replenishment during recovery, especially during the first one to two hours post-exercise when recovery rates are greatest. Reducing carbohydrate intakes to 35 percent of consumed calories during this period only serves to retard glycogen recovery, which normally can take 24 to 36 hours. Consequently, progressively lowering available glycogen stores will compromise energy and performance levels in successive workouts.The body requires carbohydrates to metabolize fats completely, and if an individual’s carbohydrates stores become progressively depleted, his or her fuel utilization will be compromised. Without adequate carbohydrates provided by the diet, the body turns to a viable alternative to convert specific amino acids to glucose for fuel or to allow it to continue burning fats. Unfortunately, 99 percent of these usable proteins exist in the form of muscle tissue; thus, this practice simply promotes attacks on muscle protein.While protein is crucial to recovery for muscle synthesis, suggesting 55 percent of the post-exercise calories originate from protein stores is excessive. Various research studies demonstrate a 3:1 or 4:1 ratio of carbohydrates-to-protein as optimal for enhancing recovery rates after exercise.Estimates of daily caloric expenditure or caloric need are important, yet very difficult to ascertain. Many rely upon standardized formulas (e.g., Harris & Benedict) and standard activity factors to estimate current activity and total daily energy expenditure. While these formulas are commonly used, it is important to understand that they can feature large margins of error of as much as 500 to 750 kcal per day.P90XBeachbody’s business model relies significantly upon income generated through their supplement line, and both the P90X and Insanity programs prominently feature supplement sales. In the interest of time, this discussion will focus upon the P90X’s Nutrition Plan, which is both extensive and controversial. Although Carrie Latt Wiatt, author of various nutritional books, is featured and appears to endorse the P90X nutrition plan (on DVD #1), this diet does deviates significantly from current 2010 USDA Dietary Guidelines.P90X contains a three-phase nutrition plan (approximately 30 days each) and allows the user to choose the most suitable timing and plan. Each phase is significantly different and some research does support the notion of changing one's diet composition and caloric intake on a regular basis as a means to induce metabolic stress and possibly assist in weight loss.Phase 1: Fat ShredderMacronutrient composition: 50 percent protein, 30 percent carbohydrate, 20 percent fatClaim: High-protein diet designed to strengthen muscle will rapidly shred fat from the bodyConcerns: The 2010 USDA Dietary Guidelines suggest that 45 percent to 65 percent of total calories should originate from carbohydrate sources, yet this dietary phase targets 30 percent, an amount considered carbohydrate-restricted.One stated objective behind this phase is to shed fat, but realistically much of the initial and rapid weight loss will stem predominantly from the loss of water rather than true fat loss. After all, carbohydrate-restricted diets gradually deplete the quantity of stored carbohydrates (glycogen) within the body, and for every gram of glycogen stored, 2.4–2.7 g of water are stored. Therefore, as these stores deplete, much of the weight lost is simply the release of water mass (e.g., sweat, urine), but this mass will return once a healthy, non-carbohydrate-restricted diet is resumed. Additionally, restricted carbohydrates diets tap energy reserves, increasing fatigue and decreasing exercise performance.As carbohydrates stores are depleted, the body attempts to spare the remaining carbohydrates and burn more fats. However, without adequate dietary carbohydrates, the body will utilize available proteins to manufacture glucose (carbohydrate). While this may spare any attacks upon existing muscle, the process of metabolizing proteins for energy or conversion to glucose exacts a toll on both the liver and kidneys, increases urine output and possible dehydration, and, as some research suggests, may potentially increase bone calcium losses.Following the example provided on page 5 of the nutrition plan (180-pound male classified in Level II aiming for 2,400 kcal/day), 50 percent of kcal from protein would amount to 1,200 kcal, or 300 g/day of protein. By contrast, the Recommended Dietary Allowance (RDA) for this same individual is 65.5 g/day, and leading fitness organizations suggest that a resistance-trained 180-pound male should consume 115 to 147 g/day of protein. In fact, the highest level of protein intake considered to be safe for this individual is 164 g/day, which is considerably less than the P90X guideline suggests.Furthermore, a high-protein intake makes even less sense given that little muscle growth actually occurs during the first four to six weeks. Rather, initial strength gains are associated primarily with neurological changes that do not require mega amounts of protein to achieve that outcome.Recommendation: Skip this phase. Be smart and follow the current USDA Dietary Guidelines. Do not restrict carbohydrates below 45 percent of total calories consumed. Keep your protein intake between 10 percent and 35 percent of total caloric intake (meets current guidelines) and not at the 50 percent this phase recommends. If you have specific needs or possess a strong desire to follow this phase, talk to a registered dietitian first.Phase 2: Energy BoosterMacronutrient composition: 40 percent protein, 40 percent carbohydrate, 20 percent fatClaim: A balanced mix of carbohydrates and protein with lower amounts of fat will supply additional energy for performanceConcerns: This phase is referred to as an energy booster, and individuals should probably experience greater energy levels because near-normal levels of carbohydrates are being reintroduced. Following this diet during the second month of training, when additional protein is needed for muscle building, does merit good protein intake. However, the recommendation to consume 40 percent protein and 40 percent carbohydrates is still outside of recommended guidelines for active individuals.Recommendation: In terms of protein and carbohydrate intake, Phase 2 is considerably better than Phase 1.Phase 3: Endurance MaximizerMacronutrient composition: 20 percent protein, 60 percent carbohydrate, 20 percent fatClaim: An athletic diet of complex carbohydrates, lean proteins and lower fat is the necessary combination to get the most out of this final training block.Concerns: This training block is simply block 1 and block 2 repeated (weeks 9 & 11 = Block 1, week 10 & 12 = Block 2). While this phase matches the current dietary recommendations and most closely resembles the traditionally dietary plans of endurance athletes, a 60 percent carbohydrate intake may not be suitable or palatable for all.Recommendation: If more cardio and endurance is the goal, then shifting toward this diet is logical. Furthermore, 45 percent to 55 percent carbohydrates, 20 percent to 25 percent protein and 20 percent to 30 percent fat is healthy and will satisfy almost all individuals.Finally, a word about Beachbody’s supplement upsale: Arguably, supplements have value for some individuals, but are they necessary when one’s goal is to simply improve overall health and fitness? Not if a well-balanced and healthy diet is followed. However, those who sell or endorse supplements will necessarily take a different stand. Supplements should always be considered a complement to diet rather than a replacement for proper nutrition.Beachbody’s recommendation to consume 4 to 8 ounces of fluid every 15 minutes during exercise is alarming given that leading health and fitness guidelines suggest 7 to 10 ounces every 15 minutes during exercise.An exceptional article from Fabio Comana, M.A., M.S., is an exercise physiologist and spokesperson for the American Council on Exercise, and an adjunct professor at San Diego State University (SDSU) and the University of California San Diego (UCSD), teaching courses in exercise science and nutrition. He holds two master’s degrees, one in exercise physiology and one in nutrition, as well as certifications through ACE, ACSM, NSCA and ISSN.via http://www.acefitness.org/certifiednewsarticle/1443/p90x-insanity-and-rushfit-a-side-by-side/

As a gun owner, can you support extended wait times and background checks to help keep guns from the mentally ill? Do you have any other good ideas to keep our children safe while maintaining your 2nd amendment rights?First, children in the US are statistically safe from mass shootings. The odds of a child being involved in one is about 0.000000135 in a year. Waiting periods alone have shown to have no effect.I’m assuming you mean to say mental health screenings will be added to the background check system in order to keep guns from the mentally ill and that the added time would be to process those screenings. The answer is no, currently this is an impossibility, but if it were made possible it is not feasible, nor do mental health screenings actually have any predictive value. The following has been written for a very similar question:One popular argument is that we should add psychological testing as a criteria for owning a firearm to weed out people with mental illnesses, and some want this test to be applied each time a firearm is purchases as a part of the background check system.There are legal and Constitutional issues with this idea, as well as problems with positive feasible results from such a policy. The legal and Constitutional issues are for the courts to decide and are fairly clear so I won’t go into that, but the evidence is overwhelmingly clear on this topic. In short, there is no way psychological evaluations would be an effective policy to prevent violence.In 2017 there were more than 25,000,000 background checks processed, down from 27,000,000 the previous year. That means we would have to run 25,000,000 evaluations as well. If you really want to degrade the already floundering mental health system tying up clinicians with bureaucratic evaluations is one way to do it, potentially exacerbating the issues that lead to the worst crimes committed with guns. This idea is more likely to make the problem worse, not better, if reducing mass shootings is the goal.We know the evaluations would have to be fairly superficial in order to sustain the inflow of requests. The most popular method of evaluation is the informal interview. Using a superficial single method of evaluation has been shown to be ineffective,Fennig and colleagues (1994) long ago showed that diagnoses derived from clinical interviews alone agreed only about 50% of the time with diagnoses derived from multi-method assessments. In short, our reliance on using one clinician and one source of information (i.e., patient interview) to generate a diagnosis may well create an unreliable and erroneous understanding of the patient.Psychological evaluationIf you want a fairly accurate result you need to use multiple clinicians all using multiple methods. So if two clinicians each use two methods of evaluation that’s about 100,000,000 new appointments a year that serve no purpose in the overall mental health field.Even using multiple clinicians and multiple methods there are still inherent issues with evaluations in general that could lead to abuse and false positives that deny citizens their rights unduly. All ten of the fallacies outlined in this article warrant a read, but this one stands out:Confusing Retrospective & Predictive Accuracy (Switching Conditional Probabilities)Predictive accuracy begins with the individual's test results and asks: What is the likelihood, expressed as a conditional probability, that a person with these results has condition (or ability, aptitude, quality, etc.) X? Retrospective accuracy begins with the condition (or ability, aptitude, quality) X and asks: What is the likelihood, expressed as a conditional probability, that a person who has X will show these test results? Confusing the "directionality'' of the inference (e.g., the likelihood that those who score positive on a hypothetical predictor variable will fall into a specific group versus the likelihood that those in a specific group will score positive on the predictor variable) causes many errors.This mistake of confusing retrospective with predictive accuracy often resembles the affirming the consequent logical fallacy:People with condition X are overwhelmingly likely to have these specific test results.Person Y has these specific test results.Therefore: Person Y is overwhelmingly likely to have condition X.10 Fallacies in Psychological AssessmentOne huge flaw in such evaluations is how incredibly easy it is to lie. Clinicians and patients must have the same goal in mind in order for the evaluation to be effective. The data collected during the interview is completely self-reported. Anecdotally, I have an acquaintance that has a rare form of a disorder that is similar to multiple sclerosis. He has “failed” three psyche evals in order to qualify for disability benefits because he doesn’t want anyone to think he is weak, so he says he is “fine” and lies about his difficulties, something he has done his entire life. Now imagine someone wants to buy a gun. Do you really think they would self-report disqualifying information? This is only made worse with people that have certain kinds of mental illness or disorders such as multiple personality disorders and antisocial personality disorder, which some argue may be risk factors for violent behavior. From 1998 to 2012 around one million people lied intentionally or unintentionally on the background check form 4473 and were denied by the NICS system. Without an instant check of background information the form 4473 would just be a checklist with no verifiable authority. We have no such check for people undergoing a self-reported evaluation.In addition to this, even if we began to run psychiatric evaluations at the time of sale we cannot actually use the results in most states,There are an estimated 3 million living Americans who have been involuntarily committed to mental institutions. The NICS database only contains the names of about 90,000 of these individuals. There are only 17 states that provide information on involuntary commitment for inclusion in the NICS database. Many of the noncompliant states simply have not computerized their records on involuntary commitment. However, a large number of the noncompliant states are also grappling with serious health-information privacy issues and are reluctant to provide the required data to NICS before these issues are resolved.Under the federal Health Insurance Portability and Accountability Act, mental health records may only be released to medical professionals, health insurance workers and quality-control personnel. Ohio’s attorney general has not yet determined how to gain access to the medical records needed to process CCW applications. Because Ohio has a relatively new CCW law, sheriffs are being asked to assist temporarily in checking courthouse records for involuntary-commitment orders. This exercise is both time-consuming and labor-intensive. It’s also unlikely to produce all of the information needed to verify the accuracy of answers provided on Ohio CCW permit applications.Although federal and state laws establish involuntary commitment as a prohibiting factor for gun purchases, mental health professionals contend that there is no scientific basis for this prohibition.According to Dr. Paul Applebaum, vice president of the American Psychiatric Association (APA), “checking for involuntary commitments…doesn’t make sense because past mental illness does not predict future violence.”Mental Illness And Gun Ownership - Guns & AmmoBecause of HIPPA the information gathered by psychiatric evaluations cannot be used in the NICS system because only medical professionals, health insurance workers, and quality-control personnel can access this information. In addition to that, as Dr. Paul Applebaum points out, these kinds of evaluations, even if they provided accurate results, would not constitute an accurate assessment of potential violent behavior in the future.As a side note, there were 19.8 times more legal transactions processed by the NICS system in 2012 alone than denials from the beginning of the NICS system to 2012. That would point to the success rate of any psychological evaluation system being incredibly low, assuming we had an effective, verifiable psychological evaluation system.For more information on evaluation effectiveness you can see: Is it possible for a psychopath to deceive psychiatrist in order to pass psychological test and consider of being normal, no mental-disorder?Psychological evaluations tied to background checks in order to purchase a firearm would only be effective in degrading the mental health system and would not present any positive benefits.ConclusionI could go on and on about other topics, like ATF budget and personnel issues, or NICS failures, but I think this is enough to explain the situation. We can’t make people submit to the system and those that operate outside the system cannot be controlled. The common claim that mental illness should be a primary factor in approving or denying a sale of a firearm is not only a costly bureaucratic mess, even if we could settle the privacy issues that make it impossible right now, but has no ability to improve the situation. Many people ask, “Why haven’t we made it harder to legally buy a firearm?”. The answer: because it wouldn’t improve anything. Making it more difficult for lawful citizens to legally own firearms doesn’t punish or restrict criminals that do not subscribe to the system. It’s only common sense that targeting people that aren’t the problem won’t fix the problem.For more information on the situation in the US you can see: Fred Lead's answer to Can pro-gunners not understand that a firearms ban is not just what we want, but what's necessary because innocent civilians are dying? They can't prevent shootings, so there's no other option.For more on school shootings: Fred Lead's answer to What should be done about school shootings?