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Archive for the ‘Preventative Medicine’ Category

Early detection of breast cancer saves lives | State | sidneyherald.com – Sidney Herald Leader

Thursday, October 15th, 2020

The drive from Big Sandy to Great Falls is awfully familiar to our family. Jon drives those 70-some miles twice a week as he travels between our farm and the Senate. Often we drive together for farm parts, haircuts, you name it. The drive is second nature. But lately, it has taken on a new meaning.

Because in early spring of this year, I was diagnosed with breast cancer.

I found the cancer as many women do, with a lump. But I had a bit of a head start: breast cancer runs in my family both my grandmothers had breast cancer, and my grandmother on my mothers side, my mother, my sister, myself, and my daughter all have the same breast cancer gene. The knowledge that its genetic has helped serve as preventative medicine for our family once I knew I was likely to get it, it empowered me to know what to look for and get screened regularly.

Cancer doesnt discriminate between gender or age, and breast cancer is no exception.

Men get it too, and it isnt shameful to talk about it, because men need to be aware of their own risk factors.

When it comes to breast cancer, monthly self-examinations are critical, because if caught early, it can save your life.

I knew from the beginning that my prognosis was good, and was lucky to feel full mostly of hope, not fear. This month, I completed my final round of chemotherapy, and I have been very lucky to have few side effects. My husband and kids have been a remarkable support system.

The love and support of my family gave me the strength to face the uncertainties of cancer head-on. And at the end of the day, I know that Im fortunate. Fortunate to have been blessed by the doctors, nurses, and health care workers at Benefis Sletten Cancer Institute in Great Falls that have given me top-notch care every step of the way. They were both professional, and personal, and made sure that every time I walked in those doors I never felt a sense of doom and gloom. And I feel more fortunate, still, that in a state where some folks have to travel for hundreds of miles to receive care, our 70-some mile drive was a pretty short hop.

And when youre counting your blessings, its hard not to consider those that arent as fortunate.

How many Montanans face the fear of cancer diagnosis without the security of affordable health care? How many folks skip cancer screenings or go without treatment because a trip to the doctor would mean the choice between paying a medical bill or putting food on the table?

Its only fitting that I received the last of my treatment during Breast Cancer Awareness Month. I encourage everyone, women and men alike, to use this month as a reminder to take precautionary steps. Check yourself often. Get regular screenings. Early detection can save your life.

Now that my treatment is finished, the drive to Great Falls will be easier again. I still have work in front of me and the outlook is promising. But the many cancer patients with a tough road ahead will still be on my mind and in my prayers.

I am not fighting my battle alone, and no Montanan ever should.

Sharla Tester is a farmer living and working in Big Sandy. She is married to U.S. Senator Jon Tester.

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Early detection of breast cancer saves lives | State | sidneyherald.com - Sidney Herald Leader

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Life Sciences – a year to remember – Lexology

Thursday, October 15th, 2020

The Life Sciences sector has not been as newsworthy, pressured and flush with investors in living memory. The arrival of COVID-19 in 2020 has suddenly and emphatically focused attention on Life Sciences. The perception of the sector, and the reality of how it operates, has shifted. But in truth, Pharma was already changing.

Trends unrelated to the pandemic began with the shift away from searching for big-earning blockbuster drugs treating broad indications. Cost-effective opportunities in this type of market are dwindling, in the face of ever-increasing R&D and approval costs. Meanwhile, the shift to precision medicine has accelerated. Digital technology and biotechnology continue to make deeper inroads and stronger interconnections in how treatments are researched, developed and consumed. And those are just some of the developments.

Back in the distant, pre-COVID world of 2019, the Pharma industry was being dogged by the competing pricing concerns of payers and producers, with increasing pressure against companies seen to be benefiting from a monopoly on human health. Calls for tighter regulation on prices were particularly prevalent in the US, becoming a major theme of political debates.

A change in perception

Then along came COVID. Much as a global conflict usually sees major advances in weaponry, this global pandemic has seen a rapid boost in life science technology, collaboration and funding, as pharma companies, research organisations, SMEs and universities collectively search for a vaccine. The perception of Big Pharma has shifted correspondingly, from profiteers to potential saviours. It is probably true to say that never has so much been known about the sector by so many, in such a short space of time.

The growth of interest in Life Sciences has included investors; funding in 2020 has been incredibly strong. Biotech companies comprised 80% of all US IPOs in the first quarter and the US Nasdaq Biotechnology Index neared a five-year high in late April.

The US is the leader for investment by a big margin, but China has also seen some large investment rounds. Investors apparently see the sector as economy-proof and this is underpinned by a stronger public perception.

Tech advances

What of the technology? It has changed the R&D landscape, significantly reducing costs. Closer ties between tech and biotech are driving speedier, more targeted drug development, replacing the previous time-consuming trial and error required to prove theories. Interaction simulations can be run at the click of a button and clinical trials can progress more rapidly and cost-effectively through technology-aided efficiencies.

As R&D expense reduces and the remaining available blockbuster indications diminish, addressing smaller markets and niche illnesses has become more commercially viable alongside the long-standing medical needs. AI is invaluable in finding links in the rapidly accumulating global data resources. It is also creating more platform plays and modular business plans designed for biotech companies to bolt onto. And it is assisting clinicians by enabling faster, accurate reviews, such as analysing scans for breast cancer.

Enabling better prevention

Technology is also improving the quality of preventative medicine. Apps are helping doctors carry out remote diagnosis and secure more real-time, comprehensive feedback. Taking advantage of the Internet of Things, devices such as smart toilets can collect and analyse samples, and provide early warning of kidney or gastro-intestinal diseases. Spotting problems before they develop has physical, emotional and financial benefits for individuals, and the use of virtual coaches can support this by guiding patients through a healthier, preventative lifestyle.

More effective therapies

At the leading edge of life sciences, tech is helping new therapies to be better understood and utilised. Cell therapy is identifying and developing stem cells suitable for specialised uses, such as dopamine producers that could combat Parkinsons disease. Better gene editing tools are delivering improvements in gene therapy, while next-generation genome sequencing is allowing the development of precision medicines to previously unattainable levels.

The race for a vaccine

Crucially, and taking us back to where we started, vaccines can be constructed differently a point more pertinent than ever as science attempts to race towards an effective COVID-19 cure.

And its side effects

Is there a downside to all this? Yes. COVID has understandably monopolised attention and pushed back most other drug trials. Around half of non-COVID trials have been delayed this year, with critical developments put on hold and many biotech firms effectively in hibernation.

Whilst the true impact of these delays remains uncertain, there have nevertheless been a number of positives for the life sciences sector in 2020.

Positives for life sciences

Public and investor perception of pharma and life sciences has improved, with a resultant increase in funding and greater interest in careers in the sector. More specialised, precision medicine is giving fresh hope to those facing currently untreatable illnesses. Advances in tech-enabled diagnosis, drug development, dosing and monitoring have accelerated progress, with the spotlight on vaccines, genetic testing and monitoring leading to greater prominence on prevention.

Many of us are getting accustomed to the new normal acknowledging that post-COVID life will never be quite the same as it was before. The pandemic has resulted in a new normal emerging for life sciences too: greater collaboration, potentially faster trials and approval, and more integration of technology leading to more targeted and effective prevention and treatment.

Memories are often short, so how long life science advances will stay in the limelight is open to conjecture. But at this point in our state of the nation review, the life sciences sector is looking encouragingly healthy.

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Life Sciences - a year to remember - Lexology

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WellQor Launches Game Changing End-To-End Solution for the Proactive Management of Emotional Health in Senior Living Communities – Benzinga

Thursday, October 15th, 2020

MELVILLE, N.Y., Oct. 15, 2020 /PRNewswire-PRWeb/ --The global pandemic has senior living communities seeking ways to rebuild public confidence in their ability to care for their residents. Vacancy rates have skyrocketed while new communities are opening across the country, giving seniors and their families more choices than ever. With anxiety surrounding senior living at an all-time high, there's an urgent need for innovative ways to reassure family members that their loved ones will be happy, safe, and secure in their community. WellQor, the nation's leader in senior behavioral health, today announced the launch of two new programs: Transitions and Peace of Mind which, when deployed in conjunction with their existing clinical services, provide a complete behavioral health solution for communities that wish to fully understand and meet the emotional needs of their residents.

"Community staff members are often overwhelmed by their day-to-day responsibilities and unable to focus on individual resident needs that aren't acute. By partnering with third party healthcare providers like WellQor, staff members can take advantage of deep expertise in identifying and addressing the myriad of health issues that seniors face" said David Schwam, CEO of WellQor. "These overlooked needs far too often result in move-outs that could have been prevented".

WellQor's new Transitions program was designed to ensure that new residents and their families are sufficiently prepared for the move to senior living. For approximately thirty days, WellQor's licensed professionals work closely with each incoming resident and family in order to help them overcome challenges which can result in an unsuccessful move. Sources of stress and anxiety are identified, the definition of a successful move is established, and realistic expectations for the transition process are set. In communities using the Transitions program, the findings from this process are discussed at length with the care team in order to facilitate an ongoing, comprehensive and collaborative approach to care.

WellQor's Peace of Mind program gives communities the ability to proactively monitor "how every resident is actually doing". After gathering information from a family member and completing a quarterly assessment of a resident's emotional and cognitive health, WellQor generates their proprietary "Wellness Report'' for each resident. This report uses an easy to understand scoring system and provides valuable insight and suggestions for the improvement of their emotional health. The Wellness Report is shared with staff and family members to be used as the basis for planning and collaboration in order to improve the residents' overall well being. WellQor's sophisticated reporting capabilities allow communities to understand, both at an individual and aggregate level, issues that may be impacting resident outcomes, duration of stay, and caregiver stress and turnover.

By deploying the Transitions and Peace of Mind Programs, communities now have the ability to proactively identify issues long before they become significant problems that require staff attention. When professional intervention is required, WellQor's clinical team of licensed Psychologists and Clinical Social Workers can immediately engage using either telehealth or in-person sessions in order to help move past the issue prior to it becoming a crisis. In this spirit, WellQor offers a one of a kind solution that makes emotional healthcare more accessible and proactive than ever before.

Increasingly, communities are leveraging preventative medicine as a way to define care and set themselves apart from those who simply react to issues as they are discovered. By helping to implement a collaborative and comprehensive approach to care, WellQor can help these communities reestablish trust and confidence with seniors and their families and rebuild their census.

SOURCE WellQor Management Services, Inc.

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WellQor Launches Game Changing End-To-End Solution for the Proactive Management of Emotional Health in Senior Living Communities - Benzinga

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People with disabilities growing sicker in poverty with no election promises to give them hope – News 1130

Thursday, October 15th, 2020

VANCOUVER (NEWS 1130) People on disability assistance say they are getting sicker because of a Grand-Canyon-sized-gap in provincial medical coverage and all three main political parties have failed to offer them hope during the provincial election campaign.

NEWS 1130 has spoken with four people who have complex disabilities and say they pay out-of-pocket for both basic and life-altering treatments they cannot afford.

So youre in a situation where youre choosing between food and medicine or youre going into debt. Eventually you end up not being able to do or afford the things that support your health at all, says one person, who has been steadily growing more sick over 25 years of what she considers inhumanely low coverage.

Lawyer Andrew Robb with Disability Alliance BC says his clients experience deteriorating health and believes the government should be challenged to uphold human rights.

I think that people do have a right to healthcare and a right to be well and I think the way that the Ministry of Social Development and Poverty Reduction administers the Persons with Disability program, right now, is not consistent with those rights, he says.

He says B.C.s regulations list very specific services and fees that are covered and bureaucrats generally will not stray from that list, unlike in other provinces, where more discretion is allowed.

It has certainly been our experience that people very frequently need and require more assistance, more services, more treatments than are covered by the regulations, he says.

The ministry covers $23.50 for each extended health visit, to a maximum of 10 visits each year.

That means a person with disabilities (PWD) only receives $230.50 annually to spend between practitioners such as physiotherapists, registered massage therapists, naturopathic doctors and acupuncturists.

Many people with complex health needs believe their situation has deteriorated because of this dearth of coverage, as they have been forced to forgo preventative treatments.

One person NEWS 1130 spoke with is moving forward with her request to seek assisted dying as she can no longer afford the care required to keep her pain within a tolerable window.

She says she does not believe the current NDP government, or any other party that could take power after this election, will change the law in time to save her life.

Dr. Rebecca Handford is the president of the BC Naturopathic Association. She says the previous provincial Liberal administration cut MSP funding to extended health, including naturopathy, which many people with complex disabilities report finding relief with.

It kind of speaks to a larger problem which is funding prevention versus emergency care Overall, as a society, we dont value prevention as a means of keeping people healthy, says Handford.

She says prevention is always cheaper than emergent care and cheaper than allowing people to descend into more painful, more complex situations because of an out-of-date approach to medicine.

The overall perspective that we need to change is to spend a little money now to prevent a larger expense later on, she argues, adding its difficult to prove the value of prevention.

When you prevent further problems, they dont happen, and how do you prove that they didnt happen? she says.

Handford says naturopathy and other extended health deserves more coverage because people with complex care needs require in-depth assessment and understanding of their conditions, as well as a holistic approach to healthcare.

If you went to see a regular medical doctor for nutrition advice, that would be outside of what is paid for by MSP, she points out, highlighting how essential diet is to overall health.

One person explained how naturopathic IV treatments have given her a quality of life she hasnt been able to achieve through any other means.

However, the total annual MSP coverage amounts to less than the cost of two visits, or one weeks worth of care.

Using the 10 visits per year on one treatment or modality means she cannot seek out other preventative and pain-relieving care, such as physiotherapy or massage.

As a result shes had to ask for charity from providers, who have been kind enough to take the hit to their income, for her benefit.

She wants to see more discretion for the government to support individuals needs when they require more than traditional Western medicine.

So that you dont end up in this fully emergent situation where youve got a patient falling off the edge of a cliff and you dont know what the hell to do because the more illnesses you have, the harder it is to manage deterioration, she says.

The DABCs Robb says his clients often stop their treatments out of necessity.

And they end up needing emergency medical care instead of receiving preventative care that might have kept them from this situation in the first place, he says.

Robb also wants to see the Ministry of Social Development and Poverty Reduction loosen up regulations about what medical treatments, devices and supports can be approved.

Were talking extremely rigid, he says of current regulations.

He blames the Employment and Assistance for Persons with Disabilities Regulation, which bureaucrats and ministry staff must adhere to.

He says PWD and their advocates, who have been trying to make the case for any needs outside of the rigid legislation, have been shut down in every case hes witnessed.

Theres no room for flexibility or discretion about that, he says.

Anti-poverty advocates argue that disability tax credits, low assistance payments and a lack of medical support are the wrong way to approach this issue.

A recent pilot project showed giving people direct cash transfers helped them find a path to better lives and out of poverty.

Claire Willaims is the co-founder and CEO of Foundations for Social Change and has a complex disability herself.

The cost of living is incredibly high, she says, outlining rent for a one-bedroom apartment in Vancouver costs double the total maximum monthly payment a PWD currently receives.

I think its incredibly unrealistic to expect people to subsist on that kind of money, never mind thrive, she says, pointing out emergency payments for employees amounted to more than double many PWD payments.

I think there is a general mistrust around people going on disability. Any situation or circumstance that ultimately puts somebody in a place where they require some kind of cash support, for whatever reason, inherently generates a sense of mistrust, she says.

The recent New Leaf pilot project showed that mistrust and stigma is unnecessary, she argues, invoking the philosophy of Dutch historian and economic equality advocate, Rutger Bregman.

He says living in poverty is not a lack of character, its a lack of cash so I think we need to start looking at more meaningful risk taking in the space of social policy to support Canadians that need that extra help.

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University Hospitals Cleveland Medical Center Joins the Cardiometabolic Center Alliance as a Key Strategic Partner and Charter Member – Newswise

Thursday, October 15th, 2020

Newswise Kansas City, Missouri & Cleveland, Ohio--The Cardiometabolic Center Alliance (CMCA), founded by Saint Lukes Mid America Heart Institute is pleased to announce the addition of University Hospitals Cleveland Medical Center as Key Strategic Partner and Charter Member.

As a coalition that seeks to establish Cardiometabolic Centers of Excellence nationwide aimed at transforming the treatment of type 2 diabetes (T2D) and related cardiovascular (CV) and renal comorbidities, the CMCA considers University Hospitals (UH) a large integrated health system based in Cleveland, Ohio a key member of the Alliance.

The goal of the Cardiometabolic Center Alliance is building on our existing success in Kansas City by working collaboratively with our member organizations to replicate and refine our novel clinical care delivery model, with the overarching objective of lessening the adverse impact of diabetes and its most common and morbid complications cardiovascular and kidney disease - on patients lives, said Dr. Mikhail Kosiborod, Cardiometabolic Center Alliance Executive Director. The addition of UH as a Strategic Partner and Charter Member of the CMCA is an essential step in meeting our mission of improving the quality of care and outcomes of patients with cardiometabolic disease, so they can live longer, healthier, and more active lives, no matter where they live.

Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 18 hospitals, more than 50 health centers and outpatient facilities, and 200 physician offices in 16 counties throughout northern Ohio.The systems flagship academic medical center, University Hospitals Cleveland Medical Center, located in Clevelands University Circle, is affiliated with Case Western Reserve University School of Medicine.

We are excited to be a part of this national alliance that will pave the way for new treatments and approaches to manage patients with cardiometabolic disorders, said Sanjay Rajagopalan, MD, Chief of Cardiovascular Medicine at UH Harrington Heart & Vascular Institute. Cardiologists are uniquely positioned to assist with the seismic shift occurring in the landscape of care for diabetes and cardiovascular complications. However, these diseases require a large degree of collaboration with other specialties. In order to provide the highest quality of care for patients, its important that we take a multidisciplinary team approach and intervene early.

Through personalized medicine and research collaborations, such as UH and CMCA, enhancements can be made for detecting disease early, developing therapeutics for treatment, and refining technology-based approaches to improve patients lives.

At UH, we are focused on providing the best value for our patients, said Peter Pronovost, MD, PhD, Chief Clinical Transformation Officer at UH. This unique alliance will help us track treatment patterns and quality of care, and will help us transform care delivery for patients at risk for future complications.

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Alliance members will adopt and implement a novel care model designed and successfully implemented bySaint Lukes Michael & Marlys Haverty Cardiometabolic Center of Excellencein Kansas City, MO. Based on the initial data, under this model the rates of optimal guideline-directed medical therapy substantially increased over the national average, ensuring that patients with T2D receive care that is aimed at both optimizing diabetes management and providing comprehensive cardiovascular risk reduction with therapies proven to improve outcomes. These results are made possible by a unified team of clinicians from across the disease continuum, who focus on holistic, guideline-directed preventative care. Through their participation, Alliance members will also contribute to a national registry that will track treatment patterns and quality of care. As the Alliance enhances its capabilities, improves processes, and expands research opportunities on a national scale, the ultimate goal is improved patient outcomes.

About University Hospitals / Cleveland, OhioUniversity Hospitals also includes University Hospitals Rainbow Babies & Children's Hospital, ranked among the top childrens hospitals in the nation; University Hospitals MacDonald Women's Hospital, Ohio's only hospital for women; University Hospitals Harrington Heart & Vascular Institute, a high-volume national referral center for complex cardiovascular procedures; and University Hospitals Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, including cancer, pediatrics, women's health, orthopedics, radiology, neuroscience, cardiology and cardiovascular surgery, digestive health, transplantation and urology. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including Americas Best Hospitals from U.S. News & World Report. UH is also home to Harrington Discovery Institute at University Hospitals part of The Harrington Project for Discovery & Development. UH isone of the largest employers in Northeast Ohio with 28,000 physicians and employees. Advancing the Science of Health and the Art of Compassion is UHs vision for benefitting its patients into the future, and the organizations unwavering mission is To Heal. To Teach. To Discover.Follow UH on LinkedIn, Facebook @UniversityHospitalsand Twitter @UHhospitals. For more information, visitUHhospitals.org.

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University Hospitals Cleveland Medical Center Joins the Cardiometabolic Center Alliance as a Key Strategic Partner and Charter Member - Newswise

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The COVID-19 pandemic emphasizes the need to manage patient obesity – Medical Economics

Thursday, October 15th, 2020

CDC listed obesity as one of the risk factors linked to severe illness from COVID-19, emphasizing the need for patients to take weight issues more seriously than ever. Obesity triples the rate of hospitalization from COVID-19, and obesity-related comorbidities worsen the outcome. Recent studies have illustrated a direct relationship between BMI and severity of the symptoms, including mortality from COVID-19 infection.

The prevalence of obesity among children and adults continues to rise. According to the CDC, 12 states in the US had an adult obesity prevalence rate of 35% or above in 2019, a dramatic but expected increase from 2018 (9 states) and 2017 (6 states). With the recent change in the lifestyle imposed on us due to this pandemic, this number will only continue to grow if we do not take adequate measures to curtail it.

How does this disease state caused by adipose tissue dysfunction lead to a spiraling cascade of metabolic, inflammatory, and mechanical derangement when exposed to a severe infection like COVID-19?

Let us explore some of the reasons:

Obesity and immune function: Clinical and epidemiological data have shown that obesity impairs the immune response. The incidence and severity of certain types of infectious diseases are higher among obese persons than lean individuals due to altered antibody response. The imbalance between energy intake and expenditure typically seen in obesity may also influence cell-mediated and humoral immune response. Research has shown a strong negative correlation between the T-cell population and its function with body weight.

Obesity and lung function: Obesity decreases total lung capacity, functional residual capacity, increases airway resistance, and makes mechanical ventilation more difficult. Acute respiratory distress syndrome due to COVID-19 requiring mechanical ventilation has been more prevalent in patients with a BMI greater than 30 and most significant in patients with a BMI greater than 35. ARDShas been the major complication and cause of death in COVID19. Obesity plays a crucial role in susceptibility to ARDS, respiratory failure, and outcome with mechanical ventilation due to baseline lung physiology changes with impaired ventilation and gas exchange. Obstructive sleep apnea that is often seen in obese patients increases the risk of hypoventilationassociated pneumonia, pulmonary hypertension, and sudden cardiac death.

Obesity and comorbidities: Obesity is closely associated with chronic illnesses like DM, HTN, etc. DM/hyperglycemia impairs the immune response, thereby making the patient more susceptible to pneumonia and nosocomial infections. Hypertension is an independent risk factor associated with severe COVID-19 infection, ARDS, and mortality as per a recent meta-analysis study.

Obesity is a chronic, complicated, multifactorial disease that has been causing a substantial medical and economic burden. As per the World Health Organization, in 2016, more than 1.9 billion adults aged 18 years and older were overweight. Of these, over 650 million adults were obese. Obesity has long been a global health issue, a slowly ravaging pandemic.

The COVID-19 pandemic has put obesity in the spotlight, illustrating the need to focus on screening and treating it more aggressively than before. Until we have a vaccine for COVID-19, we are left with only preventive measures wearing masks to curtail the spread of the contagion and diet to trim the waistline.

Aparna Chandrasekaran, M.D., is medical director of the Jersey Medical Weight Loss Center, a member of the Center for Medical Weight Loss and a committee member and mentor in the Obesity Medicine Association.

References

1.Obesity and immune function relationships - Obesity Reviews. July 2008. A. MartA. MarcosJ. A. Martnez.

2. T lymphopaenia in relation to body mass index and TNF in human obesity: adequate weight reduction can be corrective. Clinical endocrinology, 54(3), 347-354.

3. High prevalence of obesity in severe acute respiratory syndrome coronavirus2 (SARSCoV2) requiring invasive mechanical ventilation. Obesity. Obesity Reviews September 2020. Effect of obesity and body mass index on coronavirus disease 2019 severity: A systematic review and metaanalysis

4.Individuals with obesity and COVID19: A global perspective on epidemiology and biological relationships. Obesity reviews. August 2020.

5.Effect of obesity and body mass index on coronavirus disease 2019 severity: A systematic review and metaanalysis. Obesity Reviews September 2020.

6. Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis, and meta-regression. Pubmed.gov

7. Should patients with obesity be more afraid of COVID19? Obesity review June 2020

8. WHO. https://www.who.int/health-topics/obesity

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Why Africa needs to invest in mental health – The Conversation CA

Thursday, October 15th, 2020

More than 13% of the global burden of disease is due to disorders such as depression, anxiety, schizophrenia and substance abuse. Almost three-quarters of this burden lies in low- and middle-income countries, because of extremely scarce health resources and investment. Many countries allocate less than 1% of the health budget to mental health. Poor or non-existent access to evidence-based care also leads to the need for long-term care and increased costs of care.

The economic burden is also significant. The global cost of lost productivity due to depression and anxiety disorders is an estimated US$1.15 trillion a year. Around 4.7 billion days of productivity are lost.

There is good evidence that these conditions are treatable. But the estimates of people in sub-Saharan Africa receiving treatment are jarring. Only 15% of South Africans with mental health conditions receive treatment. In Ghana and Ethiopia the estimates are less than 10%.

Weve spent decades researching mental health and health economics around the world. Our research has demonstrated that, for example, peer support for treating perinatal depression shows benefits that far outweigh any costs incurred in delivering the treatment. Weve also seen the Healthy Activity Programme Psychological Treatment in India provide better clinical outcomes at lower costs. In a recent study in Ghana weve shown that investments in population-level screening and subsequent treatment could yield benefits greater than the costs. The findings imply that every $1 invested over a 10 year period in depression, anxiety disorders and schizophrenia treatment would accrue about $7.4, $4.9 and $1.7 in returns respectively to society.

There are compelling arguments that neglecting mental health will make it extremely difficult to attain many other targets. These include Sustainable Development Goals related to poverty, HIV, malaria, gender empowerment and education.

For example, poverty rates are two times higher in people with mental health conditions compared to those without. People living with mental illness or substance use disorders are more likely to become infected with HIV. Poor mental health weakens immunity and adherence to treatments for malaria.

Clearly, there is a case for investing in mental health and more importantly, making interventions and services accessible to all. Having set out this case we also offer recommendations on how this might be achieved.

Political will and support from civil servants affect the proportion of GDP allocated to mental health. For Africa as a whole, government mental health expenditure per capita is $0.1.

Practical tips for mental health advocates to convince politicians have been offered in previous writings. These include placing arguments within the political context, working with the civil servants who advise politicians, and offering a multisectoral explanation of the wider picture of mental health.

Further, advocates must take advantage of crisis situations such as the COVID-19 pandemic to promote a long-term agenda for mental health, and lobby for major cross-government commissioned reviews. For example, the US Institute of Medicines report on neurological, psychiatric and developmental disorders led to increased prioritisation and research investment in mental health by major international donors.

Convening an African ministerial summit on mental health financing as a strategic follow-up to the Global Ministerial Mental Health Summit held in October 2018 would be a major boost.

We propose that governments invest in making training for and practice of mental health care attractive and relevant. This can be done by offering mentorship programmes, and use of digital and mobile technologies for delivering care. Short re-skilling programmes that focus on evaluation and management of common cases in the community and outpatient setup can be conducted annually for students and healthcare staff.

A national survey on mental health conditions is key for every country because under-recognition of the prevalence and impact of mental health needs is one reason they dont get enough attention. No African country is currently doing one. But Nigeria comes close. It has a survey conducted between 2001 and 2003 but only in Yoruba-speaking states which account for 22% of the population.

There are other areas for innovation. One could be a decentralised public health spending model that allocates resources according to performance, linking funding to specific mental health needs.

Governments could introduce financial incentives that favour community care. This means community-based rehabilitation initiatives would get more support. For example, in Rwanda, a national government incentive for subnational public and nonprofit faith-based health providers increased healthcare services by 20%.

There is also a need to rethink health and life insurance. These must reflect a move towards investing in preventative medicine and not the current curative policies.

Deliberate government leadership must promote local production of psychotropic medication as was done in the case of personal protective equipment in response to COVID-19 containment. Technology must also be used to deliver mental health services in times of public health emergencies.

Underpinning all our recommendations is sufficient and timely mental health financing. This requires a multi-sectoral strategy that shows the health and economic benefits of investing in mental health in Africa.

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Trump’s lack of honesty on Covid hangs over his reelection bid – ABC17News.com

Thursday, October 15th, 2020

President Donald Trumps refusal to tell America the truth about the pandemic in a bid to save his political skin, on display at a potential super-spreader rally in Iowa on Wednesday night, is fostering a vacuum in national leadership and crucial public health mobilization as a winter of sickness and death looms.

Trump is touting his own recovery from Covid-19 with a cocktail of expensive experimental therapies available to almost no one else in the world as proof there is nothing to fear from a disease that has killed more than 216,000 Americans.

The President, 19 days before the election, is trying to pull the wool over voters eyes by arguing the pandemic is almost over, in the hope they wont hold him to account for his poor management of the crisis. On Wednesday, he used his own rebound and the symptom-free experience of his son Barron, who also tested positive to yet again downplay the virus.

Open your states! Trump said at a rally at which Air Force One formed a backdrop.

The cure cannot be worse than the problem itself, he said, and again wildly claimed that his own strength meant he probably didnt need the cutting-edge therapies he was given in the hospital at Walter Reed National Military Medical Center.

Maybe I would have been perfect anyway, Trump said.

The governments top infectious disease specialist, Dr. Anthony Fauci, who Trump has repeatedly attacked in recent days, said Wednesday that although he was glad the President had recovered, his case should not be seen as indicative of everyone who gets infected.

Thats sort of like saying somebody was speeding in a car at 95 miles an hour and didnt get in an accident, so I can go ahead and speed and not get in an accident, Fauci told CBS Evening News.

Fauci also criticized the concept of herd immunity, which relies on a majority of the population getting infected to build community resistance to the disease, after some White House officials appeared to partially embrace earlier this week. Trump is also advocating an approach where vulnerable people are shielded while allowing everyone else to get on with their lives nearly impossible to accomplish in practice.

What that will do is that there will be so many people in the community that you cant shelter, that you cant protect, who are going to get sick and get serious consequences, Fauci said Thursday on ABCs Good Morning America. He added that the idea that we have the power to protect the vulnerable is total nonsense.

In the real world, rather than Trumps fantasy version, the pandemic is getting worse quickly. Average daily infections are at more than 51,000. The disease that the President says should no longer dominate US life is killing more than 700 Americans a day. On Wednesday alone, newly registered infections reached nearly 60,000 with 985 new deaths. Coronavirus cases are rising in 35 states, according to Johns Hopkins University data.

The high baseline of cases that is the legacy of the failure to better suppress the virus is leaving epidemiologists in despair at the suffering that will inevitably follow as the weather cools and people move indoors.

The darkening picture would have surely dominated the second presidential debate on Thursday night. But the event was canceled amid a drama over the Presidents own diagnosis with the disease two weeks ago. Instead, Trump and Democratic nominee Joe Biden will hold dueling town halls on NBC and ABC.

Trumps tactic of minimizing the crisis is rooted in his quest to maximize turnout from his most loyal base voters, whom he and his conservative media allies constantly target with misinformation about the virus. His rallies and public acts send a visual message that life is back to normal, even as polls suggest that clear majorities of Americans disapprove of his handling of the crisis one of the dominant issues of the election.

Trump is not just risking the health of his supporters. People who get the virus at his rallies also can pass it on to others in wider society. But the Presidents word is still law among the voters who have disregarded reports that previous Trump rallies and events have spread the virus and are flocking to his events in a remarkable show of support for his reelection bid.

If Im gonna get sick and die, I guess its my turn, one rallygoer, Brenda Strothoff, told CNNs Jim Acosta in Des Moines on Wednesday night.

I feel like, yes, the Covid is kind of dangerous and it can be for some people, but for the most of us, were gonna go on with life, Strothoff said.

Another rallygoer, John Stanford, told Acosta that while he didnt want to give anybody the virus, he believed infection totals were inflated and that I figured the sooner we all get it, the sooner well be done with it.

The latest Trump rally in Des Moines, in front of a packed crowd that largely spurned masks and ignored social distancing, took place in a state where the virus is taking a deeper hold. Iowa has one of the highest testing positivity rates 18.8% in the union.

Still, the sentiments of Trumps supporters point to an important question: Has society got the balance right between fighting the pandemic and preserving as much of normal economic and social life as possible? Lockdowns and restrictions have inflicted a terrible impact on employment, family and cultural connections, and the countrys mental health and morale. A generation of schoolkids is at increasing risk of a learning deficit that could set them back years.

Trump has also taken to pointing out that European countries feted by the media for doing a better job than he has in containing the virus are now facing steep escalations in cases. Those nations, however, did experience a respite in the summer, are starting from a lower baseline of infections than the US autumn spike and saved significant numbers of lives with a more stringent approach.

And the fatalistic view of some Trump supporters also fails to acknowledge the tragedies suffered by more than 200,000 families who have lost loved ones many of whom did not have to die. It disregards the threat of hospitals being overwhelmed this winter, leading to agonizing choices for doctors and front-line workers, who are at extreme risk of taking on fatal virus loads themselves.

Reconciling these national, societal and moral dilemmas would in normal times land on the desk of the President: Its what hes elected to do. But Trumps obsession with his own political prospects is leaving such questions unaddressed. His absence is also exacerbating a leadership vacuum elsewhere; for instance, in the failure of his administration, House Democrats and suddenly thrifty Republican senators to agree on a new Covid-19 economic rescue plan.

An engaged President, reminding a weary nation of the need to commit to another round of restrictions on American life during a grim winter until vaccines become available, could save tens of thousands of lives.

If Trump wins reelection on November 3, it seems highly unlikely that he will feel a greater sense of accountability to make a more genuine effort to combat the virus. And if he loses, it seems unlikely he will be in the mood to commit to using his remaining weeks in power to tackle an issue that led to his loss.

Biden, who is leading Trump in national polls and in many swing states, may eventually be called upon to pick up the pieces, and he has anchored his campaign in criticism of the Presidents performance.

The rest of the world is wondering, what in the Lords name is happening? Biden said during a virtual fundraiser event on Wednesday.

What were living through today is not normal, the former vice president said, according to a pool report.

If the American people elect me, were going to have an enormous task in repairing the damage (Trumps) done. We have to be beating the virus, rebuilding the economy and figuring out how to restore American leadership around the world.

The Presidents negligence is not just having an immediate political impact. His constant undermining of social distancing measures and masks the only current ways of limiting the virus risks making a bad situation much worse.

Apparent hiccups with several trials being conducted by big pharmaceutical firms on vaccines and Covid-19 therapies are reemphasizing the importance of preventative measures. There was one optimistic sign on Wednesday, however, when the governments top infectious disease specialist, Fauci, predicted a safe and effective vaccine would be widely available by April.

But the Presidents dismissal of public health recommendations that are needed until then is causing despair among public health experts and front-line medics.

Its just a matter of time before we now see this terrible fall and winter surge. And this is going to be a horrible winter. We may see numbers that dwarf what we saw in March and April or during the summer, and I think we probably will, said Dr. Peter Hotez, dean of Baylor Medical Schools National School of Tropical Medicine.

And were also going to see a rise of mortality. This is going to be one of the most troubling times in our modern history in terms of the public being frightened, homeland security being affected, people worried about going outside, as the deaths mount, Hotez told CNNs Jake Tapper on Tuesday.

In a time of national peril, the White House is looked to to set priorities, to bring states together, to explain to Americans the extent of the challenge and to chart a route out of the emergency.

But Trumps coronavirus task force is invisible, as CNNs White House team reported Wednesday. Its leader, Vice President Mike Pence, is out campaigning and, like Trump and his family members, holding events that are almost certain to spread the virus. The groups most visible doctors, such as Fauci and Dr. Deborah Birx, havent appeared in public with the President for weeks.

At a time when other global leaders, including Frances Emmanuel Macron, Canadas Justin Trudeau and Britains Boris Johnson, are leveling with their people about the difficult days to come and desperately working to get new spikes of infection under control with new restrictions and partial lockdowns while trying to save their economies, Trump falsely told Americans Wednesday that they were rounding that final turn.

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Road to recovery | Free – Bolivar Herald-Free Press

Tuesday, October 13th, 2020

A local addiction recovery program recently received a sizable boost to the tune of $550,000 total in grant funding to help in its efforts to reach those seeking the road to recovery.

According to program director Christina Bravata, the following statements were provided in patient surveys last month:

Regarding Dr. Kurt Bravata: This provider spent a great deal of time talking with me, was compassionate and empathetic with the concerns I brought to him. He was able to fully explain the treatment options I had open to me and possible alternatives that could be explored at a later date. He was very careful in crafting a treatment plan for me. He was very effective in communicating and understanding many of my concerns and answered all of my questions completely. This provider also was able to garner my trust and was able to help me understand the fears I have regarding my care. This experience was very positive and I would definitely recommend this service to others.

Regarding Kelly Watson, FNP-BC: I have been seeing Kelly Watson since February and she has been a huge part of saving my life. She has done more for me than any doctor has and I'm so grateful for her. I also appreciate her nurse Cindy who is so kind to me. Thank you guys so much for everything. Thank you guys again for everything, you all are a huge part in saving my life and I will never forget what you have done for me.

According to a pair of news releases from Citizens Memorial Hospital, the CMH Addiction Recovery Program, led by Dr. Kurt Bravata and Kelly Watson, FNP-BC, was recently awarded two grants.

The programs director Christina Bravata said leaders will use one $500,000 grant from the Health Resources and Services Administration to help reduce the occurence of Neonatal Abstinence Syndrome in the community over the next three years.

This offers treatment and services to pregnant women, women of child-bearing age and mothers who are struggling with substance use disorder or at risk for relapse, she said.

She said funds will also support family members who are raising children impacted by substance abuse, such as grandparents raising grandchildren.

The consortium for this grant program includes House of Hope, Alpha House and the 30th Children's Circuit, Bravata said. Essentially, women will have access to treatment, support and resources despite which consortium member is their point of entry.

The second grant a one-year $50,000 reentry grant from the Missouri Department of Corrections will offer Medication Assisted Treatment to individuals in probation and parole who may be struggling with substance use disorder, she said.

Bravata said addiction, including substance use disorder, is a nationwide epidemic seen in every community.

I don't believe there is a family out there who has not been impacted by addiction in one form or another, she said. One of the greatest deterrents to receiving help is the stigma that surrounds addiction. If we can't talk about it, we can't solve the problem.

CMHs Addiction Recovery Program, Bravata said, aims to reduce that stigma by meeting patients where they're at and starting a non-judgmental conversation about how the program can help them overcome addiction and lead a healthy life.

Simply put, a healthy person leads to a healthy family which leads to a healthy community, she said.

To help them get healthy, the program provides patients with a combination of medical treatment and psycho/social support, helping them to live completely free of substance dependence or addiction, Bravata said.

The program began in Bolivar in January 2018 with 15 patients. Today, it serves 160 to 175 people throughout Polk County and the surrounding region each month, she said.

While theres a clinic at CMH in Bolivar, Bravata said Watson also travels outside the Polk County area to serve patients where they are located. This includes time at the Ozarks Community Health Center clinic in Hermitage and at CMH clinics in El Dorado Springs and Greenfield.

CMHs addiction recovery program has also collaborated with and received support from the Bolivar Police Department, Department of Corrections, Polk County Cares, Bolivar Public Schools and First Baptist Church of Bolivar, she said.

Individuals that may be struggling with a dependence or addiction to alcohol, opioids or other substances are welcome to call and make an appointment to see one of our providers, Bravata said.

In fact, she said its not necessary for people to be completely sober to be seen or start treatment.

The first step is talking to our team, she said. From there, we work with individuals to create a game plan and offer the support needed to see it through.

Patients can schedule an appointment for themselves or be referred by another provider.

Bravata said the program can only base its success upon program retention.

The longer patients stay in the program, the greater their chance for long term sobriety with a lesser chance of relapse, she said.

The programs current retention rate, Bravata said, is around 75% with patients staying in the program over six months.

More about the grants and program

CMHs addiction recovery program was one of 30 recipients in the U.S. and the only Missouri organization to be awarded the $500,000 HRSA grant, a news release said.

Created in 1982, HRSA is a division of the U.S. Department of Health and Human Services and is focused on improving health care to people that are geographically isolated and economically or medically vulnerable, the release said.

The HSRA grant is part of the Rural Communities Opioid Response Program that will be used to reduce neonatal abstinence syndrome rates with prenatal addiction treatment services, the release said. Additional support services including peer support and counseling are also available.

The $50,000 Missouri Department of Corrections reentry grant, running from July 2020 to June 30, 2021, covers all substance use disorders treatment costs for those in probation and parole across southwest and central Missouri and includes office visits, lab costs, medication costs and counseling for uninsured individuals in probation and parole, a release said.

The CMH Addiction Recovery Program assists in opiate and alcohol recovery by offering a highly specialized substance abuse outpatient treatment program, which is designed to lead patients to physical and psychosocial wellness, the releases said. Services include medicated-assisted treatment, individual counseling, behavioral therapies and community or church-based spiritual support.

Dr. Kurt Bravata is a family medicine and addiction specialist with CMH and is board certified by the American Board of Preventative Medicine in the subspecialty of addiction medicine and is a fellow of the American Society of Addiction Medicine, the releases said. He is also board certified by the American Board of Family Medicine.

Watson is a board certified family nurse practitioner with more than 30 years of experience, according to the releases. She has a background in traditional and alternative pain management protocols and is trained in intervention, treatment and management of substance use disorders.

The CMH Addiction Recovery Program is located at CMH Southside Medical Center Behavioral Health at 1120 S. Springfield Ave., Bolivar. Outreach services are at El Dorado Springs Medical Center, 322 E. Hospital Road, El Dorado Springs.

For more information about the program, visit citizensmemorial.com/services/addiction-recovery. To make an appointment, call 326-7840.

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Food Rx: A Cancer Expert Shares What He Eats in a Day – Everyday Health

Tuesday, October 13th, 2020

In medical school and throughout his medical training, there was zero education about nutrition, says William Li, MD, a physician, scientist, and the president and medical director of the nonprofit organization the Angiogenesis Foundation in Boston. Dr. Li recalls patients in their fifties, sixties, and seventies who had failing health and chronic diseases like heart disease, diabetes, and cancer who were once athletes and soldiers at the peak of health when they were younger. Why were they ill now?

As Li began practicing medicine, Virtually all of my patients asked me, 'Doc, what should I be eating?' So he set out to answer that by creating the Eat to Beat movement, which is based on food as medicine, he says. I began to realize that diet and lifestyle was something that needed to be addressed by scientists and doctors, not just trainers and online gurus.

That Eat to Beat movement has led to a book, Eat To Beat Disease: The New Science of How Your Body Can Heal Itself. That science is based on angiogenesis.

This may not be a term youve heard of, but when it comes to preventing cancer, or supporting your bodys defenses if you have the disease, its one you should pay attention to. Angiogenesis is the process used by the body to grow blood vessels, which is crucial to our health. Blood vessels from our circulation, a 60,000-mile network that brings oxygen and nutrients to feed every cell in our body. Too few blood vessels and our organs starve and can die. Too many, and disease can result, explains Li.

Li has been involved in the field of angiogenesis for more than three decades. As a result, I have been involved with some breakthroughs in treating cancer, blindness, and diabetes as well as food as medicine, since what we eat can help our angiogenesis system stay healthy, says Li.

Ultimately, Lis drive is a focus on prevention rather than solely treating disease. Its food as a form of preventative medicine, he says. Eating healthy food is something we can do for ourselves at home, under our own control, according to our own preferences, and between visits to the doctors office, adds Li. And, he says, your diet can have a remarkable effect on cancer prevention and treatment.

RELATED: Can What You Eat Beat Disease? It May, and an Acclaimed Researcher Shares How

What you eat makes a big difference in your bodys ability to prevent cancer. In fact, according to the American Cancer Society (ACS), at least 18 percent of all cancers and 16 percent of cancer deaths in the United States are related to lifestyle factors, including poor nutrition.

In a cancer-protective diet, the ACS specifically recommends colorful veggies like those that are dark green, red, and orange, and plant proteins like beans and peas, as well as fruit and whole grains. Lowering your risk of cancer is also about what youre not eating. The ACS recommends keeping processed foods, red meats, alcohol, and sugary drinks (soda, sports drinks, fruit juice) to a minimum.

That falls in line with the Cancer Prevention Recommendations from the World Cancer Research Fund, which is part of the American Institute for Cancer Research. The organization suggests filling most meals with plant foods including whole grains, legumes, nonstarchy veggies, and fruit. A plant-based diet is one thats rich in fiber (which helps protect against colorectal cancer), vitamins, and minerals. This also naturally pushes out less-healthy fare, like those foods that contain refined flour and sugar, which tend to be higher calorie and thus promote a higher body weight. There are 13 cancers that are associated with being overweight or obese, including cancer of the esophagus, gallbladder, liver, and pancreas, points out the Centers for Disease Control and Prevention (CDC).

RELATED: 6 Tips for Switching to a Plant-Based Diet

Li has a popular TED talk: "Can We Eat to Starve Cancer?" which has more than 1.7 million views. The talk introduces the audience to using anti-angiogenic therapy as a cancer therapy. This means eating foods that contain anti-angiogenic substances (more on this in a minute), which reduce angiogenesis, stopping tumors from developing blood vessels and growing.

While you shouldnt replace medication with diet, some foods, Li says, have potent anti-cancer properties. Those include tea, turmeric, citrus, grapes, garlic, berries, and tomatoes. Tomatoes specifically contain the powerful antioxidant lycopene. Turmeric contains curcumin, a polyphenol (plant compound) that may possess anti-cancer activity, points out a review published in October 2019 in Nutrients. Yet this compound, like many others, has shown conflicting and limited evidence in cancer treatment, which suggests there is not just one it food, but an entire pattern of eating rich in a rainbow of foods that supplies a variety of these anti-angiogenic substances thats critical.

Dietary patterns have been shown to affect certain types of cancer. In a study published in June 2015 in Cancer Prevention Research on over 900 men with prostate cancer, those who followed a prudent dietary pattern (that is, one that is linked to disease protection, and features veggies, fruits, fish, legumes, and whole grains) were 36 percent less likely to die from any cause compared with men who followed more of a processed foods Western-style diet.

RELATED: How to Eat When Youre Being Treated for Prostate Cancer

Its probably no surprise by now, but popular plant-based diets are often recommended for the prevention of cancer:

The Mediterranean Diet A review published in the journal Nutrients in September 2019 concluded that the Mediterranean diet was helpful in preventing cancer occurrence, particularly, as researchers note, theres a high intake of olive oil and fresh fruits and vegetables. These foods help reduce inflammation and contain antioxidants to prevent DNA damage that may eventually lead to cancer.

Dietary Approaches to Stop Hypertension (DASH) This diet focuses on vegetables, fruits, low-fat dairy, whole grains, fish, poultry, and nuts, while encouraging sodium reduction, notes Mayo Clinic. A systematic review and meta-analysis of 17 studies, published in the Journal of the American College of Nutrition in May 2018, suggests that following the DASH diet is associated with a 16 percent lower risk in death from any cancer, and was particularly linked to a reduced likelihood of developing colorectal cancers compared with those whose diets dont adhere to the guidelines.

RELATED: What Is the MIND Diet, and Can It Help Prevent or Reverse Alzheimers Disease?

Heres a look at how Li personally approaches food personally to help keep cancer at bay. Responses have been edited for concision and clarity.

EH: What does a typical day of eating look like for you?

WL: I will start breakfast with green tea or black coffee, with a little fruit.

Lunch tends to be on the light side, something tasty with some veggies and protein. For example: A ripe peach, a small piece of salmon, and a little quinoa, sprinkled with oregano, and a dash of olive oil. Honestly, sometimes I get so busy, I skip lunch. But thats okay because it reduces the calories I take in over the course of a week.

Dinner I save for something I really enjoy. I always build my meal around seasonal foods, especially vegetables (kale, spinach, broccoli, red peppers, carrots) and fruits.I do enjoy seafood and sometimes a little chicken thigh, but they are not on my plate every day. If I snack, I love to eat tree nuts, like pecans or walnuts. I will sip tea in the evening, which I find calming.

EH: Why is this the diet you follow?

WL:I follow several principles. One: Focus on plant-based foods, and build everything around at least one vegetable or fruit at every meal. Two: Eat whole foods seasonally, whenever I can get them. Three: I have to love what I eat, or I would rather pass. Four: Eating less calorically may help people live longer, so I quit the clean plate club many years ago. Five: I eat diversely, which means lots of variety from meal to meal. Taken together, these rules combined with the list of more than 200 healthy foods I can choose from that are in my book, make eating to be healthy an enjoyable experience.

EH: Whats your favorite healthy snack and why?

WL: My favorite snack is a handful of pecans. They are tasty and packed with fiber and healthy fat. In a study in the Journal of Clinical Oncology in April 2018, patients with stage 3 colon cancer who ate two or more servings of nuts per week were more likely to survive and less likely to experience a cancer recurrence compared with nut-free folks.

EH: How about your go-to quick breakfast? Why?

WL: Whatever fruit is in season and ripe. Stone fruits, like peaches, plums, and mangoes, have antiangiogenic compounds that have been shown to decrease risk for certain cancers. Apples, specifically Granny Smith and Red Delicious, and berries are other antiangiogenic fruits.

EH: When youre feeling rundown, which foods or drinks do you rely on to boost your energy? Why?

WL:I naturally have a lot of energy, but admit I drink a lot of tea and coffee. The good news about these is that they contain disease-fighting flavanols as well as caffeine. I find staying hydrated is critical to keep up my energy level, but so is getting a good nights sleep and having regular exercise.

RELATED: The Best Teas for Your Health

EH: Is there a cooking method or technique that you gravitate toward? Or one you avoid? Why?

WL: I love to stir-fry, which is quick and seals in flavors and nutrients, making food tasty and healthy. I avoid deep frying. Past research has connected consumption of deep-fried foods to prostate cancer; cooking at high temps, like frying, also forms acrylamides, which have been rated by several agencies, including the International Agency for Research on Cancer, as a probable human carcinogen.

EH: How do you treat yourself?

WL: Just taking a break from the various tugs and pulls of life. Taking a walk by myself in the outdoors clearing my mind is a treat I relish.

EH: Whats one healthy habit you wish you practiced more of? Why?

WL: Meditation. Im always on-the-go and push myself to do more, so my life is super-fast-paced. When I have a chance to take a pause and meditate, I feel peaceful and can recharge. I would like to do more of that.

EH:Are there any foods you would never eat? Why?

WL: I never eat old-school junk food, like ultraprocessed chips and other snacks. A study published in the BMJ in February 2018 concluded that increasing the amount of ultraprocessed foods you eat by 10 percent also increased the risk of cancer by 10 percent.

Whats more, ultraprocessed foods are made with artificial flavoring, colors, and preservatives. We now know that many of the artificial chemicals found in snacks like chips, candies, and other popular snack foods actually cause harm to our gut microbiome, the healthy bacteria in our intestines that helps control our metabolism, our mood, and our immune system. We need to treat our gut properly and avoid those types of foods.

EH:Whats your strategy when eating out?

Li: Before the pandemic, I enjoyed dining out often. My approach to ordering from a menu is to scan the choices for vegetables, legumes, herbs, spices, and other ingredients that I recognize and know activate my health defenses. Then, I decide if the proteins they are paired with, like seafood, are something I want to eat at that moment. My food always has to taste good. These days, I rarely go out to eat, but I will still order carry-away using the same philosophy.

EH:Wine with dinner: Yes or no? Why?

WL: I do enjoy red wine and will occasionally have a glass or two with a nice dinner. Very modest wine drinking is fine for your heart and even for reducing risk of some cancers and some existing research supports it with a couple of caveats. First, the benefits come from the polyphenols found in the red wine, not from the alcohol itself. And second, a glass or two with a meal is about as much as you would want. For me, I save my red wine for a fine mealusually cooked by myself using delicious whole plant-based foods.

EH: Whats one small change youve made dietary or otherwise to help reduce the risk of cancer?

WL: I cut out all processed meats from my diet, which are classed by the World Health Organization as a carcinogen.

EH:Whats one small change anyone can make to help better manage cancer?

WL: If someone has cancer, they need to cut out ultraprocessed foods and eliminate all added sugar to their diet. To know what an ultraprocessed food is, is to follow this simple rule: If it comes in a box or a can, and the ingredient label is long and filled with chemical names you cant easily pronounce, and dont recognize as healthy its a good bet that it is ultraprocessed.

EH:Any final thoughts on the link between eating choices and cancer?

WL: If you want to eat to beat cancer, theres a wealth of epidemiological research showing what we eat can be associated with cancer risk. Reducing or eliminating foods that damage your health defenses, like ultraprocessed foods, is a good move. And eating more whole plant-based foods because they are rich in natural cancer-fighting bioactive substances is wise and can taste great.Drinking green tea is also a simple way to lower cancer risk.

William W. Li, MD, is an internationally renowned physician and scientist, as well as the author of the New York Times bestseller Eat to Beat Disease: The New Science of How Your Body Can Heal Itself. His groundbreaking work has led to the development of more than 30 new medical treatments and impacts care for more than 70 diseases including cancer, diabetes, blindness, heart disease and obesity. His TED Talk, Can We Eat to Starve Cancer? has garnered more than 1.7 million views. Dr. Li has appeared on Good Morning America, CNN, CNBC, and the Dr. Oz Show, and he has been featured in USA Today, Time Magazine, The Atlantic, and O Magazine. He is president and medical director of the Angiogenesis Foundation and is leading research into COVID-19.

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Access to Health Care for Inmates Worsened Since Pandemic, Webinar Told – Crime Report

Tuesday, October 13th, 2020

Access to health care for incarcerated individuals has deteriorated as a result of restrictions imposed to prevent the spread of COVID-19 behind bars, according to correctional health experts and prisoner advocates.

With many prisons and jails adopting strict lockdown policies, in some cases quarantining individuals in solitary cells, regular checkups and tests for inmates with non-COVID health issues have been cut back or cancelled, and some outside medical providers have refused to enter the facilities, a webinar was told last week.

A lot of people [have had their] regular preventative care delayed or stopped, said Su Ming Yeh, executive director of the Pennsylvania Institutional Law Project.

That can be really devastating, because we know prevention is vital in medical care issues.

In one example Yeh provided, one of her clients who was scheduled to get regular CAT scans every six months had missed his appointment because of the pandemic and was in a lot of pain.

Yeh was speaking on the second day of a webinar examining criminal justice challenges in Pennsylvanias justice system.

Her remarks were echoed by Thomas Weber, CEO of PrimeCare Medical Inc., which provides correctional health services in 80 facilities across five states, who said there was a reluctance from outside medical specialists to enter prison facilities because of the risk of COVID.

We provide primary care, but if someone needs orthopedic or obstetric help, we rely on community providers to work with us to provide that care, he said. And we found out that a number of providers werent seeing patients or would require negative (coronavirus) tests before they would see someone.

Dr. David Thomas, a correctional medicine specialist who has worked with the Florida Department of Corrections, said that even primary care doctors and nurses inside prison facilities are faced with a Catch 22 because of COVID-era restrictions that bar inmates from going to clinics or sick bay where they might be at risk of exposure.

You try and reduce movement (by sending) your medical staff to the individual, but then its very, very difficult to provide the same kind of environment you have in a medical unit, he said.

This disease has created a situation where its virtually impossible to address (those issues) safely.

In many facilities across the U.S., prison authorities were slow in addressing the threat of coronavirus to both inmates and staff, despite evidence showing how quickly the coronavirus can spread in confined environments.

Testing is now widespread in federal and state correctional systems, as well as requirements to wear masks. At the same time, incarcerated populations have been reduced as a result of court orders. But some measures instituted by facilities, such as ending work release programs, stopping family visits and confining COVID-positive inmates to solitary cells pose additional threats to the mental health of inmates.

Courts have worked really hard to keep populations down, but some [facilities] relied on what we think are really severe and in some ways punitive lockdowns, said Yeh. You might be in a cell for 23 hours, getting out only to use the shower, or call friends and family.

Once you go beyond a certain time, these conditions are [harmful] to a persons wellbeing.

The webinar heard warnings that facilities might begin to relax testing and other restrictions if they followed the lead of a few politicians or authorities who maintained the danger of the pandemic was easing.

This is not going to go away any time soon, said Weber.

I think the most overriding difficulty weve had, and this is one that affects not just corrections health care but community health care is the lack of clear guidance on a national level.

Weber said many communities felt free to ignore many of the guidelines proposed by the Centers for Disease Control and Prevention and the World Health Organization, and that attitude spilled over into the administration of county and municipal jails.

Weber said, there has not been buy-in from all communities about health recommendations such as mask-wearing and social-distancing, and this has resulted in a fragmented approach to the pandemic in many rural and smaller detention facilities.

Depending on the political persuasion of the particular jurisdictional area, we will have different viewpoints as to how to handle [the pandemic].

Weber suggested that the key lesson to be learned from the spread of a COVID through the nations prisons was that many of those currently incarcerated have underlying health issues that could be treated outside of the correctional system.

I think we need to explore the alternatives to incarceration to keep the population down as much as we can, he said, noting that although some individuals do need to be locked up, many could be better served by expanding community health services in areas of mental health, and substance abuse.

There are far too many people coming into the facilities as a result of suffering and illness as opposed to committing a crime, he said.

Dr. Thomas noted that while medical care is constitutionally required in a correctional system, the system is not built around it.

Any other place a physician or nurse works is designed for that, like hospitals, but corrections is designed for the custody and control of inmates and detainees, he said.

The bottom line is that the correctional staff run the system.

The webinar was the latest in a series of regional justice workshops for journalists organized by the Center on Media, Crime and Justice at John Jay College. The event was co-hosted by the Quattrone Center for the Fair Administration of Justice at the University of Pennsylvania Carey Law School, and supported by the Charles Koch Foundation.

The previous webinar session can be accessed here.

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Why Africa needs to invest in mental health – Bizcommunity.com

Tuesday, October 13th, 2020

Mathari Hospital is the only psychiatric hospital in Kenya. Simon Maina/AFP via Getty Images

There is good evidence that these conditions are treatable. But the estimates of people in sub-Saharan Africa receiving treatment are jarring. Only 15% of South Africans with mental health conditions receive treatment. In Ghana and Ethiopia the estimates are less than 10%.

Weve spent decades researching mental health and health economics around the world. Our research has demonstrated that, for example, peer support for treating perinatal depression shows benefits that far outweigh any costs incurred in delivering the treatment. Weve also seen the Healthy Activity Programme Psychological Treatment in India provide better clinical outcomes at lower costs. In a recent study in Ghana weve shown that investments in population-level screening and subsequent treatment could yield benefits greater than the costs. The findings imply that every $1 invested over a 10-year period in depression, anxiety disorders and schizophrenia treatment would accrue about $7.4, $4.9 and $1.7 in returns respectively to society.

For example, poverty rates are two times higher in people with mental health conditions compared to those without. People living with mental illness or substance use disorders are more likely to become infected with HIV. Poor mental health weakens immunity and adherence to treatments for malaria.

Clearly, there is a case for investing in mental health and more importantly, making interventions and services accessible to all. Having set out this case we also offer recommendations on how this might be achieved.

Practical tips for mental health advocates to convince politicians have been offered in previous writings. These include placing arguments within the political context, working with the civil servants who advise politicians, and offering a multisectoral explanation of the wider picture of mental health.

Further, advocates must take advantage of crisis situations such as the Covid-19 pandemic to promote a long-term agenda for mental health, and lobby for major cross-government commissioned reviews. For example, the US Institute of Medicines report on neurological, psychiatric and developmental disorders led to increased prioritisation and research investment in mental health by major international donors.

Convening an African ministerial summit on mental health financing as a strategic follow-up to the Global Ministerial Mental Health Summit held in October 2018 would be a major boost.

We propose that governments invest in making training for and practice of mental health care attractive and relevant. This can be done by offering mentorship programmes, and use of digital and mobile technologies for delivering care. Short re-skilling programmes that focus on evaluation and management of common cases in the community and outpatient setup can be conducted annually for students and healthcare staff.

A national survey on mental health conditions is key for every country because under-recognition of the prevalence and impact of mental health needs is one reason they dont get enough attention. No African country is currently doing one. But Nigeria comes close. It has a survey conducted between 2001 and 2003 but only in Yoruba-speaking states which account for 22% of the population.

Governments could introduce financial incentives that favour community care. This means community-based rehabilitation initiatives would get more support. For example, in Rwanda, a national government incentive for subnational public and nonprofit faith-based health providers increased healthcare services by 20%.

There is also a need to rethink health and life insurance. These must reflect a move towards investing in preventative medicine and not the current curative policies.

Deliberate government leadership must promote local production of psychotropic medication as was done in the case of personal protective equipment in response to Covid-19 containment. Technology must also be used to deliver mental health services in times of public health emergencies.

Underpinning all our recommendations is sufficient and timely mental health financing. This requires a multi-sectoral strategy that shows the health and economic benefits of investing in mental health in Africa.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Project aims to increase COVID19 testing for Native populations – WSU News

Tuesday, October 13th, 2020

Photo by Mufid Majnun

By Sara Zaske, WSU News

SPOKANE, Wash. American Indian and Native Alaskan populations have been hit hard by the pandemicexactly how hard, no one can say for sure, since there is a lack of information and testing in these communities.

A new project led by Dr. Dedra Buchwald, a physician and professor with WSUs Elson S. Floyd College of Medicine, has received a $4.4 million National Institutes of Health grant to help address that knowledge gap and bring resources to curb the COVID-19 crisis within these populations.

Many things come together to make American Indians and Native Alaskans particularly vulnerable to COVID-19, and at the same time, make them hesitant to participate in efforts to get tested and get vaccinated, said Buchwald, who is also the director of the Institute for Research and Education to Advance Community Health or IREACH.

This grant is one of four recently received by College of Medicine researchers to help deal with aspects of COVID-19 crisis. The others include:

The National Institutes of Health grant is intended to help address health disparities among underserved and especially vulnerable Native populations in urban settings. An estimated 71% of American Indians and Native Alaskans live in urban areas. Buchwald said these populations have many risk factors, including a high prevalence of diabetes, hypertension, obesity, multi-generational households and poor living conditions. Many also struggle with poverty and limited access to quality health care and education.

This is complicated by a distrust in the federal government and health care systems, given the long history of atrocities committed against Native peoples, such as the deliberate dispersal of blankets laden with smallpox and sterilization of Native women without true consent.

In the new project, called COVID-19 Epidemiology, Research, Testing and Services or CONCERTS, researchers from WSU, University of Colorado and University of Minnesota will partner with Urban Indian Health Programs in six major cities with large Native populations: Albuquerque, N.M.; Anchorage, Ala.; Denver, Minneapolis, Seattle and Wichita, Kan.

The partners will work to understand who has been tested already and what challenges exist to getting people tested and ultimately vaccinated. The grant will also fund new resources for each site to help promote testing depending on their locally determined needs. Some sites might need PPE or testing kits while others may want to establish a testing drive-through site or send out case workers or COVID navigators to make contact with individuals.

Most of the people working on this project at the health programs will be from the tribal communities they serve, Buchwald said.

American Indian and Native Alaskan people are more knowledgeable about what is going on in their communities than outside researchers, and we want to make sure that we have good trusting relationships, she said. Our partners are really key to encouraging more people to get tested, and in the future, vaccinated, if determined to be desirable.

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How Our Health Care System Fails Black Women, and What You Can Do to Be a More Empowered Patient – LIVESTRONG.COM

Tuesday, October 13th, 2020

While it shouldn't fall solely on Black women to fight for better care, there are important steps to take to advocate for yourself.

Image Credit: LIVESTRONG.com Creative

The COVID-19 pandemic is holding up a magnifying glass to longstanding racial inequities in American health care.

Black, Latinx and Native American people have been hospitalized for COVID-19-related reasons at around five times the rate of white people, according to the Centers for Disease Control and Prevention (CDC). Black and Latinx people are nearly twice as likely to die from the viral infection as white people, per data provided by the agency to the New York Times.

There are many reasons for these disparities; among them, unequal access to COVID-19 testing. An analysis by FiveThirtyEight reveals that in many cities, COVID-19 testing sites in and near predominantly Black and Hispanic neighborhoods tend to serve a far greater number of patients, leading to longer wait times and less access for people who live in those communities.

Such inequities may have an outsized effect on Black women and their families. More than two-thirds of Black women are their families' primary breadwinners, compared with just over a third of white women, according to the Center for American Progress.

Yet whether she is a mother or not, a Black woman's ability to navigate a health care system that is stacked against her is crucial not only for her own wellbeing, but also for those around her.

'Unlike Me, Some People Didnt Make It'

Tamika Harden's experience as a Black woman trying to get tested for COVID-19 reflects how much responsibility the health care system unjustly places on patients. The 34-year-old fitness instructor first started experiencing symptoms of COVID-19 in mid-March. "I was just very tired and lethargic. Out of my norm," she tells LIVESTRONG.com.

Despite resting between sessions with personal training clients, her symptoms worsened, and several days later, "it felt like I had been hit by a truck," she says. "I could not get out of my bed." She had chills and lost her sense of taste and smell.

Harden's now-familiar collection of symptoms prompted her to call a government hotline. She responded to a series of questions and was told she would hear back within 48 hours.

It would take two weeks for the call to arrive. In the meantime, she learned that she had been exposed to someone who was hospitalized and had tested positive for COVID-19.

Harden lives in Brentwood, a predominantly Hispanic community in Long Island, New York, that was quickly becoming a COVID-19 "hotspot." By early April, it had the highest number of cases in its county and a testing site had opened in the community to address the growing need, according to ABC 7 New York.

But back in March when Harden was experiencing symptoms, Brentwood didn't have a testing site yet. The nearby community of Stony Brook, New York where the median income is 60 percent higher than Brentwood and its residents are predominantly Asian and white did. So Harden drove 15 miles to the testing site where the state had partnered with Stony Brook University.

At the time, Brentwood was averaging around 50 new COVID-19 cases each day, while Stony Brook was seeing between 3 and 10 new cases daily, according to the county's COVID-19 case tracker.

Without an appointment, Harden was told to call the same hotline as before, only to be put on hold for several hours. Instead of waiting longer, she asked the drive-up testing site staff if there was anything else she could do. She was told that a triage tent would be set up the next day for walk-ins and to come back then.

She did, with her boyfriend in tow, and both were tested, receiving positive results four days later. "By the time we both got the call back, I had already been sick approximately 10 days," she says.

COVID-19 testing and diagnosis were mishandled and problematic for many people early on in the pandemic, regardless of race. But add that to the existing health inequities facing people of color, and the outcome is catastrophic.

"Because of lack of medical supplies in predominantly minority-based communities, some people weren't able to get tested like me, and unlike my story, some of those people didn't make it," Harden says.

The Health Disparities Black Women Deal With Every Day

Harden is healthy now, and she attributes her speedy recovery to her dedication to fitness. Her age may also be a factor, since the CDC says that risk of serious COVID-19 symptoms increases in older adults.

Yet Black women, as a whole, fare worse with COVID-19 than their white counterparts. This has largely been attributed to a greater prevalence of underlying conditions such as heart disease, diabetes and obesity that the agency says puts them at higher risk for complications.

Black women are 70 percent more likely to have diabetes, 60 percent more likely to have high blood pressure and 50 percent more likely to have obesity than white women in the U.S., according to the Department of Health and Human Services' Office of Minority Health (OMH).

Even before COVID-19, such health disparities amounted to shorter lifespans among Black women 2.7 years shorter than American white women, who have a life expectancy of 81.2 years, according to the CDC.

Black women are also three times as likely to die from a pregnancy-related cause than white women a disparity that actually grows to five times as likely when you compare Black and white women with a college degree, according to the CDC.

The reasons why Black women are more likely to have diabetes and other underlying conditions have nothing to do with biology and everything to do with society: Racial inequities and discrimination in education, housing and access to health care, among other factors, can lead to chronic stress and illness, per the CDC.

Why Black Women Face Inequities in Health Care Treatment

Health Care Is Unaffordable

Black women are less likely to be able to afford health care in the first place. In 2018, 14.4 percent of Black adults 19 to 64 were without insurance, versus 8.6 percent of white adults in the U.S., according to a January 2020 Commonwealth Fund report.

"As much as we try and keep clinicians in high esteem, they mirror our community. There is still a lot of inherent racism and bias," says Nanette Thomas, MD, medical director of ambulatory care at Brookdale Hospital Medical Center in Brooklyn, New York.

Dr. Thomas remembers a time just a few decades ago when those biases were often expressed explicitly.

"I trained in Boston and I remember as a medical student hearing the residents and the attendings talk disparagingly about certain types of patients; for instance, Hispanics being considered histrionic and hysterical," she says. (She doesn't recall hearing comments aimed at Black people, which she believes is potentially because she is Black and others were hesitant to share those views in her presence.)

Yet bias doesn't have to be expressed out loud or even consciously acknowledged to affect how a health care provider might treat a patient. People of color receive lower quality care than white people on many measures tracked by the federal Agency for Healthcare Research and Quality (AHRQ), such as treatment effectiveness and patient safety, according to a 2018 report.

Implicit bias attitudes or stereotypes that affect a person's understanding, actions and decisions in an unconscious manner contributes to such health disparities, per the American Academy of Family Physicians.

"Let's face it, Black people do not trust the system. They don't trust doctors."

For instance, false beliefs about biological differences between Black and white people may be widespread among health care providers.

In an April 2016 study in the Proceedings of the National Academy of Sciences, half of medical students and residents surveyed were found to hold beliefs such as "Black people have thicker skins." When presented with mock cases, the study participants rated Black patients' pain lower than that of white patients' and made less accurate treatment recommendations.

And in a June 2019 review of pain treatment studies in the American Journal of Emergency Medicine, Black patients were 40 percent less likely to receive treatment in emergency departments for acute pain than their white counterparts, and Hispanic patients were 25 percent less likely.

Even algorithms that analyze scheduling can have racially biased outcomes. Formulas designed to identify patients who are more likely to be "no-shows" led Black patients to be overbooked more often than white patients, according to preliminary, unpublished October 2019 data from researchers at Santa Clarita University.

That in turn leads to longer wait times and results in more negative patient experiences, according to the researchers.

The System Breeds Fear and Mistrust

Black women's past experiences with the health care system can also become barriers to getting good care, says Ketly Michel, MD, an ob-gyn at Lenox Hill Hospital in New York City.

"Certain women don't have any faith in the system. Once you tell them, for example, that their blood pressure is elevated, they're thinking about their mother or grandmother who died of a stroke with high blood pressure, and they think that they are going to die."

Mistrust is another obstacle, adds Dr. Michel, who is Black. "Let's face it, Black people do not trust the system. They don't trust doctors."

This lack of trust has historical grounding: In the infamous Tuskegee experiment, the U.S. Public Health Service studied Black men with syphilis between 1932 and 1972 without telling them they had it or offering treatment. Many died from syphilis-related causes as researchers watched the natural progression of the disease.

National disclosure of the study in 1972 led to such widespread mistrust of doctors in the Black community that it measurably decreased physician interactions for older Black men, according to a June 2016 paper from the National Bureau of Economic Research. As a result, Black men's life expectancy at age 45 had dropped by 1.5 years by 1980.

Meanwhile, discrimination in the world at large may affect how some Black people approach health care settings. The more a pregnant Black woman perceives that she is subject to racial microaggressions in her daily life, the more likely she is to delay prenatal care, according to a July 2019 study in the American Journal of Preventative Medicine.

Specifically, the researchers found this effect in women who reported having light or dark brown complexions, though they did not find this effect in women with medium brown skin tones. The study authors speculated that may be due to a mix of perceived attitudes toward skin complexion, both within and outside of the Black community.

How to Confront Bias and Advocate for Yourself

Write down a list of questions before meeting with a health care provider and take notes on the answers during your appointment.

Image Credit: LIVESTRONG.com Creative

It too often falls on Black women to push to get equal treatment by health care systems, as Harden's story illustrates. There is work to be done on both the structural and individual levels by all people to make health care more equitable. But as that work is being done, experts say there are effective ways Black women can advocate for themselves and their loved ones.

For many patients, Dr. Thomas says, "being in the medical arena is very confusing. You're hearing terminology that you are not familiar with." The result can be information overload. "Oftentimes when you are hearing what the provider is saying, you're not really hearing it. It goes over your head because there's just so much to take in."

She suggests doing a little research about your symptoms or any medical questions you have before you set foot into your provider's office. "Google as much as you can, because information is power. And then you can go in and ask questions to advocate for yourself."

Because some sources are more credible than others, Dr. Thomas recommends that you look for information that has been published in respected medical journals or by the National Academies of Medicine. More consumer-friendly sources include the U.S. National Library of Medicine's MedlinePlus database and the CDC's website.

Don't be shy about speaking up when you don't understand something or want to know more. If you're not sure what to ask, Dr. Michel suggests starting with: "Is there anything that you would want me to ask that I am not asking?"

She also recommends asking: "Do you feel comfortable treating my case? If not, should I be referred to a specialist?"

Find out what hospital your provider is affiliated with as well, she says, and make sure it's one you're comfortable with, in case you should ever have to be admitted.

Be Prepared to Provide Honest Answers

At the beginning of your visit, your health care provider will likely ask you a series of questions about your symptoms, family medical history, lifestyle habits, what medications you are taking and other information to help determine what tests or treatment you might need.

This is where it's important to take a leap of faith, even if you're feeling mistrustful.

"You should tell me everything that is pertinent to your history so that I can come up with a diagnosis. You cannot hide things," Dr. Michel says. "Sometimes patients withhold the history, thinking it isn't relevant. Well, every piece of information is relevant."

Make Sure You're Comfortable With Your Provider

If you find yourself questioning whether or not your doctor is truly delivering the best available care, call it out.

In an April 2019 viral tweet, Yamani Hernandez, executive director of the National Network of Abortion Funds, thanked "#BlackWomenTwitter" for teaching her to ask a doctor to document any refusal to provide treatment or medication that she asks for.

However, Dr. Thomas recommends that you never feel wedded to using a particular doctor if you have concerns of any kind. "When you are feeling uncomfortable with a visit with a medical provider, do your own research about what the issue is, get information from friends about other providers and then get a second opinion."

Also pay close attention to the type of person giving you care, Dr. Michel says. "If you feel that you have a lot of issues, then you should not be seeing a nurse practitioner or physician's assistant. You should demand that you see a doctor."

If you prefer to be treated by a Black medical provider and don't know one, she suggests checking with the National Medical Association, which has a provider database run by BlackDoctor.org. Other organizations with databases of Black health care providers include the Association of Black Psychologists and the Skin of Color Society.

Even if you've found a provider you're happy to work with, health care settings can be intimidating.

"If you are feeling uncomfortable and you become overwhelmed with information, bring a friend or someone who you trust who can ask and advocate on your behalf," Dr. Thomas says.

Share the questions you have with that person and let them take notes for you.

Walk out of the office with a pamphlet in your hand containing information about the condition in question, Dr. Thomas says or at least with more information than you came in knowing.

Your questions may not end with the conclusion of your visit. Take notes during your visit and jot down any follow-up questions that occur to you afterward. You can always call your health care provider's office afterward with the additional queries or send a message through your online patient portal, if your doctor has one.

From there you will find out if you need to make an additional appointment or will receive an answer in the form of a call, electronic correspondence or documentation in the mail.

Learn more about the questions you should ask before, during and after a doctor visit through the AHRQ.

Harden wants other Black women to know that when they advocate for themselves, others benefit. "If they feel as if they are not receiving adequate health care or the right answers, it can't stop there. Their health and the health of their loved ones counts on them seeking the help that they need."

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More connections to the Spanish Flu : The science, spread, and public perceptions – Daily Mining Gazette

Tuesday, October 13th, 2020

A wild strain of influenza ripped through Europe, beginning in Spain, which led it to be popularly known as the Spanish Flu. This momentous disease killed more than 50 million people the world over, but did the people it lived amongst take the threat seriously as it upended their lives?

Striking the young, old, and everyone in between, health departments of the time refused to release numbers of infections, hoping to reduce panic in the population, but at the same time undercutting the publics understanding of how dangerous the Spanish Flu really was.

The lead epidemiologists of the time were sure of what caused the Spanish Flu, a Pfeiffers bacillus, their issue was not knowing what to do about it.

According to the US National Library of Medicine under the National Institute of Health, pre-vaccine measures to the Spanish Flu were very similar to those precautions being suggested and undertaken recently.

The Spanish Influenza Pandemic: a lesson from history 100 years after 1918 gives a striking overview of the virus, and one does not have to look far to see correlation between the Spanish Influenza and the current COVID-19.

Preventative measures were undertaken in the U.S. in August of 1918, including obligatory notification of suspected cases and the surveillance of communities such as day-schools, boarding schools and barracks, similar to the contact tracing health departments are doing today with COVID-19.

Suspected and confirmed cases were put under voluntary and/or mandatory quarantine or isolation, enabling the spread of the Spanish flu to be curbed. The USNLM points out that these methods were the only effective weapons against the disease at that date. There was no vaccine or antivirals readily available to the public for it yet.

March 4, 1918, a cook at an army base, Camp Fuston, came down with coughing, fever and headaches. Within three weeks, 1100 soldiers were hospitalized, thousands more becoming affected as well. The cook, Albert Gitchel, was one of the first Spanish flu cases in the U.S.

With WWI raging over the globe, the fighting and transportation of men was the best super spreader the disease could hope for. The second, much more deadly wave, found its way to Boston by hitching a ride with returning troops from Britain, bringing it to locations that may have seemed otherwise safe.

In New York City, the epidemic was declared over by Nov. 5, 1918. By that reckoning, the Spanish flu terrorized the nation for seven months. The majority of deaths occurred during the viruss second wave, from August to early November.

One of the highest profile cases was the king of Spain, Alfonso XIII.

Outside of nasty flu-like symptoms, symptoms such as nasal hemorrhages, pneumonia, encephalitis, and blood in the urine were attributed to being caused by Spanish Influenza.

Australia was one of the first countries to think it was over by December of 1918. They lifted their quarantines, and were struck by a third wave, the virus afflicting 12,000 Australians.

In January of 1919, it was back in New York for a third tour.Mortality rates matched those of the second wave. In May of 1919, the U.S. declared the pandemic over for a second time.

The NLM attributes the wildfire spread of the Spanish flu to the return of soldiers from the war fronts, the migration of refugees and the mobility of women engaged in extra-domestic activities, and therefore, preventative health measures were therefore essential in order to try to stem the spread of the disease.

In European countries, health officials closed public meeting places like theaters, and suspended public meetings. Church sermons were only allowed on Sundays, and Sunday school was only to be held for five minutes.

The world over, sanitation of public streets and places were essential. Crowds outside were limited, as were people allowed per public transport unit. However, these did not prove effective. Spitting in the streets was even prohibited. So naturally, people began carrying pocket spittoons.

Newspapers in Spain were free to report on the flu, as they were neutral in the war. In many other European countries, and to some degree the U.S., downplayed the seriousness of the flu to keep the war effort moving ahead. Spain, reporting on its full strength, helped the flu to be known as the Spanish Flu.

In Rapid response was crucial to containing the 1918 Flu Pandemic: Historical analyses help plan for future pandemics, the National Institute of Health investigated why some cities were hit harder than others. Why was St. Louis hit so much less than Philadelphia?

The answer was response time and dedication to prevention. Cities that instilled prevention measures within days cut the effects of the flu two times more than cities that waited weeks.

Dr. Anthony Fauci intimated that, These important papers suggest that a primary lesson of the 1918 influenza pandemic is that it is critical to intervene early.

Fauci then continued, While researchers are working very hard to develop pandemic influenza vaccines and increase the speed with which they can be made, nonpharmaceutical interventions may buy valuable time at the beginning of a pandemic while a targeted vaccine is being produced.

Spanish Flu, or whatever it is: The paradox of public health in a time of crisis by Dr. David Rosner explores the lessons learned, and not learned, by the American people and medicine from the Spanish flu.

Dr. Rosner stated that, Yet, for the most part, despite our advances, the basic means of addressing influenza remain the same as those nearly a century ago. Public health education, isolation, sanitation, lessening congestion, closures, and surveillance are essential tools.

The Institute of Medicine argued that public health is defined by What we, as a society, do collectively to assure conditions in which people can be healthy.

Whether it be the Spanish flu of 1918 and 1919, or COVID-19 of 2019 and 2020, it takes a whole community to come together, play as a team, and keep each other healthy. A pandemic is no time to put individual freedoms above the entire community.

The Spanish Flu was not a hoax, and neither is COVID-19. Wear a mask.

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Women’s health cannot wait 4 more years. It’s why I’m supporting Biden and Harris – The Arizona Republic

Tuesday, October 13th, 2020

Genevieve Leo, Opinion contributor Published 7:00 a.m. MT Oct. 9, 2020

Opinion: The Trump administration has made it harder to access no-cost birth control for women and girls and allowed for discrimination in health care. We can reverse this.

Conservatives ignore science in womens health debates.(Photo: AP)

It is an isolating feeling, receiving abnormal test results after an annual OBGYN visit (Im fine). Its even more terrifying to absorb this information just a month before a close relative was diagnosed with ovarian cancer.

My fear caused overwhelming anxiety.

Going to the doctor is scary and uncomfortable, especially when we dont know or understand what to expect, what is considered normal or irregular. But it does not have to be this way. Having a mother as an OBGYN who was able to talk me through basic womens health information was essential for my understanding and well-being.

Imagine if we all had the information and resources I had from my mom? Imagine if we provided proper resources for womens health, starting with basic education and health services for all female identifying human beings?

Health care is a basic human right. And for women, its a basic human right which has implications on our families, our careersand our finances.

The stigma and lack of information associated with womens health imposes stress, fear,and depression on patients and causes delays in the diagnosis and treatment. Emphasizing access and education for men and women on womens health issues should be a priority.

A Biden-Harris agenda for womens health would expand access to health care and education so that women in similar positions to me can feel empowered to make the best decisions for their care.

President Trump has prioritized a complete rollback of the ACA, including protections for those with preexisting conditions. For women, a preexisting condition is as common as pregnancy or cancer. This legislation was struck down in court but if President Trump had his way, it would have eliminated health care for millions of people, including removing no-charge preventive services for older Americans on Medicare with no substantive replacement.

Furthermore, the Trump administration has prevented family planning programs from obtaining Title X funds making it harder to access no-cost birth control for women and girls and allows for discrimination in health care. Women, including me, will have to choose between cost and the best fit for their personal needs.

This shouldnt be a choice women and families have to make. Rolling back protections and basic preventative care leaves women and others with fewer options and puts our health at risk, sending us a message loud and clear: my basic health does not matter to the Trump administration.

These rollbacks are unacceptable. Not only do they lead to a lack of basic care, but they send us in the wrong direction for education and public understanding of the health care needs of women and families. The disparity in care is for a lack of trying or caring in the Trump administration. It leaves women like myself with the stress and strain of limiting the type of basic care and information necessary for screenings of abnormalities and basic preventive medicine.

Our health care system needs to do more in order to be equitable. We need to make womens health issues more discussable and we deserve a president with a proven track record of advocating for womens health. I deserve to feel safe that my basic health care covers my needs and provides me the proper information and support to make decisions for my health.

The Biden-Harris ticket promises a step in the right direction and makes womens health a priority. The Biden-Harris administration would send the message to women and girls that their health care is important. Where, critical benefits for women are emphasized, including maternity care, preventive services provided free of charge, and protection against discrimination in care and benefits.

Men and women across the country will make health care a priority, emphasizing the importance of womens health this November and vote Donald Trump out of the White House.

Genevieve Leo is a strategy and operations consultantpassionate about women's health. She previously served as a staff accountant for the Democratic National Committee and currently focuses on campaign finance. Reach her atgenevieve.s.leo@gmail.com; on Twitter, @genevieveterese.

Read or Share this story: https://www.azcentral.com/story/opinion/op-ed/2020/10/09/womens-health-care-human-right-its-why-im-supporting-biden-harris/3593899001/

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"Telehealth’s main challenge is cost, but it’s here to stay" | TeleHealth & COVID-19 – Healthcare Global – Healthcare News, Magazine and…

Tuesday, October 13th, 2020

The adoption of telehealth has skyrocketed since the coronavirus appeared. In the US alone, the number of consumers using remote healthcare services has grown from 11 per cent in 2019 to 46 per cent just a few months into the pandemic. But how will this play out long term, once face-to-face visits can resume?

"Telehealth, or virtual care, has always been an innovative medium in healthcare, but the pandemic has pushed consumers and providers of healthcare onto virtual platforms across the continuum of care" explains Julian Flannery, chief executive and founder of virtual health advisory platform Summus Global. "Our original vision of a platform that can be accessed remotely across the continuum of care from prevention, to understanding a diagnosis, to ongoing monitoring and care has become a mainstream reality."

US-based Summus was founded in 2015, five years before today's huge demand for virtual healthcare. The platform connects users to specialists anywhere in the world who can provide advice and a second opinion - as one of the caveats of accessing clinicians in another part of the country is that without a specific license they arent allowed to practice medicine outside of their state.

However Flannery explains the need for the service. "We founded the company to solve two problems in healthcare: the challenge of accessing high quality medical expertise quickly, and the structural ways in which the system undervalues the expertise of quality providers.

"Today's healthcare system rewards procedure and treatment volume more than the connection between doctor and patient. We wanted to create a solution that would drive better outcomes by rewarding doctors for their expertise, and helping healthcare consumers understand their options."

The platform currently gives access to more than 4,000 clinical specialists. "In the traditional healthcare system, it can be very hard to find specialists, get in to see them, and spend quality time with them, given the complexity of the system and the way incentives are set up" Flannery says.

"We've changed that model by allowing members to access healthcare in a much more effective way. Consumers can ask any question that requires speciality expertise, and we use technology to connect them directly with a high-quality specialist within days. Specialists who work with Summus give quality time to our members, an average appointment lasts 44 minutes, which is three times more than the normal time of an in-person visit."

Their users' typical needs are to help manage chronic conditions, access mental health professionals, establish preventative practices, and understand serious and complicated diagnoses.

Flannery believes the biggest challenge for telehealth is figuring out how to reimburse for virtual visits, and the cost to health systems, employers and consumers. "During the pandemic insurers incentivised virtual visits by reimbursing providers at the same rate as in-person visits" he says. "If private insurers revert to lowering reimbursement rates for telehealth, it will become more costly for health systems and the pendulum may swing back to some extent."

However he adds that the benefits of virtual care will outweigh the challenges. "We believe the momentum will sustain. Of course, there will be a lower base as in-person visits come back, but we think that convenience, access and scale have convinced the market that the future of healthcare will have many virtual components. Now that consumers have been exposed to the benefits of virtual care, it will play a large role in shaping longer-term adoption of telehealth."

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Thresholds versus Anomaly Detection for Surveillance of Pneumonia and Influenza Mortality – CDC

Tuesday, October 13th, 2020

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.

Author affiliation: Saint Louis University, St. Louis, Missouri, USA

Lower respiratory tract infections, including pneumonia and influenza (P&I), are the leading cause of infectious diseaserelated death worldwide (1). Annually, up to 95,000 persons might die from P&I in the United States alone (2). Ongoing surveillance of risk factors for influenza acquisition, incident influenza disease, and clinical outcomes of influenza infection are a global public health priority (3). Ensuring that public health professionals and the public at large are informed about the incidence and severity of disease in the community is an important benefit of these surveillance programs. To fulfill surveillance needs in the United States, the Centers for Disease Control and Prevention maintains FluView (4), a public-facing web interface providing detailed results of their influenza surveillance program. Reports maintained on FluView range from spatial analytics of influenza-like illness to virologic surveillance, virus characterization, hospitalization rates, and P&I mortality. Each report is useful for focused interventions and planning at a personal, local, state, regional, and national level.

Mortality reporting in FluView is a particularly critical public health endpoint for P&I because early interventions can lessen these catastrophic outcomes. Currently, mortality is monitored and reported as epidemic if the percentage of total deaths is above a value termed the epidemic threshold. This threshold is defined at a P&I death rate 1.645 SDs above the seasonal baseline mortality (5) as measured by the National Center for Health Statistics mortality surveillance system. These statistics are useful but limited in their ability to detect abnormally high death rates because they do not rigorously account for common statistical issues inherent in influenza surveillance data, such as within- and between-season seasonality and autocorrelation (6). Without accounting for the complex temporal fluctuations (seasonality) and nonindependence of period-to-period data points (autocorrelation), traditional statistical methodologies might provide spurious results, leading to inappropriate conclusions. Because an essential aspect of surveillance is ensuring that robust statistical methods are used to provide a valid view of the state of disease or outcome, the exploration of innovative methods for computational surveillance of P&I outcomes is warranted. The objective of our study was to evaluate the utility of a novel anomaly detection algorithm for P&I mortality surveillance.

For our study, we obtained national P&I mortality data from FluView for a 350-week period ranging from week 40 of 2013 through week 24 of 2020. First, we recreated the current FluView P&I mortality plot, shading areas above the epidemic threshold to more easily delineate mortality rates higher than this limit. Next, we used Twitters time-series decomposition and the generalized extreme studentized deviate anomaly detection algorithm to identify anomalous P&I mortality rates (7,8). For anomaly detection, default (0.05) and maximum anomalies (20%) were used as options. Anomaly plots identify anomalies using red dots. We analyzed data using R version 4.0.1 (R Foundation for Statistical Computing, https://www.r-project.org).

Figure

Figure. Pneumonia and influenza mortality surveillance using anomaly detection analysis versus threshold method, United States. A) Line chart representing anomaly detection analysis of surveillance. Red points indicate anomalous data points. B)...

Using current epidemic threshold methodologies, we found that 72 (20.6%) of weekly P&I mortality rates were beyond the epidemic threshold (Figure, panel A). P&I mortality rates spiked above the epidemic threshold in approximately the same weeks every year since week 40 of 2013. Anomaly detection identified 17 (4.9%) P&I mortality rates as abnormally high (Figure, panel B). To ensure that this methodology can be continually used into the future, we also created a free, open-source, web-based application to recreate both figures on demand as data are updated (https://surveillance.shinyapps.io/fluview). Once loaded, the current national data are pulled from FluView and analyzed on the first tab. The anomaly plot and the updated current FluView P&I mortality surveillance plots are then displayed. For this web application, we included the options to modify some basic functionality of the anomaly detection algorithm with brief discussions of how they can be used (7,8). A second tab was created to enable upload of state-level P&I mortality data from FluView Interactive (https://gis.cdc.gov/grasp/fluview/mortality.html), providing the same anomaly detection plot.

The current epidemic threshold for documenting P&I mortality in the United States cannot differentiate characteristic mortality rates during peak influenza season from unusually high mortality attributable to P&I. An important benefit of mortality surveillance is the identification of periods where rates are beyond a reasonable expectation such that adequate interventions can be developed to lower death rates in the community. Currently, P&I mortality rates are compared with a basic SD statistic obtained and averaged over seasonal baseline mortality estimates. This traditional approach does not account for seasonality or autocorrelative functions within and across influenza seasons (6). Given the advancements in computational power and the development of easy-to-interpret algorithms capable of filtering out these biases, alternative approaches for surveillance of P&I mortality at a national level should be considered to complement the current FluView methods. Our approach is one such alternative. Others such as the European EuroMoMo modeling (https://www.euromomo.eu) might also be applicable methods for bolstering our understanding of P&I mortality.

Although this particular anomaly detection might underestimate the frequency of abnormally high mortality rates, our approach is also likely to produce an additional, more focused message for public health professionals. Currently, P&I mortality peaks above the epidemic threshold at approximately the same time each year. Therefore, the existing approach might have a limited ability to provide public health professionals with the reports necessary to make informed interventions to limit mortality, such as through recalibrating targeted screening and preventative approaches, and to more accurately develop focused interventions such as vaccination campaigns. To accomplish this task, a computational method motivated by identifying outlying mortality rates should be used, with the caveat that mortality data must be reported in near real-time. Our approach provides such an outcome and might be useful for public health professionals in their quest to prevent and control P&I-related death. Our approach might also be useful for computational surveillance of other respiratory diseases, such as coronavirus.

Dr. Wiemken is an associate professor at Saint Louis University School of Medicine, Division of Infectious Diseases, Allergy, and Immunology, as well as the Center for Health Outcomes Research. His primary research interests include emerging infectious diseases, influenza, vaccinology, healthcare-associated infections, and data science.

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Suggested citation for this article: Wiemken TL, Santos Rutschman A, Niemotka SL, Hoft D. Thresholds versus anomaly detection for surveillance of pneumonia and influenza mortality. Emerg Infect Dis. 2020 Nov [date cited]. https://doi.org/10.3201/eid2611.200706

The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

Read more:
Thresholds versus Anomaly Detection for Surveillance of Pneumonia and Influenza Mortality - CDC

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Worcester researchers study link between microbiome and Alzheimer’s disease – WCVB Boston

Tuesday, October 13th, 2020

Researchers in Worcester are taking a closer look at Alzheimer's disease by studying the bacteria in the gut."Our main theory on this is that your gut microbiome influences your systemic immune profile which then affects your brain immune profile," said Dr. John Haran, associate professor of emergency medicine and microbiology and physiological systems at UMass Medical School and clinical director of the UMass Center for Microbiome Research.His team was just awarded a $3.3 million grant from the National Institute on Aging to explore how the gut microbiome can affect cognitive functioning.Haran said the microbiome is a complex organ made up of billions of cells and 70% of the immune system lies there.Last year, his team reported people diagnosed with Alzheimer's dementia share certain gut microbiomes that fuel inflammation. Now, they will study know what else that could mean."If the inflammation is being driven from the microbiome, there's two things that could happen. One it could be preventative, to not have the inflammation happens in the first place. Second, if that inflammation is kind of cured or quieted down, the immune system would have time to then to recover back," Haran said.The center is actively recruiting seniors living in the Worcester area, both with an Alzheimer's diagnosis and those without. To inquire about participating in the study, you can call 508-925-0348 or email umass.emresearch@gmail.com .

Researchers in Worcester are taking a closer look at Alzheimer's disease by studying the bacteria in the gut.

"Our main theory on this is that your gut microbiome influences your systemic immune profile which then affects your brain immune profile," said Dr. John Haran, associate professor of emergency medicine and microbiology and physiological systems at UMass Medical School and clinical director of the UMass Center for Microbiome Research.

His team was just awarded a $3.3 million grant from the National Institute on Aging to explore how the gut microbiome can affect cognitive functioning.

Haran said the microbiome is a complex organ made up of billions of cells and 70% of the immune system lies there.

Last year, his team reported people diagnosed with Alzheimer's dementia share certain gut microbiomes that fuel inflammation. Now, they will study know what else that could mean.

"If the inflammation is being driven from the microbiome, there's two things that could happen. One it could be preventative, to not have the inflammation happens in the first place. Second, if that inflammation is kind of cured or quieted down, the immune system would have time to then to recover back," Haran said.

The center is actively recruiting seniors living in the Worcester area, both with an Alzheimer's diagnosis and those without.

To inquire about participating in the study, you can call 508-925-0348 or email umass.emresearch@gmail.com .

Continued here:
Worcester researchers study link between microbiome and Alzheimer's disease - WCVB Boston

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Susquehanna Wellness Clinic to Serve Primary Care Needs of the Area – GANT News

Thursday, October 8th, 2020

The Susquehanna Wellness Clinic, a primary care office located in Frenchville, is opening its doors in November of 2020 to begin serving adult patients health and wellness needs.

The clinic is focused on holistic, person-centered approaches to care, aiming to build trusting relationships and provide the personalized care to each individual.

Dr. Baltazar Corcino, M.D. and Jamie Bush, CRNP will be staffing the clinic, and will be supported by a comprehensive team of medical professionals. Both individuals have a long-standing history of providing quality and meaningful care in the Clearfield community.

Corcino has a proud history of caring for the residents of Clearfield County, and is excited to continue this work in the clinic. Hes worked in internal medicine in emergency room, private practice and hospital settings.

Bush, a board-certified nurse practitioner, specializes in family medicine and has additional experience in ICU and ER settings as well as urgent care and neurosurgery settings.

The clinic will serve a variety of needs for adult patients 18 and older. These services include adult medicine, geriatric care, preventative medicine, immunizations, annual wellness visits, health care screenings, laboratory testing, chronic care management and interdisciplinary team planning.

Additionally, the clinic will provide transportation when necessary to seniors 60 and older to clinic appointments, conduct in-home visits to patients physically unable to come into the clinic and Telehealth services to connect virtually when coming in for an appointment isnt an option.

The clinic will be hosting an open house to the public on Oct. 21, from 3 p.m. 5 p.m. The event will include facility tours, meet and greet with staff and light refreshments.

The clinic will officially open its doors on Monday, Nov. 2, 2020 to begin serving patients. Hours of service are Monday Friday, from 8:30 a.m. 3:30 p.m., by appointment.

If you have any questions about the clinic or are interested in becoming a patient, please call 814-765-2695 or e-mail info@susqwell.com. Dont forget to follow the clinic on Facebook for announcements and upcoming events.

Read more from the original source:
Susquehanna Wellness Clinic to Serve Primary Care Needs of the Area - GANT News

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