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December 2016

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Expanding Your Education “TVLC wants to be a part of improving the lives of families by providing quality mental health care. TVLC is here to contribute to the betterment of Houstonians who are battling mental illness, helping to make a difference in their lives and in Houston.”

Vitamin D3 Saves Lives By Dr. LaTronica Fisher Are you getting enough vitamin D?

PAGE 4

— Mrs. Ayanna Carr-Brown, CEO of TVLC

FDA Approves New Device for Prevention of Recurrent Strokes in Certain Patients The U.S. Food and Drug Administration recently approved the Amplatzer PFO Occluder device. PAGE 6

Mrs. Ayanna Carr-Brown

PAGES 14-15

The Village Life Center Brings Healing to Houston

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World AIDS Day: Houston Health Department HIV & AIDS Awareness By d-mars.com News Provider World AIDS Day is an opportunity to show support to and solidarity with the millions of people living with HIV. PAGE 10

Get an Inside Look at the Work of a Surgical Telemetry Nurse Supervisor in a Military Medical Center

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MD Anderson News: Gene Deletion Allows Cancer Cells to Thrive When Migrating Within the Brain

The workings of the human heart are the profoundest mystery of the universe. One moment they make us despair of our kind, and the next we see in them the reflection of the divine image. — Charles W. Chesnutt

December 2016 3

Journal Behind The

Message from the Publisher

MR. D-MARS

SR. PUBLISHER Keith J. Davis, Sr.

CO-PUBLISHER

Tiffany Davis, RN-BSN, MSN, CNE

VICE PRESIDENT

“Expanding Your Education” is the theme for this month’s d-mars.com Health & Wellness Journal. It is important to expand your education in the area of business, but it’s also important in the area of health. Are you educated when it comes to your health? If not, then it’s not too late. Now is the perfect time. Go into 2017 a healthier you. This month’s cover story highlights Ayanna Carr-Brown and The Village Life Center (TVLC). There is a definite public stigma in the community when it comes to mental illness. Under her leadership as CEO, TVLC is helping heal in the area of mental health and to combat stigmas associated with mental illness. Founded by Carr-Brown, TVLC has a true heart for healing those dealing with mental illness and advocating for mental wellness.

Kim Floyd

ASSOCIATE EDITOR Dawn Paul

ACCOUNTING MANAGER Eugenie Doualla

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.

SENIOR ACCOUNT EXECUTIVES C.J. Johnson C.T. Foster Tiffany Black

Contents

PHOTOGRAPHY L.C. Poullard Grady Carter

MULTIMEDIA DIRECTOR Andrea Hennekes

LAYOUT & GRAPHIC DESIGNER Angel Rosa

SOCIAL MEDIA COORDINATOR Charlette Washington

DISTRIBUTION

Booker T. Davis, Jr. Rockie Hayden

CONTRIBUTING WRITERS Dr. LaTronica Fisher Rhonda Dallas, B.S., C.L.C., N.C. Reggie Collier Houston Health Department The National Eye Institute d-mars.com News Provider

Vitamin D3 Saves Lives...................................................................................................................................................................................................................... 4 Take It One Pound at a Time............................................................................................................................................................................................................5 FDA News................................................................................................................................................................................................................................................6 Ways You’re Doing Cardio Wrong...................................................................................................................................................................................................6 Reggie C Fitness Tips for the Holidays......................................................................................................................................................................................... 8 Intimacy & Chronic Illness................................................................................................................................................................................................................ 8 Houston Health Department...........................................................................................................................................................................................................10 Reconnecting Eye to Brain..............................................................................................................................................................................................................10 No Food Poisoning Over the Holidays..........................................................................................................................................................................................12 Bundled Payments.............................................................................................................................................................................................................................12 Biotech News: Novel ‘Repair System’...........................................................................................................................................................................................13 The Village Life Center..................................................................................................................................................................................................................14-15 Nurse Supervisor in a Military Medical Center..........................................................................................................................................................................16 Childbirth an Athletic Event............................................................................................................................................................................................................ 17 Health Careers.....................................................................................................................................................................................................................................18 Health & Wellness Recipes..............................................................................................................................................................................................................19 Parents in Favor of Expanding Health Education...................................................................................................................................................................20 PTSD........................................................................................................................................................................................................................................................20 Healthcare Policy News...................................................................................................................................................................................................................22 Phobia Quiz..........................................................................................................................................................................................................................................23 MD Anderson News...........................................................................................................................................................................................................................24 Don’t Make Your Co-Workers Sick.................................................................................................................................................................................................24

MR. D-MARS Tip of the Month “Life is short, and it’s up to you to make it sweet.” - Sadie Delany

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December 2016

Vitamin D3 Saves Lives

By Dr. LaTronica Fisher

Contributing Writer

re you getting enough vitamin D? Do you know the benefits of vitamin D? Vitamin D is important for good overall health and for strong and healthy bones. It is also an important factor in making sure that your muscles, heart, lungs, and brain work well and that your body can fight infection. Your body can make its own vitamin D from sunlight. You can also get vitamin D from supplements. The vitamin D that you get in your skin from sunlight, and the vitamin D from supplements, has to be changed by your body a number of times before it can be used. Once itâ&#x20AC;&#x2122;s ready, your body uses it to manage the amount of calcium in your blood, bones and gut and to help cells all over your body to communicate properly.

Below please see some facts about vitamin D: 1.) The flu - In a study published in the Cambridge Journals, it was discovered

that vitamin D deficiency predisposes children to respiratory diseases. An intervention study conducted showed that vitamin D reduces the incidence of respiratory infections in children. 2.) Muscle weakness - According to Michael F. Holick, a leading vitamin D expert, muscle weakness is usually caused by vitamin D deficiency because for skeletal muscles to function properly, their vitamin D receptors must be sustained by vitamin D. 3.) Psoriasis - In a study published by the UK PubMed central, it was discovered that vitamin D analogues were found useful in the treatment of psoriasis. 4.) Chronic kidney disease - According to Holick, patients with advanced chronic kidney diseases (especially those requiring dialysis) are unable to make the active form of vitamin D. 5.) Diabetes - A study conducted in Finland was featured in Lancet.com in which 10,366 children were given 2,000 international units (IU)/day of vitamin D3 per day during their first day of life. The children were monitored for 31 years and in all of them, the risk of type 1 diabetes was reduced by 80 percent. 6.) Asthma - Vitamin D may reduce the severity of asthma attacks. Research conducted in Japan revealed that asthma attacks in school children were significantly lowered in those subjects taking a daily vitamin D supplement of 1,200 IU a day. 7.) Periodontal disease - Those suffering from this chronic gum disease that causes swelling and bleeding gums

min D deficiency. Research conducted at Harvard University among nurses found that women with low vitamin D levels (17 ng/m [42 nmol/L]) had a 67 percent increased risk of developing hypertension. 9.) Schizophrenia and depression - These disorders have been linked to vitamin D deficiency. In a study, it was discovered that maintaining sufficient vitamin D among pregnant women and during childhood was necessary to satisfy the vitamin D receptor in the brain integral for brain development and mental function maintenance in later life. 10.) Cancer - Researchers at Georgetown University Medical Center in Washington, D.C., discovered a connection between high vitamin D intake and reduced risk of breast cancer among those already having the disease. Of interest was the capacity of vitamin supplementation to help control the development and growth of breast cancer, especially estrogen-sensitive breast cancer.

should consider raising their vitamin D levels to produce defensins and cathelicidin, compounds that contain microbial properties and lower the number of bacteria in the mouth. 8.) Cardiovascular disease - Congestive heart failure is associated with vita-

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) 520-8188 or drfisherroad2wellness@gmail.com. Sources for this article: foxnews.com journals.cambridge.org vitamindcouncil.com naturalnews.com

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December 2016 5

Take It One Pound at a Time

By Rhonda Dallas Contributing Writer

s we prepare for the holidays, we must keep in the back of our mind that "We are what we eat," like the saying goes. This does not mean we cannot enjoy the holiday ham, turkey and desserts. It just means we have to think about the potential pounds we can gain during this festive season. There are so many ways we can help combat the pounds by simply eating what we like, but exercising and watching the amount of calories we digest. Who really wants to count calories as they are sitting down at the holiday table? I know I don't. I have been waiting all year for my favorite dishes and to see family that I don't usually get to see. We can all start today by watching what we eat right now before the Thanksgiving and Christmas

meals. I normally begin by watching what I eat before and especially after the holidays and also make it a priority to get in that physical activity. For me, I enjoy brisk walks through the park to jump start my metabolism, which helps burn fat. I use this time to also reflect and reboot for the New Year. As well as the physical, we must also take care of our mental well-being. The stress of the holidays can take a toll on you, so make sure to be mindful and not let it impact your mental health. Stress can lead to weight gain, depression, and other mental and physical challenges that are no way healthy. If you have unresolved issues with family members that you may see during the holidays, deal with that anxiety through meditation or with the help of a life coach or with therapy. If possible, try resolving the issue with that family member as well, if they are willing. It’s important to remember that when you are stressed, it can impact your body. Enjoy the holidays by keeping your stress level down. When it comes to the holidays, this is also a time when you can cook those dishes that you are famous for. However, for a healthier spin on holiday cooking, take your recipes and trim the calories by limiting the fat products, salt, and sugar. Keep in mind that there will be some people at the table who will need

Stephanie Hill-Polk Certified Personal Trainer Perfect Fit “No Excuses” Personal training, group training and weight loss

to stay clear of certain ingredients due to their health challenges. Another great tip is to make sure that your guests are not allergic to anything, like peanuts. You would be surprised how many people have peanut allergies. Taking these measures will help ensure a great holiday meal enjoyable for your guests and you. Reaching to Empower Women Daily (R2EWD) is my nonprofit that I founded with health in mind. Our mission is to help women and children who are at a crossroads in their lives in the area of health, also helping them take a road to a healthier life. I believe that if people feel better, they will be able to do more. I love seeing my young clients and their parents get healthy together. I cannot think of a better Christmas gift to give than a healthy lifestyle. We

at R2EWD offer health and wellness coaching classes, recipe classes, and healthy natural and raw supplements to help with the New Year’s resolutions. Getting the community healthy and helping people maintain their health is our number 1 priority. We work with companies, organizations, and individuals to provide the tools to live a healthier life. Happy Holidays! A certified health and wellness life coach can help you with a healthy lifestyle. Rhonda Dallas is a certified life coach and nutritional counselor. Contact Rhonda at rhondadallasconsulting@gmail.com for your coaching session. Get started today!

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713-894-2167 Fit 4 Lyfe (NOB) jstayfit@gmail.com

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December 2016

FDA Approves New Device for Prevention of Recurrent Strokes in Certain Patients

he U.S. Food and Drug Administration recently approved the Amplatzer PFO Occluder device. The PFO Occluder reduces the risk of a stroke in patients who previously had a stroke believed to be caused by a blood clot that passed through a small hole in the heart, called a patent foramen ovale (PFO), and then traveled to the brain. “The Amplatzer PFO Occluder provides a non-surgical method for doctors to close a PFO,” said Bram Zuckerman, M.D., director of the Division of Cardiovascular Devices in the FDA’s Center for Devices and Radiological Health. “But as the device labeling clearly states, patients need to be evaluated carefully by a neurologist and cardiologist to rule out other known causes of stroke and help ensure that PFO closure with the device is likely to assist in reducing the risk of a recurrent stroke.” About 25 to 30 percent of Americans have a PFO, which typically causes no health problems and does not require treatment. The cause of most strokes can be identified, such as poorly controlled high blood pressure, narrowed blood vessels due to cholesterol deposits and scar tissue (atherosclerosis), or a blood clot caused by an abnormal heart rhythm (atrial fibrillation). However, in some patients, medical tests cannot identify the cause of the stroke, which is referred to as a cryptogenic stroke. In a small percentage of these patients, it is

Ways You’re Doing Cardio Wrong By d-mars.com News Provider

oes your exercise routine live and die by the treadmill? Does your workout consist of an hour on the elliptical? While you can’t ignore the positive impact aerobic exercise has on your health, it may not be the dream weight-loss solution you hope for. “It seems an awful lot of people walk, jog, run and cycle on a regular basis, hoping the time spent on the treadmill, bike or trail will equate to drastic weight loss results,” says Paul Kriegler, registered dietitian and nutrition program manager for Life Time Fitness. “There’s a fair amount of research on how much cardio is best for realizing health benefits, but there are a few factors that could be compromising those benefits for you.”

believed that the PFO provided a path for a blood clot to travel to the brain where it blocked a blood vessel resulting in a stroke. Patients with a cryptogenic stroke and a PFO may be at an increased risk of having a second stroke. The Amplatzer PFO Occluder is inserted through a catheter that is placed in a leg vein and advanced to the heart. It is then implanted close to the hole in the heart between the top right chamber (right atrium) and the top left chamber (left atrium). The device had been on the market more than a decade ago under a humanitarian device exemption (HDE), but was voluntarily withdrawn by the manufacturer in 2006 after the FDA concluded that the target population for this device was greater than 4,000 patients and that the device no longer qualified for an HDE approval. For the past 10 years, no FDA-approved heart occluder devices have been on the market specifically indicated to close PFOs to reduce the risk of a recurrent stroke in patients with a prior cryptogenic stroke. In approving the Amplatzer PFO Occluder, the FDA concluded that the device demonstrated a reasonable assurance of safety and effectiveness. The safety and efficacy was assessed in a randomized study that evaluated 499 participants aged 18 to 60 years old who were treated with the Amplatzer PFO

Occluder plus blood-thinning medications compared to 481 participants who were treated with blood-thinning medications alone. While the rate of new strokes in both treatment groups was very low, the study found a 50 percent reduction in the rate of new strokes in participants using the Amplatzer PFO Occluder plus blood-thinning medications compared to participants taking only blood-thinning medications. Adverse effects associated with the device or the implantation procedure include injury to the heart, irregular and/ or rapid heart rate (atrial fibrillation), blood clots in the heart, leg or lung,

You’re doing cardio, but moving less throughout the rest of the day. Think about this: you wake up early, get to your health club and work hard for a solid hour, spinning your legs until they feel like jelly. A puddle of sweat surrounds your bike and your heart rate monitor says you burned 950 calories. That’s great, until later on, you forgo your normal walking break because you feel too worn out. And later that evening, you catch a nap before dinner rather than walking the dog or mowing the lawn. People often justify inactivity in the hours after a strenuous workout. Most experts recommend getting the majority of your movement throughout the day instead of condensing it into one particular segment.

You’re doing too much cardio. The health benefits of cardiovascular training appear to begin after around 30 minutes of moderate intensity four to five days per week, totaling around 150 minutes. When it comes to cardio, more isn’t always better, especially if you don’t give your body time to recover. According to an article titled “Effect of the volume and intensity of exercise training

on insulin sensitivity,” published in the September 2013 edition of the Journal of Applied Physiology, opting for long, frequent sessions is often less effective than shorter, higher intensity. Doing long sessions of cardio, more than 60 minutes, is rarely necessary unless you’re training for a specific event. Another observational study of recreational joggers suggest you’re better off capping your strict cardio time at 30 minutes and including several days per week of resistance training.

You think cardio means “I get to eat extra calories without consequence.” While exercising to burn off some energy may give you a little room for forgiveness, exercising to prepare for or undo poor eating habits doesn’t guarantee you results. In fact, according to a study in PubMed, large amounts of car-

bleeding and stroke. The Amplatzer PFO Occluder device should not be used in patients with a heart valve infection or other untreated infections, or a heart tumor or blood clot at the implant site. The device is also contraindicated in patients with other abnormal connections between the heart chambers or in whom the cardiovascular anatomy or blood clots would interfere with the ability to move the catheter used to deliver the device to the heart. Patients should discuss with their medical team (consisting of a neurologist and a cardiologist) the risks and benefits of PFO closure in comparison to using medications alone. The Amplatzer PFO Occluder device is manufactured by St. Jude Medical Inc. based in Plymouth, Minnesota. 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

dio training have been shown to induce compensatory eating patterns, especially in women. It’s easy to get into this mindset, but exercise is far more than just a way to expend calories. Well-planned, properly executed bouts of activity can stimulate your body to go through incredible changes, but not if you’re using food as a reward.

All your cardio sessions are the same. Cardio can be helpful for getting a little solitude or zone out time, but doing the same workout every day when you’re looking for results is definitely not the answer. A good exercise program incorporates variability from one workout to the next. Your body has a few major energy systems, and they all need to be challenged over time. Try an Active Metabolic Assessment from Life Time to scientifically determine your most efficient heart rate zones so you can exercise smarter. Cardiovascular exercise may promote a positive mood, better cognitive function and reduce diabetes risk, but only if you do it right. Take these factors into consideration the next time you lace up your gym shoes and hop on the nearest cardio machine. - BPT

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December 2016

Reggie C Fitness Tips for the Holidays

By Reggie Collier Contributing Writer

ccording to researchers at the National Institutes of Health, most Americans never lose the weight they gain during the winter holidays. The pounds add up year after year, making holiday weight gain an important factor in adult obesity. Weigh Yourself at Night, Three Times a Week Before You Go to Bed. Nightly weigh-ins are best. This is because you are at your heaviest due to the daily food consumption and you can determine from the stats if you need to wake up and get your morning workout in. Also, you won’t be let down if you had weighed yourself in the morning. Get Your Workout in Within Three Hours of Waking Up. It’s important to get your workout in before your day becomes too busy. You may have very good intentions, but after the busyness and stress of the day, it’s so easy to put

your workout off until tomorrow and again tomorrow, and then again tomorrow. Don’t Diet - Distribute. Distribute your meals. Eat small meals every two to three hours. Preferably eat lean protein and vegetables. Save the carbs for later, so by the time you get to those family dinners or holiday parties, you won’t be starving and have a desire to eat everything you see. Skipping breakfast or lunch in order to “save your appetite” is definitely a no-no. It’s not the best weight loss tactic, but a lot of people do it during the holidays. Reggie's 15 by 3 Method. Most people may not have time to workout for 1 to 2 hours a day. Instead do 15 minutes of exercise 3 times per day. This will actually amount to 45 minutes. I would recommend high intensity movement to get the heart rate going and to burn those calories. Set a reminder on your phone so you’ll be held accountable. 3 by 3 Rule. Take 3 bites every 3 minutes, and try and stop at 3.

Intimacy & Chronic Illness

By d-mars.com News Provider

reating and sustaining both emotional and physical intimacy (closeness and affection with another person) in any relationship can be difficult. For people living with a chronic disease, such as rheumatoid arthritis (RA) – an autoimmune disease of the joints[i] that impacts 1.6 million people in the United States[ii],[iii] – it can be even more challenging. In fact, a study of those living with RA revealed that more than half feel that their disease places limitations on intimacy and more than a third say that living with RA has strained their relationship with their partner.[iv] For many people, browsing the selfhelp section of a book store, an internet search, or picking up a women’s magazine can help provide some suggestions for how to build or repair intimacy. However, for those with RA, help and advice is more limited and there’s a real need for support for those with a chronic disease looking to address intimacy challenges. So, let’s start here. The best first step to addressing any challenge — whether it’s

related to RA or not — is to take a look at it from a higher perspective and evaluate the bigger picture. When we step back and look at relationship “issues,” the first thing we realize is that when it comes to relationships, “normal” doesn’t exist. There is no one way to define a healthy relationship. Once you’ve accepted that there is no “normal,” you can start to focus on redefining your relationships in the face of a chronic disease, like RA. Here are a few tips that may help address intimacy with RA: • Focus on self-love. The old adage “you must love yourself first before someone else can love you” rings true. While it can be difficult to love yourself when it feels like you are fighting against your body, it is even more important to exercise healthy self-love behaviors when dealing with a chronic disease. Focus on things that you love about yourself, practice positive affirmations, and take the time to do things that make you feel good. • Communicate with your partner.

This helps you to not overindulge. This will also help kill the cravings. 1 Gallon in 1 Day. Before you drink any alcohol,

make a promise to drink 1 gallon of water throughout the day. If you don’t finish the gallon, try and alternate between your glass of alcohol and a glass of water. Sneak a Snack. Bring a healthy snack or two that you can fit in your pocket or purse. It’s better to munch on snacks versus going back for the second piece of sweet potato pie. Fuel up on Fiber. Veggies increase fiber, which helps make us feel fuller. So dive in for the asparagus, broccoli, Brussels sprouts, and whatever other veggies are on that holiday table. Maximize the Meat. Protein will help you feel full and control your appetite. So make the lean meats the second largest portion on your plate next to the vegetables. If you are hosting the dinner, make sure you encourage your guests to leave with a to go plate. This will help prevent you from snacking on holiday foods for the next couple of days; which can definitely pack on the pounds. For more Reggie C Fitness Tips, please visit www. reggiecfitness.com or follow on Facebook at @reggiecfitness1.

An open dialogue is a critical component to intimacy — both physically and emotionally. Communicating openly and honestly paves the way for a feeling of closeness that comes from shared expectations and understanding. It’s also important to know that intimacy doesn’t require physicality, and if there are times you can’t be physical due to RA symptoms such as fatigue or swollen joints — that’s okay as long as you are open and honest with your partner. Make sure the intimacy in your relationship is maintained by enjoying shared interests or hobbies – have pillow talks or compliment one another out of the blue! • Work as a team. There are times in every relationship when each person faces his or her own challenges. You and your partner are in this together. You are each other’s advocates. Maintaining a healthy and successful relationship is all about balance and understanding that challenges come in all shapes and forms. Living with RA is no exception. • Talk to a professional. If your RA symptoms are inhibiting your relationship, talk to a professional. The right professional probably has some good ideas of how to address the impact on intimacy. If you don’t feel comfortable talking to your rheumatologist, try speaking with someone who specializes in intimate relationships such as a relationship counselor or sex therapist.

If you have a chronic disease like RA, it’s important to remember that it does not define you and there are steps you can take to better manage lifestyle challenges as a result of your condition. With a little research and communication with your rheumatologist or other healthcare professional, there are ways to prioritize your health, but not sacrifice your relationships and ability to enjoy life with the people closest to you. For more tips on relationships while living with RA from intimacy and relationship expert Logan Levkoff, Ph.D., visit www.Arthritis.com. ### [i] National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). National Institutes of Health, Department of Health and Human Services. Handout on health: rheumatoid arthritis. August 2014. http:// www.niams.nih.gov/Health_Info/Rheumatic_ Disease/default.asp. Accessed May 2016. [ii] Sacks J, Lou Y, Helmick, C. Prevalence of specific types of arthritis and other rheumatic conditions in the ambulatory health care system in the United States 2001-2005. Arthritis Care Res. 2010;62(4):460-464. [iii] Howden L, Meyer J. 2010 U.S. Census Bureau results --- U.S. Census Bureau, 2010 Census Summary File 1. [iv] Hill J, Bird H, Thorpe R. Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology. 2003;42(2):280-286. PP-G1P-USA-1491-01

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December 2016

World AIDS Day: Houston Health Department HIV & AIDS Awareness By d-mars.com News Provider

PrEP is Part of the Prevention

orld AIDS Day is an opportunity to show support to and solidarity with the millions of people living with HIV. World AIDS Day is held on the 1st December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV, and to commemorate people who have died. World AIDS Day was the first ever global health day, held for the first time in 1988. Globally there are an estimated 34 million people who have the virus. Despite the virus only being identified in 1984, more than 35 million people have died of HIV or AIDS, making it one of the most destructive pandemics in history. Today, scientific advances have been made in HIV treatment, there are laws to protect people living with HIV and we understand so much more about the condition. World AIDS Day is important because it reminds the public that HIV has not gone away, and there is still a great need to increase awareness. When it comes to raising awareness and the education of HIV/AIDS in Houston, the Houston Health Department (HIV-STD Viral Hepatitis Prevention) is a vital component to the prevention of HIV/AIDS in this city. This department remains diligent in their efforts to eliminate HIV,

viral Hepatitis, and STDs. This department is proactive in the fight of HIV/AIDS in our community. The department’s mission is to come together with community partners to help implement, assess, and plan effectual public health strategies to reduce the spread of HIV, viral Hepatitis, and other STDs in Houston. Raising awareness on PrEP, a daily pill for HIV prevention, is one of their efforts to help decrease the rate of HIV cases in Houston and the surrounding areas. PrEP (short for Pre-Exposure Prophylaxis) is a new way to prevent HIV. It’s a prescription medicine that, when taken every day, greatly reduces your risk of getting HIV by blocking the virus. If you are HIVnegative and think you might be at risk of getting HIV, taking PrEP can give you protection and peace of mind. One PrEP pill a day is 92% effective at preventing HIV. PrEP works to prevent HIV by interfering with HIVs ability to copy itself in your body after exposure. This prevents the virus from establishing an infection and making you sick. When taken every day, PrEP has shown to reduce the risk of HIV infection in people who are at high risk by more than 90%. PrEP is much less effective if not taken every day. PrEP can be more effective if combined with other

Reconnecting Eye to Brain By the National Eye Institute Contributing Writer

ichael Crair, Yale University, and Carol Mason, Columbia University, have co-authored a report published online today in the Journal of Neuroscience. “Reconnecting Eye to Brain” is a comprehensive assessment of what scientists know about optic nerve development, regeneration, and reconnection. The report was based on input gathered during the Oct. 16, 2015, panel discussion, titled “Reconnecting Neurons in the Visual System,” sponsored by the National Eye Institute Audacious Goals Initiative (AGI). The panel comprised two dozen leading experts on neural development and regeneration. The AGI is developing therapies to restore vision, lost through disease or injury, by regenerating the retina. A major

Chinfei Chen, Boston Children's Hospital (center), and Hollis Cline (right), Scripps Research Institute, react to comments by David Feldheim, University of California Santa Cruz, during the 2015 National Eye Institute Audacious Goals panel discussion, "Reconnecting Neurons in the Visual System."

AGI challenge is reconnecting retinal ganglion cell (RGC) axons that project from the retina to the brain. Zebrafish do this naturally after injury. What might we learn from Zebrafish to inform us about the regeneration mecha-

ways to prevent HIV infection, like using condoms and drug abuse treatment. If you think you may be at risk for HIV, talk to your healthcare provider about whether PrEP is right for you. If your healthcare provider is unfamiliar with PrEP, AIDS Foundation Houston and the Houston Health Department can connect you to PrEP nisms in humans? The report addresses guiding RGC axons to targets in the brain, promoting target engagement and synaptogenesis, replicating successful approaches in other organ systems, and fostering new approaches and opportunities. It highlights advances of the past two decades in understanding guidance factors, and lingering challenges—for example, RGC subtypes vary in their ability to regenerate. “The collective wisdom of the conference participants pointed to important gaps in our knowledge and barriers to progress in promoting the restoration of visual system function,” wrote the authors in the report. The NEI AGI is an effort to push the boundaries of vision science. By facilitating cross-disciplinary research, the AGI is tackling the most devastating and difficult-to-treat eye diseases. Learn more about the NEI AGI at www.nei.nih.gov/ audacious.

About NEI NEI leads the federal government's

services while your primary care doctor maintains your primary health needs. If you do not have insurance, AIDS Foundation Houston can help you find programs that cover the cost of your appointments and blood tests, as well as co-pay assistance programs for the cost of your prescription. PrEP does not protect against sexually transmitted diseases like gonorrhea or syphilis, so you should continue using condoms to prevent the spread of sexually transmitted diseases. If you have a sex partner who is HIV-positive and are considering getting pregnant, talk to your doctor about PrEP. It may be an option to protect you and your baby. For more information on PrEP, please contact the Houston Health Department at 832-393-5010, AIDS Foundation Houston, Inc. or visit www. preptopreventhiv.org.

One pill. Once a day. PrEP now. Prevent HIV. Sources: www.worldaidsday.org Houston Health Department AIDS Foundation Houston, Inc. www.preptopreventhiv.org

research on the visual system and eye diseases. NEI supports basic and clinical science programs to develop sight-saving treatments and address special needs of people with vision loss. For more information, visit www.nei.nih.gov. About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www. nih.gov. Source: nei.nih.gov References: Crair, Michael C. and Carol A. Mason. “Reconnecting Eye to Brain(link is external),” Published online in J. Neuroscience, Oct. 19, 2016. DOI:10.1523/JNEUROSCI.1711-16.2016.

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December 2016â&#x20AC;&#x192; 11

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December 2016

No Food Poisoning Over the Holidays

food: in the refrigerator, submerged in cold water, and in the microwave. Food thawed in cold water or in the microwave should be cooked immediately. Keep raw meat and poultry separate from other foods, and use one cutting board for fresh produce and a separate one for raw meat and poultry. And it is worth a reminder — never place cooked food on a plate that previously held raw or undercooked meat or poultry.

By d-mars.com News Provider

ood hosts want positive experiences around the dishes they prepare for the holidays — great conversation and good memories. What’s a sure way to mar the feast? Not being consistent in following safe food handling techniques that every home cook should know. Each year, one in six people experiences food poisoning, affecting some 48 million people, according to the Centers for Disease Control and Prevention (CDC). “Sometimes, the causes of food poisoning are beyond our control, in spite of regulations and best practices by farmers and food companies. While ready-to-eat foods and restaurants are often highlighted in the fight against food poisoning, we often overlook that home cooks are important partners in reducing the risk of foodborne illness,” said Mike Robach, vice president of food safety at Cargill. “The most common foodborne pathogens, like salmonella and campylobacter, can cause serious illness, particularly in young children, the elderly, pregnant women and other immune-compromised people,” said Shelley Feist, executive director of the Partnership for Food Safety Education. "Consistently practicing good hand hygiene and safe food handling at home is important to protect your family from these microorganisms and the serious illness they can cause.” Each year, foodborne illnesses lead

Cook to safe temperatures

to 128,000 hospitalizations and 3,000 deaths, according to the CDC, as they can lead to serious conditions such as sepsis and kidney failure. Like any skilled chef, you are best prepared to create a memorable feast when you keep these safe food handling practices top-of-mind. They are just as necessary to a great meal as sharp knives, highquality cookware, fresh ingredients and the right appliances.

Clean hands and surfaces often Before you begin cooking, start by making sure your work area and tools are clean. Wash all preparation surfaces, including cutting boards, with hot, soapy water. If any tools or containers you will need are dirty, either run the dishwasher cycle or hand-wash the items in a sink of hot, soapy water. Finally, wash your hands with warm water and soap for 20 seconds before and after handling food.

Rinse fresh fruits and vegetables Depending on what you are using,

some foods will require rinsing. Rinse fresh fruits and vegetables under running water just before eating or using. Firmskinned produce like cucumbers and apples should be rubbed under running tap water by hand or with a clean brush. You should also rinse any produce that will be peeled, because microorganisms on the surface can be easily transferred to the flesh with a peeler or knife blade. Blot fresh fruits and vegetables dry with paper towels. There is no need to rinse raw meat or poultry, at least, not in the name of food safety. All that will accomplish is potentially spreading bacteria in your sink and beyond. Raw meat and poultry must be cooked to a safe internal temperature.

Safely handle meat and poultry The best home cooks know it’s important to safely handle raw meat and poultry. To start with, do not thaw frozen meat and poultry at room temperature — to do so gives harmful bacteria an ideal environment to multiply and spread. There are three safe ways to defrost

Here is a compelling reason to cook food to a safe temperature: Even a professional chef cannot say with precision if a food item is cooked to a safe internal temperature. Food is safely cooked when it reaches a high enough internal temperature to kill the harmful bacteria that cause illness. Get a food thermometer and use it consistently. For a list of safe internal temperatures, visit the Partnership for Food Safety Education website at fightbac.org.

Safe leftovers Proper storing of leftovers in a refrigerator at 40 degrees Fahrenheit or below helps reduce the risk of food poisoning. Keep leftovers in shallow containers so they cool off more quickly. When reheating leftovers, make sure they reach a safe temperature of 165 F degrees as measured with a food thermometer. Consume or freeze refrigerated leftovers within three to four days. For more tips to build your skills and expertise in food safety, visit Storyof YourDinner.org. Check out an animated video, as well as fun items such as kidfriendly placemats to download, and a collection of delicious side dish recipes that incorporate home food safety tips. – BPT

Business

Bundled Payments: Impact on Hospitals, Employers & Patients

undled payments are becoming not just the choice for payors, but for employers and the general public as well. A new survey from PricewaterhouseCoopers (PWC) shows just how essential it is for hospitals to get on board with this growing reimbursement trend. The PWC survey was designed to measure the current state of bundled payments, including their popularity among various stakeholders in health care. Out of all respondents, 31% of hospitals and 20% of employers are participating in some sort of bundling program. In addition, 35% of hospitals are in an accountable care organization (ACO) where patient outcomes are tied to payments. Although most hospitals aren’t participating in bundling arrangements, the benefits may soon convince more facilities to get on board before it’s required. Out of all hospitals in bundling arrangements, 63% experienced cost savings, and 69% improved the quality of care they provide patients.

Companies’ preferences Employers are looking to participate in

more bundled arrangements with hospitals and payors so they can reap some of the benefits themselves – most notably the cost savings. In fact, 88% of employers surveyed said the current cost of health care is their top concern, and 72% said they’d require a decrease in at least 6% of their costs before they’d consider entering into a bundling arrangement (34% of employers who’ve adopted bundling said they’ve already achieved this goal). The only area where employers and hospitals agree is cost-savings. While employers want broader, more far-reaching bundling arrangements, most hospitals plan to keep bundling agreements relatively narrow in scope. In addition, employers want more bundles that focus on chronic conditions like diabetes, which can be costly to manage. Hospitals in bundling arrangements are mostly focusing on acute and procedural conditions (e.g., pneumonia, joint replacements).

What patients think Generally, patients are more satisfied with bundled services than they are with

The best way for hospitals to counter this is by working closely with primary care physicians to get the word out about bundling, since 69% of patients said that information from their primary care doctor is the most helpful resource in choosing where to pursue care.

Paving way for bundling other healthcare arrangements: 55% said they preferred the bundling arrangement over the previous services they received. Even those who don’t directly participate are intrigued by their benefits – 61% of patients surveyed found bundles appealing (only 5% found them unappealing). And 80% of them would pick an ideal bundle over their current care arrangements. Sixty-two percent would choose a bundling arrangement with reasonable restrictions and “at par” pricing over their current care. However, many patients aren’t aware of their options for bundling arrangements – which could be a hindrance for hospitals as more payors pressure them to participate in these arrangements. Only 31% of patients surveyed were familiar with bundles before the survey.

According to the PWC survey, hospitals can take other steps to make bundled arrangements more beneficial to employers and patients by reviewing the characteristics of their local market, including employer/patient preferences, and their own strengths before choosing to participate in a voluntary bundling program. Hospitals can also be proactive with anticipating services that may be subject to bundling by payors in the near future. Facilities should identify services that have the most variation throughout the hospital in terms of quality and costs. That way, facilities can start putting their efforts into standardizing care for these conditions, reducing variation and improving outcomes. Source: www.healthcarebusinesstech.com

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December 2016â&#x20AC;&#x192; 13

Biotech

Novel â&#x20AC;&#x2DC;Repair Systemâ&#x20AC;&#x2122; Discovered in Algae May Yield New Tools for Biotechnology

new way of fixing inactive proteins has been discovered in an algae, which uses chloroplast extracts and light to release an interrupting sequence from

a protein. Research specialist Stephen Campbell and Professor David Stern at the Boyce Thompson Institute report the discovery in the July 29 issue of the Journal of Biological Chemistry. This repair system may have applications in agriculture and biotechnology because it could potentially be harnessed to enable proteins to become active only in the light. Many proteins contain extra sequences, called insertions, that can disrupt their function. The current paper demonstrates that the algae Chlamydomonas reinhardtii has the necessary toolkit to repair proteins by removing these insertions. Campbell discovered this new repair system while purifying a protein from the chloroplasts of C. reinhardtii that can cut RNA. Upon sequencing the protein, he identified it as RB47, a protein that was not known to have any RNAcleaving ability. Campbell noticed that the middle of the protein was missing.

This is a TEM image of the algae C. reinhardtii. Credit: Photo courtesy of Mary Morphew and J. Richard McIntosh via the Cell Image Library.

When he compared the protein sequence to its corresponding gene sequence, the protein was much shorter than expected. Upon further study, Campbell found that he could detect a long version of the protein that contained an insertion and a short version that didn't. The cells make both versions when grown in the light or the dark, but only the short version can cleave RNA. The long version of the pro-

tein could be converted into the short one by mixing it in a test tube with chloroplasts from cells grown in the light and by illuminating the reaction. This process removed the interrupting insertion and restored the RNA-cutting activity of the protein. It is likely that the chloroplast maintains the machinery necessary to remove the sequence so that it can restore functionality to the protein.

This new type of repair system provides intriguing possibilities for biotech applications. Because the insertion can be placed so that it interrupts a protein's function, the insertion and repair system may be useful for producing certain pharmaceuticals or protein products -- such as cancer drugs -- in culture, which would otherwise kill the cell. After purification, the inactive products could be treated with chloroplast factors and light to remove the insertion and activate the proteins. In future work, the researchers plan to investigate exactly how the insertion becomes spliced out of the protein and which plant factors facilitate its removal. They also aim to understand the purpose of the insertion, and whether the algae can control the splicing to respond to changes in the environment. Campbell and Stern also want to know how widespread this new type of protein splicing might be. "If it is happening in plants, is it happening in animals?" said Stern. "We're pretty sure that this protein is just one example; that we have only found the tip of the iceberg." Source: ScienceDaily.com

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December 2016

A Heart and Advocate for Mental Health & Wellness

By Dawn Paul

Associate Editor

ublic stigma occurs when a large population collaboratively accepts a discrediting stereotype (e.g., about out-group members, about individuals who are different in physical, behavioral, and other intrinsic characteristics from the perceived norm). There is a definite public stigma in the community when it comes to mental illness. Public stigma can lead to self-stigma, where one battling mental illness can become overly fixated on their diagnosis and neglect their positive attributes. Self-stigma can also impair an individual’s social and emotional functioning and quality of life. Helping heal in the area of mental health and to combat stigmas associated with mental illness, is The Village Life Center (TVLC), located in Houston, TX. Founded by Ayanna Carr-Brown (CEO), TVLC has a true heart for healing those dealing with mental illness and advocating for mental wellness. TVLC is based in Plaquemine, Louisiana, but Ayanna has expanded the center’s reach to Houston, now taking its healing on a national level, making Houston a second home. With this being one of the largest and most diverse cities in the nation and having the experience in this area of health, TVLC has the ability to do great work in Houston, contributing to helping our community in the area of mental health and wellness. According to a recent report by CHILDREN AT RISK, an estimated 14,000 Houston children with severe mental illness do not have access to public or privately funded systems of care. “I truly have a heart for children and families in low-income areas. In many cases, the children are in low-performing school districts and the parents lack the information and resources to get their child’s needs met. What I know for sure is, if a child is not ‘mentally well,’ he/she cannot excel in school or in life. Even with a skilled teacher and great curriculum, if children don’t have the tools needed for mental wellness, they will fail or not reach their full potential. Also, if an adult is not ‘mentally well,’ he/she cannot be successful in life,” says Ayanna. TVLC wants to be a part of improving the lives of families by providing quality mental health care. TVLC is here to contribute to the betterment of Houstonians who are battling mental illness, helping to make a difference in their lives and in Houston. Ayanna runs TVLC’s day-to-day operations and is highly-skilled when it comes to addressing mental healthcare needs. She earned her B.S. degree in Social Work from Framingham State University and her MBA from Clark Atlanta University. Not only does she have the education, but she also has the heart and the extensive experience. Her work experience started in a group home for adolescent girls. Though she worked in corporate and was very successful, it became very apparent to her that she needed to return to her calling, working to help families and children. Ayanna says, “I needed to find my way back into the lives of children that needed extra attention and support. Out of that desire, I started a company called Village Learning Solutions that offered tutoring for low-income students in failing school districts through No Child Left Behind. When that program ended, I decided to focus on mental health in children and adults, as it is the foundation for the success of any individual. From this experience, TVLC was born.” Over the years, TVLC has worked with countless children who are dealing with issues that make it difficult for them to learn and retain information. The problems have ranged from psychological deficiencies such as ADHD to trauma, abuse, and/or neglect they may have experienced. “I thought, how can we expect these children to learn when they are not ‘whole’ mentally and physically?

Many of them had negative perceptions of schools, and in some cases it was a continuation of what their parents experienced,” Ayanna expresses. It became very apparent to Ayanna that in order for children in at-risk situations to learn, grow, and reach their full potential, they had to have psychological support. Just like children need adequate food and shelter to grow and progress, they also must have the psychological support. Also, adults cannot live up to their full potential without being at their best mentally. This is where TVLC comes in. Through the leadership of Ayanna, TVLC is a great resource for adults and families whose children need quality and accessible mental health care.

“

The Village Life Center has served hundreds of children and adults. As a result of our services, children have fewer incidents of suspension, hospitalization, and repeat incarceration. Also, adults are able to get and maintain employment and have improved relationships. We will be a leader in fighting the stigma associated with mental illness, being an educational resource and most importantly, advocating for mental wellness.” – Mrs. Ayanna Carr-Brown, CEO of The Village Life Center

TVLC’s motto is Be Positive, Patient & Persistent. Their mission is also to educate the community about the need for mental health support and that there is no shame in seeking help. Ayanna and TVLC’s staff will work diligently to change the mindset that seeking mental health support means that you are crazy. Ayanna says, “Seeking mental health support is no different than seeing a doctor for cancer or diabetes. You should nurture your mind. Our community tends to feel that counseling is embarrassing or it means that something is wrong with you. That could not be further from the truth. We are proud to be members of the Houston community, contributing to the mental health and well-being of Houstonians in need of the quality help that they need and deserve. TVLC will continue to be an advocate for mental wellness. We are proud to be in Houston, and we are here to stay.” The Village Life Center is located at 2101 Crawford, Suite 208, Houston, TX. For more information, please call 713-7399725 or visit the center on the web at www.VillageLifeCenter.com.

Sources: smhp.psych.ucla.edu CHILDREN AT RISK

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December 2016 15

Get to know

The Village Life Center 1. Talk about the stigma associated with mental illness. Stigma is a huge factor in our community. TVLC and we as a community can work together towards ending stigmas in regards to mental illness. The way counseling and mental illness are perceived has a substantial impact on people deciding not to seek help. They don’t want to be labeled as crazy. TVLC is fighting against the stigma associated with mental illness. If you have cancer, you seek medical attention, if you break your arm, you seek medical attention, diabetes, high blood pressure, and the list goes on. Well, mental illness is the same way. If you are depressed, if you have ADHD, if you have suicidal thoughts, if you have anxiety, there is help. You should see a professional and there is no shame! In fact, people with mental illness can live full, productive, successful, and happy lives if they get the help they need.

2. What does TVLC want people to understand about mental illness? There is hope for EVERY person suffering from mental illness. The right service, the right team, and the right medical attention, results in success. 3. How does TVLC want to make change in regards to addressing mental illness? As a respected member of the medical community, TVLC seeks to affect change by advocating for improvements in policy and practice. For one, making sure that all insurances, including Medicaid and Medicare cover necessary treatment for people who suffer with mental illness. Next, we can affect social change by coordinating and participating in community discussions, working with media outlets, and using social media to manage the portrayal of mental illness that reflects hope instead of negativity. Finally, we can change the perception of mental illness in an individual through education and our services. 4. Please talk about TVLC’s success rate when it comes to treating mental illness in children, youth, and adults. TVLC has served hundreds of individuals. As a result of our services, children have fewer incidents of suspension, hospitalization, and repeat incarceration. Adults are able to get and maintain employment, have improved relationships at home, and in the community. TVLC will be a leader in fighting stigma and being an educational resource for mental illness, and most importantly advocating for mental wellness. 5. Where do you see TVLC years from now? We see TVLC offering a full spectrum of mental health services to include residential facilities where people can grow and live independently. We also envision offering a safe place for children and adolescents to deal with and overcome the debilitating aspects of mental illness. Our services are and will continue to be led with love and compassion for all individuals, regardless of their circumstances.

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December 2016

Careers

Get an Inside Look at the Work of a Surgical Telemetry Nurse Supervisor in a Military Medical Center By d-mars.com News Provider

eith F. Holliday R.N., Ph.D.(c), M.P.A., a Lieutenant Colonel (LTC) in the United States Army Nurse Corps, is a Clinical Nurse Officer in charge of a surgical telemetry unit in a Level 1 Trauma Center at San Antonio Military Medical Center in San Antonio, TX. This facility provides the highest quality medical and trauma care for active duty service members, dependent family members, retirees and civilians. As a health care manager and administrator, LTC Holliday supervises 80 personnel on a 28-bed surgical telemetry unit that operates 24 hours per day, 365 days per year. In addition to his supervisory responsibilities, he addresses patient complaints, provides customer service and monitors key quality metrics on his unit. Telemetry is an automated process used to monitor patients at risk for cardiac arrhythmias. Telemetry provides alerts to nursing and medical staff so appropriate life-saving measures can be taken if needed. Telemetry nurses are trained to use telemetry equipment and analyze the data it provides. Surgical telemetry nurses work specifically with patients who have had surgery. The unit admits medical patients for telemetry monitoring as well.

ment of a student’s time and energy because students are learning not only to be adept with didactic knowledge but with clinical knowledge also. I suggest that nursing students eliminate all distractions that take away from their preparation for examinations and clinicals. They should also examine their study habits. I found that re-writing key points from my lecture notes helped me to perform better on examinations. I went to Adelphi University School of Nursing initially but transferred to Excelsior College to complete my bachelor’s degree. Not every school is a good fit for every student. Students should not give up on their dreams, and they should recognize that anything worthwhile does not come easy. Changing schools may give a student the fresh start he or she needs to succeed.

What advice do you have for high school students who want to join the military and become a health care professional? The earlier you find your career goal and make it a passion, the faster you will reach your goals. If you are interested in a career in the military, start off with ROTC in high school. If you want to come in as an officer, joining the ROTC in college is a great option for paying your way through undergraduate school. Most of the military’s top leaders are ROTC college graduates.

Did you experience any hurdles or obstacles as you prepared for your career?

What is a typical day like for you?

Nursing school is very difficult. Getting through it takes a total commit-

A general workday consists of 10 to 12 hours depending on the mission that

needs to get accomplished. As a nurse manager, my greatest concern is the well-being of the patients and my staff working the unit. I am involved with the supervision of bedside care, staffing, scheduling, clinical policy and hospital committee functions. My day begins at 6:45 a.m. in a morning huddle with the night and day shift staff. During these huddles, we discuss how many patients are in the unit, staffing considerations and safety/education needs that staff must know before starting the day. Next, I make rounds, visiting patients to ask how their care is going and if there is anything I can do to assist them. After that, I check my calendar for scheduled meetings and answer e-mails. I generally have a brief meeting with my Assistant Clinical Nurse Officer in Charge who is a civilian RN and my Non-Commissioned Officer in Charge to address any staff disciplinary concerns or supply issues. A portion of my day is spent writing officer evaluations and awards for Air Force and Army personnel assigned to my unit. One reward of my position is being able to mentor the future generation of nurses. I can make a difference in the lives of new officers and encourage them to be the best that they can be.

What kind of challenges do you face in your workday? Patient flow is our greatest challenge. Since we have many admissions and discharges, keeping beds available for new patients is a daily challenge. In a large hospital, collaboration is needed at all levels to achieve the mission. Many clin-

ical and administrative decisions have to be vetted through higher chains of command. When decisions are made at higher levels, there is greater continuity across the organization and processes are consistent and streamlined.

What is the difference between your role in the military and a civilian health care professional? The main difference between my position and that of a civilian is the Army’s training and physical fitness requirements. There is also always a possibility of deploying overseas. As a supervising officer, I am also responsible for counseling and mentoring the junior officers and providing them with guidance for their future success in the military. Aside from those differences, my position is quite similar to a nurse manager in a civilian facility.

What are some of the educational benefits offered by the military? The military provides wonderful benefits. The education benefits are outstanding. Many service members are fortunate to attend college through programs like the Green to Gold Program and the Long Term Health Education and Training Program. The Post 9-11 GI bill offers tuition benefits for service members and their selected beneficiaries. Many colleges and universities also participate in the Yellow Ribbon Program, adding an additional benefit to that which the Army already pays. Source: explorehealthcareers.org

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December 2016â&#x20AC;&#x192; 17

Sports Medicine

Childbirth an Athletic Event? Sports Medicine Used to Diagnose Injuries Caused by Deliveries

By d-mars.com News Provider

hildbirth is arguably the most traumatic event the human body can undergo, and new imaging techniques show that up to 15 percent of women sustain pelvic injuries that don't heal. Researchers from the University of Michigan reasoned that using MRI to diagnose childbirth injuries -- a technique usually reserved for sports medicine -makes sense because childbirth is as traumatic as many endurance sports. "If an athlete sustained a similar injury in the field, she'd be in an MRI machine in an instant," said Janis Miller, associate professor at the U-M School of Nursing. "We have this thing where we tell women, 'Well, you're six weeks postpartum and now we don't need to see you -- you'll be fine.' But not all women feel fine after six weeks nor are ready to go back to work, and they aren't crazy." Researchers found that women can take eight months or longer to heal from pelvic injuries sustained during childbirth, and in some cases the Kegel exercises commonly prescribed don't work at all. "Women with pelvic injuries often feel like something isn't right, but they don't understand why and can't get answers from physicians," Miller said. "A woman

may have bladder problems, and in some cases prolapse of organs if the pelvic muscles are not functioning well enough to hold them in place." How could Miller give her patients a better explanation? She and a team of midwives, radiologists and obstetricians studied a group of pregnant women at high risk for pelvic muscle tears, and used MRI to diagnose injury and track healing time. What the MRI scans showed turned prevailing wisdom upside-down. Previously, experts thought that postpartum pelvic injuries were primarily nerve-tomuscle related. But the images in Miller's study showed

that one-quarter of women showed fluid in the pubic bone marrow or sustained fractures similar to a sports-related stress fracture, and two-thirds showed excess fluid in the muscle, which indicates injury similar to a severe muscle strain. Forty-one percent sustained pelvic muscle tears, with the muscle detaching partially or fully from the pubic bone. Kegels are the most commonly prescribed exercise, but they can't reattach pelvic muscles to the pubic bone -- nothing can. Many women do these exercises religiously but don't heal as they've been told they would, Miller said. She stressed that the study group was se-

lected for high-risk factors of muscle tear, and isn't representative of the population of expectant mothers. Most injuries including all fractures healed by the eightmonth return visit time. Miller hopes the study derails the onesize-fits-all approach to treating postpartum injuries so women will stop blaming themselves if problems linger. She recalls one patient who made her particularly sad. "I walked into my office, and before she even said 'Hi,' the woman told me, 'I know it's all my fault because I didn't do enough Kegel exercises,'" Miller said. "We're not saying that every woman who gives birth needs an MRI nor that women should not do Kegel exercises. A key point is that if a woman is sensing that she has delayed recovery or unusual symptoms of discomfort or feels she just can't Kegel anymore, she should see a specialist." The team will follow the women through subsequent births to determine how the pelvic floor injuries impact childbirth and overall health and well-being. At U-M, a Healthy Healing Clinic helps women who have experienced a more complex birth, a weakened pelvic floor, or have delayed recovery postpartum. The clinic is the first of its kind in the country and relies on the findings from Miller's studies. Source: www.ScienceDaily.com

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December 2016

Careers

Put Your Bachelor’s Degree to Work with These Three Health Careers: Athletic Trainer, Public Health and Health Administration By d-mars.com News Provider

personal trainer. If you go to a gym, you may have used the services of a personal trainer. They can be quite helpful. However, personal trainers may have little or no formal instruction or education, and their skill sets and job duties are quite different. They focus on fitness and are not considered health care professionals. Only graduates of an accredited athletic training program who pass the board examination are allowed to use the title of athletic trainer.

hoosing a health care field is a personal choice that involves careful thought, planning and exploration. Your career decision will be based on a number of factors. One important aspect to consider will be the number of years of school required to obtain a degree and practice in your chosen field. Some professions require more education than others. Fortunately, there is a wide range of choices at all degree levels. For example, ExploreHealthCareers.org offers three profiles of careers in health care for students who want to start working after graduating from college.

Public Health

Athletic Trainer On any given weekend, a prominent professional or collegiate athlete goes down on the field or court with a significant injury. Immediately, the athletic trainer springs into action to provide medical care. The high-profile athletes may receive the most attention from the media, but the medical care provided to athletes should be the same regardless of their level of competition. Athletic trainers provide care to athletes at all levels and have been credited with saving the careers, limbs and lives of those under their care. Athletic trainers are highly qualified, multi-skilled health care professionals who work as part of a collaborative interprofessional team. Athletic trainers provide injury/illness prevention, wellness and protection, clinical evaluation and diagnosis, immediate and emergency care, treatment and rehabilitation to their patients. Typical work settings include intercollegiate athletics, performing arts, physicians’ offices, professional sports and more. Athletic trainers must

graduate from an accredited professional program at either the bachelor’s or master’s degree level. Upon successful completion of the certification exam, you can obtain national certification that will qualify you to apply for a state license to practice as an athletic trainer. Starting in the fall of 2022, the degree requirements for athletic trainers will change from a bachelor’s degree to a minimum of a master’s degree. If you obtain your degree and certification before this official change is made, you do not have to go back to school to obtain a master’s degree. However, according to the National Athletic Trainers Association, more than 70% of athletic trainers currently hold at least a master’s degree. Don’t confuse this profession with a

You have likely seen the news about the Zika virus, its link to birth defects and how it can be spread by a bite from a specific type of infected mosquito. Public health professionals work to prevent the spread of viruses like Zika and other diseases by educating the public on how they are transmitted and tracking the spread of the disease. Public health is the science and art of creating healthy communities through education, research and promotion of healthy lifestyles. There are 20 major fields of study with five core disciplines. For example, students may choose minority health and health disparities as their field of study. Practitioners in this field of study address factors causing gaps in quality of health care across social, ethnic, sexual orientation and socioeconomic groups. Baccalaureate degrees in public health became accredited in 2007. Prior to 2007, public health degrees were only offered at the master’s and doctoral degree levels. A baccalaureate degree allows you to receive early and broad training in order to work in the public health field and/or prepare for further study in public health. After obtaining a bachelor’s degree, you can work in government, private and nonprofit organizations. According to the National Center for Education Statistics, public health is one

of the fastest growing undergraduate majors in the United States.

Health Administration If you are a fan of the TV show House, you probably remember Dr. Lisa Cuddy, the character played by Lisa Edelstein. Although she was a physician, her primary role at the hospital was as a health administrator. In Nurse Jackie, Anna Deavere Smith plays Gloria Akalitus, who is also a hospital administrator. Health administrators are leaders. They head up hospitals, physician group practices, nursing homes and home health agencies. They are responsible for facilities, services, programs, staff, budgets, relations with other organizations and other management functions, depending on the type and size of the organization. Unlike clinicians, health administrators or managers do not deal directly with patients on a day-to-day basis. Instead, they help to shape policy, make needed changes and lead our nation’s health-related organizations in a way that serves individual patients by helping to improve the health care system. Degrees in health management/administration are available at the baccalaureate level. You can choose to further your education by obtaining a master’s or doctorate degree. Graduates of baccalaureate programs are prepared for employment in for-profit and nonprofit organizations, such as ambulatory care facilities, residential health care settings, group practices, health maintenance organizations, community health settings, government agencies and hospitals. According to the Bureau of Labor Statistics, employment in the field of health care management is projected to grow 17% from 2014 to 2024—much faster than the average for all occupations. Source: explorehealthcareers.org

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December 2016 19

Healthy Holiday Cocktails As you raise your glass this holiday season, make it a point to bring this traditional toast to reality with these recipes for healthy holiday cocktails. For more recipes, please visit www.CookingLight.com.

Cranberry Cosmopolitan Apple-Jack Spiked Hot Cider

Ingredients • • • •

1/2 cup Cranberry Liqueur, 1/4 cup Cointreau, 2 tablespoons lime juice. Mix with 1 cup crushed ice; strain into martini glass. • Makes 2 cocktails.

Ingredients

Sparkling Pomegranate Cocktail Ingredients

• 2 cups pomegranate juice (such as pom Wonderful) • 1 1/2 cups lemon-flavored sparkling water • 1/2 cup berry-flavored vodka or plain vodka • Lemon rind strips (optional) • Combine first 3 ingredients in a pitcher • Pour 1/2 cup into each of 8 ice-filled glasses • Garnish with lemon rind strips if desired.

• • • • • • • • • • • • • •

2 tablespoons butter 2 tablespoons dark brown sugar 10 black peppercorns 8 whole allspice berries 5 whole cloves 2 (3-inch) cinnamon sticks 6 cups apple cider 1 tablespoon honey 1/2 teaspoon vanilla extract 2 (2-inch) orange rind strips 2 (2-inch) lemon rind strips 3/4 cup applejack brandy Melt butter in a large saucepan over medium heat Stir in sugar and next 4 ingredients (through cinnamon sticks); cook 1 minute • Add cider and next 4 ingredients (through lemon rind); bring to a simmer • Reduce heat to medium-low; simmer 15 minutes • Remove from heat; stir in applejack • Strain; discard solids

Cranberries

Cranberries are a seasonal powerhouse protecting against urinary tract infections as well as being an excellent source of Vitamin C, manganese, and other phytonutrients called flavonoids. These powerful antioxidants help maintain cell structure and eliminate “free radicals” (aka: toxins) from the body. Not only are they super healthy, but they’re festive, colorful, and delicious. Jazz up your holiday offerings this year with our Cranberry Cosmopolitan – made with your own homemade Cranberry Liqueur.

Pomegranate

Pomegranate are rich in Vitamin C, B6, and potassium – not to mention their peak season is in sync with holiday time. Just one glass of pomegranate juice has the same cancer-fighting polyphenol content as two glasses of red wine or 10 cups of green tea. Add some healthy, festive holiday cheer to your party with one of our bubbly pomegranate refreshers.

Cinnamon

Cinnamon is a powerful antioxidant and is currently under research for its potential to help regulate blood sugar and inhibit tumor growth. Cinnamon has the highest antioxidant capacity of any spice, and is a potent antimicrobial agent. Don’t hesitate to sprinkle extra cinnamon on those holiday dishes (and cocktails) this year.

Cheers to Moderation

Enjoy this holiday season with these suggested festive cocktails. But remember that excessive drinking may not only increase your risks for some diseases and cancers, it can also add lots of calories and lower your “healthy-eating” inhibitions. So cheers to moderation… and dedicate this holiday season “to your health!”

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December 2016

Education

Let’s Talk About More Than Sex: Parents in Favor of Expanding Health Education Teaching kids about drugs, alcohol and sex appears to be less controversial than ever before with the majority of parents in a new poll saying schools should and do teach these subjects.

What parents say should be covered in health education. Credit: C.S. Mott Children’s Hospital National Poll on Children’s Health

By d-mars.com News Provider

any parents want more -- saying those topics are not enough -finds the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health. Researchers surveyed a nationally representative sample of parents with kids in middle or high school. Two-thirds of parents polled say schools should definitely cover emotional and mental health issues -- which may include such subjects as dealing with depression, stress and bullying -- yet only a third say these topics are currently covered by their child's school. Another 68 percent of parents want to see schools cover basic first aid, and 63 percent say kids should learn CPR. "Most parents today support traditional health education topics like pregnancy prevention, drug abuse and other risk behaviors that used to generate more debate in years past. However, they clearly perceive a gap between what their

children need and what they are receiving in the area of mental health education, as well as basic first aid and CPR," says Sarah Clark, M.P.H., co-director of the C.S. Mott Children's Hospital National Poll on Children's Health. "We are seeing increasing concerns for such issues as stress, depression and suicide among young people, and parents want schools to be a part of the solution. These results suggest that the stigma of mental health issues may have relaxed among today's parents, in favor of using a broad array of resources to help children and adolescents with these critical areas."

Changing trends in health education Mental health topics dominated parent concerns in an August Mott Poll re-

port on the top 10 child health concerns, with bullying, stress, suicide and depression all making the list. Teen suicide is a growing health concern, recently moving from the third to second leading cause of death for adolescents, surpassed only by car accidents, according to the American Academy of Pediatrics. Sex education has come a long way from 1975 when nearly half of state legislatures voted to restrict or abolish it compared to today when most adolescents in the U.S. receive some form of sex education between sixth and 12th grade. Parent perspectives reflect the trend, too, with more than two-thirds of parents polled saying traditional health topics should definitely be covered at their child's grade level, including physical activity, drug and alcohol abuse, healthy

eating and sex education and pregnancy prevention. Most parents say these topics are currently taught at their school. Nearly four in 10 parents (39 percent) also believe schools should educate students on how to use the health care system. But only one in 10 parents say the topic is covered in their child's school. Low-income parents are more likely to say schools should teach students how to use the health care system -- perhaps, Clark notes, because these parents face challenges themselves in accessing health care. Clark also notes that schools face significant barriers in expanding their formal health education curriculum. Core academic requirements, parent or student preferences for electives and the financial burden of hiring more teachers can limit opportunities to expand health education courses. But schools may seek other strategies such as recruiting health care professionals from local hospitals or clinics or nonprofits to offer occasional sessions on first aid or CPR. Schools with onsite health centers may ask those staff to expand their educational sessions. "Most parents believe schools are on the right track with what kids are learning in health education, but recognize that today's youth face a growing set of issues impacting their health," Clark says. "School leaders may consider ways to incorporate health topics in the classroom." Source ScienceDaily.com

Medicine

Blood Pressure May Open Door to Personalized Medicine for PTSD By d-mars.com News Provider

reatment with the drug prazosin effectively reduces symptoms of posttraumatic stress disorder (PTSD) for many people, but about one third of patients don't respond to the treatment at all. Attempts to understand why people respond differently, based on symptom type or severity, have fallen short. Now, a new study reports that soldiers with higher blood pressure before beginning prazosin treatment see better results from the medication. The study, published in Biological Psychiatry, is the first to look for a biological marker that could be used to predict individual response to a drug treatment for combat PTSD. "These findings suggest that higher standing blood pressure is a biomarker that can contribute to a personalized medicine approach to identifying soldiers and veterans with combat PTSD likely to benefit from prazosin," said

Murray Raskind of the VA Puget Sound Health Care System and the University of Washington in Seattle, who led the study. A biomarker such as blood pressure would have exceptional clinical utility because it would provide an easily measureable and immediate predictor of treatment response that could help doctors determine the role of prazosin or a similar medication in the treatment strategy for an individual. Prazosin blocks α1-adrenergic receptors (α1AR), and through this mechanism prevents some of the effects of adrenaline and noradrenaline, chemicals released by the body during stress. "It would make sense if prazosin was most effective in those patients with the greatest activation of noradrenaline systems," said John Krystal, Editor of Biological Psychiatry. However, activity of α1AR cannot be measured directly in humans. So the researchers identified a peripheral biological marker that is regulated by α1AR activity; noradrenaline stimulation of

α1AR increases blood pressure, suggesting that blood pressure may be a useful indicator of α1AR activity. The researchers analyzed the combat PTSD symptoms and blood pressure measures collected previously as part of a randomized controlled trial of 67 soldiers who had returned from Iraq and Afghanistan. Thirty-two participants had received prazosin, and 35 had received placebo for 15 weeks. "Pretreatment standing systolic blood

pressure strongly predicted response to prazosin," said Raskind. By the end of the 15 week treatment period, participants with a higher initial blood pressure saw a bigger improvement in their PTSD symptoms, with a better outcome for every 10 mmHg increment above 110 mmHg. In addition to suggesting that blood pressure may help predict which soldiers with PTSD will benefit the most from treatment, the findings also provide insight into the pathophysiology of the disorder. "The increase in blood pressure in these PTSD patients may be a biomarker for patients who are more likely to benefit from prazosin," said Krystal. "If so, it may be a useful indicator of activation of noradrenergic activation associated with PTSD in these patients." Reference Elsevier. (2016, November 3). Blood pressure may open door to personalized medicine for PTSD. ScienceDaily. Retrieved November 15, 2016 from www.sciencedaily.com/ releases/2016/11/161103091008.htm

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December 2016

Healthcare Policy News

New DOJ and DOL Rules Could Change Providers’ Business Operations

he healthcare industry is inundated with complex regulations and laws that most industries don’t have to navigate. But as executives and compliance officers dig their heels deep into ICD-10, Meaningful Use, HIPAA and other healthcare-specific regulations, the employee payroll – business’ great common denominator – still can’t be overshadowed. In this guest post, Keith Dennen, a member attorney with a full-service law firm, reviews two rules that’ll affect providers’ bottom line. Employment law and rules governing employees’ provisioning of services respective to the healthcare industry has been rapidly changing in recent months, and it has real bottom-line implications for providers. Two notable changes have come from the Department of Labor (DOL) and the Department of Justice (DOJ). Both changes could require healthcare providers to address their current business structure and set protocols in place in order to prevent potential law suits, fines or other sanctions.

DOJ’s call for expanded equal treatment This May, the DOJ issued its final rule for changes to the nondiscrimination provision – or Section 1557 – of the Affordable Care Act (ACA). Section 1557 expressly prohibits discrimination on the basis of race, color, national origin, sex, age or disability in the provision of services for any health program

or activity that receives Federal financial assistance. To note, Medicare Part B payments are not “Federal financial assistance,” but any other payments received from the federal government may be deemed Federal financial assistance.

But the new rule takes nondiscrimination further still, recognizing four new bases of discrimination: 1. Sexual stereotyping. Healthcare providers can’t discriminate because a person doesn’t fit pre-conceived gender notions, such as voice, dress, mannerisms, etc. 2. Gender identification. An individual can’t be discriminated against because of his or her internal sense of gender, which may be different than the sex assigned at birth. 3. Association. Healthcare providers cannot discriminate because a person is associated with a person of a protected class. 4. Limited English proficiency. An individual cannot be denied service because he or she is not proficient in the English language. The limited English proficiency protection will likely be most challenging for providers, as compliance may come with added financial burden. Turning a patient away, even because of an inability to communicate, can now be considered discrimination. Providers will now need to have translators available and

ready to handle situations where communication barriers exist. Compliance with the other three protected classes will not be as financially strenuous. However, healthcare employers shouldn’t assume that any of these discriminatory acts will be organically avoided. Employers should adjust employee handbook policies to include the new protected classes, and consider training staff and management on how to identify and prevent potential discrimination.

DOL’s expansion of overtime pay The DOL recent expansion of overtime pay exemptions will also have a significant impact on providers and the management of their employees. This May, the DOL issued its final rule updating the requirements for employees to qualify for exemption from the overtime requirements outlined under the Fair Labor Standards Act (FLSA). Under the new rule – which goes into effect Dec. 1, 2016 – in order for employees to qualify for the executive, administrative or professional exemptions, they will need to make $47,476 annually or $913 per week. That’s more than double the current threshold of $23,600 per year, or $455 per week for salaried employees. And beginning in January of 2020, that salary level will automatically be adjusted every three years to the 40th percentile of full-time salaried workers in the lowest-wage Census region (currently, the South). As a result, providers could face a dra-

matic change in overtime payouts, particularly with support and operational staff like receptionists, office/practice managers, billing specialists and others who don’t directly care for patients. To mitigate this, providers should perform a diagnostic overview of what their overtime costs look like under the new rule, taking into account employees who may currently be exempt but make less than $47,476 a year. The comprehensive audit will provide the information necessary to determine if any adjustments to work schedules or staffing are needed to keep operations financially sustainable and profitable. It will also be important for providers to implement and consistently use time tracking tools. Whether by using software or employing a third-party service, providers will need an accurate account of all hours spent working – whether in the office or remotely – so that overtime pay is appropriately distributed. Such tools will also provide formal records of hours worked. Should there be any type of overtime dispute or lawsuit, providers will have objective evidence at their fingertips. Proactively aligning health care business strategy to comply with new laws and regulations is one of the best ways to ensure that employees and patients don’t pursue litigation. After all, the most cost-effective lawsuit is one that never needs to be filed in the first place. Source www.healthcarebusinesstech.com

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December 2016 23

Mental Health

Your Frights and Fears: Phobia Quiz

phobia is an unreasonable sort of fear that can cause avoidance and panic. Specific phobias are an overwhelming and unreasonable fear of objects or situations that pose little real danger but provoke anxiety and avoidance. Unlike the brief anxiety you may feel when giving a speech or taking a test, specific phobias are long lasting, cause intense physical and psychological reactions, and can affect your ability to function normally at work, at school or in social settings. Specific phobias are among the most common anxiety disorders, and not all

phobias need treatment. But if a specific phobia affects your daily life, several therapies are available that can help you work through and overcome your fears — often permanently.

4. If your child must sleep with the light on, it’s a phobia.

1. What is Indiana Jones afraid of?

5. A phobia might limit your sandwich options.

a. Spiders b. Heights c. Snakes

2. Which fear affects one in six adult Americans? a. Heights b. Flying c. Spiders

3. Clown phobias are:

Answers 1. Snakes. Indiana Jones faced his ophidiophobia, fear of snakes, when he came across thousands of the slithering creatures in the 1981 film “Raiders of the Lost Ark.” 2. Flying. Aviophobia, or fear of flying, is common. Even experienced crew members can get it. In fact, fear of flying is a major cause of airline and Air Force personnel being grounded. Some people are bothered by bumpy flights or bad weather. They can be scared of having a panic attack or feel anxious in tight spaces. Others are terrified they are going to die in a plane crash.

a. Real phobias b. Not real phobias 3. Real phobias. If you panic at the idea of seeing someone make balloon animals while wearing white makeup and a red wig, you are not alone. Coulrophobia -- an abnormal fear of clowns -- is no laughing matter. 4. False. If your child is afraid of the dark or says monsters are hiding under the bed, don’t worry too much. That doesn’t mean he has nyctophobia, an extreme fear of the dark or night. Most children outgrow these normal worries. A phobia is an intense fear that upsets your life. It causes strong emotional and physical reactions. People with phobias know they are overreacting. 5. True. If you had arachibutyrophobia,

a. True b. False

6. You may have a phobia if you’re afraid of losing: a. Keys b. Wallet c. Cell Phone

7. Which would scare people with agoraphobia? a. Standing in line at a bank finding a PBJ in your lunch bag would be a nasty surprise. People with this phobia are afraid of peanut butter sticking to the roof of their mouths. 6. Cell phone. If the idea of losing your cell phone makes you panic, some counselors would say you have nomophobia (no-mobile phone phobia). Although leading medical groups don’t include it in their lists of official phobias, it’s clear that some people are very attached to their phones. One small study found that 73% of students even slept with their phones. 7. Standing in line at a bank. People who have this phobia are afraid of being trapped

b. Being alone in a house c. Being near a cat 8. Phobias often begin in childhood. a. True b. False

9. You can have a phobia about having phobias. a. True b. False

10. The best way to get over a phobia is to face it head-on. a. True b. False Sources Mayo Clinic MedicineNet.com in a busy place, such as a bank, with no way to get out easily. The fear can be so extreme that some people stay in their homes. Most people who have agoraphobia develop it in their 20s. 8. True. Phobias can come from an upsetting event during childhood. A person who fears birds may have been frightened as a child by a bird flying into his home. The causes of phobias aren’t always clear but having phobias seems to run in families. 9. True. If you are afraid of getting a phobia, you might have phobophobia. 10. False. Confronting a phobia could make it worse. Therapists recommend that people face their fears slowly, over time.

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December 2016

Research

MD Anderson News: Gene Deletion Allows Cancer Cells to Thrive When Migrating Within the Brain By d-mars.com News Provider

stronauts survive in space by wearing hightech space suits. But how do brain cancer cells thrive when they migrate to inhospitable sites within the brain? A study at The University of Texas MD Anderson Cancer Center believes their survival may be due to deficiency of a tumor suppressor gene called quaking (QKI), a potential new target for therapies. Findings from the study, led by Jian Hu, Ph.D., assistant professor of the Department of Cancer Biology, were published in the Nov. 14 online issue of Nature Genetics. “Cancer stem cells require ‘niches’ to remain viable but it is unclear how they survive in an environment outside of these niches both within the same tissues or during invasion to other organs,” said Hu. “We discovered that QKI is a major regulator of these cancer stem cells in glioblastoma, the deadliest type of brain tumor.” “Evidence is emerging that some brain cancer cells called glioma stem cells possess an inexhaustible ability to self-renew and produce tumors that resemble the features of original tumors,” said Hu. Self-renewal is a unique feature of all stem cells that creates identical “daugh-

ter” stem cells. To maintain this ability, they must be in a suitable environment providing them proper cellular cues. Hu’s team knew that glioma stem cells thrived when they reside in niches, such as structures called subventricular zone, due to their ability to self-renew. “However, left unanswered is how glioma stem cells still manage to maintain this ‘stemness’ when they invade and migrate from their niches to other areas where optimal niches are less likely to be available,” said Hu. The research team believed glioma stem cells must acquire the ability for stemness maintenance independent of their niches during invasion and migration. Using a mouse model, they studied deletion of major suppressing genes including QKI to see what correlation might exist. “Our previous studies showed that QKI is one of the tumor suppressor genes that can potentially regulate cancer stem cells and we confirmed this in

our latest investigation,” said Hu. QKI impacted a vital cellular activity called endocytosis, responsible for degrading the cell receptors that are essential for maintaining stem cell selfrenewal. Loss of QKI can greatly enrich the level of these receptors and consequently enhance the self-renewal capacity even when glioma stem cells are not in the niches. Just as a space suit protects the astronaut from the dangers of space, a deficiency of QKI makes the new environment safe for the transported cancer stem cell. “This study may lead to cancer therapeutic opportunities by targeting the mechanisms involved in maintaining cancer stem cells,” said Hu. “Although loss of QKI allows glioma stem cells to thrive, it also renders certain vulnerabilities to the cancer cells. We hope to design new therapies to target these.” MD Anderson study participants included Takashi Shingu, Ph.D., Liang Yuan, Ph.D., Xin Zhou, Ph.D., Congxin Dai, Ph.D., and Baoli Hu, Ph.D., all of Cancer Biology; Siyuan Zheng, Ph.D., and Qianghu Wang, Ph.D., Genomic Medicine; Yiwen Chen, Ph.D., and Roeland Verhaak, Ph.D., Bioinformatics and Computational Biology; Yi Zhong, Ph.D., Epigenetics and Molecular Carcinogenesis; James Horner, Institute for Applied Cancer Sciences; Brandon Liebelt, M.D., Amy Heimberger, M.D.,

and Qing Chang, M.D., Ph.D., Neurosurgery; and Gregory Fuller, M.D., Ph.D., Pathology. Other participating institutions included Stanford University, Stanford, Calif.; Houston Methodist Neurological Institute, Houston; and Fudan University Huashan Hospital, Shanghai. The study was funded by The National Cancer Institute (2P50CA127001) and the National Institutes of Health (R00 CA172700 and CA120813).

About MD Anderson The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. The institution’s sole mission is to end cancer for patients and their families around the world. MD Anderson is one of only 45 comprehensive cancer centers designated by the National Cancer Institute (NCI). MD Anderson is ranked No. 1 for cancer care in U.S. News & World Report’s “Best Hospitals” survey. It has ranked as one of the nation’s top two hospitals since the survey began in 1990, and has ranked first for nine of the past 10 years. MD Anderson receives a cancer center support grant from the NCI of the National Institutes of Health (P30 CA016672).

Don’t Make Your Co-Workers Sick When the common cold hits, sharing is not caring By d-mars.com News Provider

eing considerate of others when you’re sick is one of the first steps to good sick etiquette. For example, you may think you’re going to score points for showing up at work despite feeling under the weather. However, if you were to run this by an etiquette expert like Diane Gottsman, she would probably tell you the reverse is true. “A recent survey found that half of Americans feel anxious about getting sick when others cough around them,” Gottsman says. “So when you cough, your co-workers are likely going to be thinking of themselves and may not sympathize with you.” That’s why Gottsman says the best thing you can do is steer clear of the office. If working remotely isn’t an option, it is best to take a sick day. “When you’re sick, it’s so important to take precautions to keep your germs from infecting others, which should always include staying home from work or other activities until symptoms have subsided,” says Gottsman. “I understand that sometimes life seems too busy

to get sick or a workplace may not offer enough paid time off. So staying home and putting work on the back burner until you’re well is not an option for everyone. Still, productivity will decline when you are sick and you may prolong your illness by overexerting yourself." With that, Gottsman says the name of the game is keeping those germs to yourself. Don’t be afraid to be demonstrative about that so you send a clear signal that you care and you don’t want to infect anyone — it will put your friends and colleagues at ease. Here are Gottsman’s sick etiquette tips: Telecommute: If it is physically possible for you to complete a day’s work at home, that is probably the second most ideal solution to taking a sick day. If that’s not a typical arrangement at your place of employment, though, frame it as being beneficial to your boss and your fellow employees. For example: “I understand we have this important deadline coming up, which is why I would prefer not to spread this bug to others. What if I worked on the project from my home office today instead of coming in? If you sent me the call-in information, I could still join the conference call later. Of course, if you need anything at

all, I’m just a phone call or email away.” Touch no one: If a friend moves in for a hug or a handshake, kindly warn them that you are recovering from a cold and would prefer to “play it safe” before extending your hand or leaning in for a hug. Keep a sickness arsenal: Keep your desk well stocked to help you treat your symptoms and keep common areas germ-free. For your kit, consider items like tissues, disinfecting wipes and hand sanitizer, as well as relief for sick symptoms, like pain relievers and a cough syrup like Robitussin. Avoid shared surfaces: Cold viruses can survive several hours on surfaces, transferring easily to your colleagues. Germs can be hard to contain and avoid, but you can do your part by wiping down shared areas like a table or chair with a disinfecting wipe when you are finished using them.

Cover your mouth wisely: Coughs and sneezes give germs and viruses a nice little vehicle to get around and infect others nearby. When you must cough or sneeze, use a tissue or cough into your arm or elbow — never your hand, because the hands help spread the germs around. When using a tissue, promptly dispose of it and sanitize your hands. Minimize coughing: When people hear someone cough in a crowded space, 26 percent feel annoyed, and 46 percent feel anxious about getting sick themselves, according to a recent online survey conducted by the Harris Poll. Keeping the medicine cabinet stocked with a powerful cough reliever is one effective way to suppress your cough. One product Gottsman recommends is Robitussin 12 Hour Cough Relief, because the long-lasting formula gets you through the whole work day by providing soothing relief from the hacking coughing. (You'll also be much quieter, which is a bonus.) It’s not always possible or practical to stay home for several days when you come down with a cold, but practicing good sick etiquette can help keep viruses from spreading to those around you. – BPT

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December 2016

TH E

E X P E R T

N E TW O R K

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