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January 2017

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Inspire, Inform & Educate

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66th Edition

Your Leading source for minority health information

Raising Awareness for Cervical Health Awareness Month 14-15

INSIDE

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FDA Grants Accelerated Approval to New Treatment for Advanced Ovarian Cancer

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By Dr. LaTronica Fisher Reasons 2 Stop Smoking in 2017

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New Report Details Impact of the Affordable Care Act

2  |  January 2017

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January 2017 | 3

Publisher’s Message

MR. D-MARS

This is the time of year when people make resolutions regarding their health. However, the d-mars. com Health & Wellness Journal encourages you to take charge of your health all throughout the year. If you have not made your health a priority, now is a great time to start, and keep the momentum going 365 days a year to be a healthier you.

This month is Cervical Health Awareness Month and a chance to raise awareness about how women can protect themselves from HPV (human papillomavirus) and cervical cancer. HPV is a very common infection that spreads

Behind the Journal

SENIOR ACCOUNT EXECUTIVES C.T. Foster Tiffany Black PHOTOGRAPHY L.C. Poullard Grady Carter Taelor Smith

10 4 06

DISTRIBUTION Booker T. Davis, Jr. Rockie Hayden

ADVERTISING | MARKETING MEDIA | COMMUNICATION

10 Business New Rules for Effective Marketing

12 Career 12 Explore This Career: Art Therapist 13 Education 13 Ways Going to College Affects Your Health 16 Healthy Lifestyles 16 Reasons 2 Stop Smoking in 2017 16 Starting the Year off Light 24 5 Smart Steps to Preserving Brain Health

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17 Mental Health 17 Know the Warning Signs 18 Medical 18 Unique Dialysis Device

LAYOUT & GRAPHIC DESIGNER Angel Rosa

Project Coordinator Taelor Smith

our services

08 Biotech 08 Rheumatoid Arthritis

MULTIMEDIA DIRECTOR Andrea Hennekes

SOCIAL MEDIA COORDINATOR Charlette Washington

— Marian Wright Edelman

06 Glaucoma Awareness Month

VICE PRESIDENT Kim Floyd

ACCOUNTING MANAGER Eugenie Doualla

“You really can change the world if you care enough.”

contents

SR. PUBLISHER Keith J. Davis, Sr.

ASSOCIATE EDITOR Dawn Paul

through sexual activity. It’s also a major cause of cervical cancer. About 79 million Americans currently have HPV. Many people with HPV don’t know they are infected. And each year, more than 11,000 women in the United States get cervical cancer. Encourage the women in your family and community to get a regular exam.

As always, thank you for your continued support of d-mars. com. When you support us, you are supporting more than just our company; you are supporting the communities in which we live and work. Working together, we can succeed in making positive things happen.

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• Business Journal • Health & Wellness Journal • Community Journal • Black Pages Online Business Directory • Top 50 Black Health, Medical & Wellness Professionals • Top 50 Black Professionals & Entrepreneurs • Top 30 Influential Women of Houston • Top 25 Prime & Subcontractors for Diversity • Business Connection • Business Development • Business Consulting • Graphic Design • Photography • Printing • Web Design • Online & Email Marketing • Public Relations • Social Media • Advertising • Writing • Promotional Marketing

20 Policy 20 Affordable Care Act

22 Research 22 Research News: Cervical Cancer 22 School Lunches, Nutrition and Your Children 23 MD Anderson News 24 Sports Medicine 24 24 Sports and Concussions

CONTRIBUTING WRITERS Rhonda Dallas, B.S., C.L.C., N.C. Dr. LaTronica Fisher Dr. D Ivan Young National Eye Institute d-mars.com News Provider

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14-15 Cover Story 14-15 Cervical Health Awareness Month

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Other News You Can Use 04 A Message from God to You 05 FDA News 08 Health & Wellness Quiz 19 Health & Wellness Recipes 19

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4 | January 2017

A Message from God to You

Know this - God is pressing you for a reason. I’m here to tell you you’re much stronger than you think. He’s using travail to help you prevail. To whom much is given, much is required. By now, you’re wise enough to know who’s laughing at you instead of with you. By now, you’re wise enough to know who loves you as opposed to who lusts for you. Stop casting your pearls before swine. God is teaching you to be wise as a serpent and harmless as a dove.

The battle is over. God knows you’re weary. He was teaching you to stop putting your hope in people and to trust in yourself and in Him. Only He alone can renew your strength. Starting right now you will soar like an eagle; right now you will run and not grow weary. He’s already provisioned you with the strength you need to walk the rest of the way. You will NOT faint. The human eye has not seen, nor ear heard, neither has it entered into the hearts of men, the things which God has prepared for you. Now see the vision, write it down, and make it plain. It is your time. It is your season. I’ve already prayed for you. Please say one for me too.

By Dr. D Ivan Young Contributing Writer

Dear One,

know you feel pressed. I know you are tired. You may even feel devoid of hope, but know this - everything is working for your good. What do you do when you have given your all to everyone, and it’s never enough? What do you do when you’ve sacrificed everything for everyone and received nothing in return? What do you do when you feel as if there's nothing left to give? What do you do? Do you just shut down? Do you just tell everyone no more, not today? Don’t despair. I have good news. I’ve got an answer for you.

Be still. Allow God to be God. When you’re all tapped out, that’s when you can tap into the divine resources your Creator has set aside for you.

After more than a decade of practice, I've experienced all of the above and then some. What you don’t know is what I’ve been through. I’m human just like you. While dealing with my own

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I love you madly. I truly do.

Most sincerely, Dr. D Ivan Young bouts of anxiety and depression, while feeling discouraged, I had to muster up the courage to encourage you.

I, more than most know what it’s like to have people talk about me behind my back all because I wouldn’t allow them to continue exploiting me for resources

and connections. I also know what it’s like to go out of my way to help others when I needed some help myself. Beyond that, I know better than most what it’s like to comfort the brokenhearted when my heart was depleted and empty.

But God…

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For more wisdom from Dr. D Ivan Young, please visit him on the web at www. drdivanyoung.org.

#DrDIvanYoung #RelationshipExpert #Wisdom

January 2017 | 5

FDA Grants Accelerated Approval to New Treatment for Advanced Ovarian Cancer he U.S. Food and Drug Administration today granted accelerated approval to Rubraca (rucaparib) to treat women with a certain type of ovarian cancer. Rubraca is approved for women with advanced ovarian cancer who have been treated with two or more chemotherapies and whose tumors have a specific gene mutation (deleterious BRCA) as identified by an FDA-approved companion diagnostic test.

“Today’s approval is another example of the trend we are seeing in developing targeted agents to treat cancers caused by specific mutations in a patient’s genes,” said Richard Pazdur, M.D., director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research and acting director of the FDA’s Oncology Center of Excellence. “Women with these gene abnormalities who have tried at least two chemotherapy treatments for their ovarian cancer now have an additional treatment option.”

The National Cancer Institute estimates that 22,280 women will be diagnosed with ovarian cancer in 2016 and an estimated 14,240 will die of this disease. Approximately 15 to 20 percent of patients with ovarian cancer have a BRCA gene mutation.

BRCA genes are involved with repairing damaged DNA and normally work

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to prevent tumor development. However, mutations of these genes may lead to certain cancers, including ovarian cancers.

Rubraca is a poly ADP-ribose polymerase (PARP) inhibitor that blocks an enzyme involved in repairing damaged DNA. By blocking this enzyme, DNA inside the cancerous cells with damaged BRCA genes may be less likely to be repaired, leading to cell death and possibly a slowdown or stoppage of tumor growth.

Today, the FDA also approved the FoundationFocus CDxBRCA companion diagnostic for use with Rubraca, which is the first next-generation-sequencing (NGS)based companion diagnostic approved by the agency. The NGS test detects the presence of deleterious BRCA gene mutations in the tumor tissue of ovarian cancer patients. If one or more of the mutations are detected, the patient may be eligible for treatment with Rubraca.

The safety and efficacy of Rubraca were studied in two, single-arm clinical trials involving 106 participants with BRCA-mutated advanced ovarian cancer who had been treated with two or more chemotherapy regimens. BRCA gene mutations were confirmed in 96 percent of tested trial participants with available tumor tissue using the FoundationFocus CDxBRCA companion diagnostic. The trials measured the percentage of participants who experienced complete or partial shrinkage of their

tumors (overall response rate). Fifty-four percent of the participants who received Rubraca in the trials experienced complete or partial shrinkage of their tumors lasting a median of 9.2 months.

Common side effects of Rubraca include nausea, fatigue, vomiting, low levels of red blood cells (anemia), abdominal pain, unusual taste sensation (dysgeusia), constipation, decreased appetite, diarrhea, low levels of blood platelets (thrombocytopenia) and trouble breathing (dyspnea). Rubraca is associated with serious risks, such as bone marrow problems (myelodysplastic syndrome), a type of cancer of the blood called acute myeloid leukemia and fetal harm.

The agency approved Rubraca under its accelerated approval program, which allows approval of a drug to treat a serious or life-threatening disease or condition based on clinical data showing the drug has an effect on a surrogate (substi-

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tute) endpoint that is reasonably likely to predict clinical benefit. The sponsor is continuing to study this drug in patients with advanced ovarian cancer who have BRCA gene mutations and in patients with other types of ovarian cancer. The FDA also granted the Rubraca application breakthrough therapy designation and priority review status. Rubraca also received orphan drug designation, which provides incentives such as tax credits, user fee waivers and eligibility for exclusivity to assist and encourage the development of drugs intended to treat rare diseases.

Rubraca is marketed by Clovis Oncology, Inc. based in Boulder, Colorado.

The FoundationFocus CDxBRCA companion diagnostic is marketed by Foundation Medicine, Inc. of Cambridge, Massachusetts.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Source: www.fda.gov

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6 | January 2017

Glaucoma Awareness Month News From the National Eye Institute

laucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness. However, with early detection and treatment, you can often protect your eyes against serious vision loss.

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Howdoes doesthe theoptic opticnerve nerve How getdamaged damagedby byopen-angle open-angle get glaucoma? glaucoma?

Several large studies have shown that eye pressure is a major risk factor for optic nerve damage. In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues. The fluid leaves the chamber at the open angle where the cornea and iris meet. (See diagram below.) When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

In open-angle glaucoma, even though the drainage angle is “open”, the fluid passes too slowly through the meshwork drain. Since the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve.

When the optic nerve is damaged from increased pressure, open-angle glaucoma-and vision loss—may result. That’s why controlling pressure inside the eye is important.

Another risk factor for optic nerve damage relates to blood pressure. Thus, it is important to also make sure that your blood pressure is at a proper level

for your body by working with your medical doctor.

CanI Idevelop developglaucoma glaucomaififI Ihave Can have increased eye pressure? increased eye pressure?

Not necessarily. Not every person with increased eye pressure will develop glaucoma. Some people can tolerate higher levels of eye pressure better than others. Also, a certain level of eye pressure may be high for one person but normal for another.

Whether you develop glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged. This level is different for each person. That’s why a comprehensive dilated eye exam is very important.

It can help your eye care professional determine what level of eye pressure is normal for you.

CanI Idevelop developglaucoma glaucoma without without Can anincrease increasein inmy my eye eye pressure? pressure? an Yes. Glaucoma can develop without increased eye pressure. This form of glaucoma is called low-tension or normal-tension glaucoma. It is a type of open-angle glaucoma.

Whoisisat atrisk riskfor foropen-angle Who open-angle glaucoma? glaucoma?

Anyone can develop glaucoma. Some people, listed below, are at higher risk than others: • African Americans over age 40 • Everyone over age 60, especially Mexican Americans

• People with a family history of glaucoma A comprehensive dilated eye exam can reveal more risk factors, such as high eye pressure, thinness of the cornea, and abnormal optic nerve anatomy. In some people with certain combinations of these high-risk factors, medicines in the form of eyedrops reduce the risk of developing glaucoma by about half.

GlaucomaSymptoms Symptoms Glaucoma At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal. Glaucoma can develop in one or both eyes.

Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye. They seem to be looking through a tunnel. Over time, straight-ahead (central) vision may decrease until no vision remains.

drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

• Tonometry is the measurement of pressure inside the eye by using an instrument called a tonometer. Numbing drops may be applied to your eye for this test. A tonometer measures pressure inside the eye to detect glaucoma.

• Pachymetry is the measurement of the thickness of your cornea. Your eye care professional applies a numbing drop to your eye and uses an ultrasonic wave instrument to measure the thickness of your cornea.

Canglaucoma glaucomabe becured? cured?

Can No. There is no cure for glaucoma.

Vision lost from the disease cannot be restored.

How Howisisglaucoma glaucomadetected? detected?

Glaucoma GlaucomaTreatments Treatments

Glaucoma is detected through a comprehensive dilated eye exam that includes the following: • Visual acuity test. This eye chart test measures how well you see at various distances.

• Visual field test. This test measures your peripheral (side vision). It helps your eye care professional tell if you have lost peripheral vision, a sign of glaucoma.

• Dilated eye exam. In this exam,

Immediate treatment for early-stage, open-angle glaucoma can delay progression of the disease. That’s why early diagnosis is very important.

Glaucoma treatments include medicines, laser trabeculoplasty, conventional surgery, or a combination of any of these. While these treatments may save remaining vision, they do not improve sight already lost from glaucoma.

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Source: www.nei.nih.gov

January 2017  |  7

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8 | January 2017

Biotech

To Avoid Rheumatoid Arthritis, Brush Those Pearly Whites By d-mars.com News Provider

he idea that gum disease can be a driver of more detrimental systemic disorders has been kicked around the immunological community for a number of years; however, the molecular evidence linking the ideas together has been slow to accumulate. Yet now, investigators at Johns Hopkins University report they have new evidence that a bacterium, known to cause chronic inflammatory gum infections, also triggers the inflammatory autoimmune response characteristic of chronic, joint-destroying rheumatoid arthritis (RA). The researchers believe that these new findings have important implications for the prevention and treatment of RA. "This is like putting together the last few pieces of a complicated jigsaw puzzle that has been worked on for many years," remarked senior study investigator Felipe Andrade, M.D., Ph.D., associate professor of medicine at the Johns Hopkins University School of Medicine.

The findings from this study, which were published recently in Science Translational Medicine in an article entitled “Aggregatibacter actinomycetemcomitans–Induced Hypercitrullination Links Periodontal Infection to Autoimmunity in Rheumatoid Arthritis,” describes a common denominator the Hopkins team identified in periodontal disease and many people with RA—the bacteria A. actinomycetemcomitans. Infection with A. actinomycetemcomitans appears to induce the production of citrullinated proteins, which are suspected of activating the immune system and driving the cascade of events leading to RA. "This research may be the closest we've come to uncovering the root cause of RA," noted lead study investigator Maximilian Konig, M.D., a former

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Johns Hopkins University School of Medicine fellow now at Massachusetts General Hospital.

The clinical association between periodontal disease and RA was first noticed in the early 1900s, and over time, researchers have suspected that both diseases may be triggered by a common factor. In recent years, studies have focused on a bacterium known as Porphyromonas gingivalis, found in patients with gum disease. However, while major efforts are currently ongoing to demonstrate that this bacterium causes RA by inducing citrullinated proteins, all attempts by this research team have failed to corroborate such a link. Dr. Andrade and his colleagues have persisted on finding alternative bacterial drivers because of intriguing links between periodontal disease and RA. “We used mass spectrometry to define the microbial composition and antigenic repertoire of gingival crevicular fluid in patients with periodontal disease and healthy controls,” the authors wrote.

“Periodontitis was characterized by the presence of citrullinated autoantigens

that are primary immune targets in RA. The citrullinome in periodontitis mirrored patterns of hypercitrullination observed in the rheumatoid joint, implicating this mucosal site in RA pathogenesis. Proteomic signatures of several microbial species were detected in hypercitrullinated periodontitis samples. Among these, Aggregatibacter actinomycetemcomitans (Aa), but not other candidate pathogens, induced hypercitrullination in host neutrophils.”

Citrullination happens naturally in everyone as a way to regulate the function of proteins. However, in people with RA, this process becomes overactive, resulting in the abnormal accumulation of citrullinated proteins. This drives the production of antibodies against these proteins that create inflammation and attack a person's own tissues, the hallmark of RA. The Hopkins team found that A. actinomycetemcomitans was the only pathogen able to induce hypercitrullination in neutrophils, which are highly enriched with the peptidylarginine

deiminase (PAD) enzymes required for citrullination. Neutrophils are the most abundant inflammatory cells found in the joints and the gums of patients with RA and periodontal disease, say the researchers. These cells have been studied for many years as the major source of hypercitrullination in RA. Moreover, the investigators found that A. actinomycetemcomitans initiates hypercitrullination through the bacterial secretion of a toxin—leukotoxin A (LtxA)—as a self-defense strategy to kill host immune cells. The toxin creates holes on the surface of neutrophils, allowing a flux of high amounts of calcium into the cell where concentrations are normally kept low. Since the PAD enzymes are activated by calcium, the increased exposure overactivates these enzymes, generating hypercitrullination.

Gathering 196 samples from a large study of patients with RA, the researchers found that almost half of the patients—92 out of 196—had evidence of infection by A. actinomycetemcomitans. These data were similar to patients with periodontal disease, with approximately 60% positivity, but quite different in healthy controls, where 11% of people were positive for A. actinomycetemcomitans. More strikingly, exposure to A. actinomycetemcomitans was a major determinant in the production of antibodies to citrullinated proteins in patients with genetic susceptibility to RA. However, the scientists cautioned against overinterpretation of the results, as more than 50% of the study participants who had RA had no evidence of infection with A. actinomycetemcomitans, which, they say, may indicate that other bacteria in the gut, lung, or elsewhere could be using a similar mechanism to induce hypercitrullination.

Source: www.genengnews.com

Health & Wellness Quiz: Test Your Health Knowledge 1. People who regularly eat dinner or breakfast in restaurants double their risk of becoming obese.

TRUE or FALSE? 2. Farting helps reduce high blood pressure and is good for your health. TRUE or FALSE? 3. Laughing 100 times is equivalent to 45 minutes of exercise on a stationary bicycle. TRUE or FALSE? 4. Sitting for more than three hours a day can cut two years off a person's life expectancy.

TRUE or FALSE? 5. Sleeping less than 5 hours each night reduces your life expectancy. TRUE or FALSE? 6. 1 Can of Soda a day increases your chances of getting type 2 diabetes by 22%. TRUE or FALSE? 7. The U.S. spends more money per person on health-

care than any other developed country, and its life expectancy is above average. TRUE or FALSE? 8. Eating too much meat can accelerate your body's biological age. TRUE or FALSE? 9. The first heart transplant using a "dead heart" was performed by surgeons in California, in 2012.

TRUE or FALSE? 10. Working past age 65 is linked to a shorter life, a study found. TRUE or FALSE? 11. People who read books live an average of almost 2 years longer than those who do not read at all, a Yale research found. TRUE or FALSE? 12. Road traffic accidents kill more people around the world than malaria. TRUE or FALSE? 13. You can burn 50% more fat by exercising in the

morning on an empty stomach. TRUE or FALSE? 14. "Rhinorrhea" is the medical condition otherwise known as a "runny nose." TRUE or FALSE? 15. A father's diet before conception plays a crucial role in a child's health. TRUE or FALSE?

Answers: 1.) True | 2.) True | 3.) False. It is equivalent to 15 minutes of exercise on a stationary bicycle | 4.) True | 5.) False.

Less than 7 hours | 6.) True | 7.) False. Its life expectancy is below average. | 8.) True | 9.) False. It was performed by surgeons in Australia, in October 2014 | 10.) False. It is linked to a longer life | 11.) True | 12.) True | 13.) False. You can burn 20% more fat. | 14.) True | 15.) True Source: www.factslides.com

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January 2017  |  9

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10 | January 2017

Business

4 New Rules for

Effective Hospital Marketing By d-mars.com News Provider ospital marketing has taken an unexpected turn: Because of a policy that ties 30% of hospitals’ Medicare reimbursements to patient satisfaction scores, some hospitals are using hotel-like amenities to attract and pamper patients. But these luxuries don’t assuage concerns about high healthcare costs.

If your hospital’s marketing program misses the mark in any of the following ways, then it’s time to reconsider how you present yourself to patients: • Non-Care Orientation. Hospitals that focus on luxuries misunderstand why patients choose hospitals.

According to Gallup, patients choose hospitals on the basis of the facilities’ specific treatment expertise and medical-error histories. What’s more, research on 31 U.S. hospitals conducted by the Johns Hopkins University School of Medicine found no link between patient satisfaction and surgical care quality scores.

While patient satisfaction should be a priority, it can’t replace measures of quality.

• Overuse of Outbound Tactics. While many hospitals still use television ads and direct mail tactics to snare patients, the marketing world has moved solidly away from outbound techniques. Instead, HubSpot found 92.3% of companies using inbound tactics such as blogs, search engine optimization, and social media see increased site traffic, and 92.7% of companies report inbound marketing increases lead generation.

• Short-Term Focus. Healthcare marketing requires patience. The great majority of individuals don’t need care immediately, so hospital marketing must understand the long-term nature of the work. Someone might view an advertisement or marketing materials for your hospital but not need health service for months or even years. Patience and persistent community outreach are must-haves for hospital marketers trying to win new patients.

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NewRules Rulesfor forHospital Hospital Marketing New Marketing Hospital marketing can be a boon for hospitals and patients, but gone are the days when direct mail magazines speak to consumers – postcards and newsletters go straight into recycling cans. Today, people first go online for health information. Many Google their symptoms, while others look to sites such as WebMD or social media for information.

Here’s how to bring your marketing program into the 21st century – and how to maximally benefit both the hospital and the community.

Prioritize Social Media. Hospitals have been notoriously slow to adopt social media, but those channels are remarkably effective (and free) ways to reach prospective patients. Across industries, marketers spend

just 15% of their budgets on social media, but 79% of marketers view social media as the most effective digital channel.

Hospital marketers should look to the Mayo Clinic when crafting a socially savvy strategy. Its Center for Social Media was the first of its kind, and the worldrenowned medical organization has a YouTube channel that presents physician interviews, how-to videos and stories about everyday people receiving care. Patients get eyewitness reports of the Mayo Clinic experience, from check-in to follow-up care. It’s a better way to educate patients about their health while positioning the Mayo Clinic as a world leader in care.

Increase Content Marketing. With 80% of Internet users searching online for answers to their health questions, it’s in all parties’ best interests for hospitals to increase their content production.

Cleveland Clinic has been an early adopter of content marketing. The healthcare provider’s Health Hub is an online center for health tips and news, physician blogs and expert Q&As. The hospital’s doctors and nurses have provided exclusive content, and consumers have come flocking. Since its launch in May 2012, the site has posted traffic numbers exceeding 100,000 visitors per month.

Invest in Community Health. In August, the U.S. Department of Health and Human Services allocated $169 million for community health programs associated with the Affordable Care Act. By embracing this paradigm for hospital marketing, hospitals can both help community members and improve mindshare.

Allina Health, an early adopter of community health programs, awarded grants to initiatives that improve environmental and social conditions, such as community gardens, improved transportation, and nutrition education for students. Kaiser Permanente, for its part, found schools are the natural place to reach community members and “should be seen as an extension of the delivery system.”

Look to form partnerships with community stakeholders such as elementary schools and elder care centers. Found your outreach program on health concerns important to the community, such as improving access to care, increasing preventive services, managing chronic conditions and offering behavioral health programs.

Come Bearing Gifts. One marketing adage that hasn’t been replaced online is “leave something behind.” Don’t overlook the branding opportunity in healthy lifestyle tools. For a few hundred dollars, a hospital can personalize hundreds of products to spread the message.

Long after the hospital outreach team has left the premises, patients keep and use low-cost healthcare products such as stress balls, pill boxes, pedometers, first-aid kits and hand sanitizers. These tools provide a constant reminder to stay fit and take your medicine – messages that promote community health and enhance healing.

For all hospitals’ advanced care technologies, marketing has lagged behind. Evaluate how your hospital might be falling short, and then follow these new rules for hospital marketing. Your community – and your bottom line – will thank you.

Source www.healthcarebusinesstech.com

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January 2017  |  11

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12 | January 2017

Career

Explore This Career: Art Therapist

By d-mars.com News Provider

rt therapy is an established mental health profession that uses the creative process of art making to improve and enhance the physical, mental and emotional well-being of people at all ages. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and selfawareness and achieve insight.

Art therapy integrates the fields of human development, visual arts and the creative process with models of counseling and psychotherapy. Art therapy is used with children, adolescents, adults, older adults, groups and families to assess and treat: • Anxiety, depression and other mental/emotional problems • Mental illness • Substance abuse and other addictions • Family and relationship issues • Abuse and domestic violence • Social/emotional difficulties related to disability or illness

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• Personal trauma, post-traumatic stress disorder and loss • Physical, cognitive and neurological problems • Psychosocial difficulties related to medical illness Some art therapists work as part of a health care team that includes physicians, psychologists, nurses, mental health counselors, marriage and family therapists, rehabilitation counselors, social workers and teachers. Together, they determine and implement a client’s therapeutic goals and objectives. Other art therapists work independently and maintain private practices with children, adolescents, adults, groups and/or families.

If you’re considering this career, keep in mind that an art therapist needs certain personal qualities – such as sensitivity, empathy, emotional stability, patience, interpersonal skills, insight into human behavior and an understanding of artistic media. An art therapist must be an attentive listener and a keen observer. Flexibility and a sense of humor are also invaluable.

WorkingConditions Conditions Working Art therapists work in a wide variety of settings -- including, to name a few: • Hospitals and clinics, both medical and psychiatric • Outpatient mental health agencies and day treatment facilities • Residential treatment centers

• Halfway houses • Domestic violence and homeless shelters • Community agencies and nonprofit settings • Sheltered workshops • Schools, colleges and universities • Correctional facilities • Elder care facilities • Art studios • Private practice Salaries for art therapists vary widely.

Salaries for those just beginning in the career are generally around $30,000 to $40,000 while those with experience may earn salaries over $100,000. Keep in mind that salaries will vary considerably, depending on experience, location and type of practice.

Academic Requirements Art therapists must have a master's degree in art therapy or counseling or a related field with an emphasis in art therapy and must complete the required core curriculum as outlined in the American Art Therapy Association's (AATA) education standards.

AATA-approved art therapy programs generally consist of 48 to 60 semester credits (or approximately 18 months to 2 years of full-time education). The typical curriculum includes: • History and theory of art therapy • Techniques or practice in art therapy • Application of art therapy with

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people in different treatment settings • Understanding of group art therapy and counseling methods and skills • Ethical and legal issues of art therapy practice • Art therapy assessment • Standards of practice in art therapy • Cultural and social diversity • Thesis or culminating project In addition, each art therapy student must complete a practicum or internship, involving a minimum of 700 hours of supervised art therapy practice, at least half of which must be spent working directly with patients in individual, group or family formats. There also are opportunities for specialization (i.e., specific patient age groups, practice settings and types of intervention).

AATAmaintains maintainsaalist listofofapproved AATA approved schools. schools.

After receiving a master's degree in art therapy, accumulating the required number of supervised hours and submitting professional references attesting to your competency, you may apply to become a registered art therapist (ATR) through the Art Therapy Credentials Board (ATCB). After being granted the ATR, you then can sit for the board certification (ATR-BC) examination. The exam is offered once a year at various locations throughout the United States.

Source: explorehealthcareers.org

January 2017 | 13

Education

Ways Going to College Affects Your Health C

ountless young people are working on their college education. Though it may seem like a breeze, there are students who are dealing with pressures in college. Some may face challenges to their health, both physical and mental, that may have long-term effects reaching well past their undergraduate years.

“I advise students to maintain a balance,” says James Davidson, assistant vice president for student wellness at the University of Nevada. “Your health is more than the physical condition of your body. There are multiple aspects of wellness to consider… When one area gets out of balance, it usually affects the other aspects of your life, whether you realize it or not.”

Some of the challenges college students face are stress, the psychological effects of debt, and sleep deprivation.

Below are some additional health issues that college students face as they embark on higher learning: Binge drinking - Up to 40 percent of all college students report engaging in binge drinking (typically defined as consuming four drinks on one occasion for women, and five drinks on one

occasion for men). The behavior does a number on students’ brains, with research showing that young adults who drink heavily have abnormalities in the gray and white matter of their brains.

While binge drinking has an array of short-term negative effects, it can have more residual effects as well. A survey of 1,972 U.S. college students, interviewed during their college years and again 10 years later, found that some binge drinkers were more likely to experience alcohol dependence and alcohol abuse later in life. They also had poorer job opportunities and a higher risk of dropping out of college.

Depression - Research shows that college students face heightened levels of depression and anxiety, with freshman often suffering the most from these issues as they adjust to a new environment.

The conditions can also lead to increased substance abuse, poor academic achievement and suicide. Depression often goes unreported by college students, but some studies suggest that students are becoming more comfortable in speaking out about this problem – the rate of reporting depression is increasing.

Social anxiety - Most college students experience a brand-new social environment upon entering college, and research confirms that almost all of them experience varying levels of social anxiety and stress. One study that followed the social lives of 53 college women for five years found that social hierarchy was a dominant force in their lives, and that

pressure to achieve high social status was prevalent. The study also found that social stresses were correlated with excessive drinking, and could lead to poorer academic and life outcomes due to a ‘partying’ lifestyle.

Weight gain - While many new college students fear the fabled “freshman 15,” the addition of 15 extra pounds is not as common as it’s made out to be.

“Less than 5 percent of students are likely to gain 15 pounds during the freshman year,” said Sareen Gropper, a professor of nutrition at Auburn University in Alabama. “Instead, the typical college freshman gains anywhere from 3 to 5 pounds.” And what makes the pounds pile on? College students tend to eat more high-calorie foods, and fail to get enough physical activity, Gropper said. “Those foods are often consumed late at night while studying, as well as during evening social activities.” With effort and planning, healthy eating can easily be achieved on any meal plan.”

Casual sex - Although many college students engage in casual sex, a study of more than 1,800 18-to-25-year-olds

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who had completed at least one year of college found that the students were not any more promiscuous during their first year of college, than they were in the years prior to college. Nonetheless, studies show that college students believe their peers are much more sexually active than is actually the case. Commonplace or not, casual sex comes with health risks, including sexually transmitted diseases, emotional and mental distress, sexual violence and unintended pregnancy.

Long-termhealth healtheffects effectsofofaa Long-term college degree college degree While the health risks that can come with college may seem intimidating, overall, college tends to be good for a person’s body and mind. Higher levels of education generally correlate to better health, as well economic success and family stability, which can indirectly lead to better health outcomes. People with higher levels of education tend to have improved brain development, less biological aging and better understanding and compliance with healthy behaviors, studies show. Furthermore, research shows that education is associated with a longer life.

Thus, while college life can present some challenges, the research still supports sticking it out at school.

Story Source: www.livescience.com

14 | January 2017

Helping Spread the W

By d-mars.com News Provider

C

ervical Health Awareness Month is a chance to raise awareness about how women can protect themselves from HPV (human papillomavirus) and cervical cancer. HPV is a very common infection that spreads through sexual activity. It’s also a major cause of cervical cancer. About 79 million Americans currently have HPV. Many people with HPV don’t know they are infected. And each year, more than 11,000 women in the United States get cervical cancer.

Whatisiscervical cervicalcancer? cancer?

What Cervical cancer is cancer that starts in the cervix, the narrow opening into the uterus from the vagina. The normal “ectocervix” (the portion of the uterus extending into the vagina) is a healthy pink color and is covered with flat, thin cells called squamous cells.

The “endocervix” or cervical canal is made up of another kind of cell called columnar cells. The area where these cells meet is called the “transformation zone” (T-zone) and is the most likely location for abnormal or precancerous cells to develop.

Most cervical cancers (80 to 90 percent) are squamous cell cancers. Adenocarcinoma is the second most common type of cervical cancer, accounting for the remaining 10 to 20 percent of cases. Adenocarcinoma develops from the glands that produce mucus in the endocervix. While less common than squamous cell carcinoma, the incidence of adenocarcinoma is on the rise, particularly in younger women.

More than 12,000 women in the United States will be diagnosed with cervical cancer each year, and more than 4,000 of women will die. Cervical cancer is the second most common type of cancer for women worldwide, but because it develops over time, it is also one of the most preventable types of cancer. Deaths from cervical cancer in the United States continue to decline by approximately 2 percent a year. This decline is primarily due to the widespread use of the Pap test to detect cervical abnormalities and allow for early treatment. Most women who have abnormal cervical cell changes that progress to cervical cancer have never had a Pap test or have not had one in the previous three to five years.

Cancer of the cervix tends to occur during midlife. Half of the women diagnosed with the disease are between 35 and 55 years of age. It rarely affects women under age 20, and approximately 20 percent of diagnoses are made in women older than 65. For this reason, it is important for women to continue Experience Our World of Advertising, Marketing, Media and Communication

January 2017 | 15

Word and Keeping cervical cancer screening until at least the age of 70. Some women need to continue screening longer, so ask your health care provider what’s best for you.

Whatcauses causescervical cervical cancer?

What cancer?

Human papillomavirus (HPV) is found in about 99% of cervical cancers. There are over 100 different types of HPV, most of which are considered low-risk and do not cause cervical cancer. High-risk HPV types may cause cervical cell abnormalities or cancer. More than 70 percent of cervical cancer cases can be attributed to two types of the virus, HPV16 and HPV-18, often referred to as high-risk HPV types.

HPV is estimated to be the most common sexually transmitted infection in the United States. In fact, by age 50 approximately 80% of women have been infected with some type of HPV. The majority of women infected with the HPV virus do NOT develop cervical cancer. For most women the HPV infection does not last long; 90% of HPV infections resolve on their own within 2 years. A small number of women do not clear the HPV virus and are considered to have “persistent infection. A woman with a persistent HPV infection is at greater risk of developing cervical cell abnormalities and cancer than a woman whose infection resolves on its own. Certain types of this virus are able to transform normal cervical cells into abnormal ones. In a small number of cases and usually over a long period of time (from several years to several decades), some of these abnormal cells may then develop into cervical cancer.

SymptomsofofCervical Cervical Cancer Symptoms Cancer Precancerous cervical cell changes and early cancers of the cervix generally do not cause symptoms. For this reason, regular screening through Pap and HPV tests can help catch precancerous cell changes early and prevent the development of cervical cancer.

Possible symptoms of more advanced disease may include abnormal or irregular vaginal bleeding, pain during sex, or vaginal discharge. Notify your healthcare provider if you experience: • Abnormal bleeding, such as: • Bleeding between regular menstrual periods • Bleeding after sexual intercourse • Bleeding after douching • Bleeding after a pelvic exam • Bleeding after menopause • Pelvic pain not related to Experience Our World of Advertising, Marketing, Media and Communication

your menstrual cycle • Heavy or unusual discharge that may be watery, thick, and possibly have a foul odor • Increased urinary frequency • Pain during urination These symptoms could also be signs of other health problems, not related to cervical cancer. If you experience any of the symptoms above, talk to a healthcare provider.

Thegood goodnews? news?

The • The HPV vaccine (shots) can prevent HPV. • Cervical cancer can often be prevented with regular screening tests (called Pap tests) and follow-up care.

Cervical cancer screenings can help detect abnormal (changed) cells early, before they turn into cancer. Most deaths from cervical cancer could be prevented by regular Pap tests and follow-up care.

Howcan canCervical Cervical Health Health Awareness How Awareness Month make a difference?

Month make a difference?

We can use this opportunity to spread the word about important steps women can take to stay healthy.

Hereare arejust justa afew fewideas: ideas: Here • Encourage women to get their well-woman visit this year.

• Let women know that most insurance plans must cover well-woman visits and cervical cancer screening. This means that, depending on their insurance, women can get these services at no cost to them.

• Talk to parents about how important it is for their pre-teens to get the HPV vaccine. Both boys and girls need the vaccine.

How can I help spread the word?

• Add information about HPV and cervical cancer prevention to your newsletter.

• Tweet about Cervical Health Awareness Month.

• Host a community event to raise awareness about cervical health.

Sources: U.S. Department of Health and Human Services National Cervical Cancer Coalition

16 | January 2017

Healthy Lifestyles

Reasons 2 Stop Smoking in 2017 What Happens When You Quit

Dr. LaTronica Fisher Contributing Writer

moking is the leading cause of preventable death in the United States. Cigarette smoking and exposure to secondhand smoke cause an estimated average of 438,000 premature deaths each year in the United States. Of these premature deaths: • 40 percent are from cancer.

Cigarette smoking causes many types of cancer, including cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach, and cervix, as well as acute myeloid leukemia.

• 35 percent are from heart disease and stroke.

• 25 percent are from lung disease.

This includes chronic lung diseases, bronchitis, emphysema, and sthma.

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• Immediately after quitting smoking, heart rate and blood pressure, which is abnormally high while smoking, begin to return to normal.

• Within a few weeks, circulation improves, you don’t produce as much phlegm, and you don’t cough or wheeze as often.

• Food tastes better, and your sense of smell returns to normal.

• Everyday activities no longer leave you out of breath.

• Within several months of quitting, you experience significant improvements in lung function.

• In one year, your risk of heart disease, heart attack, and stroke is halved.

• In five years, many kinds of cancer, including lung, larynx, mouth, stomach, cervix, bladder, show decline in risk, and that decline approaches the risk of someone who has never smoked.

• Conditions such as cataracts, macular degeneration, thyroid conditions, hearing loss, dementia, and osteoporosis are positively affected.

• Nerve endings in the mouth and nose begin to regenerate, improving taste and smell.

• You’ll have decreased risk for impotence and infertility.

• Years will be added to your life: people who quit smoking, regardless of their age, are less likely than those who continue to smoke to die from smoking-related illness.

Preparing to Quit Quitting is hard. But quitting can be a bit easier if you have a plan. Before you actually quit, it's important to know why you're doing it. Do you want to be healthier? Save money?

Keep your family safe? If you're not sure, ask yourself these questions:

• What do I dislike about smoking?

• What do I miss out on when I smoke?

• How is smoking affecting my health?

• What will happen to me and my family if I keep smoking?

• How will my life get better when I quit?

Dr. Fisher has a proven system that has already helped thousands to remove the restrictions to healing. Dr. Fisher assists in helping prepare the body to heal.

In addition, she helps re-educate the body to heal, produce its own hormones, and restore optimal wellness. For more information on how to get tested, please contact Dr. Fisher at (713) 5208188 or drfisherroad2wellness@ gmail.com.

Resources: www.tobaccofreemaine.org www.smokefree.gov

Healthy Lifestyles

Starting the Year off Light

By Rhonda Dallas Contributing Writer

s a certified life coach and nutritional counselor, I am often referred to as “Coach D” by my clients. On several occasions I get the question, “What is BMI and why is this so important to my health?”

BMI stands for Body Mass Index, and it is the measure of body fat based on height and weight that applies to adult men and women. It is very important to maintain a healthy BMI weight. Below

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please see BMI categories from the U.S. Department of Health and Human Services (HHS).

er food portions.

I encourage you to eat healthier and start getting physical. Also, get the family involved by exercising together as a unit and prepare your family healthier meals. The weight loss journey is not easy, so if you need accountability, seek the services of a credible health and wellness professional. Start the year off light!

BMI Categories: Underweight = <18.5 Normal weight = 18.5–24.9 Overweight = 25–29.9 Obesity = BMI of 30 or greater Now why is this so important? For every pound over, we risk several health challenges. The higher our BMI, the higher risk we face for certain diseases such as heart disease, high blood pressure, type 2 diabetes, and breathing challenges.

As a certified health and wellness life coach, it is important to me for my family, my friends, my clients, and my readers to know that being overweight and obese can have a dangerous impact on your total

health and life expectancy. BMI is so important that physicians have started tracking your body fat and are required to document it in your electronic medical record.

Being overweight can be attributed to lack of exercise for our children and youth who grow up to be obese adults.

Also, video games and social media play a part, allowing young people to sit for hours and punch buttons which limit exercise, reduce the amount of time at school for recess, and can encourage larg-

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Rhonda Dallas is a certified life coach and nutritional counselor.

Rhonda offers Healthy Lifestyle Living Classes for adults and children, as well as vitamins and natural holistic weight loss packages that include coaching sessions to ensure you are held accountable. Contact Rhonda at rhondadallasconsulting@gmail.com for your coaching session.

Get started today!

January 2017 | 17

News From the National Alliance on Mental Illness following:

Know the Warning Signs By d-mars.com News Provider

ental illness is real. It is something that we no longer need to sweep under the rug. Staying silent is not the answer. The latest national and local news coverage shining the spotlight on mental illness makes this something that can no longer be ignored. Unfortunately, many of us are unaware of the warning signs of someone who is dealing with mental illness.

However, there are organizations out there that are raising awareness, providing vital information, and support. The National Alliance on Mental Illness (NAMI) is one of those organizations.

NAMI is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.

Trying to tell the difference between what expected behaviors are and what might be the signs of a mental illness isn’t always easy. There’s no easy test that can let someone know if there is mental illness or if actions and thoughts might be typical behaviors of a person or the result of a physical illness.

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Each illness has its own symptoms, but common signs of mental illness in adults and adolescents can include the

• Excessive worrying or fear • Feeling excessively sad or low • Confused thinking or problems concentrating and learning • Extreme mood changes, including uncontrollable “highs” or feelings of euphoria • Prolonged or strong feelings of irritability or anger • Avoiding friends and social activities • Difficulties understanding or relating to other people • Changes in sleeping habits or feeling tired and low energy • Changes in eating habits such as increased hunger or lack of appetite • Changes in sex drive • Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality) • Inability to perceive changes in one’s own feelings, behavior or personality (”lack of insight” or anosognosia) • Abuse of substances like alcohol or drugs • Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing “aches and pains”) • Thinking about suicide • Inability to carry out daily activities or handle daily problems and stress • An intense fear of weight gain or

able in your community.

If you or someone you know needs helps now, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.

Receiving a Diagnosis

concern with appearance (mostly in adolescents) Mental health conditions can also begin to develop in young children. Because they’re still learning how to identify and talk about thoughts and emotions, their most obvious symptoms are behavioral. Symptoms in children may include the following: • Changes in school performance • Excessive worry or anxiety, for instance fighting to avoid bed or school • Hyperactive behavior • Frequent nightmares • Frequent disobedience or aggression • Frequent temper tantrums

Where to Get Help Don’t be afraid to reach out if you or someone you know needs help. Learning all you can about mental health is an important first step.

Reach out to your health insurance, primary care doctor or state/country mental health authority for more resources.

Contact the NAMI HelpLine to find out what services and supports are avail-

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Knowing warning signs can help let you know if you need to speak to a professional. For many people, getting an accurate diagnosis is the first step in a treatment plan.

Unlike diabetes or cancer, there is no medical test that can accurately diagnose mental illness. A mental health professional will use the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, to assess symptoms and make a diagnosis. The manual lists criteria including feelings and behaviors and time limits in order to be officially classified as a mental health condition.

After diagnosis, a health care provider can help develop a treatment plan that could include medication, therapy or other lifestyle changes.

Finding Treatment Getting a diagnosis is just the first step; knowing your own preferences and goals is also important. Treatments for mental illness vary by diagnosis and by person. There’s no “one size fits all” treatment. Treatment options can include medication, counseling (therapy), social support and education.

Source: www.nami.org

18â&#x20AC;&#x201A; |â&#x20AC;&#x201A; January 2017

Medicine

Unique Dialysis Device With Telehealth Capabilities Connects Home Therapy Patient to Doctor 250 Miles Away By d-mars.com News Provider

oann Still is living the life she wants despite a 21 year battle with a medical condition that caused her kidneys to stop working. Fortunately, recent advancements in medical technology allow Still to maintain her home in rural Nebraska and an active life filled with family, friends and work - 250 miles away from her doctor. Still performs peritoneal dialysis at home in the evenings while she sleeps. Meanwhile, her healthcare providers are using a firstof-its-kind, two-way telehealth platform to monitor Still's therapy and securely adjust her treatment from their office in Lincoln, Nebraska.

A mother of three, Still has lived and worked in rural Nebraska her entire life.

In her late forties, she was diagnosed with membranous nephropathy, a kidney disease that can progress to endstage renal disease (ESRD) requiring patients to go on dialysis therapy or receive a transplant. As time went on and the disease gained momentum, she began feeling worse and worse.

"I did not realize how much I had declined and how bad I was feeling," Still said. "I didn't have the energy to work in the yard, go anywhere or do anything. I was just existing."

Earlier this year, Still's doctor indicated she needed to start dialysis to filter toxins from her blood, the work her kidneys were no longer performing. Current dialysis options include peritoneal dialysis (PD) or hemodialysis (HD).

PD is a self-administered therapy managed at home by patients. The therapy works inside the body, overnight,

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using the abdominal lining as a natural filter to remove toxins from the bloodstream. PD therapy also may facilitate preservation of a person's remaining kidney function. During HD, a patient's blood is sent through a filter to remove toxins from the body. HD is usually performed at a hospital or dialysis center three times a week for three to five hours per session.

From her peaceful ranch in Nebraska, the nearest HD center is 80 miles away.

The three-hour commute, in addition to a four-hour treatment session would make it hard for Still to maintain her home and lifestyle. And, she would need someone to transport her to and from the treatment sessions, which created additional challenges for her and her adult children's work schedules. For Still, PD therapy provided the best clinical and lifestyle option.

"My peritoneal dialysis has been so easy to do at night, by myself, and then I get up and go about my day - doing whatever I want," Still said.

Still's renal care team in Lincoln offered her access to the AMIA Automated Peritoneal Dialysis System with the SHARESOURCE remote patient management platform, a unique home dialysis system developed by Baxter.

"The best part of the AMIA system is that it is patient-friendly," Still said. "The machine walks you through the steps for my treatment preparation. All I have to do is listen to her; there are pictures on the screen to guide me, as well. Overall, it is very simple."

AMIA was designed so more patients may have the ability to perform therapy from their home with intuitive features,

such as voice guidance, a touchscreen control panel and the SHARESOURCE remote patient management platform.

AMIA also is up to 40 percent smaller and 30 percent lighter than another cycler on the market, HOMECHOICE, and features a folding design when the touch screen is not in use. [1], [2] The compact design means Still can pack AMIA in her car or take it on an airplane, enabling her to conduct therapy when traveling for work or leisure.

Still tested this out earlier in the year when she traveled with the AMIA system to Texas for her granddaughter's high school graduation.

SHARESOURCE is a secure telehealth platform that also allows Still's healthcare providers to proactively manage her care by viewing recently completed home dialysis-related treatment data that is automatically collected after each PD session. Her healthcare providers can then act on this information by remotely adjusting her home device settings without requiring her to go to the clinic.

"It's like knowing you've got a guardian angel looking over you," Still added.

Still now visits her nephrologist in Lincoln once a month, a much simpler commute than traveling three days a week for hemodialysis therapy. And between her monthly visits, Still feels confident about her healthcare team in Lincoln being able to view data from her therapy sessions in a timely manner.

"Peritoneal dialysis has given me my life back," Still said. "I encourage anyone facing kidney failure to talk with their nephrologist about all their treatment options, including doing peritoneal di-

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alysis at home."

The AMIA Automated PD System is intended for automatic control of dialysate solution exchanges in the treatment of adult renal failure patients undergoing peritoneal dialysis. All therapies using the AMIA Automated PD System must be prescribed and performed under the responsibility of a physician who is familiar and well-informed about peritoneal dialysis.

The SHARESOURCE remote patient management platform is intended for use by healthcare professionals to remotely communicate new or modified treatment parameters with compatible dialysis instruments and transfer completed treatment data to a central database to aid in the review, analysis, and evaluation of patient's historical treatment results. This system is not intended to be a substitute for good clinical management practices, nor does its operation create decisions or treatment pathways.

Baxter, AMIA, SHARESOURCE and HOMECHOICE are trademarks of Baxter International, Inc. Rx only. For safe and proper use of the devices mentioned herein, refer to the complete instructions in the Operator's Manual.

This is one patient's perspective. Individual results may vary. Talk with your healthcare provider for therapy options that are best for you.

[1] Amia Automated PD System Patient Guide. Baxter Healthcare Corporation. Deerfield, IL. [2] HomeChoice and HomeChoice PRO APD Systems Patient At-Home Guide. Baxter Healthcare Corporation.

Deerfield, IL. -BPT

January 2017 | 19

Healthy Soul Food Recipes You can eat healthy and enjoy your soul food favorites.

Below see some soul food recipes that are flavorful with less calories.

For more recipes, please visit www.eatingwell.com.

Collard Green & Black-Eyed Pea Soup

One-Bowl Chocolate Cake This easy-to-make chocolate cake is dark, moist, rich—and only dirties one bowl! Not quite as easy as boxed cake mixes, but those often contain trans fats. Our simple “from scratch” recipe gives you a home-baked cake with healthful canola oil and whole-wheat flour.

Antioxidant-rich collard greens and fiber-packed black-eyed peas have a starring role in this nutritious soup. There’s no need for loads of ham or salt pork—just a small amount of bacon gives it a wonderful smoky flavor. You can skip the bacon and substitute vegetable broth for chicken broth for a great vegetarian dish.

Shrimp Po’ Boy This twist on the Louisiana favorite piles grilled shrimp and creamy-dressed cabbage onto a crusty bun. Bread that’s soft on the inside and crusty on the outside is perfect for a Po’ Boy sandwich. We grill both sides of a whole-wheat bun for that added crunch. You may need a few extra napkins to enjoy it, but this quick and easy sandwich is well worth it. Serve with: Sauteed corn and bell peppers.

Ingredients Ingredients • • • • • • • • • •

1 tablespoon extra-virgin olive oil 1 large onion, diced 1 large carrot, sliced 1 stalk celery, sliced 5 cloves garlic, (4 sliced and 1 whole), divided 1 sprig fresh thyme ¼ teaspoon crushed red pepper, or to taste 4 cups reduced-sodium chicken broth 1 15-ounce can diced tomatoes 5 cups chopped collard greens, or kale leaves (about 1 bunch), tough stems removed • 1 15-ounce can black-eyed peas, rinsed • 6½-inch-thick slices baguette, preferably whole-grain, cut on the diagonal • 6 tablespoons shredded Gruyère or Swiss cheese • 2 slices cooked bacon, finely chopped

Preparation

Ingredients

1. Heat oil in a Dutch oven over medium heat. Add onion, carrot and celery and cook, stirring, until just tender, 5 to 7 minutes. Add sliced garlic, thyme and crushed red pepper and cook, stirring, until fragrant, about 15 seconds. Increase heat to high and add broth, tomatoes and their juice. Bring to a boil, scraping up any browned bits. Stir in collard greens (or kale), reduce heat to maintain a simmer and cook, stirring occasionally, until the greens are tender, 5 to 10 minutes.

Discard the thyme sprig. Stir in black-eyed peas; remove from the heat and cover.

2. Position rack in upper third of oven; preheat broiler.

3. Place baguette slices on a baking sheet and broil until lightly toasted, 2 to 4 minutes. Rub each bread slice with the remaining garlic clove. (Discard garlic.) Turn the slices over and top with cheese. Broil until the cheese is melted, 1 to 3 minutes. Serve the soup topped with the cheese toasts and bacon.

• • • • • • • • • • • •

2 cups finely shredded red cabbage 2 tablespoons dill pickle relish 2 tablespoons reduced-fat mayonnaise 2 tablespoons nonfat plain yogurt 1 pound peeled and deveined raw shrimp 4 teaspoons canola oil, divided 1 teaspoon chili powder ½ teaspoon paprika ¼ teaspoon freshly ground pepper 4 whole-wheat hot dog buns, or small sub rolls, split 4 tomato slices, halved ¼ cup thinly sliced red onion

Preparation

1. Preheat grill to medium-high.

2. Combine cabbage, relish, mayonnaise and yogurt in a medium bowl.

3. Toss shrimp with 2 teaspoons oil, chili powder, paprika and pepper in a medium bowl. Place the remaining 2 teaspoons oil in a small bowl. Dip a pastry brush in water, then in the oil and lightly brush the inside of each bun (or roll).

4. Place a grill basket (see Kitchen Tip) on the grill. Add the shrimp and spread in a single layer. Grill, stirring occasionally, until the shrimp are pink and just cooked through, about 3 minutes. Open the buns and grill, turning once, until toasted on both sides, about 1 minute total.

5. To assemble the sandwiches, divide tomato and onion among the buns. Spread about ⅓ cup cabbage mixture down the middle of each and top with about ½ cup grilled shrimp.

• ¾ cup plus 2 tablespoons whole-wheat pastry flour • ½ cup granulated sugar • ⅓ cup unsweetened cocoa powder • 1 teaspoon baking powder • 1 teaspoon baking soda • ¼ teaspoon salt • ½ cup nonfat buttermilk • ½ cup packed light brown sugar • 1 large egg, lightly beaten • 2 tablespoons canola oil • 1 teaspoon vanilla extract • ½ cup hot strong black coffee • Confectioners’ sugar, for dusting

Preparation

1. Preheat oven to 350°F. Coat a 9-inch round cake pan with cooking spray. Line the pan with a circle of wax paper.

2. Whisk flour, granulated sugar, cocoa, baking powder, baking soda and salt in a large bowl. Add buttermilk, brown sugar, egg, oil and vanilla. Beat with an electric mixer on medium speed for 2 minutes. Add hot coffee and beat to blend. (The batter will be quite thin.) Pour the batter into the prepared pan.

3. Bake the cake until a skewer inserted in the center comes out clean, 30 to 35 minutes. Cool in the pan on a wire rack for 10 minutes; remove from the pan, peel off the wax paper and let cool completely. Dust the top with confectioners’ sugar before slicing.

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20 | January 2017

Policy

New Report Details Impact of the Affordable Care Act Millions of Americans have gained coverage, and millions more have had their coverage substantially improved

By d-mars.com News Provider he U.S. Department of Health and Human Services recently released an extensive compilation of national and state-level data illustrating the substantial improvements in health care for all Americans in the last six years. The uninsured rate has fallen to the lowest level on record, and 20 million Americans have gained coverage thanks to the Affordable Care Act (ACA). But beyond those people who would otherwise be uninsured, millions of Americans with employer, Medicaid, Medicare, or individual market coverage have benefited from new protections as a result of the law.

“As our nation debates changes to the health care system, it’s important to take stock of the historic progress in recent years,” said Secretary Sylvia M. Burwell. “Whether they get their coverage through an employer, Medicaid, the individual market, or Medicare, Americans have better health coverage and health care today as a result of the ACA. Millions of Americans with all types of coverage have a stake in the future of health reform, and it’s time to build on the progress we’ve made, not move our system backward.”

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Highlightsofoftoday’s today’sdata Highlights data release include: release include: Employer Coverage: More than 150 million Americans are covered through employer-sponsored health plans. Since the ACA was enacted, this group has seen: • An end to annual and lifetime limits: Before the Affordable Care Act, 105 million Americans with employer or individual market coverage had a lifetime limit on their insurance policy.

The ACA prohibits annual and lifetime limits on policies, so all Americans with employer plans now have coverage that’s there when they need it.

• Young adults covered until age 26: An estimated 2.3 million young adults have benefited from the ACA provision allowing kids to stay on their parents’ health insurance up to age 26.

• Free preventive care: Under the Affordable Care Act, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers, benefiting about 137 million - PDF Americans, most of whom have employer coverage.

• Slower premium growth: Average family premiums for employer coverage grew 5 percent per year from 2010-

2016, compared with 8 percent over the previous decade. Family premiums are $3,600 lower today than if growth had matched the pre-ACA decade.

• Better value coverage: Insurers must now spend at least 80 cents of premium dollars on health care, rather than administrative costs, or else give consumers a refund. Americans with employer coverage have received more than $1 billion in insurance refunds to date.

Medicaid: More than 70 million Americans are covered by Medicaid or the Children’s Health Insurance Program, including millions of children, seniors, and people with disabilities. Under the ACA, Medicaid provides: • More coverage: Thanks in large part to Medicaid expansion, 15.7 million more people have Medicaid coverage today than before the ACA’s major coverage provisions took effect.

• Better health and financial security: Medicaid expansion has resulted in more than 500,000 - PDF people getting all needed care, over 625,000 - PDF fewer people struggling to pay bills, and more than 5,000 - PDF fewer avoidable deaths each year.

• Better addiction and behavioral health coverage: The ACA is helping states improve care for people struggling with opioid or other addictions or mental illness. Nearly 30 percent of those who could gain coverage if more states expanded have a mental illness or substance use disorder.

• Less uncompensated care: Hospital uncompensated care costs fell by an estimated $7.4 billion - PDF after the ACA’s major coverage provisions took

effect. Expansion states account for $5 billion of that reduction, while states choosing not to expand are leaving an estimated $4 billion - PDF in savings on the table.

Individual market: More than 10 million people have coverage through the Marketplace. Individual market coverage is dramatically better compared to before the ACA: • No discrimination based on preexisting conditions: Up to 129 million - PDF Americans have a pre-existing health condition. Before the ACA, this group could have been denied coverage or charged an exorbitant price if they needed individual market insurance.

Now, health insurance companies cannot discriminate against people based on of their medical history.

• Tax credits to help pay for coverage: Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance.

Now, about more than 9 million moderate- and middle-income Americans receive tax credits averaging $300 per month to help them get covered.

• Women pay the same as men: Before the ACA, women were often charged more for health insurance than men just because of their gender. Thanks to the ACA, that is now illegal, protecting roughly half of all Americans.

• Greater transparency and choice: Before the ACA, consumers struggled to compare individual market plans and prices. Thanks to the ACA, they can now shop for coverage on a transparent market, choosing among an average of 30 plans - PDF on HealthCare.gov.

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Medicare: 55 Million Americans are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from: • Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, more than 11 million Medicare beneficiaries saved more than $23 billion total, an average of more than $2,000 per beneficiary.

• Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 26 million - PDF seniors, or 73 percent - PDF of all seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.

• Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Medicare beneficiaries dropped 8 percent, which translates into 565,000 times Medicare beneficiaries have avoided an unnecessary return to the hospital since 2010.

• More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated highquality care to the Medicare patients they serve. Accountable Care Organizations now offer 8.9 million Medicare beneficiaries higher quality, more coordinated care.

Source: U.S. Department of Health & Human Services

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Research

Cervical Health Awareness Month: Scientists Advance a Novel Urine Test to Predict High-Risk Cervical Cancer By d-mars.com News Provider

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ohns Hopkins Medicine specialists report they have developed a urine test for the likely emergence of cervical cancer that is highly accurate compared to other tests based on genetic markers derived directly from cervical tissue.

The new urine test, they say, is different because it analyzes not only multiple sources of human cellular DNA altered by precancerous changes, but also DNA from HPV that is sexually transmitted and causes virtually all cases of the disease.

In a proof-of-concept study, described online in Cancer Prevention Research on November 8, the investigators say their genetic markers test showed a "sensitivity" or accuracy rate of 90.9 percent in identifying so-called CIN2 lesions -- cervical lesions with abnormal cells likely to not only develop into cancer, but also to develop into cancers likely to spread.

Additionally, they demonstrated that the DNA for all three human genes and one viral gene could be successfully extracted from urine, and they could identify such lesions with 75 percent sensitivity.

Two commercial tests based on markers of DNA chemical changes called methylation, released in Europe last summer, require Pap smears or swabs of cervical tissue, and show 64 percent sensitivity in identifying similar lesions, according to senior investigator Rafael GuerreroPreston, Dr.P.H., M.P.H., assistant professor of otolaryngology-head and neck surgery at the Johns Hopkins University School of Medicine and member of the Johns Hopkins Kimmel Cancer Center.

"If further studies confirm these findings, we see a significant use of urine screening as a way to quickly and inexpensively determine if a biopsy is warranted, or if physicians can use a 'watch

and wait' approach before intervening," says Guerrero-Preston. Typically, he says, a woman who tests positive for HPV and has an abnormal Pap smear undergoes a biopsy to rule out cervical cancer using cells taken directly from cervical tissue.

But previous studies suggest more than 50 percent of these biopsies are unnecessary and can result in pain, worry, infertility and higher health care costs.

"Our urine test would serve as a molecular triage," he says, "at times supplementing Pap test information. In developing countries that don't have the money, medical infrastructure or cultural approval for Pap test, our test could be used instead."

The new study builds on the Johns Hopkins team's previously published work, in which investigators identified three genes associated with cervical cancer or abnormal-looking cells known to become cancerous: FKBP6, INTS1 and ZNF516. As abnormalities progress, these genes were more likely to have a chemical methyl group attached to their DNA in certain spots.

The researchers tested the value of these genes as markers using 214 cervical cell samples collected from women undergoing Pap smears at Hospital Dr. Hernan Henriquez Aravena in Chile.

The women ranged in age from 18 to 86.

Among the test samples, 34 showed no abnormalities in their cervix; 87 showed one of three types of precancerous, abnormal tissue; and 90 showed clear evidence of cervical cancer.

Next, Guerrero-Preston's team isolated DNA from each cervical tissue sample and used advanced genetic sequencing methods to spell out the DNA makeup of cells in the cervical tissue samples. The researchers then compared the number of methyl groups attached to each gene in samples from the 34

healthy women to 53 samples with a specific subset of precancerous markers.

Using methylation as a value to diagnose malignancy, the three genes together showed a 90 percent sensitivity, meaning that their presence was able to predict a true positive cancer sample this percentage of the time. The test had an 88.9 percent specificity, meaning the percent of time the test correctly identified someone without the disease.

To further improve the accuracy of the test, the investigators added a new gene marker to the test. This time, rather than using a human gene, they used one from the virus, HPV16-L1, which also becomes methylated in human cells as cancer develops. They did the test again with the four-gene combination on a new population of women from the University of Puerto Rico. The 115 women ranged in age from 21 to 49; 41 participants had healthy cervical tissue, and 74 had one of three types of precancerous cells. Using all four genes, the test now had a sensitivity of 90.9 percent and a specificity of 60.9 percent.

"When developing a new cancer screening test, we want something in the range of 90 to 95 percent sensitivity, which is competitive with the effective-

and broccoli are among the most nutritious foods. However, they all contain very bitter phytochemicals that affect their taste. Broccoli is a perfect example. Everyone knows adding salt to these vegetables makes them taste much better, and reducing salt use will mean fewer vegetables are eaten by kids, if at all.

A research paper from the University of Pennsylvania examined the response of tasters to varying amounts of salt in a range of foods that were naturally bitter, including vegetables and other foods deemed to be healthy. Reducing the salt intake made these foods less appealing and adversely affected the tasters' nutrient intake.

In another study conducted at Ohio State University, cooked broccoli was fed to individuals from three different age groups: children, adults and senior citizens. The broccoli florets were prepared with different levels of salt. The

results showed that even though participants were unaware as to which sample was which, salt significantly increased broccoli's palatability.

A University of Vermont study to measure food consumption in schools before and after the salt reduction mandate confirmed what school lunch officials feared: they witnessed most students putting fruits and vegetables into the trash instead of their mouths. The study showed that although students were required to place more fruits and vegetables on their trays, they ate less of each.

When students were involved in setting choices, several new student-approved recipes were added to the menu: barbecue chicken, buffalo chicken wraps, chicken salad wraps and peanut butter and jelly sandwiches - all savory comfort foods everyone enjoys. It was a stark reminder you cannot impose bland foods on individuals. And there is a rea-

ness of tests developed and now marketed in Europe," says Guerrero-Preston.

The next step, the researchers report, was to verify that the four-gene test worked using freely circulating DNA from blood and urine, rather than DNA taken directly from cervical tissue.

For this experiment, they tested 40 samples of paired cervical tissue, blood and urine from a subset of the patients from Puerto Rico. Using the DNA from blood, they found the test had an 85.7 percent sensitivity and a 60.9 percent specificity. Using urine, they found a 75 percent sensitivity and an 83.3 percent specificity.

During the course of the study, the time to process cervical samples, blood or urine and get a test result took four days. They plan to continue modifying the test to improve the urine sensitivity to that of the cervical tissue samples.

According to World Cancer Research Fund International, 84 percent of cervical cancers occur in less developed countries, with the highest rates in Africa, Latin American and the Caribbean. In the United States, cervical cancer used to be the highest cause of cancer deaths among women, but that soon changed when the yearly Pap smear was introduced over 40 years ago. Countries without the infrastructure or cultural acceptance for regular Pap tests have not seen declining cancer rates.

Guerrero-Preston and his colleagues have a research agreement with Cepheid to develop a way to reduce the waiting time for a test result from a maximum of four days in the lab to under three hours in a Cepheid instrument using sealed cartridges to minimize sample handling and contamination.

Sources: Johns Hopkins Medicine

Research

School Lunches, Nutrition and Your Children By d-mars.com News Provider he U.S Department of Agriculture proposed a complete overhaul of school lunches subsidized by the federal government in 2012. These changes, to be implemented over a period of years, aim to limit calories, reduce sodium and increase the consumption of vegetables and whole grains. Improved nutrition is a laudable goal, but the realities of science and nutrition may surprise most people. That's because scientific studies show kids are more likely to eat their vegetables if they have adequate salt.

Dark green vegetables like spinach

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son for that - our bodies are telling us we need sufficient amounts of the essential nutrient, sodium. Public health policy that is not based on evidence cannot outdo our bodies built-in mechanisms demanding those nutrients.

Without salt, serious consequences arise. Per Dr. Michael Alderman of the Albert Einstein College of Medicine in New York City, until the medical community has adequately studied the effects of population wide sodium reduction, it is best to exercise caution. "I'm concerned that experiments in population wide sodium reduction are making Americans, children and adults, guinea pigs. For instance, my research indicates that cardiac patients put on low salt diets had a higher rate of cardiac events than cardiac patients on normal sodium diets. We need to proceed carefully here so that we don't cause harm," he says. â&#x20AC;&#x201C; BPT

January 2017 | 23

Research

MD Anderson News: Research Shows Patients Ineligible for Studies May Benefit From Trial Participation By d-mars.com News Provider

HOUSTON - Patients who potentially could benefit most from participation in clinical trials due to poor prognoses often are not included based on eligibility criteria, such as existing medical illnesses. A novel study at The University of Texas MD Anderson Cancer Center revealed some patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), who traditionally could not be considered for clinical trials, responded well and were safely treated in this setting.

The study, led by Guillermo GarciaManero, M.D., professor of Leukemia, followed 109 patients with AML and MDS undergoing treatment with azacitidine (AZA) and vorinostat. Research results were presented Dec. 3 at the 58th Annual Meeting of the American Society for Hematology in San Diego.

“Most cancer clinical studies exclude patients with co-morbidities, active or recent malignancies, organ dysfunction or poor performance status,” said Garcia-Manero. “How these criteria protect patients is unclear. Although some are based on clinical reasoning, it seems these criteria are in place more to protect

the drug or intervention being studied rather than the patient.”

The study initially enrolled 30 patients age 17 and older who had not previously been treated for AML or MDS. Patients eligible for the study had either poor performance, poor renal or hepatic function or any other active systemic disorder such as other cancer.

Sixty-day survival was 83 percent with low-grade gastrointestinal side effects reported. The study was expanded to include an additional 79 patients. Sixtyday survival for the second group was 79 percent with a median overall survival of 7.6 months. The average event-free survival was 4.5 months. Again, only lowgrade gastrointestinal side effects were observed.

The study was designed with “stopping rules” that included monitoring of side effects and complete response rates.

Patients were immediately placed on another therapy if their assigned therapy did not indicate there would be a complete response within a 60-day period.

To define the minimum expected survival and response rates that would trigger the stopping rules, researchers relied on prior data of 181 patients previously treated at MD Anderson.

“Participation in clinical trials is fundamental for the development of new therapeutic interventions,” said Guillermo Montalban-Bravo, M.D., fellow in Leukemia, a research team member.

“Despite this need, only three to five percent of patients with cancer treated in the U.S. currently are enrolled in clinical trials.”

The study points to further evaluation of standard exclusion criteria, potentially increasing the pool of patient likely to benefit from therapy, with the aim of future larger clinical trials specifically treating patients with AML and MDS.

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MD Anderson research team participants included: Elias Jabbour, M.D.; Gautam Borthakur, M.D.; Courtney DiNardo, M.D.; Naveen Pemmaraju, M.D.; Jorge Cortes, M.D.; Srdan Verstovsek, M.D.; Tapan Kadia, M.D.; Naval Daver, M.D.; William Wierda, M.D., Ph.D.; Yesid Alvarado, M.D.; Marina Konopleva, M.D., Ph.D.; Farhad Ravandi, M.D.; Zeev Estrov, M.D.; Nitin Jain, M.D.; Ana Alfonso Pierola, M.D., Ph.D.; Mark Brandt; Troy Sneed; Hui Yang, M.D., Ph.D.; Sherry Pierce; Elihu Estey, M.D.; Zachary Bohannan, and Hagop Kantarjian, M.D., all of Leukemia; Carlos Bueso-Ramos, M.D., Ph.D., Hematopathology; and Xuelin Huang, Ph.D. and Hsiang-Chun Chen, Biostatistics.

The study was funded by the Cancer Prevention and Research Institute of Texas (RP140500), the National Institutes of Health (P30 CA016672), Merck Sharpe and Dohme Corp.

(NCT00948064), the Dr. Kenneth B. McCredie Chair in Clinical Leukemia Research endowment, the Edward P. Evans Foundation, the Fundación Ramón Areces, and the MD Anderson MDS/AML Moon Shots Program.

24 | January 2017

Sports Medicine

Sports and Concussions: What Are the Recommendations?

By d-mars.com News Provider

W

hen it comes to making recommendations, doctors' organizations tend to come late to the game, calling press conferences to state the obvious. The American Academy of Neurology states that "any athlete who is suspected to have suffered a concussion should be removed from participation until he or she is evaluated by a physician with training in the evaluation and management of sports concussions."

The Academy's position also includes an educational component to increase concussion education for parents, athletes, and coaches; and reminds us that players should not return to competition until they had recovered from their injury.

It took a little while for common sense to return to the halls of neurology academia; their last position paper from 1997 allowed players with concussions to return to play immediately if they were deemed to be asymptomatic with normal neurologic assessment at rest and with exercise. It was routine to see players running on the sideline after a head injury, as part of their evaluation to determine if concussion symptoms could be provoked.

While unintentional head injuries occur in sports and daily life, there are sports in which the head is a target, and winning happens when a concussion occurs and the player is knocked unconscious. The Academy has a 2008

5 Smart Steps to Preserving Brain Health

By d-mars.com News Provider

E

veryone knows aerobic exercise gets the heart pumping and lifting weights keeps muscles strong. But when it comes to keeping the brain healthy, most people are unsure what to do.

As you age, brain health and maintaining memory functions becomes a top concern. Turns out, these issues may begin sooner than you think.

“We tend to think about memory decline as an older person’s issue, but that’s not the case at all,” says Dr. Aimee Gould Shunney, a licensed naturopathic doctor specializing in women’s health and family medicine. “There was a study published in 2012 in the British Medical Journal that examined cognitive function in people age 45 to 70. The researchers did not expect it, but they

money to pay for those trainers at pee wee football practice, bantam hockey, gymnastics, and the host of sports that make kids happy and get them to be active mentally and physically.

Instead, let us consider a reasonable alternative. Let's teach parents and coaches how to recognize the signs and symptoms of concussion. The education can begin with a few words during routine yearly exams as the kids grow up. Let family doctors and pediatricians spend a few minutes talking about concussion and head injury. Make that education part of the sports physical examination.

Kids are smart enough to look out for their teammates if they're given the opportunity and responsibility. And let's make concussion education part of the certifying requirements for coaches.

Concussions are an unfortunate consequence and complication of many sports. Minimizing the risk of brain injury demands that athletes try to play in control, avoid head contact, and wear safe head gear. Even with all the prevention in the world, accidents will happen. Kids will trip. Adults will fall off bicycles and people will run into each other. When that accident occurs, we have to be our brother's keeper and know what to look for, when to send a player to the sideline, and when to get them to a doctor.

position paper on sports that promotes intentional trauma to the brain. One would think that it would be to demand a ban. Instead, while concluding that sports like boxing and mixed martial arts are a serious threat to brain function and even with protective gear can cause "measurable and persistent damage to the brain," the recommendations are muted: Try to decrease the number of blows to the head, educate potential participants about the damage, and work on prevention, especially for kids younger than 16 years of age.

Concussions and violent hits to the head in the NFL made league officials take action and tell players to lower their

targets away from the head and neck.

Add an instructional video and tens of thousands of dollars in fines, and player behavior changed almost immediately.

Rules mandated that players with concussions be removed from the game and not be allowed to return to practice or play until cleared to do so by a qualified physician.

The neurologists seemed to agree, and tried to adapt this solution to the masses. They failed by recommending an impossible solution: "A certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk for concussion." There are neither enough trainers, nor enough

found evidence of cognitive decline in the 45-year-old participants as well as the older participants.”

She notes there are two basic pathological processes that cause degeneration of the brain: oxidative stress and inflammation. Basically, the standard American diet and lifestyle contribute to those processes. So who is this really an issue for? Men and women of all ages.

No matter your age, you can take charge of your brain health by following these five smart steps from Dr. Shunney:

Supplements

Thinking activities

In addition to a quality multivitamin, Dr. Shunney recommends an omega-3 supplement. “Getting enough omega-3s is one of the most important measures we can take,” she says. “DHA is the dominant omega-3 in the brain. Just like we need to make sure babies have enough DHA to grow their brain, we need to make sure older people get enough DHA to keep their brains healthy.”

She suggests Omega Memory by Nordic Naturals. It’s a DHA-dominant omega-3 formula that also includes other brain healthy ingredients: curcumin, phosphatidylcholine and huperzine A. Learn more at www.nordicnaturals.com.

“I recommend anything that keeps your mind working,” says Dr. Shunney. “Activities that require things to be arranged or puzzles that have to be put together. Crossword puzzles, word games and board games are all great.”

She also notes some activities to avoid: “It’s important to limit certain activities. The constant scanning of social media and newsfeeds eliminates creativity and keeps us on edge. Limit the time you spend doing that and instead do things that cause you to explore and think and put ideas together on your own.”

Healthy eating “A Mediterranean-type diet that focuses on whole foods, good fats and foods high in antioxidants is a great place to start,” says Dr. Shunney.

She encourages her patients to focus on getting omega-3 fats from fish and monounsaturated fats from olives, olive oil, nuts and seeds. She also recommends increasing fruits (especially berries) and beans (they’re packed with antioxidants). What’s more, research shows a little cocoa, coffee and red wine can act as antioxidants and are beneficial in low to moderate amounts.

Regular sleep Poor sleep is a risk factor for cognitive decline. “Studies show both sleep deprivation and sleeping too much impact cognitive performance,” Dr. Shunney says. “A good goal is to go to bed around the same time each night, sleep for 7-8 hours, and get up around the same time every morning.”

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Source: www.medicinenet.com

Socialize “Social isolation has been linked with cognitive decline,” says Dr. Shunney.

“In one study, people who were lonely experienced cognitive decline at a 20 percent faster rate than people who were not lonely.”

Make time to take a foreign language class, join a Toastmaster’s Club, take a watercolor class - anything that connects you regularly to other people. – BPT

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TH E

E X P E R T

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