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Don’t let the flu poop all over your patients’ good time this party season

In case you didn’t notice, the seasons are changing and the nights are drawing in. And for reasons only understood by the influenza virus itself, it’s time for the flu season to kick off. Thousands of us will soon be laid low by a bug we can’t even see. And worse still, we know that we’ll get sick just in time for party season. So what can health professionals do to help their patients avoid this party-pooping illness?

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In case you didn’t notice, the seasons are changing and the nights are drawing in. And for reasons only understood by the influenza virus itself, it’s time for the flu season to kick off. Thousands of us will soon be laid low by a bug we can’t even see. And worse still, we know that we’ll get sick just in time for party season. So what can health professionals do to help their patients avoid this party-pooping  illness?

Take a look at some of these tips.

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TELL THE PATIENTS TO QUIT THE BOOZING

Booze is one of the biggest things that can help bring on the flu, and it’s all to do with sleep. Most people think that booze is a sleeping aid. They’ll have a glass of wine before bed to help themselves nod off. But while drink might induce sleep, it doesn’t guarantee that that sleep with be of high quality. In fact, it has been shown that booze reduces the amount of rapid eye movement sleep that people get. That means that it stops people from going into the type of deep sleep that’s really good for them.

So what’s the link with the flu?

The more sleep-deprived you are, the lower will be your immune defenses. And the lower your immune defenses, the more likely you are to get the flu. It’s that simple.

TELL THE PATIENTS TO DRINK TEA THROUGHOUT THE DAY

Murray Grossman is an MD from Los Angeles. He works in the ear, nose and throat department. So he’s used to seeing people battle against colds and flu. His advice is to sip tea throughout the day. The warm steam from the tea helps to activate the tiny hair-like structures that line the gullet and trachea. The more active these structures are, the more they will be able to remove germs and other gunk.

Grossman also suggests people include a small amount of lemon and honey if they are drinking green tea. Lemon helps activate some of the life-extending compounds in green tea. And it also helps to thin mucus. Honey has antibacterial properties that help destroy pathogens before they can do any damage.

GET TRAINED ON THE SIGNS AND SYMPTOMS

It’s not all about the patients, of course. It’s about what the doctors themselves can do to prepare for the next flu season. Influenza training is an important part of any physician’s arsenal against the disease. Doctors need to understand how the different vaccines work, which are the most effective, and which demographics are at risk. They also need to be able to tell how the flu differs from other common, but similar conditions.

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TELL THE PATIENTS TO PAMPER THEIR NOSES

Jeffrey Demain is a medical doctor from Alaska. He says that he does a nasal rub daily. He uses a bulb syringe to flush out nasal secretions and viruses from his nasal canal. He says that patients who are concerned about picking up the flu virus can go to their local pharmacy. There, they can pick up a saline solution to irrigate their nostrils.

The recipe for the solution is simple meaning you can make your own. Demain suggests mixing three teaspoons of salt and 1 teaspoon of baking powder. Then add a teaspoon of the powder mixture to 250 ml of pure water. Rinse.

GET PATIENTS JUICING

Kristina Economou is a paramedic from California. As a paramedic, she’s constantly exposed to new bacteria and viruses. As a result, she insists on boosting her immune defenses with vegan smoothies and juices. She includes immune-boosting foods like oranges, kale, spinach, ginger, parsley, cucumber, chard and mint. She says that it helps her get closer to her recommended intake of fruits and vegetables.

DOCTORS SHOULD LEAD BY EXAMPLE

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Doctors should lead their patients by example. They should wash their hands after they have spent time examining a patient. And they should get a flu jab themselves if they are eligible.

TELL THEM TO KEEP THE WORLD AT PEN’S LENGTH

Kim Okochi is a mother from Maryland. She has a child with a compromised immune system. As a result, it’s important that she does everything she can to avoid bringing bugs back to the house. She’s decided to adopt the pen strategy. Now when she goes out, she doesn’t touch ATMs at the supermarket or the bank. Instead, she uses her pen to punch in her PIN codes. This helps her to avoid bringing germs back to the house that could affect her child. She even takes her pen with her when she visits the doctor’s office.

"If someone asked you about me, about what I do for a living, it's to 'weave words'," says Kiki Tan, who has been a writer "for as long as I care to remember." With this, this one writes about... anything and everything.

Health & Wellness

Covid-19 affects adolescent and young adults sexual and reproductive health

LGBTQ youth have also been impacted. And for some youth whose families are less accepting, being quarantined for months can lead to significant tensions and confidentiality concerns, which could make LGBTQ youth more isolated.

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Social distancing and limited access to contraceptive and abortion care during the COVID-19 pandemic is affecting the sexual and reproductive health of adolescents and young adults, according to a new study by researchers at Columbia University Mailman School of Public Health and Rutgers University. The researchers address how these challenges, as well as peer and romantic relationships, are being navigated.

The finding are published in the journal Perspectives on Sexual and Reproductive Health.

Huge changes for adolescents and young adults, include school closures, potentially much more time with family, the interruption of the normal trajectory toward increased independence and, for many, very limited or no physical proximity to sexual and romantic partners.

Even though the pandemic may lead to less opportunities for sex for some young people, disruptions in access to contraception and abortion can be extremely problematic for adolescents and young adults who are still able to be physically close to their partners during the pandemic, note the authors. “The good news is that some services, including obtaining many forms of contraception and receiving testing and treatment for sexually transmitted diseases can be handled through telemedicine,” said Leslie Kantor, a professor and chair of the Rutgers Department of Urban Global Public Health. “If telemedicine remains as widely available as it has been during the coronavirus pandemic, access to sexual and reproductive health care may actually improve for young people.” However, Kantor and colleagues say that lack of privacy and confidentiality, which many adolescents and young adults are experiencing while living at home with family, can also hinder the ability to get necessary sexual and reproductive healthcare.

In terms of testing for sexually transmitted infections or seeking abortion care, there is not a lot of data specifically on young people. But many states have tried to restrict abortion access by arguing it is not an essential service despite the fact that abortion clearly is essential and needs to be timely. There also have been very concerning declines in vaccinations for all children older than age 2 and the use of the HPV vaccine, which prevents cancer-causing infections and pre-cancers, has plummeted.

Photo by Sharon McCutcheon from Unsplash.com

LGBTQ youth have also been impacted, although fortunately, many LGBTQ centers quickly moved support groups and other services online. And for some youth whose families are less accepting, being quarantined for months can lead to significant tensions and confidentiality concerns, which could make LGBTQ youth more isolated.

While social disruption resulting from the pandemic affects young adults’ sense of health and well-being, one positive aspect is that young adults are digital natives familiar with online platforms and social media. “Young people are supposed to be gaining independence at this time in life, so for those who have had to return home after a period of being away, maintaining relationships with friends and romantic partners at a distance may be particularly challenging. Our view that their constant digital connection was negative is now a positive for them at this time,” said David Bell, MD, MPH, Columbia Mailman School of Public Health associate professor of Population and Family Health and Pediatrics.

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Health & Wellness

Study finds gender-affirming health care good on paper; still lacking in practice

Fact: Many trans women, especially those in rural areas, couldn’t find a doctor trained to provide those hormones, and the doctors they could access did not know where to refer them for more specialized care.

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Good in reports; shitty in actual practice.

This is the state of gender-affirming policies and health care for transgender women, with many of pro-LGBTQIA polices actually still not fully realized in practice, according to a study from Oregon State University found.

In the US, the Supreme Court recently barred employment discrimination against LGBTQIA people, which brings national law more in line with laws that have been in place in various states for several years.

Oregon, for instance, has the Oregon Equality Act of 2008 that protects trans people against employment and housing discrimination, while the expansion of Medicaid in 2015 expanded health coverage to include gender-affirming care like hormone-replacement therapy and transition surgery.

However – and this is worth stressing – those legal protections are not enough to address social determinants of health such as financial status and access to housing, or the everyday discrimination still felt by many trans women in Oregon, said Jonathan Garcia, a researcher ins the OSU College of Public Health and Human Sciences said. The cumulative effect of those subtler forms of discrimination takes a significant toll on trans women.

“In spite of ranking so highly in terms of Oregon’s support for gender-affirming care, the impact of social discrimination is so great that it challenges policy implementation and the lived experience of people,” Garcia said. “This is how discrimination sort of gets in between the cracks – it plays out in more complicated and indirect ways so that you can’t really weed it out.”

Garcia’s study, published in the Transgender Health journal, gathered detailed interviews with 25 trans women in Oregon, ages 18 to 39. Of those 25, six had been homeless at some point in the 12 months prior and only 20% had full-time employment, though all had some form of health insurance.

According to the study’s findings, one of the biggest challenges facing trans women is navigating the health care system. At least in Oregon, though the law requires insurance to cover hormone-replacement therapy, many trans women, especially those in rural areas, couldn’t find a doctor trained to provide those hormones, and the doctors they could access did not know where to refer them for more specialized care.

In other cases, trans women had to undergo a psychological evaluation to obtain a diagnosis of gender dysphoria – the distress people feel when the sex they’re assigned at birth doesn’t match the gender with which they identify – before they could begin to access hormone replacement therapy. This route is much more time-consuming and cost-prohibitive than the “informed consent model,” wherein trans patients can attest that they understand the risks and benefits of pursuing gender-affirming medical treatment, without first having to prove psychological distress. For some study participants, the idea of gender dysphoria made them feel like they had a medical problem and invalidated their lived experience.

“All of that is really, really confusing,” Garcia said. “It requires them to become experts in their rights, in the law, in the availability of these services and where they are offered.”

Most trans women who were able to navigate that system credit their success to their social support network of other trans people. In addition to this informal network, Garcia said, the system needs to have trained and properly compensated health workers in place who can act as navigators, and they need to understand not just health care but the intersections with housing and the legal system that affect people’s access to care.

“We need help with navigating these systems and establishing trust, so that people are actually able to claim and enjoy the rights that they have, so that the rights don’t remain on paper,” he said.

The study was limited in that 21 of 25 participants were white women. Despite numerous efforts to recruit Black and Latinx trans women, Garcia said, they were unable to reach them through participant referrals and community center contacts. He attributed this to their extreme marginalization in queer spaces in Oregon.

“But we can tell that whatever this set of women is experiencing, I expect the experience of trans women of color to be far more challenging,” Garcia said. “Specifically because of structural racism and disenfranchisement from queer networks, which were a critical resource for the women who were able to navigate these systems.”

Garcia’s co-author was Richard Crosby at the University of Kentucky.

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Health & Wellness

Suicide rate for people with schizophrenia spectrum disorders 170 times higher

The authors suggest increasing the age limit for admission to first episode psychosis programs (most are closed to people over 30) and increasing the length of clinical follow-up care after a first episode of psychosis.

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The suicide rate for people with schizophrenia spectrum disorders (SSD) is 170 times higher than the general population, according a study just published in the journal Schizophrenia Research, a figure the authors call “tragically high.”

The study of 20-years of population data, believed to be the largest of its kind ever done, examined statistics on over 75,000 patients who received a first diagnosis of SSD. On average, each patient was followed for almost ten years. The study found several key factors that were predictors of suicide including:

  • During the first five years after an individual has been diagnosed with SSD
  • If there was evidence of a mood disorder or hospitalization prior to diagnosis
  • If the individual was diagnosed with SSD at a later age

“What this study teaches is us that although people with SSD are at higher risk for suicide, we can target those at the highest risk with changes in policy and treatment,” said lead author Dr. Juveria Zaheer, Clinician Scientist at the CAMH Institute for Mental Health Policy Research.

“In the past clinicians have focused on treating the psychosis itself when it first appears,” said senior author Dr. Paul Kurdyak, Director, Health Outcomes and Performance Evaluation, CAMH Institute for Mental Health Policy Research and Clinician Scientist at ICES. “This study shows that treatment has to include suicide prevention safety planning as well from the very beginning.”

The authors suggest increasing the age limit for admission to first episode psychosis programs (most are closed to people over 30) and increasing the length of clinical follow-up care after a first episode of psychosis.

“Now that we know what is happening, we need to better understand why,” said Dr. Zaheer. “Our next step will be to study the lived experience of people with SSD who have had suicidal ideation.”

Suicide – by itself – is a big issue in the LGBTQIA community.

In 2018, for instance, a study found that almost 14% of adolescents reported a previous suicide attempt, with disparities by gender identity in suicide attempts. Female to male adolescents reported the highest rate of attempted suicide (50.8%), followed by adolescents who identified as not exclusively male or female (41.8%).

Still in 2018, another study found that 50.8% of transmasculine adolescents between the ages of 11 and 19 have attempted suicide at least once, while 41.8% of nonbinary adolescents – those who don’t identify as exclusively male or exclusively female – have attempted suicide.

And in June 2020, yet another study noted that death records of LGBTQ youth who died by suicide were substantially more likely to mention bullying as a factor than their non-LGBTQ peers.

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Health & Wellness

Physical activity in all of its forms may help maintain muscle mass in midlife

Hormonal changes during menopause decrease muscle mass, but physical activity might slow the decrement.

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A large study of middle-aged women shows that age-related changes in skeletal muscle are part of everyday life for women in their fifties. During this time, women transition from perimenopause to postmenopause and the production of estrogen ceases. Loss of estrogen has an effect on muscles and leads to a decline in muscle mass. Physical activity in all of its forms may help maintain muscle mass in midlife.

“We already knew that estrogen has a role in the regulation of muscle properties,” says doctoral student Hanna-Kaarina Juppi. “By following the hormonal status, measuring many aspects of muscles and by taking into consideration the simultaneous chronological aging of women going through menopausal transition, we were able to show that the decrease of muscle mass takes place already in early postmenopause.”

In the current study, muscle size was measured in the perimenopausal state and right after entering postmenopause, when menstruation had permanently stopped. Women were on average 51-and-a-half years old at the beginning of the study and 53 years old at the final measurements, so the average duration of menopausal transition was one-and-a-half years. The time it takes a woman to go through menopause is unique: in this study it varied from less than six months to more than three years. During this time, the decrease in muscle mass was on average one percent.

Juppi continues: “The observed change does not seem like much, but what is meaningful is that the decline happens in a short period of time and can have an impact on metabolism, as muscles are important regulators of whole-body metabolism.”

Physical activity was found to be positively associated with the maintenance of muscle mass during the menopausal transition. Women who were more active had higher muscle mass before and after menopause compared to the less active women. It seems that even though menopause alone decreases muscle mass, staying physically active throughout middle age can help women to slow the change.

The current study was conducted in the Gerontology Research Center and Faculty of Sport and Health Sciences, and is part of a larger study, Estrogenic Regulation of Muscle Apoptosis (ERMA), led by Academy Research Fellow Eija Laakkonen. More than a thousand women between the ages of 47 and 55 from the Jyväskylä region participated in the ERMA study. At the beginning of the study, 381 of them were perimenopausal, while 234 reached early postmenopause during the study. The research was funded by the Academy of Finland and the European Commission.

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Health & Wellness

Repetitive negative thinking linked to dementia risk

“Looking after your mental health is important, and it should be a major public health priority, as it’s not only important for people’s health and well-being in the short term, but it could also impact your eventual risk of dementia.”

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Persistently engaging in negative thinking patterns may raise the risk of Alzheimer’s disease, finds a new UCL-led study.

In the study of people aged over 55, published in Alzheimer’s & Dementia, researchers found ‘repetitive negative thinking’ (RNT) is linked to subsequent cognitive decline as well as the deposition of harmful brain proteins linked to Alzheimer’s.

The researchers say RNT should now be further investigated as a potential risk factor for dementia, and psychological tools, such as mindfulness or meditation, should be studied to see if these could reduce dementia risk.

Lead author Dr Natalie Marchant (UCL Psychiatry) said: “Depression and anxiety in mid-life and old age are already known to be risk factors for dementia. Here, we found that certain thinking patterns implicated in depression and anxiety could be an underlying reason why people with those disorders are more likely to develop dementia.

“Taken alongside other studies, which link depression and anxiety with dementia risk, we expect that chronic negative thinking patterns over a long period of time could increase the risk of dementia. We do not think the evidence suggests that short-term setbacks would increase one’s risk of dementia.

“We hope that our findings could be used to develop strategies to lower people’s risk of dementia by helping them to reduce their negative thinking patterns.”

For the Alzheimer’s Society-supported study, the research team from UCL, INSERM and McGill University studied 292 people over the age of 55 who were part of the PREVENT-AD cohort study, and a further 68 people from the IMAP+ cohort.

Over a period of two years, the study participants responded to questions about how they typically think about negative experiences, focusing on RNT patterns like rumination about the past and worry about the future. The participants also completed measures of depression and anxiety symptoms.

Their cognitive function was assessed, measuring memory, attention, spatial cognition, and language. Some (113) of the participants also underwent PET brain scans, measuring deposits of tau and amyloid, two proteins which cause the most common type of dementia, Alzheimer’s disease, when they build up in the brain.

The researchers found that people who exhibited higher RNT patterns experienced more cognitive decline over a four-year period, and declines in memory (which is among the earlier signs of Alzheimer’s disease), and they were more likely to have amyloid and tau deposits in their brain.

Depression and anxiety were associated with subsequent cognitive decline but not with either amyloid or tau deposition, suggesting that RNT could be the main reason why depression and anxiety contribute to Alzheimer’s disease risk.

“We propose that repetitive negative thinking may be a new risk factor for dementia as it could contribute to dementia in a unique way,” said Dr Marchant.

The researchers suggest that RNT may contribute to Alzheimer’s risk via its impact on indicators of stress such as high blood pressure, as other studies have found that physiological stress can contribute to amyloid and tau deposition.

Co-author Dr Gael Chételat (INSERM and Université de Caen-Normandie) commented: “Our thoughts can have a biological impact on our physical health, which might be positive or negative. Mental training practices such as meditation might help promoting positive- while down-regulating negative-associated mental schemes.

“Looking after your mental health is important, and it should be a major public health priority, as it’s not only important for people’s health and well-being in the short term, but it could also impact your eventual risk of dementia.”

The researchers hope to find out if reducing RNT, possibly through mindfulness training or targeted talk therapy, could in turn reduce the risk of dementia. Dr Marchant and Dr Chételat and other European researchers are currently working on a large project to see if interventions such as meditation may help reduce dementia risk by supporting mental health in old age.

Fiona Carragher, Director of Research and Influencing at Alzheimer’s Society, said: “Understanding the factors that can increase the risk of dementia is vital in helping us improve our knowledge of this devastating condition and, where possible, developing prevention strategies. The link shown between repeated negative thinking patterns and both cognitive decline and harmful deposits is interesting although we need further investigation to understand this better. Most of the people in the study were already identified as being at higher risk of Alzheimer’s disease, so we would need to see if these results are echoed within the general population and if repeated negative thinking increases the risk of Alzheimer’s disease itself.

“During these unstable times, we are hearing from people every day on our Alzheimer’s Society Dementia Connect line who are feeling scared, confused, or struggling with their mental health. So it’s important to point out that this isn’t saying a short-term period of negative thinking will cause Alzheimer’s disease. Mental health could be a vital cog in the prevention and treatment of dementia; more research will tell us to what extent.”

This is also an issue among members of the LGBTQIA community. In 2019, for instance, a study found that more than 14% of sexual and gender minorities (SGM) reported subjective cognitive decline, significantly higher (p<0.0001) than the 10% rate among cisgender heterosexual participants.

In 2018, meanwhile, SAGE CEO Michael Adams noted: “While the LGBT community faces similar health concerns as the general public, LGBT people who receive a dementia diagnosis and LGBT caregivers face uniquely challenging circumstances. This brief shines a light on these challenges, so we can begin taking steps to address them and improve the care and support LGBT people receive.”

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Health & Wellness

How to navigate a crisis and come out stronger

Learn how to take charge of your emotional health with these practical and effective tips.

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When life, or the people in your life, push your limits, the emotional load may feel insurmountable. Making sense of the chaos in your life can allow you to rediscover peace and joy, but circumstances like a world crisis can complicate the process of emotional healing.

“Almost nobody is trained on what to do with their emotions in times of crisis and stress, and most of us are never taught how to manage our emotions in normal times,” said Eric Paskel, an author and motivational speaker who spent 34 years exploring how human beings can rise above their dysfunctional tendencies and control their emotions. “If you’ve ever admired someone who was cool under pressure then you know it’s possible to emotionally survive, and even thrive, in a crisis.”

Learn how to take charge of your emotional health with these practical and effective tips.

Be Open to Learning

During a crisis is when personal growth is most possible. During adversity and crisis, there are always lessons to be learned and shared. Sometimes growth comes as the result of overcoming the pain of a crisis, but there are other sources of growth.

To accelerate your growth, begin by recognizing you need help then be willing to accept that help. It may come in the form of advice from a professional or it may be simply listening to the perspective of others with similar experiences.

Look for Opportunity

A simple change in perspective like a crisis or a forced change, such as having to work from home, is both a challenge and an opportunity, although the challenges and benefits will likely be different for each individual person.

Some people will benefit from the isolation, which they’ll see as solitude. Some will be challenged by a noisy home while others will be thrilled to have the company of family or roommates all day. The key is to find a way to turn those challenges into gold.

Begin by identifying your challenges. Then find the silver lining. What are the benefits that come with these challenges? It may be that your rigorous travel schedule allows more time at home or that you’ve been able to tackle a long-standing list of lower-priority tasks. Then choose to focus on the positive and find ways to adapt to the challenges. Use your former commute time to practice yoga or exercise. Buy noise-cancelling headphones to reduce distractions. Find different strategies that work for you.

Embrace Self-Sufficiency

Being self-sufficient is critical to your personal and emotional freedom and a crisis can serve as an opportunity to become more self-sufficient. Being self-sufficient means you’re able to manage yourself and have sovereignty over your body and mind. It means your thoughts and emotions do not control you; you control them.

Consider the example of an ending relationship. If you’re codependent, the end of that relationship is more likely to devastate and destroy you. If you’re self-sufficient, as painful as the end of a relationship or a life situation may be, you can let it go and move on to the next chapter in your life.

Find Joy

You can always find joy, even in the midst of change, confusion, chaos or crisis. Celebration comes from the way one chooses to see, perceive and be in the world. However, you may have trepidation about celebrating and having joy when others are focusing on negativity or you see suffering in the world around you.

Confetti flying and champagne bottles popping isn’t what defines joy; joy comes out of positivity. Celebration comes out of acknowledgements and affirmations, and out of your sense of freedom and purpose. Finding joy is not just for joyous moments. Embracing joy and celebrating in challenging times can help reframe your mentality about what challenges really are and help provide longer-lasting positive effects on your body and mind.

Know You’re Not Alone

You may think you’re alone, especially during hard times, but when you understand it’s a matter of creating relationships and making connections, you’ll never feel truly lonely again. Whatever it is, the difficulty you’re going through isn’t unique to just you. Once you understand that other people have been through your problem, you will be able to understand that you have a large pool of connections and help.

Just connecting with other people who’ve had the same experiences can give you an emotional tailwind to push you forward. Recognize that feeling alone is a warning sign that you need to reach out to loved ones. Daily maintenance, contact, connection and working on relationships can help keep you from feeling disconnected from the world around you.

Learn how to manage your way through troubling times and become part of the solution at ericpaskel.com.

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