Infectious Diseases A-Z: Flu Vaccine Myths

From: Mayo Clinic http://www.youtube.com/watch?v=U15r1wuPC58

Internal Medicine Recertification Course 2017: Hematology Pearls

From: Mayo Clinic http://www.youtube.com/watch?v=n2r_vqxdjfA

Laptop stolen from doctor's car had info of thousands of hospital patients

Officials at Children’s Hospital Los Angeles say a laptop stolen from a physician’s car last year may have contained personal health information for nearly 3,600 patients

From: http://www.cbsnews.com/news/childrens-hospital-los-angeles-laptop-stolen-doctors-car-info-thousands-of-hospital-patients/

Many Americans worried about losing health insurance

As an axe looms over Obamacare, and with no details given on its replacement, many Americans are worried about losing their health insurance

From: http://www.cbsnews.com/news/obamacare-affordable-care-act-many-americans-worried-about-losing-health-insurance/

4 ways to reach (and maintain) New Year's resolutions

From: http://www.mayoclinic.org/4-ways-to-reach-and-maintain-new-years-resolutions/art-20270847

Nutrition claims: How to tell fact from fiction

From: http://www.mayoclinic.org/nutrition-claims-how-to-tell-fact-from-fiction/art-20300972

Can caffeine perk up heart health, too?

A new study might help explain why past research has linked higher caffeine​ intake to a longer life

From: http://www.cbsnews.com/news/can-caffeine-perk-up-heart-health-too/

Expert: Today might be the "Bluest Monday" ever

In 2005, a light-hearted formula was created to explain when we've hit the nadir of the January doldrums, and this year's is rather bad

From: http://www.cbsnews.com/news/january-16-2017-might-be-the-bluest-monday-ever-expert-says/

Good news for people who love spicy food

A new study suggests eating chili peppers may be linked to a longer life

From: http://www.cbsnews.com/news/good-news-for-people-who-love-spicy-food/

Mayo Clinic Minute: Winter skin protection ideas

From: Mayo Clinic http://www.youtube.com/watch?v=l7AgatNOjK0

How to take the bite out of frostbite

Young children and older people are at greater risk, but no one is immune, experts warn

From: http://www.cbsnews.com/news/taking-the-bite-out-of-frostbite/

Nutrition claims: How to tell fact from fiction

From: http://www.mayoclinic.com/nutrition-claims-how-to-tell-fact-from-fiction/art-20300972

4 ways to reach (and maintain) New Year's resolutions

From: http://www.mayoclinic.com/4-ways-to-reach-and-maintain-new-years-resolutions/art-20270847

Racism and discrimination in health care: Providers and patients

“People fail to get along because they fear each other; they fear each other because they don’t know each other; they don’t know each other because they have not communicated with each other.”
— Martin Luther King, Jr.

A patient of mine recently shared a story with me about her visit to an area emergency room a few years ago.* She had a painful medical condition. The emergency room staff not only did not treat her pain, but she recounted: “They treated me like I was trying to play them, like I was just trying to get pain meds out of them. They didn’t try to make any diagnosis or help me at all. They couldn’t get rid of me fast enough.”

There was nothing in her history to suggest that she was pain medication seeking. She is a middle-aged, churchgoing lady who has never had issues with substance abuse. Eventually, she received a diagnosis and appropriate care somewhere else. She is convinced that she was treated poorly by that emergency room because she is black.

And she was probably right. It is well-established that blacks and other minority groups in the U.S. experience more illness, worse outcomes, and premature death compared with whites.^1,2 These health disparities were first “officially” noted back in the 1980s, and though a concerted effort by government agencies resulted in some improvement, the most recent report shows ongoing differences by race and ethnicity for all measures.^1,2

Why are certain groups of patients getting different care?

Doctors take an oath to treat all patients equally, and yet not all patients are treated equally well. The answer to why is complicated.

Cases like my patient’s above illustrate the negative assumptions and associations we can label racism, but “most physicians are not explicitly racist and are committed to treating all patients equally. However, they operate in an inherently racist system.”³ In addition, we know that our own subconscious prejudices, also called implicit bias, can affect the way we treat patients.⁴ Basically, there are so many layers and levels to this issue, it’s hard to wrap our heads around it. But, we’ll try.

We now recognize that racism and discrimination are deeply ingrained in the social, political, and economic structures of our society.^3,4 For minorities, these differences result in unequal access to quality education, healthy food, livable wages, and affordable housing. In the wake of multiple highly publicized events, the Black Lives Matter movement has gained momentum, and with it have come more strident calls to address this ingrained, or structural, racism, as well as implicit bias.

Then, there was the 2016 presidential election. Explicitly expressed racism and religious intolerance has become commonplace. Last week, an older Muslim patient of mine* related that lately she has been harassed by strangers for wearing a headscarf. “I don’t feel safe even walking around my neighborhood,” she wept. “I used to love walking in the mornings or after work … it’s been months since I felt I could do that.”

In response to the rhetoric of the election and this alarming increase in hate speech, a large group of physicians published an open letter seeking to reassure patients. The letter is a statement of commitment to health as a human right, women’s health, mental health, LGBTQ health, evidence-based medicine, dismantling structural racism, and ending race-based violence.⁵ It’s everything I want to tell my patients right now.

Why are doctors sometimes the targets of bias and racism?

A colleague of mine, Dr. Altaf Saadi, recently wrote about her experiences treating patients at our own hospital. She has been questioned, insulted, and even attacked by patients, because she is a Muslim woman who wears a headscarf.⁵ She is not alone. Recent published reports include overt bigotry expressed towards doctors of black, Indian and Jewish heritage.^6,7,8 Several medical journals have just published guidelines for doctors with titles like “Dealing with Racist Patients” and “The Discriminatory Patient and Family: Strategies to Address Discrimination Towards Trainees.”^9,10 It’s sad that we need these guides.

And can we fix this?

Articles addressing racism in medicine suggest many of the same things. To fight racism and discrimination, we all need to recognize, name, and understand these attitudes and actions. We need to be open to identifying and controlling our own implicit biases. We need to be able to manage overt bigotry safely, learn from it, and educate others. These themes need to be a part of medical education, as well as institutional policy. We need to practice and model tolerance, respect, open-mindedness, and peace for each other.

It is important to link all of these goals and actions together, as they are layers of the same huge problem. The insidious structural racism, subconscious implicit bias, and overt, external discrimination come from the same place. Dr. Saadi’s words hold very true:

“We — as physicians and society more generally — must realize that the struggles of one marginalized community are struggles of all of us. My fight as a Muslim-American doctor to serve my patients without fear of racism, and the fight of an African-American patient to be treated with dignity and respect, should also be your fights.”

To that end, the call to action to address racism and discrimination in medicine is for all of us, providers and patients.

*Details omitted or changed to protect the patients’ privacy.

Sources

1. National Center for Health Statistics (US). Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. Hyattsville, MD: National Center for Health Statistics (US); 2016 May. Report No.: 2016-1232.
2. The Department of Health and Human Services, United States (HHS). National partnership for action to end health disparities: Offices of Minority Health. Washington, DC, 2011.
3. Rachel R. Hardeman, Ph.D., M.P.H., Eduardo M. Medina, M.D., M.P.H., and Katy B. Kozhimannil, Ph.D., M.P.A. Structural Racism and Supporting Black Lives — The Role of Health Professionals. New England Journal of Medicine, October 12, 2016.
4. King CJ, Redwood Y. The Health Care Institution, Population Health and Black Lives. Journal of the National Medical Association, May 2016.
5. Sreshta, Nina, et al. The Social Justice Coalition of the Cambridge Health Alliance: An open letter to our patients in the Trump era.
6. Saadi, Altaf: A Muslim-American doctor on the racism in our hospitals.
7. Gupta, Renuka. Slaves. Annals of Internal Medicine, November 1, 2016.
8. Howard, Jaqueline. Racism in medicine: An ‘open secret’ CNN.
9. Okwerekwu, Jennifer Adaeze. The patient called me “colored girl.” The senior doctor training me said nothing. STAT news.
10. Kimani Paul-Emile, J.D., Ph.D., Alexander K. Smith, M.D., M.P.H., Bernard Lo, M.D., and Alicia Fernández, M.D. Dealing with Racist Patients. New England Journal of Medicine February 25, 2016.
11. Whitgob EE, Blankenburg RL, Bogetz AL. The Discriminatory Patient and Family: Strategies to Address Discrimination Towards Trainees. Academic Medicine, 2016 Nov (11 Association of American Medical Colleges Learn Serve Lead: Proceedings of the 55th Annual Research in Medical Education Sessions):S64-S69.
12. Sharma M, Kuper A. The elephant in the room: talking race in medical education. Advances in Health Science Education: Theory and Practice, November 5, 2016. [E-pub ahead of print]

The post Racism and discrimination in health care: Providers and patients appeared first on Harvard Health Blog.

From: Monique Tello, MD, MPH http://www.health.harvard.edu/blog/racism-discrimination-health-care-providers-patients-2017011611015

Joint Statement on Syria

DAVOS, Switzerland – While efforts to fully implement a ceasefire in Syria continue, we again appeal for immediate, unconditional, and safe access to reach the children and families who are still cut off from humanitarian aid across the country.

From: http://www.who.int/entity/mediacentre/news/statements/2017/joint-statement-syria/en/index.html

The power and prevalence of loneliness

All the lonely people, where do they all come from?
All the lonely people, where do they all belong?
—The Beatles, “Eleanor Rigby”

A few years ago, when I was the attending emergency physician working in the emergency department, the senior medical resident asked permission to discharge an older man. The resident was convinced the patient was a malingerer, having been seen multiple times in the last week at the medical clinic with “shortness of breath.” The patient had multiple tests, scans, and more — all normal — and yet here he was again, in the emergency department complaining of continued difficulty breathing. “Wait,” I said. “There must be a reason that he keeps coming back. Let me take a look at him with you.”

We entered the room, and saw an old man, shrunken in the corner with no animation in his face. He looked forlorn, so I asked, “Are you sad?” He burst into tears and told me that his partner of more than 20 years had died a week ago; he was devastated.

His real condition? Not shortness of breath, not crying wolf to get attention, and certainly not a malingerer. What he had was pure and simple: loneliness.

The medical resident was stunned. As he admitted to me later, he learned a powerful lesson that day: that the pain of loss can be as profound as not breathing. And sometimes the symptom comes not from the body, but is a cry from the soul.

The epidemic — and health dangers — of loneliness

Loneliness affects 25% to 60% of older Americans and puts millions of Americans 50 and over at risk of poor health from prolonged loneliness. Loneliness is almost as prevalent as obesity. In a survey of members of the AARP Medicare Supplement Plans, insured by UnitedHealthcare, 27% to 29% were lonely; about 9% were severely lonely. Among those members representing the top 5% with the most chronic conditions, spending 5% of the healthcare dollar, loneliness rises to 55% of that population, half of whom suffer with severe loneliness.

Notwithstanding the impact on quality of life and life satisfaction, loneliness has an equivalent risk factor to health as smoking 15 cigarettes a day, shortening one’s lifespan by eight years.

Per the Harvard Study of Adult Development, a 75-year longitudinal study of men, loneliness is toxic. The more isolated people are, the less happy they are, and brain function declines as well as physical health. Note that isolation is the objective measure of how large your social network is, whereas loneliness is a subjective perception of how one feels. In other words, you can have many friends and be lonely, or no friends and not be lonely. Isolation, whether from becoming homebound, loss of mobility, absence of transportation, or losing a spouse or partner, are all risk factors for loneliness. Hearing loss, too, can foster isolation and miscommunication, and set the stage for loneliness.

Loneliness also can be contagious, just like a cold. According to a recent study, “Alone in a Crowd: The Structure and Spread of Loneliness in a Large Social Network,” lonely people tend to share their loneliness with others. Over time, a group of lonely, disconnected people move to the fringes of social networks. The problem is compounded because lonely people, those on the periphery, tend to lose the few contacts they have.

According to the UK Campaign to End Loneliness, more than half of lonely people simply miss having someone to laugh with. Their research also showed that simply being together with someone is missed most of all (52%), and 46% miss having a hug. Older people experiencing loneliness also miss simple everyday moments, such as sharing a meal (35%), holding hands (30%), taking country walks (32%), or going on holiday (44%).

“Treating” loneliness

Back to my patient. He was classically lonely, having lost his dearest friend of 20 years. We had to allow him to share his grief, support him in his loss, and acknowledge the pain, so he didn’t have to substitute a physical ailment to say he needed help. There is a huge stigma to admit to loneliness, and yet it is such a profound human condition that we all recognize, and yet so often turn our faces away.

Social connection helps us thrive and gives us resilience. The support of family, friends, colleagues, and caregivers allows us to celebrate our experiences, weather our pains, and face each day as we journey forward.

AARP Foundation recently launched a social isolation platform called Connect2Affect. The goal is to create a network that not only builds awareness about social isolation and its impact, but also identifies solutions. The Connect2Affect website features tools and resources to help users evaluate isolation risk, reach out to others who may be feeling disengaged, and find practical ways to reconnect to the community.

Now that the holidays have come to an end, our friends and family have returned to their everyday lives while others have retreated into hibernation during these cold months. As you ponder these next few weeks and months, think about who you know who recently lost a loved one, who might be going through a divorce, an empty nester, or someone who might still be lonely even though surrounded by friends and family. They may well be sad, isolated, or feeling lonely. Reach out to them. As the old ad jingle says, reach out and touch someone. You can ease the loneliness and isolation and be a bright spot in their lives. You can laugh with them, reminisce, and thank each other for just being there.

Let us not forget, now that the holidays have ended, the power we each hold in our hands — the power of connection, friendship, and being human. Hold a friend’s hand today and every day. You will have just contributed to life itself.

The post The power and prevalence of loneliness appeared first on Harvard Health Blog.

From: Charlotte S. Yeh, MD http://www.health.harvard.edu/blog/the-power-and-prevalence-of-loneliness-2017011310977

Trump promises health "insurance for everybody"

An embrace of universal health care would mark a sharp break for most Republicans

From: http://www.cbsnews.com/news/donald-trump-promises-health-insurance-for-everybody/

Nutrition claims: How to tell fact from fiction

From: http://www.mayoclinic.org/nutrition-claims-how-to-tell-fact-from-fiction/art-20300972

4 ways to reach (and maintain) New Year's resolutions

From: http://www.mayoclinic.org/4-ways-to-reach-and-maintain-new-years-resolutions/art-20270847

The power and prevalence of loneliness

All the lonely people, where do they all come from?
All the lonely people, where do they all belong?
—The Beatles, “Eleanor Rigby”

A few years ago, when I was the attending emergency physician working in the emergency department, the senior medical resident asked permission to discharge an older man. The resident was convinced the patient was a malingerer, having been seen multiple times in the last week at the medical clinic with “shortness of breath.” The patient had multiple tests, scans, and more — all normal — and yet here he was again, in the emergency department complaining of continued difficulty breathing. “Wait,” I said. “There must be a reason that he keeps coming back. Let me take a look at him with you.”

We entered the room, and saw an old man, shrunken in the corner with no animation in his face. He looked forlorn, so I asked, “Are you sad?” He burst into tears and told me that his partner of more than 20 years had died a week ago; he was devastated.

His real condition? Not shortness of breath, not crying wolf to get attention, and certainly not a malingerer. What he had was pure and simple: loneliness.

The medical resident was stunned. As he admitted to me later, he learned a powerful lesson that day: that the pain of loss can be as profound as not breathing. And sometimes the symptom comes not from the body, but is a cry from the soul.

The epidemic — and health dangers — of loneliness

Loneliness affects 25% to 60% of older Americans and puts millions of Americans 50 and over at risk of poor health from prolonged loneliness. Loneliness is almost as prevalent as obesity. In a survey of members of the AARP Medicare Supplement Plans, insured by UnitedHealthcare, 27% to 29% were lonely; about 9% were severely lonely. Among those members representing the top 5% with the most chronic conditions, spending 5% of the healthcare dollar, loneliness rises to 55% of that population, half of whom suffer with severe loneliness.

Notwithstanding the impact on quality of life and life satisfaction, loneliness has an equivalent risk factor to health as smoking 15 cigarettes a day, shortening one’s lifespan by eight years.

Per the Harvard Study of Adult Development, a 75-year longitudinal study of men, loneliness is toxic. The more isolated people are, the less happy they are, and brain function declines as well as physical health. Note that isolation is the objective measure of how large your social network is, whereas loneliness is a subjective perception of how one feels. In other words, you can have many friends and be lonely, or no friends and not be lonely. Isolation, whether from becoming homebound, loss of mobility, absence of transportation, or losing a spouse or partner, are all risk factors for loneliness. Hearing loss, too, can foster isolation and miscommunication, and set the stage for loneliness.

Loneliness also can be contagious, just like a cold. According to a recent study, “Alone in a Crowd: The Structure and Spread of Loneliness in a Large Social Network,” lonely people tend to share their loneliness with others. Over time, a group of lonely, disconnected people move to the fringes of social networks. The problem is compounded because lonely people, those on the periphery, tend to lose the few contacts they have.

According to the UK Campaign to End Loneliness, more than half of lonely people simply miss having someone to laugh with. Their research also showed that simply being together with someone is missed most of all (52%), and 46% miss having a hug. Older people experiencing loneliness also miss simple everyday moments, such as sharing a meal (35%), holding hands (30%), taking country walks (32%), or going on holiday (44%).

“Treating” loneliness

Back to my patient. He was classically lonely, having lost his dearest friend of 20 years. We had to allow him to share his grief, support him in his loss, and acknowledge the pain, so he didn’t have to substitute a physical ailment to say he needed help. There is a huge stigma to admit to loneliness, and yet it is such a profound human condition that we all recognize, and yet so often turn our faces away.

Social connection helps us thrive and gives us resilience. The support of family, friends, colleagues, and caregivers allows us to celebrate our experiences, weather our pains, and face each day as we journey forward.

AARP Foundation recently launched a social isolation platform called Connect2Affect. The goal is to create a network that not only builds awareness about social isolation and its impact, but also identifies solutions. The Connect2Affect website features tools and resources to help users evaluate isolation risk, reach out to others who may be feeling disengaged, and find practical ways to reconnect to the community.

Now that the holidays have come to an end, our friends and family have returned to their everyday lives while others have retreated into hibernation during these cold months. As you ponder these next few weeks and months, think about who you know who recently lost a loved one, who might be going through a divorce, an empty nester, or someone who might still be lonely even though surrounded by friends and family. They may well be sad, isolated, or feeling lonely. Reach out to them. As the old ad jingle says, reach out and touch someone. You can ease the loneliness and isolation and be a bright spot in their lives. You can laugh with them, reminisce, and thank each other for just being there.

Let us not forget, now that the holidays have ended, the power we each hold in our hands — the power of connection, friendship, and being human. Hold a friend’s hand today and every day. You will have just contributed to life itself.

The post The power and prevalence of loneliness appeared first on Harvard Health Blog.

From: Charlotte S. Yeh, MD http://www.health.harvard.edu/blog/the-power-and-prevalence-of-loneliness-2017011310977