How Extreme Heat Is Changing Patient Care for Older Adults

Posted on by Joseph Gerard

Meeting the needs of all populations.

Written by Lucy Peters

Every summer breaks new temperature records. The periods of extreme heat that used to occur only rarely have become normal and are increasingly long and frequent. For the healthcare system, the unusual environmental phenomenon has long since become a serious clinical issue in dealing with older people. Heat-related illness is becoming a common clinical issue as the climate continues to heat up. However, heat does not just cause dehydration. In fact, it can worsen existing disease, interact with medicines and even cause transient cognitive impairment or alter mental status in otherwise stable patients.

Why Heat Has Become a Growing Healthcare Concern

Global average temperature is still rising and abnormal weather such as longer lasting and stronger heat waves keeps occurring all over the world. In addition, the temperature in cities is getting higher. This is because city surfaces, roads and buildings made of concrete and asphalt retain heat throughout the day, and create what researchers describe as the urban heat island effect.

Extremes of heat are becoming a predictable seasonal challenge for health care systems. Besides placing increased pressures on hospital and emergency department services and other health care services and programs in the community, a very large proportion of younger and middle aged people are admitted due to the effects of heat. However, older adults account for a disproportionate number of heat-related admissions, and the reasons extend far beyond spending too much time outdoors. The reality is that aging changes how the body responds to heat in ways that many people never consider.

Ageing Changes the Body’s Response to Heat

Keeping your internal temperature at a constant level is very important. Your body has a natural defense in the form of the cardiovascular system, kidneys, nervous system and your skin. As we age, the protective functions are weakened. Less sweat is produced by your sweat glands, which means that evaporation cannot take place to cool down your body. Blood vessels respond more slowly, which limits the body’s ability to move heat from its core to the skin where it can dissipate. Cardiac reserve also declines with age, reducing how effectively the heart can increase circulation during periods of thermal stress.

A reduced sense of thirst can also affect older people. Consequently, they can become seriously dehydrated before feeling thirsty and experiencing its effects. These natural changes of aging and the uncomfortable conditions of extreme weather can quickly create problems for older people such as dehydration, and imbalanced supply of electrolytes. So what causes mild discomfort for a fit, young person could cause a problem like heat exhaustion for someone over 75 years of age.

Chronic Illnesses Multiply the Risks

Most older adults are managing at least one long-term health condition, while many live with several. During periods of extreme heat, these conditions can become considerably harder to control. Heart failure provides a clear example. As temperature rises, blood vessels dilate to release excess heat. This normal cooling response causes blood pressure to drop. The heart of failing patients therefore, tries to compensate for decreased blood pressure by increasing work to attempt to maintain circulation. Since the failing heart is already working suboptimally, an increase in its work can lead to a decline in clinical status and even to hospitalization.

People with kidney disease also need consideration. Their kidneys rely on a constant supply of blood to be able to clear waste products from the body. In the dehydrated patient with kidney disease, the blood supply to the kidneys can rapidly drop, which can lead to a sudden decline in kidney function and may result in a patient developing acute kidney injury even after relatively modest fluid loss.

People with diabetes have additional issues to contend with in heatwaves. The higher temperature can cause the insulin in a diabetic patient to be absorbed more quickly into the body, leading to a risk of a hypoglycemic attack. In addition, they are at risk of fluctuations in blood glucose levels due to dehydration. Therefore, diabetes management becomes far more complex during a prolonged heatwave.

The problems of respiratory disease can also increase in extreme heat. The hot stagnant air can be very loaded with pollutants and with ozone which can irritate the inflamed airways of people suffering from respiratory disease such as asthma or chronic obstructive pulmonary disease. Combined, they explain why extreme heat can destabilize patients whose health had previously been well managed.

Medications Can Increase Heat Vulnerability

As we’ve discussed, the conditions themselves are causing enough issues, but many of the typical medications for older adults also affect the body’s ability to regulate in the heat. Diuretics for example cause increased fluid loss thus increasing the chance of dehydration in hot, long periods of time. Other blood pressure medications (e.g. ACE and angiotensin receptor blockers) may contribute to declining kidney function when dehydration develops. Beta blockers reduce the heart’s ability to increase its rate in response to heat stress, limiting one of the body’s natural cooling mechanisms.

Certain types of antidepressants and antipsychotics have anticholinergic effects, and can cause people to stop sweating with severe consequences in hot weather. Because older people are often on medications for long-term health conditions, the risk of severe heat-related illness becomes even higher. But the good news here is that medication reviews help patients before the warm months and also during the warm months. These reviews become even more valuable when the weather gets hotter, and this is especially true for patients who manage several chronic illnesses.

Practical Steps Healthcare Professionals Can Take

Prevention of heat related illness starts well before temperatures reach dangerous levels. Use of routine medical appointments to discuss patients’ hydration and to review their medications for potential effects of heat is important. By asking questions such as whether the patient lives alone, whether they have air conditioning and can easily leave their home during a heatwave may reveal risks that would otherwise remain hidden.

Strategies to cool down the body are important to reduce the body load. Air conditioning is especially effective, as it not only cools down but also reduces the humidity. This way the body can lose heat by evaporation, which is the most beneficial and effective for people of any age. It’s also important to mention that even spending a few hours each day in a cool environment can significantly reduce the risk of heat-related illness for vulnerable older adults.

In addition to early warning signs of severe heat illness, such as dizziness, unusual fatigue, muscle cramps, confusion, headaches and reduced urine output, patients should be encouraged to monitor for these early signs of heat illness. Patients during periods of extreme heat can also benefit from cooling centers, from welfare checks and home support services during prolonged periods of extreme heat. Home safety should also be part of these conversations. Portable air conditioners, ceiling fans and other cooling devices can only be effective if the home’s electrical system can safely support them. This means a property could have old wiring or too many appliances on for too long a time, potentially resulting in an electrical fault. Where upgrades or repairs are needed, families can use local trusted directories to search for qualified electricians to complete the work. Also, family caregivers need education as well. Many people think that offering a drink now and then is enough, but older adults often need frequent reminders to drink water before they feel thirsty.

Heat Will Continue to Shape Future Patient Care

Heat is becoming a regular feature of clinical practice, affecting people with cardiovascular disease, kidney disease, diabetes, respiratory illness and cognitive decline. To address heat, healthcare needs to think differently about it, because dehydration is no longer considered a seasonal health problem but a clinical risk factor that affects health in every dimension for older people. Early education, proactive medication reviews, environmental assessments and coordinated community support can all prevent serious illness and its consequences before they occur.

Author bio

Lucy is a freelance writer who enjoys contributing to a range of publications, both in print and online. She spent almost a decade working in the care sector with vulnerable people before taking a step back to start a family and now focuses on her first love of writing.

 

 

Please also review AIHCP’s Health Care leadership Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Christian Counseling and Etiology of Psychopathology

Posted on by Mark Moran

Pathology is disease and sickness.  With disease and sickness is the result of suffering and death.  These concepts are all intimately tied to the human condition which begs the question “why must we suffer”?  Different philosophies have different explanations throughout time.  Secular sources recognize pathology as the natural order of evolution.  Psychopathology and any pathology is part of life as organisms live and die within the cosmic struggle of existence.  Pathology is treated in the present moment and its etiology is categorized according to an empirical process of elimination based upon categories of biological causes, psycho-social causes and cultural causes.   Religious traditions also vary.  Buddhism and Hinduism recognize suffering as central to the human condition.  Buddhism seeks to escape the pathologies and resulting suffering of this world through Nirvana or the becoming into nothingness, while Hinduism recognizes this world as a great illusion and suffering as a result of karma.  Monotheistic creeds consider suffering to be a result of deviance from God’s moral law.  Christianity, in particular, recognizes suffering not merely as deviation from God, but also a broken human condition as a result of that deviation.  Individuals are born into this world subject to suffering.  Hence, as a result of sin, humanity experiences a traumatic condition, its consequences and also the continuance of sin itself in actuality (Boerger, et. al., 2023).   Sin, according to St. Thomas Aquinas, is thus a disordered action from God which leads to disastrous consequences that naturally include pathology.

In this blog, we will examine these concepts, but look deeper from a Christian Counseling perspective of an etiology that encompasses sin as the core root of pathology and how integration of modern psychology and pastoral care can emerge to a more holistic and complete care of not just mind and body, but also soul.  Please also review AIHCP’s Christian Counseling Certification, as well as its Christian Grief Program and also its Christian Spiritual Direction Certification.

Theodicy

Since pathology is part of life, humanity experiences suffering and death.  At the core root and etiology of it is sin, yet this suffering and pain seems so unfair.  The death  and gross genocide of a population at the hands of a ruthless regime, the death of an young child to cancer, or the devastation of a storm to a community all point to a horrific world marred by sorrow.  When individuals refuse to acknowledge sin and its corruption of the natural design, it leads to anger towards God.  The question within Christian theodicy is how can a good and all powerful God permit evil? Kelly, 2002) Either God is not all powerful to prevent the evil, or He is not all good to permit it.  This classical attempt to limit one to either/or confuses the reality of human and angelic free will and its part in the cosmic story of temporal reality.   Free will is what guarantees sentience.  God has given sentient creation made in His image the choice to love or hate Him.  When disordered response emerge in free willed creatures, horrible consequences occur.  God was willing in His foresight to permit these evils at the expense of free will.  One can only include that the price of free will is essential to being made in the image and likeness of God.

Unlike other faiths or philosophical explanations of evil in the world, the Christian worldview believes in a God who through Jesus Christ, both God and man, died for His creation to repair the spiritual damage of sin with promise of eternal life free of suffering.  God, through Jesus, did not allow His creation to suffer alone but came as an example to expose the temporal world for its folly, and to suffer with humanity and ultimately die for it.  This is the ultimate act of mercy and justice grounded in infinite love.

Soul Care and Modern Psychology

Care of the soul and mind is essential in treating psychopathologies. Please also review AIHCP’s Christian Counseling Certification

Psychology before the advent of Sigmund Freud was more likened to pastoral care for the mind.  Within it existed not only age old wisdom collected from Scripture, patristic fathers, and medical knowledge of the times, but also an element that acknowledged that beyond the mind existed the soul.   With this metaphysical prerequisite, care of the soul equated to treating many pathologies from a religious and spiritual perspective (McRay, et al., 2016).   This allowed certain conditions of the mind to be seen in correlation with states of the soul.  Concepts of sin, its consequences, the habitual growth of vice in the soul, and the forces of the demonic were all considered when tying things to depression, anxiety, sexual deviations, or even anti-social disorders.  Of course, the primary issue was that pre-scientific minds were limited in the study of pathology.  This led to an over emphasis of explaining everything as a result of the unseen and in some cases superstitious understandings of mental defect.  Modern psychology corrected this but went a step even farther that eliminated any emphasis of soul care.  Empiricism and the scientific method over corrected the imbalance, removing any concepts of metaphysical causes or the need of care of the soul.  Instead, modern science attempted to eradicate metaphysics all together since metaphysics is a non-observable study.

The modern scientific method corrected many superstitious ideals and labeled unknown pathologies to their proper etiologies but in its clean sweep of all metaphysical explanations, it reduced itself to a sterile tool only capable of abstracting data from observable phenomenon.  Concepts of sin or its correlation with mental defect were removed and the idea of the soul was attempted to be completely explained within the physiology of the brain.  Modern and secular science boasted it had mapped the “soul” to the brain and reduced it to a physical origin.   This led to a new imbalance.  Instead of a pre-scientific mindset which over attributed all pathology to the unseen, the post-scientific mindset attributed all pathology only to the observable and natural.

Christian Worldview

A Christian worldview is a religious and metaphysical worldview.  Uniquely different than other religious and metaphysical views, it considers the physical world to be broken with death and suffering.  It considers the temporal world to be a flawed design that was not originally intended by the Creator but marred because of sin or deviation from God.   First, the disobedience the demonic and then followed by the sin of Adam created a disturbance in creation that led to discord.  For humanity in particular, the sin of Adam thrust humanity into the temporal reality.  Genesis states that due to Adam and Eve’s sin, death entered into their world.  St. Augustine coined the term for this as “Original Sin” (Lamoureux & Wadell, 2010).  Original sin corrupted the nature of humanity.  Before, Adam contained great knowledge, control of his passions, and an inclination towards good that was not clouded to disorder, but after his fall, humanity’s nature, albeit not totally corrupted, was disorientated away from God.  With this traumatic state, grace was cut off from the soul and humanity’s body was subject to suffering, pathology and death.  Hence, a new condition, its consequences and continued deviance resulted in the fall of Adam.

A Christian worldview acknowledges the disorder of sin and its consequences as the core and universal starting point for all pathology.

Redemption came through Christ who paid the price of sin.  Through Christ’s death as the perfect priest and perfect victim, the infinite debt and injustice was paid and God’s mercy and reconciliation was granted to humanity.  Through grace earned by Christ and dispensed through the Holy Spirit, the spiritual consequences of sin and its metaphysical wounds were healed, but the the physical broken condition and consequences of Original sin remained.  So while the debt of sin was paid, its lingering consequences of a disordered nature, pathology and death still remained in the temporal reality.

A Christian world view accepts the brokenness of human nature and the role sin has played in marring the world, but also  maintains a hopeful future with God since the spiritual death has been paid in full by Christ for those willing to accept it.

The Importance of Recognizing the Metaphysical In Pathology

As pointed out, when everything in psychopathology is reduced to demons or sin, or the opposite, when everything in pathology is reduced to the observable, there exists an imbalance.  A good balance recognizes that not every illness or mental defect is a direct result of sin, or a devil, but within the norms of the modern psychology has its source in natural and explainable phenomenon.  This balance also acknowledges, however, that many defects are more than physical but also tie directly to the soul and deeper metaphysical realties, such as demonic influence or vice.  When metaphysical realities are neglected or dismissed, then a  more complete care of the total person is lost.

For instance consider these mental disorders.

Depression and anxiety are unsettled emotional states.  Modern science and the DSM-V-TR has given insightful diagnosis to their symptoms and etiologies.  At a biological level, they are tied to imbalance of serotonin for depression and GABA in anxiety.  While there are other neurotransmitters that play key roles, for brevity, just consider these elements tied with multiple psycho-social implications of trauma, abuse, low self-esteem, and behavioral practices.   All of this paints a picture of why melancholy exists within the person but what if there are deeper issues afflicting the person that are beyond the temporal?  What if at a deeper state, the low self-esteem is tied spiritual disorder?  What if despair and rejection of God’s mercy is at play, or even worst, demonic oppressive thoughts tormenting the person (Amorth, 2016). Many times, resistant depression has deeper issues that SSRI’s cannot rebalance because they are not temporal but metaphysical in origin.  The original source is the brokenness and until that original source is recognized, the person may experience physical symptoms or relate to a particular event, but the nature of the underlying issue is not exposed until spiritual issues are addressed.  Whether these issues are self imposed through sinful and destructive habit or encouraged through demonic influence.  It is no wonder that in many cases exorcisms reveal the names of demons by their vice or pain inflicted upon the person (Amorth, 2016).

Another example includes paraphilias or sexual deviations.  Modern psychology identifies disorders as things that cause impairment not based on objective reality of right or wrong but upon cultural and social norms, as well as mental functioning.  Deviations are only considered wrong when impairment occurs or harm to self or others exists.  This differential treatment of morality avoids a particular religious bias but also ignores the source of the disorder which is primarily a rejection of God’s moral law and the natural purpose of the conjugal act.  It ignores the lustful mutation of the sexual act, as well as the underlying demonic sources surrounding this distortion.  How can one truly find healing with these disorders when the actions themselves are not condemned.

Finally, for brevity, one last example includes anti-social personality disorders.  While modern psychology attempts to understand the brain of sociopaths, narcissists and psychopaths, their behavior includes numerous conditions that lack empathy, compassion, and love for others.  Instead, their malignant will chooses themselves over others.  These actions become imposed upon their very character and nature as to be as natural as breathing.  This attempt to explain evil behavior based solely on biological factors, as well as psycho-social and traumatic early childhood events is lacking.  These types of individuals are not just programmed wrong, but their soul is also sick.  They chose at one point actions tied to vice that eventually became habitual to form a sinful character.  Tying together the new neuro processes of their mind with a sick spirituality is a far more complete explanation.

Virtue and Vice are parts of life.  Individuals who cultivate virtue, lead to behaviors and characters that become naturally virtuous and good while those who cultivate selfish, proudful, lustful, or hateful actions lead to be behaviors and characters that are bad.   Modern psychology cannot by itself label these things due to its restricted empirical lens, but when tied with theology and spirituality, one can probe deeper and identify these malignant issues and face them.

An integrated Christian view with modern psychology represents a stronger balance in meeting the etiologies of pathology from both a scientific and metaphysical team that does not look to under or over emphasize each other (Johnson, 2010).

A Psychological and Spiritual Treatment

Healing through proper orientation is key in pastoral care.  The vice tied to a mental pathology is identified and the pastoral work involves cultivating the opposing virtue.  Individuals dealing with paraphilias receive spiritual direction and moral support in cultivating temperance and the virtue of purity in conjunction with various proven behavioral therapies that help reframe and rewire the neuropathways.  Those facing depression, would focus on God’s mercy and love, as well as the virtue of hope and faith to counter the vice of despair, but the psychological and pharmaceutical treatments would concur with them.  Or again, individuals facing personality disorders would focus on humility and charity to counter pride and envy and anger but still receive the critical psychological guidance needed to form better habits and curb certain impulses.

Christian professionals are tied to ethical standards but also sometimes ostracized by secular peers for beliefs or mistrusted by the faithful for their adherence empirical methods of study

These are all examples of uniting psychological and spiritual treatments.  There has existed a grave mistrust between mental health professionals who are secular and those who are religious.  Many religious communities mistrust empirical methods due to the dismissal of God, while many secular communities doubt the professionalism of many religious due to extremism and excessive superstitious beliefs.  There is a place where reason, the scientific method and faith can coexist when properly balanced.  This is well seen in the Catholic Church which has thoroughly integrated the process of exorcism.  Unlike the Middle Ages, where any mental defect that was misunderstood was considered demonic or a hex, modern science has afforded the faith to utilize its tools to rule out mental defect before proceeding into the rite of exorcism (Amorth, 2016).  It is only logical when treating mental pathology to follow the critique of science before assuming the metaphysical to rule out hysteria and superstitious belief.  This is not a sin against faith, but a logical narrowing of mental defect from true metaphysical occurances.

The religious professional faces a twofold mission.  First to convince their fellow secular colleagues of their qualifications and empirical knowledge, so as not to become ostracized and secondly to convince the local church to understand the importance of the scientific method as a tool that is when used properly is not hostile to the faith (Johnson, 2010).

In addition, the religious professional is sometimes tied to ethical standards.  Their role as a counselor in a secular setting demands the creation of a therapeutic atmosphere that encompasses empathy, unconditional regard and safety to speak without judgement or be viewed with bias.  Their role in a religious setting changes when it becomes pastoral and the need to guide with moral clarity manifests.  This can be conflicting and sometimes difficult but the key is to identify the particular role and function at a particular time and the service being rendered (Johnson, 2010).

Conclusion

It is important to identify a proper etiology of mental psychopathology.  This involves balancing spiritual and empirical causes of mental defect without causing an imbalance or extreme in other direction.  The Christian worldview presents a view that sin is the ultimate cause of pathology in the world and that care involves pastoral as well as clinical guidance.  The care of the person must not just include body and mind, but also soul.  Prior times over-emphasized the spiritual causes of mental defect and pathology, but when properly balanced, one can find an effective and integrated way that addresses all the needs of the totality of the person.

Please also review AIHCP’s Christian Counseling and Spiritual Direction Programs

Please also review AIHCP’s Christian Counseling Certification, as well as its Spiritual Direction Program.

References

Amorth, G. (2016). An exorcist explains the demonic: The antics of Satan and his army of fallen angels. Sophia Institute Press.

Boerger, J. (2023). The original wound: Considering sin as trauma and psychopathology as the disintegration of human personhood. Journal of Psychology and Christianity.  42(4). 307-321

Collins, G. (2007). Christian counseling: A comprehensive guide (3rd ed). Thomas Nelson.

Johnson, E (ed) (2010). Psychology and Christianity: Five Views (2nd ed). IVP Academic

Kelly, J. (2002). The problem of evil in the western tradition: From the book of Job to modern genetics. The Liturgical Press

Lamoureux, P. & Wadel, P. (2010). The Christian moral life: Faithful discipleship for a global society. Orbis Books

McRay, B, Yarhouse, M. & Butman, R. (2016). Modern psychopathologies: A comprehensive Christian appraisal (2nd ed). IVP Academic

 

Additional AIHCP Blogs

Diagnosing Psychopathology.  Access here

What is Psychopathology.  Access here

Additional Resources

Psychology and Christianity: Exploring the Five Views of Integration. (2024).  NeuroLaunch.  Access here

Abercrombie, W.P. (2013). Psychopathology or Sin? BSI. Access here

Tarrent, J. (2025). “Spiritual Awakening or Psychopathology?”. Psychology Today.  Access here

 

 

 

Christian Spiritual Direction Video Blog on Spiritual Discontent

Posted on by Mark Moran

Spiritual Directors can help individuals see happiness in a different light from spiritual perspectives.  This in turn can lead others away from discontent and a better understanding of thie relationship with God.  Please also review AIHCP’s Christian Spiritual Direction program

Mitochondrial Signaling and Metabolic Regulation: Emerging Insights in Cellular Research

Posted on by Joseph Gerard

Stethoscope laying on top of research graphsWritten by Harry Wolf,

Mitochondrial Signaling and Metabolic Regulation: Emerging Insights in Cellular Research

Mitochondria are no longer viewed solely as bioenergetic organelles. No. Over the past decade, research has established them as central signaling platforms – shaping gene expression, stress adaptation, immune modulation, and metabolic control. 

For clinicians and researchers working across metabolic, cardiovascular, and neurodegenerative domains, understanding mitochondrial signaling is becoming pretty essential.

Mitochondrial Signaling in Metabolic Regulation

Metabolic regulation was once framed as a largely cytosolic and endocrine process. Contemporary evidence positions mitochondria as upstream regulators capable of transmitting stress and energetic cues directly to the nucleus.

Investigators at the University of Cambridge’s Medical Research Council Mitochondrial Biology Unit describe mitochondrial retrograde signaling as a coordinated communication pathway – which adjusts nuclear gene expression in response to mitochondrial dysfunction or metabolic demand. 

Changes in membrane potential, reactive oxygen species, and metabolite flux – they can all initiate transcriptional programs, which recalibrate cellular metabolism.

For practitioners managing chronic metabolic disease, such cross-talk offers insight into why mitochondrial impairment often coexists with:

  • Insulin resistance
  • Altered lipid handling
  • Systemic inflammation

Several upstream signals are consistently implicated. They include:

  • Altered mitochondrial membrane potential
  • Accumulation of reactive oxygen species
  • Perturbations in NAD+ and AMP levels
  • mtDNA instability and release

Each of those inputs can activate adaptive nuclear programs that modify substrate utilization and energy efficiency.

Retrograde Signaling Pathways and Tissue-Specific Effects

Retrograde signaling is not uniform across tissues. Pancreatic β cells, hepatocytes, adipocytes, skeletal muscle, and cardiomyocytes all demonstrate distinct transcriptional outputs – and that’s despite shared upstream mitochondrial cues.

A 2023 analysis published in Nature highlights how mtDNA integrity and mitochondrial quality control influence metabolic phenotype in tissue-specific ways. 

When mitochondrial quality control pathways are disrupted, cells may shift substrate preference, alter oxidative capacity, or activate stress-response transcription factors – such as ATF4 and ATF5.

Emerging evidence also connects mitochondrial retrograde signaling to epigenetic regulation. According to a 2026 review by Science Direct, metabolites generated within mitochondria – including acetyl-CoA and α-ketoglutarate – can directly influence chromatin remodeling. 

The metabolic-epigenetic interface suggests that mitochondrial dysfunction may leave durable transcriptional imprints that extend beyond acute bioenergetic deficits.

Tissue-level consequences? They often include:

  • Impaired insulin secretion in pancreatic β cells
  • Reduced fatty-acid oxidation in skeletal muscle
  • Altered lipid storage in adipose tissue
  • Compromised stress resilience in cardiomyocytes

Such findings reinforce the view that mitochondrial signaling contributes to systemic metabolic phenotypes – rather than isolated organ dysfunction, that is.

Mitochondrial Dynamics and Metabolic Plasticity

Mitochondrial morphology… It is tightly linked to metabolic capacity. Fusion and fission events determine how:

  • Efficiently substrates are oxidized
  • Mitochondrial DNA is distributed
  • Damaged components are segregated for removal

Research discussed in recent mechanistic analyses emphasizes that mitochondrial dynamics are not merely structural phenomena. 

Proteins – such as dynamin-related protein 1, mitofusin 1 and 2, and optic atrophy 1 – coordinate morphological remodeling in response to nutrient availability and energetic stress. 

Alterations in those proteins have been associated with both impaired oxidative phosphorylation and reduced metabolic flexibility.

Metabolic plasticity depends on coordinated shifts in mitochondrial architecture. Fragmented mitochondria are frequently observed in states of nutrient excess and oxidative stress. Whereas interconnected networks support efficient oxidative metabolism and substrate switching.

Key regulatory components include:

  • Drp1-mediated fission facilitating segregation of damaged regions
  • Mitofusin-dependent fusion supporting mtDNA complementation
  • OPA1 regulation of inner membrane integrity and cristae structure
  • Post-translational modifications that tune dynamic balance under stress

Clinical correlations continue to emerge. Dysregulated fission has been reported in obesity and insulin resistance. And impaired fusion has been implicated in cardiomyopathies characterized by energetic insufficiency. 

Appreciating how mitochondrial dynamics influence metabolic adaptability adds an important layer to understanding disease progression and therapeutic vulnerability – for healthcare professionals, that is. 

Mitochondrial-Derived Peptides and Nuclear Reprogramming

Now, let us turn our attention to mitochondrial-derived peptides. They represent an additional layer of intracellular communication beyond classical retrograde signaling pathways. 

Encoded within short open-reading frames of mitochondrial DNA, these peptides extend mitochondrial influence beyond bioenergetics and into:

  • Transcriptional regulation
  • Stress adaptation
  • Systemic metabolic control

MOTS-c is a 16-amino-acid mitochondrial-derived peptide – encoded within the 12S rRNA region of mitochondrial DNA. It has been described as an endocrine-like signaling factor capable of nuclear translocation, where it influences metabolic gene expression programs. 

Experimental studies associate MOTS-c activity with the following: enhanced glucose uptake, improved insulin sensitivity, and modulation of inflammatory signaling through activation of AMP-activated protein kinase pathways.

In preclinical laboratory settings, the MOTS-C research peptide is frequently referenced when investigating mitochondrial-to-nuclear signaling mechanisms and metabolic stress adaptation.

Mechanistic analyses suggest that MOTS-c translocates to the nucleus under metabolic challenge – including nutrient excess and oxidative stress conditions. 

Once localized to the nucleus, it interacts with transcriptional regulators involved in antioxidant defense and metabolic remodeling. 

Research summarized in an article in MDPI describes how MOTS-c participates in stress-responsive signaling networks that influence glucose metabolism and redox homeostasis.

Experimental models have demonstrated activation of AMP-activated protein kinase signaling and downstream transcriptional reprogramming linked to energy balance. 

A clinical study published by the National Library of Medicine outlines an ongoing Phase 2a trial evaluating MOTS-c in adults with prediabetes and overweight or obesity – focusing on insulin sensitivity and pharmacodynamic markers. 

Such investigations represent a progression from mechanistic characterization toward structured translational evaluation.

Core mechanistic themes? They include:

  • AMPK pathway activation during metabolic stress
  • Nuclear translocation associated with gene-expression modulation
  • Enhancement of cellular glucose uptake pathways
  • Regulation of inflammatory and redox-responsive signaling networks

Organelle Cross-Talk and Integrated Metabolic Control

Mitochondrial signaling… It rarely occurs in isolation. Interactions with the endoplasmic reticulum, peroxisomes, and cytoskeletal elements all influence how metabolic information is processed.

Mitochondria-associated membranes facilitate calcium exchange and lipid transport – which are processes that directly affect ATP production and metabolic flexibility. 

Disruption in these contact sites has been linked to impaired excitation-metabolism coupling in skeletal muscle. And altered substrate utilization.

Mitochondrial stress can activate integrated stress responses that intersect with inflammatory signaling cascades. 

These intersections may help to explain why metabolic disorders seem to frequently present with low-grade chronic inflammation.

Metabolism encompasses the full spectrum of chemical reactions that sustain life – from ATP generation to biosynthesis. Integrating this broader clinical definition with emerging mitochondrial data clarifies how subcellular dysfunction can translate into systemic pathology.

What are key organelle interactions? Well, they include:

  • Calcium flux between endoplasmic reticulum and mitochondria
  • ROS-mediated signaling affecting cytosolic kinases
  • Metabolite exchange influencing nuclear transcription
  • Quality-control pathways linking mitophagy to metabolic adaptation

Mitochondrial QC and Mitophagy in Metabolic Disease

Metabolic regulation… It requires more than adequate ATP production. Preservation of mitochondrial integrity through quality-control systems is equally essential for sustained cellular performance.

Multiple reviews describe how mitochondrial quality control encompasses proteostasis, selective autophagy, and genome surveillance. 

The PINK1–Parkin pathway, for example, tags depolarized mitochondria for degradation- thus limiting propagation of dysfunctional organelles that generate excess reactive oxygen species.

Beyond mitophagy, the mitochondrial unfolded protein response coordinates transcriptional adaptation when misfolded proteins accumulate within the organelle. 

Nuclear-encoded stress-response genes are activated to restore proteostatic balance – linking organelle dysfunction directly to transcriptional reprogramming.

Here are some central quality-control processes:

  • PINK1 stabilization on depolarized mitochondria initiating Parkin recruitment
  • Ubiquitination of outer membrane proteins marking organelles for autophagic removal
  • Activation of mitochondrial unfolded protein response transcription factors

Clinical implications extend across metabolic and cardiovascular disease. Impaired mitophagy has been associated with insulin resistance. And defective mitochondrial proteostasis contributes to cardiomyocyte vulnerability under ischemic stress. 

Integrating mitochondrial quality control into the broader framework of mitochondrial signaling and metabolic regulation strengthens mechanistic interpretation of disease trajectories – and supports more precise research hypotheses.

Implications Across Metabolic and Cardiovascular Disease

Mitochondrial signaling pathways increasingly appear in cardiovascular research. And metabolic research. 

A study published by the National Library of Medicine reported that MOTS-c administration in preclinical models attenuated oxidative stress. And it partially preserved mitochondrial enzyme activity during ischemia-reperfusion injury. 

Although mechanistic pathways require further validation, findings suggest that mitochondrial-derived peptides may influence cardiac stress responses.

In metabolic disease, altered mtDNA copy number and impaired mitochondrial biogenesis have been observed in individuals with insulin resistance and type 2 diabetes. And mitochondrial genomic stability contributes to metabolic resilience.

So, for clinicians managing cardiometabolic conditions, several translational themes are emerging:

  • Mitochondrial quality control as a determinant of tissue resilience
  • Retrograde signaling as a mediator of chronic metabolic adaptation
  • Peptide-based signaling molecules as investigative targets
  • Metabolic-epigenetic coupling influencing long-term outcomes

Such insights do not yet redefine clinical guidelines. But they do inform research priorities and therapeutic exploration.

Future Directions 

Research momentum suggests that mitochondrial signaling will remain central to metabolic science over the coming decade or so. Advanced imaging, metabolomics, and single-cell transcriptomics… They are all clarifying how mitochondrial states vary within and across tissues.

Ongoing clinical studies will help determine whether mitochondrial-derived signaling molecules translate into measurable metabolic improvements in humans. 

Refining methodological rigor will be essential. Standardization of mtDNA quantification, harmonization of bioenergetic assays, and longitudinal clinical phenotyping are needed to connect mechanistic signaling data with patient outcomes.

Advancing Clinical Understanding 

Mitochondrial signaling and metabolic regulation… They are no longer peripheral topics in cellular research. Evidence supports the view that mitochondrial communication networks influence systemic metabolic health.

So, explore ongoing research initiatives, review emerging data, and consider contributing to discussions within your institution or through specialized platforms to advance understanding in this rapidly evolving field. And check out related content on our site.

 

Author bio: Harry Wolf is a freelance writer. For almost a decade, he has written on topics ranging from healthcare to business leadership for multiple high-profile websites and online magazines.

References:

Schirrmacher, Volker. (2020). Mitochondria at Work: New Insights into Regulation and Dysregulation of Cellular Energy Supply and Metabolism. National Library of Medicine.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7700424/

Meichsner, Anna, Bader, Verian, Winklhofer, Konstanze F. (2026). Mitochondria as sources and targets of cellular signaling. Science Direct.

https://www.sciencedirect.com/science/article/pii/S1097276526000286

Picard, Martin, Shirihai, Orian S. (2022). Mitochondrial signal transduction. Cell Metabolism: A Cell Press Journal.

https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00459-4

Kim, Mi Eun, Lim, Yeeun, Lee, Jun Sik. (2025). Mitochondrial Dysfunction and Metabolic Reprogramming in Chronic Inflammatory Diseases: Molecular Insights and Therapeutic Opportunities. MDPI.

https://www.mdpi.com/1467-3045/47/12/1042

Chen, Wen, Zhao, Huakan, Li, Yongsheng. (2023). Mitochondrial dynamics in health and disease: mechanisms and potential targets. Nature.

https://www.nature.com/articles/s41392-023-01547-9

Unauthored. (Undated). Mitochondrial retrograde signalling. University of Cambridge MRC Mitochondrial Biology Unit.

https://www.mrc-mbu.cam.ac.uk/research-groups/ryan-group/mitochondrial-retrograde-signalling

Unauthored. (2024). Metabolism. Cleveland Clinic.

https://my.clevelandclinic.org/health/body/21893-metabolism

Hudson Biotech. (2026). MOTS-c for Improving Insulin Sensitivity in Adults With Prediabetes and Overweight/​Obesity (MOTS-MET). National Library of Medicine.

https://clinicaltrials.gov/study/NCT07505745

 

 

Please also review AIHCP’s Managed Health Care Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Why Every Healthcare Leader Should Understand Building Safety

Posted on by Joseph Gerard

A icon of a hospital building with a red cross on a blue background

Written by Lucy Peters,

When was the last time you walked into a hospital and thought about the roof? The answer is probably never, and that’s a good thing. If the lights turned on, and the elevators were running, and nothing seemed out of place, the building had already done exactly what it was supposed to do, which is to disappear into the background. Building safety is not typically discussed by anyone involved in the healthcare of a patient. We notice hospitals for the people inside them, which is usually the nurses moving quickly between patient rooms, and the physicians making difficult decisions.

But what happens when that infrastructure stops doing its job? For all the focus healthcare receives on issues of patient safety, as well as on infection prevention, on the number of medication errors and on quality improvement, too little attention is given to the physical environment in which all this is going on. So even though the healthcare setting is where all this care is given, that description of healthcare misses the fact that the building itself is what actively supports the work being done.

The systems no one notices 

Even for a senior healthcare leader, it would be very unusual to have to check the roof  membrane for damage, find the cause for a flickering light, or describe how air is kept moving safely through an Operating Theatre by means of an HVAC system. That’s the expertise of engineers, contractors, and facilities teams. But understanding why those systems matter, and what happens when they don’t work as they should, is an entirely different story. The building that delivers healthcare could easily be reduced to the four walls of the hospital, yet the structure around the activity delivers healthcare constantly and usually unnoticed on a daily basis. In a moment when the power fails for example the electrical failure will reveal itself to be a potentially disastrous problem for the scheduled surgery. Similarly, an unreliable ventilation system isn’t merely a maintenance headache, as it can actually affect infection control, patient comfort, and the environments where some of the most complex care is delivered.

The patient never sees the machinery

Most patients will never give a second thought to a hospital’s ventilation system, its backup generators, or the network of electrical and mechanical systems working quietly behind the walls. Nor should they have to. They arrive expecting those things to work, just as they expect the lights to come on when they flip a switch or the water to run when they turn on a tap. This type of confidence is part of what healthcare organizations spend years earning, even if patients rarely think about it in those terms. The moment those systems stop doing what they’re supposed to do, however, the experience of care changes. A procedure delayed because of a facilities issue feels very different from one delayed for a clinical reason. A broken elevator for instance, can create an enormous amount of hardship for patients with disabilities during what should be a routine appointment. In addition, patients can be affected by uncomfortable room temperatures and leaks in the waiting room, which can lead them to wonder whether the environment around them is being cared for as expected.

None of these situations say anything about the skill or dedication of the clinicians providing care, but the thing is, they inevitably shape how an organization is perceived. Patients rarely separate the quality of the healthcare they receive from the condition of the place where they receive it, because to them, it’s all part of the same experience. Perhaps that’s why building safety deserves to be thought of as more than an operational responsibility. Every functioning elevator, every reliable power supply, every well-maintained patient room contributes to something that is difficult to measure but incredibly easy to lose, which is confidence.

 

The workplace shapes the work

The same principle applies to the people providing care. Healthcare workers often spend more time inside these buildings than almost anywhere else. From nurses moving between patient rooms to technicians operating complex equipment and environmental services teams keeping spaces safe and functional, thousands of people depend on the facility around them every day. When the building works well, it becomes almost invisible, and that’s exactly how it should be.

But anyone who has worked in healthcare knows how quickly small building issues become everyone’s problem. An elevator that’s constantly breaking down. A clinical area that’s too hot. Repairs that are postponed again and again. On paper, these can sound like relatively minor inconveniences, but in practice, they become one more obstacle in professions that already operate under extraordinary pressure. Individually, they’re frustrating, and collectively, they add unnecessary friction to a working day that leaves very little room for it. And there’s another message hidden in a well-maintained facility, too. It tells employees that leadership values the place where they spend their days. Investing in the building is, in many ways, an investment in the people who make healthcare possible.

Look up

Perhaps no part of a healthcare building illustrates this better than the roof. The roof is easy to forget about until there is a problem, and yet it is a critical component of a hospital. The roof protects valuable healthcare assets including patient rooms, surgical suites, imaging equipment (many of which have very high value), IT infrastructure, pharmaceuticals, and most importantly patients and their families 24/7. When it comes to hospitals in tornado-prone regions, that responsibility becomes even greater. Communities across parts of Texas, Oklahoma, Kansas, Nebraska, and surrounding states face weather conditions that demand more than routine maintenance. Strong winds, flying debris, and increasingly unpredictable storms mean roof replacement can’t simply restore what was there before, but should also improve resilience for the future. Instead of rebuilding a healthcare facility for yesterday’s weather, we need to prepare for tomorrow’s weather. That’s not a question of building, but of providing continuity of care. A strong roof is important not only in case of rain but also to ensure patients can still receive treatment, staff can continue working safely, and communities have access to healthcare precisely when they need it most.

 

So, What Does Understanding All of This Actually Mean for Healthcare Leaders? 

It means they get to ask the right questions, stay curious, and recognize that a small issue now can become a much bigger problem, sometimes, in just a matter of hours. Is the emergency generator ready if the power fails? Are the people in charge of maintenance actually taking care of recurring concerns about the hospital? Are the people planning renovations for the hospital thinking about risks to the hospital instead of just looking at what happened in the past? Whilst not the most exciting of questions in the boardroom, these are of critical importance to enable an organization to respond when something unexpected happens. A hospital is not just four walls, a roof, and a place where doctors and nurses work. The building itself helps make healthcare possible, and when the systems behind the scenes are reliable, everyone inside can focus on what matters most, which is taking care of patients.

Author bio

Lucy is a freelance writer who enjoys contributing to a range of publications, both in print and online. She spent almost a decade working in the care sector with vulnerable people before taking a step back to start a family and now focuses on her first love of writing.

 

 

 

Please also review AIHCP’s Health Care leadership Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

The Role of Data Encryption in Protecting Electronic Medical Records

Posted on by Joseph Gerard

Press enter button on the keyboard computer Shield cyber Key lock security system abstract technology world digital link cyber security on hi tech Dark blue background, Enter password to log in. lock finger Keyboard

Written by Alex Morphy,

Electronic medical records (EMRs) have revolutionized the way healthcare providers manage, gather, and distribute patient data. Medical practices can now store vast quantities of confidential information online rather than on paper and retrieve it at any time. But digital records have their problems of security. Patient information can be shared as a result of cyberattacks, unauthorized access, data breaches, and accidental disclosure.

What is Data Encryption?

Data encryption is a process of making data hard to read or incomprehensible from plaintext (readable) to ciphertext (encoded). The encrypted information can only be converted back into its original form by someone with the appropriate decryption key.

In healthcare, encryption can be used for patient data security when it’s stored and when it’s transferred between systems.

Encryption at Rest

Encryption at rest is the security method used to protect information, whether it’s on the device, on the server, on the database, or on the cloud. Once an unauthorized user accesses a storage system, files are much more difficult to access without a decryption key.

If a health care organization stores patient data in a database, for instance, encryption can help protect the patient information stored on the database if the storage device is compromised or stolen.
Encryption in transit

Security of data as it is being transferred from one location to another. Healthcare providers often share patient data with other authorized individuals, such as other healthcare providers, pharmacies, insurance companies, and laboratories, among others, between computers, servers, and the like.

Secure encryption protocols help to ensure that the data is protected from being accessed while in transit over networks.

Why is it important to use encryption with an electronic medical record system?

Some of the more subtle information relating to the people is included in EMRs. Personal information, such as names, addresses, medical history, diagnoses, treatment details, insurance information and more can be found in a single patient record.

This security breach can wreak a great amount of harm on the patient and the health care organization.

Minimizing the risk of data breaches

Healthcare organizations often hold all the trimmings for cybercriminals to strike because of the information they typically store. Encryption is another level of security because if it is lost or stolen or intercepted, it is not as easy to use.

Though encryption is not a solution for all cyberattacks, it does limit the potential impact if a cyberattack succeeds in gaining access to sensitive information.

Protecting Patient Privacy

Doctors and other health care professionals are expected to keep patient information confidential. Robust encryption methods can help organizations protect this data from unauthorized access.

Encryption makes patient information more difficult for an unauthorized user to access or utilize.

Supporting HIPAA Compliance

The Health Insurance Portability and Accountability Act (HIPAA) sets forth regulations for healthcare companies in the United States dealing with protected health information (PHI). HIPAA provides guidelines to protect private patient information.

Encryption is a key element of an overall strategy of securing electronic PHI. When selecting an EMR system, organizations should look for a solution that has robust security measures and encryption features. Healthcare providers can also conduct a search for the best HIPAA-Compliant EMR software solutions and find one that meets their privacy and security needs when researching options.

How Encryption is used in EMR Systems.

There are multiple ways in which modern EMR platforms can provide data security across the healthcare data’s lifecycle.

Security of Stored Patient Data

Medical professionals typically keep extensive patient records in data centers and cloud systems. This data can be protected from unauthorized access using encryption.

Another way cloud-based EMR systems can protect information stored on their servers is through the use of encryption. But for healthcare organizations, it is important to consider a vendor’s security measures and its implementation of encryption.

Providing secure remote access

The use of remote access in the healthcare sector is increasingly prevalent. Authorities and doctors may require accessing information from patient records on multiple devices or places.

Encryption may be used to help secure information during remote sessions, and should be used in conjunction with other security measures like multi-factor authentication, access controls and secure device management.

Access Controls

Patient information must be accessed by only authorized employees. Role based access controls can restrict access to information based on users’ role in order to allow access to only the information that they need to do their job.

Regular Security Updates

The vulnerability in software can give rise to an opportunity for attackers. Security risks can be minimized by maintaining EMR platforms, operating systems, and connected devices up to date.

Employee Security Training

There is still the possibility of human error as a security threat. Similar to the other characters, regular training of healthcare employees should be conducted regarding password security, phishing attacks, social engineering, and handling patient information.

Let’s look at some of the things that healthcare organizations should consider.

Healthcare providers need to consider factors beyond mere functionality when choosing an EMR system. Security should be an important consideration throughout the decision-making process.

Organizations should seek out information from vendors on encryption, data storage methods, access control, authentication, backup, and data incident response. They should also assess if the vendor has the necessary documentation and agreements to deal with protected health information.

 

Conclusion

Encryption is one of the fundamental technologies used to defend electronic medical records in the modern digital healthcare surroundings. Encryption not only protects data while it is being transmitted but also when it is stored, helping to minimize the chances of unauthorized access or data breaches and contributing to overall patient privacy and security measures.

 

About the Author : Alex Morphy is a B2B content writer who specializes in creating clear, well-researched content for business audiences. His work focuses on breaking down complex subjects into simple, practical insights that readers can easily understand and apply. He is passionate about transforming technical information into engaging, accessible content that supports informed decision-making. With a strong emphasis on accuracy, clarity, and value, Alex strives to create content that earns readers’ trust and delivers meaningful results.

 


Please also review AIHCP’s Managed Health Care Certification program and CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Christian Counseling, the DSM-V-TR & Sexual/Paraphilic/Gender Deviations & Issues

Posted on by Mark Moran

Forewarning, this blog presents adult topics regarding a sexual nature but also from a Christian perspective for purposes of Christian Counseling and Direction.  As a program of AIHCP, the content regarding morality is for purposes of Christian Counseling and sexuality not official views of AIHCP.  Regardless, the material presented represents a detailed and academic description of these issues and presents the various understandings of them, while maintaining a Christian mandate that requires love and respect of differing opinions regarding the subject.  For those of differing morality and faith or sexual orientation, please feel invited to still review in an attempt to foster better understanding of different views.

Please also review AIHCP’s numerous spiritual based programs in Christian Counseling, Christian Spiritual Direction,  general Spiritual Counseling and Spiritual Trauma Informed Care.

DSM-V-TR /Sexuality/Christian Worldview

Love and sex can become distorted within the DSM-V list of paraphilias. Please also review AIHCP’s Christian Counseling Program

Correlated with the free love movement of the 1960s, there has been a shift in society’s view of morality.  This is not to say that sexual morality was restructured by the movement, but it did challenge the then existing social norms regarding sexuality in regards to public discourse outside the bedroom and also looked to challenge the Judeo-Christian morality that dominated these social norms.  What was once labeled “sinful” or at least socially not publicly consumable became more open to the masses and questioned.  In addition, society itself and its definitions of marriage, gender and appropriate sexual interaction became redefined. The DSMs also evolved with the changing perceptions.  This was not just due to the cultural shift of a more open sexual morality in the public sphere, but also as science and psychology advanced, new studies and discoveries about the human brain and its development emerged which forced the DSM to re-evaluate the sexual norm.  This led to various acts that were once considered a disorder to not even be listed.  For instance homosexuality as a way of life became a non-disorder and an equally healthy mental and emotional way of expressing love.  The DSM-IV as it evolved into the present DSM-V in 2013 also emerged with different understandings of gender identity reversing the title of Gender Identity Disorder to Gender Dysphoria.   In addition, multiple paraphilias became labeled disorders only if harming others, self, or causing impairment (DSM-V-TR, 2022).

From a Christian Counseling perspective this has caused some friction.  The Christian worldview is at odds with many secular and  sexual actions .  What is seen as a disorder also can carry the weight of sin within itself – at least with action tied to the thought.  Furthermore, various paraphilia which carry  negative values in Christian morality are reduced to alternative drives that if not causing harm to others or self, or causing impairment, then become not spiritual problems but only mental.  This is expected to some extent since psychology is a science and should not be biased with religious belief.  Sexual deviations should be listed in a scientific and non-biased way that does not reflect one religious morality over the other but it does show a shift in what was once considered a disorder.  One can even speculate that some of the science itself may have become biased based upon the new social norms shaping it.  These are issues that Christian Counselors must acknowledge within the DSM-V-TR and learn to properly integrate the science of the DMS-V-TR with a Christian world view when counseling in a pastoral setting.

So what is the Christian worldview on sexual morality before continuing?  The Christian world view holds to an objective morality that is binding upon everyone that is based within Scripture and Christian tradition, theology and morality.  It recognizes that humanity is fallen and mental illness is a result of sin (McRay, et al., 2016).  It views sexuality and gender as a gift from God for purposes of reproduction, but also unifying love between husband and wife.  It recognizes two sexes that are tied to only two genders.  It holds that God created male and female and saw that this was good.  Christian Counseling, especially integrated Christian Counseling does not reject mental illness as an ingredient for sinful actions.  Furthermore, Christian Counseling does not look to judge others but to merely understand not only the morality but also the psychology of the person in helping individuals find a healthy spiritual, emotional and mental health that is tied to Christ.  This  means that sexual morality must coincide with one’s moral actions, despite urges, and that one must accept the commandments and follow Christ.  Christian Counseling recognizes failure and sins, but it does not look to marginalize one particular group but to hold all sexual sins accountable to God.  Unfortunately, many Christians condemn one group’s sins over another group’s of sins.  For instance, it can appear at times that some Christian churches will single out homosexual sins or Transgender sins over the sexual sins of heterosexuals.

Due to the fall, human nature has become inclined to sexual sin.  It can easily gravitate towards these sins and become engulfed with the sin of lust (McRay,  et al., 2016).  Not all sexual sins are deviations from the norm, but all sexual sins still nonetheless lead one away from God and corrupt His original design and intention.  Christian Counseling recognizes this fall, the need of Redeemer in Christ and the need for sanctification of the Holy Spirit in everyday life.  While some may not be tempted in the area of lust as others, it still remains a powerful urge that can be corrupted into deeper immorality.  This is the goal of the demonic.   Sadly, due to the fall of humanity, many also suffer not only from the vice of lust, but are also afflicted with mental disorder, or unnatural urges.  Many of these urges are not choices but come to the person and can be stronger due to a variety of biological issues.   These individuals not only face a temptation but also mental issues.  In this way, Christian Counseling not only recognizes many paraphilias as mental disorders but also sins.  In treating the paraphilia, it is more than just merely recognizing impairment or harm to self and others, but is also understood in a spiritual way.    This spiritual focus in Christian Counseling recognizes many paraphilias as sins within themselves and unnatural to the sexual act not merely in a physical way but in a completely body, mind and soul way.  It recognizes the role mental health plays in spiritual warfare with the devil and how treating many of these disorders also requires spiritual and pastoral care.  In this way, the DSM-V-TR serves as tool but a tool that only brushes the top of the surface.

Paraphilias of the DSM-V-TR

Paraphilias distort and corrupt God’s original plan for man and woman

The DSM-V-TR lists many odd, as well as socially unacceptable paraphilias.  In definition, the DSM-V-TR recognizes paraphilias as “any intense or persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners (2022)”.  According to the DSM-V-TR a disorder differs from a mere urge and thought in that the intensity is causing impairment, harm to self or others, as well as becoming the dominant of way of sexual expression over normal means.  In this way, the value of morality based on right or wrong is merely replaced with these thoughts as deviation from the norm without any moral questions.  Of course, one may question this distinction between thought and action when discussing pedophilia or zoophilia or necrophilia.  Are the presence of these thoughts not a disorder within themselves because they are so unnatural?  While acting upon a urge is far worst, the presence of these urges represent a serious problem within themselves that should not require impairment or harm of others or self to red flag it. As it stands, zoophilia (sexual intercourse with animals), necrophilia (sexual attraction or intercourse with corpses) as well as urophilia (urine) and coprophilia (feces) all find classification with the DSM-V-TR under “other specified paraphilic disorders”.

Other than the “other” list, the DSM-V-TR lists 8 paraphilias with diagnosis for disorder again to include impairment of quality of life in all areas, as well as harming oneself or others.  Many of these disorders are inherently tied to harm of others, while others can be merely addictive in nature.  Interestingly enough, pornography is not even listed as an addiction, much less a deviation although it is gateway to many of these disorders and can become a type of disorder if it inhibits social and professional activities.

Voyeurstic Disorder

This involves an intense and recurrent interest and sexual arousal over a 6 month period of observing other naked people or watching them engage in sex without their consent.  The person must be at least 18 to differentiate between adolescent curiosity versus a full blown disorder.  For diagnosis as disorder it requires action taken on these urges and if these fantasies or actions lead to significant distress or impairment in social, occupational or important areas of functioning (DSM-V-TR, 2022).

Exhibitionist Disorder

This involves intense or recurrent sexual arousal  over a 6 month period regarding exposing one’s genitals to an unexpecting person.  Specifiers include the target audience as children only, adults only, or both (DSM-V-TR, 2022).

Frotteuristic Disorder

This involves intense or recurrent sexual arousal over a 6 month period from touching or rubbing up against unexpecting and nonconsenting individuals (DSM-V-TR, 2022).

Sexual Masochism Disorder

This involves intense and recurrent sexual arousal over a 6 month period from being humiliated, beaten, bound, and made to suffer.  It can have a specifier tied to strangling or asphyxiophilia (DSM-V-TR, 2022).

Sexual Sadism Disorder

This involves intense and recurrent sexual arousal over a 6 month period in the suffering or causing of suffering in another human person.  This disorder is tied to bondage-domination-sado masochism where two disorders interact in bondage.  The sadism in this particular case is not ruled as a disorder if with a consenting adult.  However, sadists are tied to sexual crimes and rape, albeit, most rapes are still tied to control and authority than mere pleasure of others pain (DSM-V-TR, 2022).

Pedophilic Disorder

This involves intense and recurrent sexual arousal over a 6 month period with prepubescent children under the age of 13 years.  Specifiers include those who are attracted to only children, or both children and adults, as well as those attracted to only males, females or both (DSM-V-TR, 2022).  Obviously this disorder, like sadism also carries legal and criminal prosecution, beyond just being a disorder, much less within Christian theology a horrible sin.

Fetishistic Disorder

This involves intense and recurrent sexual arousal over a 6 month period with objects, or nonliving things with a high focus on non-genital body parts (DSM-V-TR, 2022).

Transvestic Disorder

This involves intense and recurrent sexual arousal over a 6 month period from crossdressing (DSM-V-TR, 2022).

All of these disorders above relate to sexual deviations from the social norm.  In this way, psychology does not necessarily give to them a moral value.  Instead psychology looks at impairment, harm to self and harm to self and others.  This does not mean that these thoughts in themselves are not dangerous and sinful.  In addition, many of these disorders can become addictive.  Starting with the smallest thing, pornography can open a window of deviations which hamper a person’s social functioning.  Individuals then become slaves to their passion of lust and it begins to dominate the person.  From a Christian perspective, this is the goal of the demonic.  The goal is to corrupt, mock and displace sexuality with crude and disgusting acts and use human beings as the tool leading them farther away from God and deeper into addictive and dark practices.  These actions look for pleasure and gratification as the primary purpose of sexuality.  However, the norm of sexual expression or attraction ceases to arouse, so one slowly goes deeper and deeper into corruption.  This not only dismisses the original intent of the conjugal act, but it also reduces people to things and objects to find pleasure.  Whether consenting or not, it still represents a a deep corruption (McRay,et al. 2016).

Mental health can biological factors can play a role in the deviations, but also trauma, sexual abuse, and mistreatment in one’s  youth.  Others never learn about sexuality or how to properly express it.  Not surprisingly, many of the differential diagnoses of these actions are also tied to impulse control disorders as well anti-social personality disorders (DSM-V-TR, 2022).

Gender Dysphoria

Gender dysphoria is incongruence between physical sex and perceived gender and the anxiety resulting from within

As sexual orientation and gender idealogy became more prominent within the social norms of modern society, the DSM-V responded as well with less emphasis of any mental defect in regards to gender identity, much like previous versions adjusted to mental diagnosis of same sex attraction.  The current trend is to one day even remove gender dysphoria as it did prior with homosexuality from the manual, but many lament if diagnostics do not remain, then this may affect gender altering elective surgeries for purposes of medical insurance and payment.

As it stands gender dysphoria in itself does not point towards a disorder but only when impairment, anxiety, depression and suffering result from it due to a lack of congruence between assigned sex at birth and chosen gender (DSM-V-TR, 2022).   Due to this, the DSM-V carefully redefines sex and gender.  Sex is defined as biological and physical manifestations of male or female.  It is also referred to as the birth assigned gender or assigned sex.  Gender, according to the DSM-V denotes the social, cultural and public role a person chooses as a boy or girl (2022).    When someone does not adhere to the assigned birth they are said to be gender atypical, gender nonconforming, gender diverse, or gender variant (DSM-V-TR, 2022).   One’s gender identity is what one adheres to, which can be male or female, or even gender fluid which is neither male nor female.  Transgender refers to a broad spectrum of individuals whose identity is different than their assigned sex at birth.  However, only if incongruence and distress occur, does the DSM-V-TR list it as a disorder within itself (2022).  A transsexual is a person who has undergone surgery altering procedures to their physical/biological appearance as male or female.

The DSM-V-TR points out that gender dysphoria can be both experienced in children but also with adolescents and adults.  In its diagnosis, the DSM-V-TR lists the following as criteria for children and adults.  For both groups, the first criteria requires a marked incongruence between ones expressed gender and assigned gender at birth for a period over 6 months.  In children, the manifestations include.

  1. strong desire to be the other gender
  2. with boys, crossdressing
  3. strong preference for cross gender roles in play and make believe
  4. strong preference for toys of the opposite sex
  5. strong preference for playmates of the other gender
  6. rejection of toys associated with opposite sex
  7. strong dislike of one’s anatomy
  8. strong desire to possess characteristics of the other sex

Within adults

  1. marked incongruence with assigned sex
  2. strong desire to rid oneself of one’s primary and secondary sex characteristics
  3. strong desire for sexual characteristics of other sex
  4. strong desire to be the other gender
  5. strong desire to be treated like the other gender
  6. strong conviction that one has the feelings or reactions of the other sex

Specifiers include if one was born with a sexual abnormality or congenital defect such as adrenogenital disorder, adrenal hyperplasia or androgen insensitivity.    For these individuals, there is less mental perception but a reality that one was physically born with varying degrees of both genitals.  Many within this category of DSDs require immediate medical intervention and surgery when sex is assigned at birth (DSM-V-TR, 2022).  This often results in some type of gender dysphoria in what gender they align with.

It is extremely important to show intense care for especially children who express these symptoms in life.  Many in teen years are going through changes that may be only temporary, or dealing with a body dysmorphic disorder.  Some, in the case of girls, may just be the classical tomboy.  Hence from a purely secular perspective, any major operations or assignments should be withheld until adulthood.  In addition, from a Christian perspective, it is important to help children understand their gender and work with them.  For many, Gender Affirming Therapy can help individuals come to congruity with their gender and sex (McRay, et al., 2022).  While this group represents a very small percentage of the population, their inner turmoil is real.  Empathy and nonjudgement are critical.  These are not choices but true inner turmoil.   Christianity teaches that this inner turmoil is a result of sin but the disgust with one’s body can also be demonic in origin.  Satan wishes for humanity to hate itself from the original design of the Creator.

Etiology and Treatment

Moral decisions about sexuality are very personal.  They touch not only the mental aspect of oneself but also the very spiritual.  When spiritual understanding of sexual issues are disconnected from the mental, it can cause a deeper misunderstanding of the sexual paraphilias.  From a purely mental and biological perspective, trauma, abuse, anxiety, and sexual experiences as child or teen can play a big role in not only sexual paraphilias but also sexual disorders. Experts also agree that psychosocial factors play a large role in paraphilia as well as sexual dysfunctions that stem from poor communication skills and inabilities to form meaningful relationships (McRay, et al., 2016).  Rape victims obviously can have trauma that is innately tied to the conjugal act.  Others may have experiences with conjugal sex at an early age which misshaped their future experiences.  This can lead to a variety of inabilities to sexually function.  These types of sexual disorders are also listed in the DSM-V.  They lead to physiological issues that affect sexual performance, or also negatively affect sexual arousal or even sexual interest.

However, the darker deviations while also tied to past trauma or events, or even some biological markers within the brain have spiritual origins.  This is where the DSM-V-TR as a tool has reached its limit to help.  The darker issues of sexual deviations are tied to sin, lust, vice and addiction.  They can transform into deeper issues if not met on the spiritual battlefield.  Christian Counselors need to be aware of the mental issues behind them but they must also understand how these mental issues are utilized by the enemy to distort the moral fabric of a person’s soul in regards to a host of immoral sexual actions.  Lust is a distortion of love.  Lust rejects temperance.  Lust corrupts the heart to see God.   It is of no wonder then that this capital sin is employed so frequently by the enemy to lead the soul away from true happiness and true design.  Lust ultimately leads to addictions that become more demanding and more perverse until the person loses sight of control and respect of one’s body and others.

Treatments usually only include treating the symptoms of anxiety or depression or the past trauma associated.  More dangerous and predatory in nature paraphilias sometimes require peer groups and also legal intervention.  Those seeking to avoid dangerous sexual behavior need to remove themselves from places that facilitate their urges.  Isolating from stimuli is key.  This could involve for a pedophile staying away from a school area, or one to avoid strip clubs, or drink, or even the internet and porn.   Changing behaviors and breaking addictions may require behavioral and cognitive therapies and token systems.  Positive reinforcements.  From a psychoanalytical school, it would involve understanding one’s childhood and why these sexual issues are manifesting.  Christian Counseling can present a blue print of right versus wrong with emphasis on prayer, penance and the formation of virtue.  Virtue of purity and habit takes time but with patience and prayer, God’s grace can transform and help one carry one’s cross.

Conclusion

Christ heals and makes whole the broken. Please also review AIHCP’s Christian Counseling Certification

The four D’s of mental health regarding danger, distress, dysfunction and deviation play a large role in defining disorder (McRay, et al. 2016).  These are based on standards.  Obviously Christian standards will differ from secular standards and create friction between the label of sin.  However, the DSM-V-TR still recognizes the distress sexual paraphilias and even gender dysphoria can cause.  In this Christian Counselors and secular counselors can agree.  This distress robs the person of peace and the sense of being loved.  This is why it is so important to never judge but also try to help individuals who suffer from such deviations.  While one is tied to ones choices and legal consequences, many of these feelings flow through these individuals creating difficulties in life.  Christian Counselors are called to help individuals in distress but also to align oneself with the commandments and God.

Please also review AIHCP’s Christian Counseling Certification

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorder” DSM-5-TR (5th ed., text revision). American Psychiatric Association Publishing.

McRay, B.W., Yarhouse, M.A., Butman, R.E., & Kiple, C. (2016). Modern psychopathologies: A comprehensive Christian appraisal. (2nd, ed.) IVP Academic

Additional AIHCP Blogs

Christian Morality and Sexuality: Access here

Additional Resources

Paraphilias.  WebMD.  Access here

15 Most Common Paraphilias.  Psychology for Mental Health.  Access here

Paraphilic Disorders. APA.  Access here

Signs and Types of Paraphilic Disorders. VeryWellMind.  Access here

Mental Health and Psychotherapy Video Blog

Posted on by Mark Moran

Mental health is health.  Psychotherapy is a proven way to help individuals with mental issues and disorders.  This video looks at mental health and the numerous types of schools of psychotherapy and various therapies that help individuals everyday. Please also review AIHCP’s Healthcare Certification Programs

 

How to Choose a HIPAA Compliant Phone System

Posted on by Joseph Gerard

Stethoscope on red smartphone on a grey background. Written by Rob Mcmanus,

Finding a HIPAA-compliant phone system will let you communicate with patients without worrying about the safety of their data. Don’t buy one without checking if it actually meets your practice’s needs. Prioritizing safety and learning about the vendor’s rules on recording helps you make a smart decision.

What would happen if a private conversation you had with your patient ended up in the wrong hands? Some of them are probably about health concerns they are dealing with. Patients also often call to ask for medication advice before their next follow-up session.

Ensure you protect all the conversations regardless of what they are about. Having a phone system with the safeguards you need makes your work easier.

Do Phone Systems Need to be HIPAA Compliant?

Yes.  Anytime you’re using a phone to talk about information that’s protected by HIPAA, ensure the systems behind it protect the data.  When you ask yourself these questions, you’ll be able to determine if you need to change your phone system:

  • Does it protect patient conversations?
  • Can unauthorized people access call records?
  • Are all the messages encrypted?
  • Can my team control who accesses the phone?

What Is the Best HIPAA-Compliant Phone System?

It depends. Always consider the size of your practice before you buy a phone system. You might not need to use the same one other healthcare providers in your area use. Focus on ensuring it has all the features you need and is still able to protect data.

A lot of practices prefer to use mobile phones so employees can take calls and text from anywhere. You need to have proper controls when using these. Learning about topics like Google Voice HIPAA compliance will help you know if you’re actually using a safe system.

If you have VoIP, you probably chose it because a lot of your employees are already familiar with internet calling.  VoIP apps often don’t come with the kind of protection you need for your practice. Always look beyond basic calling features as you weigh your options.

What Is the Most Secure Phone for Privacy?

None is automatically safe. If you have a phone with data encryption, you won’t worry about the details in it leaking or being used by the wrong people in case you lose it. All these features are important too:

  • Strong authentication
  • Remote management options
  • Secure messaging apps

Even if you get the most secure phone, you still need to be keen about how you use it. Connecting it to public Wi-Fi makes you more likely to lose data to hackers. Avoid giving apps permissions to things they don’t actually need.

Choosing a HIPAA-Compliant Phone System

Don’t make the mistake of looking for the phone system with the most features or the most affordable one. Your team’s work will be easier once you find a phone system that simplifies communication.

They shouldn’t have to worry about healthcare security by taking extra steps that reduce the time they actually have to serve patients.

Review Your Practice Communication Needs

Consider how your team communicates with patients and ask yourself how many people need to use it.  If some employees work from home, you probably need a different system than a practice where employees are all in one facility. As you review your needs, think about:

  • Whether you want employees in different departments to use the same system
  • If you often send appointment reminders through text
  • Whether you record some calls

It’s always important to think about the direction your practice is headed. Having a system just meant to accommodate a few employees won’t work if your clinic is taking on a lot more patients. You need a scalable system. It will help you avoid redoing the onboarding process or having to transfer data later.

Confirm the Vendor Offers a Business Associate Agreement (BAA)

You should know how your vendors handle protected details. Reading BAAs gives you the information, and it makes it easier to compare vendors. Some of them:

  • Store the information
  • Process it
  • Transmit it via several servers

When you have an agreement, you’ll know whose duty it is to protect the data in different situations. A lot of popular messaging apps actually don’t offer a BAA. Even if you love the features and find them much simpler, it’s better not to risk using them.

Check Encryption and Security Features

You’ll often need to move information when emailing other employees in your healthcare center. Using different networks requires strong encryption. You shouldn’t have to add security protections on your own to make a phone system safer. Get one that comes with the features installed.

A lot of systems made specifically for healthcare providers will work better for you than those meant for regular use. These are some of the aspects you shouldn’t ignore:

  • User authentication
  • Password protection rules
  • Secure data storage

The security features shouldn’t feel like something you think about after looking for the communication tools you need. Make them a priority too. You’ll be able to avoid a lot of data safety issues down the line.

Consider Shared Lines for Team Triage

When you have a busy clinic, your triage nurses should be able to receive calls instead of waiting for only one person to handle each incoming one.

Get a phone system with shared lines. As one of the employees answers a call, another one can respond to text messages. You’ll boost patient satisfaction once you have the tools allowing you to get back to them in just a short amount of time.

Having shared lines makes it easy to route calls to the right department. In case a patient calls to follow up on test results, they can just be connected to the right person. Employees will save time and avoid a lot of confusion.

Control access even if your phone system makes it easy for multiple people to use it at a time. Every employee doesn’t need unlimited access to all the information. Consider everyone’s roles as you assign shared lines.

Understand Call Recording Rules

Recording calls gives you a lot of material you can refer to when training your employees. Healthcare facilities often use the information to learn what their customers want so they can find ways to improve their services. Think about your patients’ privacy before you go ahead and record conversations.

Learn about the laws in your state regarding call recording, too. It will save you from dealing with legal issues later. Your phone system should always store the recorded conversations in a secure file.

You wouldn’t want information you just stored for documentation purposes to end up in the wrong hands. Be keen about who has access to each recording.

After you find a phone system with the features allowing you to record calls and keep them safe at all times, you’ll have peace of mind.

Look for Audit Logs and Reporting Tools

It’s important to be able to see who is using your phone system and what they are using it for. Your admin may need to see the information a patient gave earlier before texting back.

When you have a system with audit logs, you can quickly spot any unusual activity. You’ll be able to protect your information and do internal review to figure out if you need to take extra security measures.

Reporting tools analyze the data you store. Get a system with these and use them to check if your system is actually doing what it’s advertised to do. Use the information it gathers to improve how you serve your patients. You might notice things like:

  • Missed calls during busy hours
  • Long wait times before patients reach someone
  • Some departments receiving a lot more calls
  • Peak calling times that require additional staff

It’s much easier to improve when you have reports with such details. A lot of practices struggle to retain patients simply because they aren’t addressing issues that frustrate them. Having additional features on your HIPAA-compliant phone system helps you know where to direct resources.

Ensure the System Works With Your EHR

You probably already have many tools to support your team and help you manage records with less stress. Clinics need phone systems they can connect to:

  • EHR platforms
  • Scheduling software
  • Patient management tools

If you have to transfer data between your phone system and any of these tools, there’s a high risk of making mistakes. Integration avoids costly errors, and it also saves time for everyone.

As you look for a phone system, don’t hesitate to read reviews. These can help you figure out if other healthcare providers like using it. Learn about any potential issues you’re likely to come across.

You’ll feel more confident if you’re able to get a system you can use to organize all your communication history without having to do a lot of manual work.

Finding the Best HIPAA-Compliant Phone System

Investing in a HIPAA-compliant phone system saves you from a lot of the stress you might be dealing with because of using regular messaging apps.

These don’t come with the security features and reporting tools you need in your practice. Go for solutions with data encryption. Having a system multiple people on your team can use for triage also improves efficiency. Check out our page for tips to help your practice stay compliant.

Author Bio

Rob Mcmanus writes about healthcare compliance, cybersecurity, and healthcare technology. He’s been creating practical content for 7 years, helping healthcare professionals stay up to date with industry trends and best practices. When not writing, Rob enjoys reading and planning the next getaway.

 

References:

Federal Trade Commission. (2023). Are Public Wi-Fi Networks Safe? What You Need to Know.

TechTarget. (2024). What is user authentication?

Additional Resources:

Summary of the HIPAA Security Rule. U.S. Department of Health & Human Services. Access here.

Primary Mitigations to Reduce Cyber Threats to Operational Technology. Cybersecurity and Infrastructure Security Agency (CISA). Access here 

 

Please also review AIHCP’s Telehealth Nursing & Triage Nursing Certification program and CE Courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification