In Good Health: ROC #223 - March 2024

When the Big Boss is a Nurse

Dan Ireland has tracked a path from bedside nursing to C-level hospital leadership. He is now the president of three Rochester Regional Health hospitals: United Memorial Medical Center, Newark-Wayne Community and Clifton Springs.

NEW INTERNET

ADDICTION SPECTRUM: WHERE ARE YOU ON THE SCALE?

Jonathan Westfall is the executive director at ROCovery Fitness, a community recovery outreach center.

NONPROFIT USES FITNESS AND EXERCISE TO FIGHT ADDICTION

Turns Out Dogs Have Fave Things to Watch on TV

Think nature documentaries, Lassie or good old Scooby-Doo, a new study suggests.

Dogs are most engaged when watching videos that feature other animals, according to a new study published recently in the journal Applied Animal Behavior Science.

The study is part of an overall effort to develop better ways to check

canine vision, something that the researchers say is sorely lacking in veterinary medicine.

“The method we currently use to assess vision in dogs is a very low bar. In humans, it would be equivalent to saying yes or no if a person was blind,” said researcher Freya Mowat, a professor at the University of Wisconsin-Madison's School of

that video

featuring animals was the most popular among dogs

Veterinary Medicine.

“We need more sensitive ways to assess vision in dogs, using a dog eye chart equivalent,” Mowat added in a university news release. “We speculate that videos have the potential for sustaining a dog's attention long enough to assess visual function, but we didn't know what type of content is most engaging and appealing to dogs.”

To figure out what canines like to watch, Mowat created a web-based questionnaire for dog owners around the world to report their four-legged friends' TV habits.

The survey included questions about the types of screens in a home, how dogs interact with the screens and the kinds of content that most engaged them. Owners also described how their dogs behaved while watching videos.

Unlike humans, data show that dogs are commonly active when watching TV — running, jumping, vocalizing and tracking the action on the screen, rather than lying down or sitting as they watched.

Dog owners also had the option of showing their dog four short

videos featuring subjects of possible interest: a panther, a dog, a bird and road traffic.

Based on more than 1,200 responses, researchers concluded that:

• Video content featuring animals was the most popular among dogs

• Other dogs were by far the most engaging subjects to watch

• Humans weren't that interesting, ranking ninth out of 17 categories

• Age and vision were related to how much a dog interacted with a screen

• Sporting and herding dogs were more likely than other breeds to engage with any type of TV

• Movement on screens was a strong draw for dogs' attention

These results will be used to develop video-based methods that can track changes in visual attention as dogs age, Mowat said.

“We know that poor vision negatively impacts quality of life in older people, but the effect of aging and vision changes in dogs is largely unknown because we can't accurately assess it,” Mowat said. “Like people, dogs are living longer, and we want to make sure we support a healthier life for them as well.”

Understanding how a dog's vision ages also could help the humans who share their home, Mowat added.

“Dogs have a much shorter lifespan than their owner, of course, and if there are emerging environmental or lifestyle factors that influence visual aging, it might well show up in our dogs decades before it shows up in us,” Mowat explained. “Our dogs could be our sentinels the canine in the proverbial coal mine.”

“My days are filled with friendships and activities, combined with the care I need.”

Adult Day Health Care is a medical model day program that serves adults with physical, psychosocial and medical needs. Services include medication assistance, cultural arts, and a noon meal. Transportation available within Monroe County.

Ask about our new evening program from 2:00-7:00 p.m. Call (585) 784-6570 or visit JSLAdultDayHealthCare.org for more information.

A service of Jewish Senior Life

FDA Approves First Treatment for Severe Frostbite

The U.S. Food and Drug Administration (FDA) in February approved the first treatment for severe frostbite.

Known as Aurlumyn (iloprost), the injected medication lowers the risk of finger or toe amputation in cases of profound frostbite, the agency said.

“This approval provides patients with the first-ever treatment option for severe frostbite,” physician Norman Stockbridge, director of the division of cardiology and nephrology in the FDA's Center for Drug Evaluation and Research, said in an agency news release. “Having this new option provides physicians with a tool that will help prevent the life-changing amputation of one's frostbitten fingers or toes.”

Frostbite can range from mild cases that don't require medical intervention and don't cause permanent skin damage to severe cases where both the skin and underlying tissue are frozen and blood flow is stopped. In those instances, amputation is sometimes required, the FDA said.

Iloprost is a vasodilator, which opens up blood vessels and prevents blood from clotting.

The FDA approval hinged on the results of a trial that randomized 47 adults with severe frostbite, all of whom received aspirin by IV and standard of care, into one of three treatment groups.

Group 1 received iloprost intravenously for six hours a day for up to eight days. The two other groups received other medications that aren't approved for frostbite, given with iloprost (Group 2) or without iloprost (Group 3). The main measure of efficacy was a bone scan taken seven days after the initial frostbite that predicted the need for amputation of at least one finger or toe.

None of the 16 patients receiving iloprost alone was found to need amputation, compared to 19% of patients in Group 2 and 60% of patients in Group 3.

Aurlumyn's most common side effects included headache, flushing, heart palpitations, fast heart rate, nausea, vomiting, dizziness and hypotension (very low blood pressure).

Iloprost was first approved in 2004 for the treatment of pulmonary arterial hypertension (high blood pressure).

Meet Your Doctor

By Chris Motola

Lydia Morrison, DO

New

OB-GYN at Thompson hails from Canada, did missionary work in Kenya, Guatemala, Honduras. She shares her experience

Q: You're originally from Canada. What brought you to the U.S.?

A: I'm originally from Canada and all of my family is still there, but I did all of my medical training in the U.S.

Q: Why did you decide to do your medical training here?

A: Initially I applied broadly for med school. I got in in the U.S. first. As I got into my training and decided I wanted to do OB, I looked at the practice differences between the U.S. and Canada. In Canada you're treated more like a sub-specialist. Here you're doing a little bit of everything like seeing patients for annuals, pap smears, managing pregnancies of all types. In Canada, you're usually only seeing an OB if you're a high-risk pregnancy, which I didn't really love. I've never practiced in Canada, but a lot of the uncomplicated deliveries there are actually done by midwives. I like having both high- and low-risk patients.

Q: You graduated high-school at 16. Did you go right to college?

A: Yeah. So my schooling is a

Virginia at 20 for med school. So I just kind of marched out from that early start to high school.

Q: How long have you been practicing?

A: I just finished my training in Buffalo; that was four years of residency. And this is my year out as an attending. So I've been practicing about five years.

Q: So you're pretty young for a doctor.

A: Yes.

Q: What's that like? Is it a culture shock?

A: A little bit. There's a little bit of imposter syndrome, though I think a lot of attending physicians feel that way when they're first starting out. So there's a lot of finding your rhythm. I think in residency you're used to just doing whatever the attending says versus now you have to speak up and use your own voice. So it's been a change but it's been good. It feels like my opinion is valued.

Q: So you're probably younger than a lot of your patients.

A: Yes. Younger or the same age. age. So we're growing babies

feel like I'm a lot more conscious of is when I'm seeing patients dealing with fertility issues while here I am pregnant. So I'm self-conscious of that.

Q: Is this your first child?

A: Yeah.

Q: How is pregnancy shaping your approach to obstetrics? Is it giving you a better idea of what to focus on?

A: I think it allows me to add a personal touch. I can talk about symptoms from experience. I think it also helps patients to know that I'm going through the same things. I think when talking about birth plans and stuff like that they want to know what I'm doing to compare notes.

Q: Can you talk a bit about your missionary work?

A: That was actually my first exposure to medicine and an OR [operating room]. My first was to Honduras with a team of pediatric cardiothoracic surgeons. I had no clue how to scrub in. I remember seeing a beating heart for the first time. It was crazy. That kind of set off my desire to get into medicine. Then I did a medical mission trip with my medical school to Guatemala in my second year. We were there for two or three weeks and I got to work in a few of the clinics. And then, right at the tail end of medical school, I spent a month living in Kenya. We kind of lived on the hospital grounds. The village was right across the street from the hospital. We woke up, worked, got to know the locals. I haven't done anything since residency because the hours are so rigorous. Once I have this baby we'll see what's next.

Q: Did you get to see the OB-GYN practices of those countries?

A: Not so much in Guatemala, but in Kenya I kind of focused on it. It was shocking. Their OR is completely different. Their labor wards are really just one big room with all the patients lined up in their beds. You've got patients walking through these wards. They don't do continuous fetal monitoring. The practice is just very different. The vaginal deliveries are mostly done by nurses. The physicians do the sections, but their medical training process is very different. I remember having to push a patient from the labor ward down a gravel path to the OR. All the outcomes I was involved in were great, though.

Lifelines

to grow with your patients. The one

Name: Lydia Morrison, DO

Position: OB-GYN physician at Thompson Health Canandaigua Medical Group

Hometown: Barrie, Ontario

Education: Liberty University College of Medicine, Doctor of Osteopathic Medicine. residency, University at Buffalo (Catholic Health System), Buffalo

Affiliations: FF Thompson Hospital

Organizations: American College of Osteopathic Obstetricians and Gynecologist; American College of Obstetricians and Gynecologists

Family: Married, child on the way

Hobbies: Travel, boating, following the Toronto Maple Leafs or the Buffalo Bills

Pain, Tingling or Numbness in Your Feet?

By Andrea Ide

Pain, Tingling, or Numbness in your hands, feet or legs may be due to Nerve Damage. If left untreated this small annoyance can lead to big problems. Unfortunately, most people have no idea what to do abut this problem and some don’t even realize how big of a problem it is. They tell their doctor who gives them drugs and injections which only mask the pain and there is no surgery, other than amputation, that will heal/stop neuropathy from progressing.

Neuropathy is a term used to describe damaged nerves, primarily in the hands and/or feet, that are progressively breaking down due to a lack of blood supply, nutrients and oxygen reaching the nerves along with a lack of communication from the brain. Since the nerves are what the brain uses to communicate with the area and they are breaking down, the brains ability to communicate with the area lessens over tine, allowing for the progression of more breakdown and worse symptoms. It can be caused by Diabetes, Poor Ciculation, Poor Nutrition, Chemotherapy, Agent Orange, Misaligned Spinal Bones Placing Pressure on the Nerves, along with over 100 other causes. “Patients experience extreme sensations, loss of feeling, even No Feelings in their Hands and/or Feet along with muscle spasms, pain, weakness, numbness, tingling, and burning and many have a very hard time with balance” says Dr. Nathan Riddle of Riddle Wellness, a Neuropathy testing and treatment clinic.

This condition can eventually lead to further nerve damage, causing complete loss of legs or arms leading to amputation, death or brain injury due to falls, burns or other injuries that will not heal, along with organ failure in some cases.

Are you or someone you love suffering with loss of balance, numbness or pain from Nerve Damage in your hands and/or feet that just won’t heal? You don’t have to any longer. This local clinic right here in Rochester, NY is helping people find lasting relief without the use of drugs or surgery! That’s BIG EWS!

HEALING IS POSSIBLE

More than 20 million people in the U.S. Are dealing with some form of Neuropathy. Most commonly noticed first in the hands or feet, causing weakness, numbness, tingling pain and debilitating balance problems, often frustrated with no place to turn to and no hope of recovery. “By the time they come to see us, they feel like they have tried everything. Their MD put them on Anti-Seizure or Epilepsy meds like Gabapentin, Neurotin, Cymbalta or Lyrica and told them they will just have to live with the pain,” said Dr. Riddle.

ADVANCED TECHNOLOGY

With recent advancements in nerve regeneration technology and treatment options, clinics all over are seeing larger success rates and faster results with their neuropathy patients.

“This new technology paired with our multifaceted approach, has been life altering for our patients and our clinic,” said Dr. Riddle.

The development and success of these new, highly effective Neuropathy Protocols by Dr. Riddle and his team at Riddle Wellness have been the talk of the town in recent months. “Neuropathy patients have been coming in from all over the state and the results that they are getting is truly amazing,” said the Patient Coordinator at the Clinic. There are some things people can do at home to aide in the healing process of their neuropathy however, healing neuropathy is an all-encompassing process that ill require lifestyle changes, home care and may or may not include chiropractic, (varying from patient to patient) along with guidance from a medical professional that is experienced, skilled and trained to treat neuropathy.

Dr. Riddle and his skilled care team in Rochester have been treating neuropathy for years now in and judging by their 5 Star patient reviews, and all their patient video testimonials, they have been doing a very good job providing excellent patient care. One person had all but given up, they were crying in their testimonial. They were so thankful and its all because of this amazing new treatment option! They state it

New Treatment Options for Neuropathy

“Numb feet and legs better!”

-Jean L

“Reducing gabapentin with Riddle Wellness neuropathy protocols!”

-Ray F

has about a 98% effective rate!

FIND LASTING RELIEF

Claim Your Voucher Now for a Consultation & Examination to determine if you are a good candidate for treatment... Dr. Riddle and his care team are here once again to help readers learn about new options for finding pain relief! Call the clinic today to receive your comprehensive (normally $250).

The clinic utilizes the most advanced Pain Free Testing and a full, easy to understand report of finding

with Dr. Riddle going over your options for care if you are able to move forward.

Call 585-670-0020 and use Code NUMB0021. They have agreed to reduce their usual cost of $250.

But hurry, due to the number of patients the office can see, this is a limited time offer, with only 25 spaces at this exclusively discounted rate. These will be on a first come, first serve basis, messages left will count. My advise, don’t suffer any longer, waiting around for it to get worse... If you or your loved one is experienc-

ing pain, numbness, tingling, pins and needle sensations, cramps and burning in your feet, or hands, along with the many other bodily symptions this horrible condition plagues people with, take action because it will progress.

Not everyone is able to start care at the clinic but, those who do are thankful! Find out if you are a candidate for their Neuropathy Protocols so they can help you regain the feeling in your hands or feet, stop the pain and start living life again! “Our Neuropathy Protocol is a multifaceted approach to heal neuropathy by nurturing the nervous system, increasing circulation, blood and oxygen, working to rebuild, strengthen and balance the body, all while stimulating the damaged nerves. Revitalizing and healing the damaged areas, enabling them to reactivate and function at an increasingly higher rate over time, all while increasing the patients quality of life dramatically,” said Dr. Riddle.

Over the years they have treated thousands of patients with chronic conditions of Neuropathy, Sciatic nerve pain, Back & Neck problems, Whiplash Injuries along with Knee Pain. The office is well known and has a good reputation. Patients drive hours to this clinic and the vast majority enjoy superior, lasting relief. In fact, many who have suffered and tried other treatment options with no luck, only to have been told that they are just stuck with their pain and discomfort, have credited the care team at Dr. Riddle office for giving them their lives back!

Call them now at their Rochester, NY location, for a full, thorough Consultation and extensive Neuropathy Consultation at $49. Use Code: NUMB0021 (saving you over $200) to determine if and how Dr. Riddle and his team can help you recover, just as they have helped so many others that suffer with the Pain and Numbness of Nerve Damage.

Healthcare in a Minute

By George W. Chapman

Skilled Nursing Facilities in Dire Financial Straits Situation may

get worse with NYS proposed budget cuts

Over 97,000 people in New York state depend on skilled nursing facilities for their care. For many, it is end of life care. Ninety percent of SNFs in the state have difficulty covering basic operating costs which typically leads to staffing shortages. To make matters worse, the proposed 2024 NYS budget calls for a $500 million cut in SNF Medicaid funding. On average, 70% of SNF patients are covered by Medicaid, so the proposed cuts are financially

Rural Hospital Outlook Brighter

After years of struggling financial ly, further exacerbated by the recent pandemic, rural hospitals see light at the end of the tunnel.

About 100 rural hospitals have closed altogether since 2005 and many more probably would have closed had they not been rescued by a nearby larger healthcare system.

About 75% of rural hospital executives revealed in a recent survey that they plan to remain independent and, after years of shrinking, plan to expand services. This is great news for rural residents who depend on their local, albeit small, hospital for primary care, specialty care and emergency services. Industry experts surmise the increased financial viability of rural hospitals will actually make them all the more appealing to larger healthcare systems. Ultimately, merging into a larger regional healthcare system would be the best route to solidifying their future viability.

Tracking Prior Authorization Denials

Prior authorizations for care have created anxiety for patients and frustration for physicians. Prior authorizations

devastating. Staffing shortages will get worse. This is a 10% cut in the daily reimbursement rate which has not kept up with inflation. Current rates (before the proposed cuts) are based on 2008 costs. Since then, costs have risen 40%. Eleven SNFs closed in 2021 and 2022. Currently, eight more are on the verge of closing this year. To add insult to injury, federal surveys (Medicare) cite SNFs for staffing shortages, consequently lowering a SNF’s overall star rating.

slow care and interfere with treatment plans. Consequently, the Federation of American Hospitals has petitioned CMS (Medicare/Medicaid) to factor in a Medicare Advantage plan’s denial rate when determining their star rating from one to five. The FAH wants CMS to monitor the percentage of a plan’s prior authorizations that are finally denied or denied than overturned. A high denial rate would reduce their star rating. The hope is to discourage insurers from abusing prior authorizations and to promote getting coverage decision right and timely the first time. MA plans have overturned initial denials 80% of the time in 2021. The Office of Inspector General reported traditional Medicare would have covered 13% of denials. The five-star rating system impacts how much Medicare pays an Advantage plan annually to care for their members. The FAH is requesting a three-day turnaround for urgent prior authorizations and seven days for standard authorizations. The AMA would like to see those times shortened further.

Private Practice Shrinking

Ten years ago, 60% of physicians were in private practice. (If you go back decades, it was probably close to 90%.) In 2022, 47% of active physicians were in private practice. The downward trend has been accelerating. Medicare rates, typically used as a benchmark or guide by

(Star ratings range from one to five stars.) It should be noted that Medicare does pay relatively adequately but not nearly enough to offset the low Medicaid rate. In a letter to the NYS legislature, SNF executives are requesting a 16% rate increase to stay afloat which will allow them to increase staffing and prevent further closures. Some perspective helps next time a loved one or friend is in a nursing home.

commercial carriers, have remained virtually flat over the last 20 years. Operating expenses, obviously, have not. Constantly changing the hoops physicians must jump through to get paid adds to the expense and frustration facing physicians. Increasingly, younger physicians, wary of the financial difficulties, frustrations and time commitment of private practice are opting for employment with hospitals, hospital centric healthcare systems or even Walmart or CVS. As employees, they can focus on patient care and maintain a reasonable lifework balance. Hiring and retaining staff, updating equipment, reimbursement rates and balancing the books are someone else’s problem. Most expect the percent of physicians in private practice to plummet over the next 10 years as baby boomer docs are replaced by the new generation of docs. So, what does that mean for patients? Insurance companies long ago inserted themselves in the doctor-patient relationship, so where your doc works won’t make a difference. Unfortunately, many patients don’t first select their physician. They first select an insurance plan based on benefits, especially drug coverage. If your physician of choice happens to be in the plan selected, then great. Physicians will always do what’s best for their patients.

No Surprises

Surprises can be nice, except when it’s an unexpected medical

bill. The No Surprises Act went into effect a couple of years ago. So far, it has prevented more than 10 million surprise medical bills from out-of-network or non-participating providers. A classic scenario was you went to a participating hospital emergency room that was in your plan. Little did you know, but the ER physician group was not in your plan. Your plan covered the ER facility charge and what it would have paid a participating physician. Consequently, you received a surprise bill from the hospital or the physician group for the difference between their full charge and what your plan paid. Another surprised bill could come from a out-of-network specialist that was called in to treat you. You assumed if the hospital was in your plan, so would the physicians. Thanks to the NSA, two-thirds of insurers have since expended their networks of participating providers to include the physicians that treated you in the participating ER. No plans have decreased their networks because of the NSA. 80% of the now much fewer NSA claims are resolved without having to go through arbitration or dispute resolution.

Doomsday Scrolling

More and more of us, especially adolescents and young adults, are experiencing anxiety, depression, anger or helplessness. Social media and 24/7 world news coverage have contributed to the crisis in mental health. According to experts, we have naturally evolved to be aware of potential threats around us for survival. Before highly invasive social media and ubiquitous 24/7 world news networks, most of our perceived threats and bad news came from and maybe an hour of local and national news. The number of perceived and real threats were relatively low and more easily managed. We can only handle so much bad news. Doomsday scrolling refers to the habit (addiction?) of virtually seeking threats or bad news via social media or 24/7 cable news. We are now bombarded with bad news: wars, natural disasters, food insecurity, drug addiction, inept politicians and injustice. Few of us can handle this overload without getting depressed, anxious or angry. Mental health experts are urging us to put our phones down and limit cable TV news viewing. In other words, limit our doomsday scrolling. People who have done so have reported they are much happier, less anxious and have time for more pleasant activities.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

When you’re in pain or feeling sick, we want to help you find the right care, right when you need it. There are several ways to seek care:

PRIMARY CARE DOCTOR

When possible, this is the best place to start. Your primary care doctor will know your health history and can help with the best next steps to start feeling better.

TELEMEDICINE

This is a great option when you can’t visit your doctor in person. Your primary care doctor might offer telemedicine visits but if they don’t, we’ve partnered with MDLIVE* for 24/7 virtual care.

URGENT CARE

Urgent care can be a good option for in-person care when your doctoris not available. Urgent care centers are designed to treat non-emergent conditions, like sprains and strains, colds and flu, cuts and lacerations, and can perform x-rays and lab testing.

EMERGENCY ROOM

If you’re experiencing a life-threatening event, call 911 or go straight to the nearest emergency room.

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

'Beware the Ides of March' ... or Not!

In William Shakespeare’s “Julius Caesar,” a fortune teller warns Caesar to “beware the ides of March.” That immortal phrase portends gloom and doom, and has given this month a bad rap.

Sure, March can be cold, gray and damp. But it doesn’t need rain on your parade.

If the month of March is stretching out in front of you as a dreary void to fill, you are not alone. For many, our winter wonderland is not so wonderful during this unpredictable time of year.

That's when anxiety can make an unwelcome visit. You might feel yourself spiraling down, questioning the past, and second-guessing your decisions. And that’s when you could be tempted to grab the TV remote and head to the couch.

I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening ahead was almost unbearable.

After too many nights watching mind-numbing reruns, I had finally had enough and started making better use of my “me time.” I am now much more comfortable spending time by myself and have come to enjoy my own company.

In fact, it’s not unusual for me to pass on an invitation out, in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do.

If you are challenged by time alone this time of year, consider the suggestions below. You might even clip this column and post it on your refrigerator as a handy reminder.

Read

When’s the last time you read a good book?

In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely one.

Don’t know where to start? Ask a friend for a suggestion or select a “New York Times” bestseller. Snuggle up in a comfy place, and let a good book introduce you to new people, new places and new ideas. We rarely feel alone when reading.

If you haven’t read “Lessons in Chemistry” by Bonnie Garmus, I highly recommend it.

Write

Marcel Proust wrote, “We are healed of a suffering only by expressing it to the full.” I’ve found that to be so true.

Writing has been, and always will be, a helpful tool on my journey to create a fulfilling life on my own. Chronicling my emotional ups and downs, the steps I’ve taken to improve my life, and the progress I’ve made has helped to strengthen my resolve and self-confidence.

If you’ve never kept a journal, why not give it a try this month?

Make it a practice to make a journal entry at least daily. For me, the best times are first thing in the morning and last thing at night. Keep it short and simple to start.

Write about your day, your feelings and fears, your observations, your successes and setbacks, and — most importantly — your aspirations for the future.

You may discover, as I have, how

powerful and therapeutic the act of capturing your thoughts in writing can be. Numerous studies have found that journaling can increase emotional well-being, reduce stress, and even result in a better night’s sleep.

As you work through some of the issues associated with living alone, and you become more content, you may find that reading and rereading your journal entries can be a great way to see how much progress you are making.

I guarantee you’ll find it fascinating reading a year from now!

Clear Out The Clutter

I know this might sound uninspiring, but clearing out the clutter can be very satisfying and a great way to spend a few hours alone.

Recently, I spent an evening sorting out my closet and filling two bags for a local refugee resettlement program. It was very satisfying. I not only lightened my load, I did something for a good cause.

As a result, I felt part of something bigger than myself and less alone.

Pursue a passion

This can be daunting, especially if you’ve yet to identify a passion, but hang in there.

Many women and men in long-term relationships often lose sight of their own interests in favor of attending to the needs of others. The pursuit of your own passions or personal pursuits can be lost in the process.

Now is a good time to rediscover your “loves” and to dedicate your time alone to those pursuits. Do some digging and identify the things you loved as a child or young adult, then make a conscious decision to revisit those things now.

I did some digging years ago and discovered that digging, in fact, was a passion of mine: digging in the garden, that is! I now enjoy bountiful flower and vegetable gardens, and use the month of March to plan what I want to grow and prepare for the planting season.

When you’re engaged in an activity you’re passionate about, you

born preterm,” concluded the team led by senior researcher, physician Jenny Bolk, a consultant neonatologist with the Karolinska Institute in Stockholm.

“The findings may help professionals and families to better assess risk, follow-up and healthcare systems planning for children born moderately or late preterm,” they added.

Being Born Even a Bit Early Could Harm a Child's Development

Babies born even slightly early have a higher long-term risk of developmental difficulties that could affect their behavior and learning ability, a new study finds.

Infants born moderately (32-33 weeks) or late preterm (34-36 weeks) are more likely to have epilepsy or problems with brain function, motor

skills, vision or hearing, according to analysis of data from more than 1 million Swedish children.

About 80% of preterm births fall into these categories, researchers noted.

“The risks should not be underestimated as these children comprise the largest proportion of children

Previous studies have shown that babies born early have higher risks of developmental and behavioral disabilities through childhood and adolescence, researchers said.

However, few studies have investigated long-term outcomes of these children, compared with children born at full term.

For this study, researchers analyzed Swedish health data to compare children born at full term (39-40 weeks) compared to moderate- or late-preterm births.

The data included nearly 1.3 million babies born without birth defects in Sweden between 1988 and 2012.

may experience a state of “flow,” where you are fully immersed in the task at hand and lose track of time. I know that happens to me. And it can happen to you, too.

Start digging and uncover your passion this month!

Reach Out

With time on your hands, you are in a great position to reach out and make connections with others, including long-lost friends. This can be a very meaningful way to spend an evening.

Just yesterday, I received an email from a former colleague. I was very touched, and accepted her kind invitation to get together.

So, I encourage you to reach out to someone you haven’t seen in a while. Extend an invitation to get together and, chances are you'll be rewarded with a warm reunion.

“Veg out”

That’s right, veg out. Grab the TV remote, a pint of ice cream, and head for the couch. Do it without guilt, give yourself a break, and remember you’re only human.

Everyone is entitled to an occasional night when they just hang out, do nothing, and eat junk food. Indulge yourself and tell yourself you deserve it.

Wake up the next morning free of remorse and ready to take on the day: alone at home and “at home” with yourself, even in the Ides of March.

Gwenn Voelckers is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” She welcomes your thoughts on this column as well as topic suggestion for future essays at gvoelckers@rochester. rr.com.

During an average follow-up period of 13 years, more than 75,000 children had at least one diagnosis of developmental impairment.

Babies born moderately or late preterm showed higher risks for any developmental impairment than those born at full-term, results showed.

That included a nearly five-fold increased risk of motor impairment and a nearly two-fold increased risk of epilepsy for children born moderately preterm, the study found.

The results were published Jan. 24 in the BMJ journal.

Researchers noted in a journal news release that since this was an observational study, they can't establish a direct cause-and-effect relationship between preterm birth and developmental problems.

For example, they can't rule out the possibility that factors like alcohol or substance use during pregnancy caused some of the developmental difficulties.

U.S. Prescription Drug Prices Nearly Triple Those of Other Nations

Gap is widening for name-brand drugs

Americans pay nearly three times as much for their prescription drugs as residents of other nations do, new research shows.

Drug prices in the United States average nearly 2.8 times those seen in 33 other countries, the report from RAND Health Care found.

Brand-name drugs are even more expensive, with U.S. prices averaging 4.2 times those in comparable nations, the researchers added.

On the other hand, Americans receive a real bargain when it comes to unbranded generic drugs. Those run about two-thirds (67%) the average price found in comparable countries.

“These findings provide further evidence that manufacturers' gross prices for prescription drugs are higher in the U.S. than in comparison countries,” said lead researcher Andrew Mulcahy, a senior health economist at RAND.

“We find that the gap is widening for name-brand drugs, while U.S. prices for generic drugs are now proportionally lower than our earlier analysis found,” Mulcahy added in a RAND news release.

Generics account for 90% of prescription drugs sold in the United States, the researchers noted.

For the report, researchers com-

pared U.S. drug prices to those of 33 other countries in the Organization for Economic Co-operation and Development (OECD).

Across all of the OECD nations studied, total drug spending was $989 billion in 2022, results show.

The United States accounted for 62% of the money paid to drug companies, but only 24% of the total drugs sold.

U.S. drug prices ranged from 1.7 times prices found in Mexico to more than 10 times prices in Turkey.

The analysis relied on manufacturer's gross prices for drugs because net prices — what is actually charged after negotiated rebates and discounts — are not systematically available.

However, estimates that attempted to account for those discounts found that U.S. prices for brandname drugs are still more than three times higher than those in other countries.

Retail prescription drug spending in the United States increased by 91% between 2000 and 2020, and spending is expected to increase 5% a year through 2030, researchers said. Prescription drugs now account for more than 10% of all health care spending in the United States.

SERVING MONROE AND ONTARIO COUNTIES

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from people who will work to understand how your experiences and behaviors make sense rather than diagnose

When the Big Boss is a Nurse

Dan Ireland has tracked a path from bedside nursing to C-level hospital leadership

By John Addyman

For most of us, there’s one day that stands out crystalline and piercing: we remember exactly where we were and what we were doing when the first plane hit the World Trade Center.

In the healthcare community, a different and even more significant event occurred. It didn’t happen in one day. It was a realization, a shock hitting you in the face.

Dan Ireland provides an example.

“We were sitting in my office at the hospital, looking at the emergency room tracker board,” he said. “We had 18 beds in the ER and a couple of hall beds. In a half-hour’s time, the ER had 28 new patients. My director of nursing and I both got up from our chairs and said, ‘We need to go down there and help!’ And we did. I spent the next 12 hours practicing bedside nursing like I used to years ago — I’m not sure I could have gotten a med out of the med system — but I was transporting people and doing vital signs. I was doing what I could.”

COVID-19 had come to United Memorial Medical Center in Batavia.

Ireland, corporate suit and all — he is the president and chief operating officer of Rochester Regional’s three Finger Lakes Rural Hospitals at Newark-Wayne, Clifton Springs and UMMC — did what he could at that

moment to meet an immediate need.

For him, it was an act that came naturally. “I believe that’s what leadership is,” he said. “Sometimes we have to step in and help whatever way we can.”

The COVID-19 days gave every healthcare worker pause. Ireland led his staff by examples, many of them small but none insignificant. He parked his car at the lot at St. Jerome’s Hospital and took a shuttle to UMMC, using the opportunity to talk to staff members on the way, sharing information and feelings about what everyone in the hospital was facing as the pandemic blew up.

He had an added purpose in parking offsite.

“It was a measure to make sure we had a parking spot for patients back at the UMMC campus,” he said. “It was my responsibility to do that and others followed.”

Gaining recognition for setting examples is something Ireland brought to healthcare when he started, right out of high school, in the St. Jerome hospital service. He had started school at Genesee Community College, wanting to be a computer programmer. Indeed, part of that desire is still in him.

“I was an intermediate EMT,” he explained. “There was a crossroads for me at that time — either go to paramedic school and commit to

doing EMS or go into the nursing profession — that’s where I stayed and I stay inspired.

“There were nurses, female and male, at St. Jerome’s emergency department and eventually Genesee Memorial, who took me under their wings and showed me what nursing could be like and how they provided care.”

Steady Promotions

Dan Ireland became a registered nurse in 1992. He added his BS degree in nursing two years later. An MBA in IT and finance from RIT followed in three years. By 2005 Ireland was vice president of clinical service after serving as the ED nurse manager and clinical analyst and director of quality management in Batavia. He became VP of operations and chief operating officer at UMMC in 2010. Three years later he led the merger that has become the Finger Lakes Rural Hospitals.

Ireland made the improbable trip from bedside nursing to a C-level office.

Then the gift of COVID-19 fell on him.

Goethe said what doesn’t kill you makes you stronger and Ireland has been tempered by COVID-19. The way he and his staff responded to it has changed — and will continue to

change — the look of healthcare in their rural community hospitals.

“We are in the most significant transformation of healthcare that I’ve witnessed in my 33 years,” he said with no hesitation. “We have no choice but to fundamentally think differently about how healthcare is provided, both in hospital care and outpatient care. I often tell my team, it is the most exciting time to be in healthcare, yet it can also be the most scary because there are still many unknowns that have yet to reveal themselves. Every change has a ripple to other changes. As we make a change in one area, we have to be mindful to what that does elsewhere. Opening up a clinic over here changes the way healthcare is provided in those communities.

“You want to make all these changes, but you have to maintain the quality of healthcare you provide today. You have to always have a keen focus on quality and engagement. The other challenge is we have a whole lot of non-healthcare people out here who have to ride this change with us. We have to be able to demonstrate that doing care differently — sometimes telehealth is the right visit and sometimes it’s not the right visit. We have to help people discern that.

“Then there’s the fact that the cost and healthcare finance over the

Dan Ireland is the president and chief operating officer for Rochester Regional's Finger Lakes Rural Hospitals in Newark, Clifton Springs and Batavia.

Dan Ireland, right, talks day-to-day issues with Clifton Springs Hospital Associate Chief Operating Officer Hannah Smith.

Dan Ireland, left, and Hannah Smith (associate chief operating officer) discuss local issues at Clifton Springs Hospital.

years has been woefully neglected by the payor systems, the governmental payor systems as well. You’re getting Medicaid dollars that are 68 cents on the dollar — to cover the cost of healthcare. We see growing numbers of people on Medicaid. Something has to balance out there.”

Technology driving changes

He said the first things to change in healthcare will be spurred by technology.

“Finding different ways of interacting with patients. I think when we take artificial intelligence and layer it on top of that, we start allowing algorithms to help with decision making to pinpoint accuracy. I think those are the changes people haven’t embraced fully yet and maybe haven’t really contemplated. But those are things we’re anticipating looking at,” he said.

Ireland unwound a specific instance where artificial intelligence may come into play.

“We have shortages in many medical specialties out there — radiologists, pathologists — those type of roles. Some of that medical work can’t be fully replaced — but some of it can be augmented by AI. Reading radiology images as a first pass to lighten the load of the radiologist could help us. It’s being worked on and studied in England right now. Those are things I see we’re going to have to prepare for. We have to build structures to prepare for that.

“I think AI can help nurses at the bedside. There are so many functions that require multiple checks and involve multiple people and you don’t always have the people to do that. You want to shore that up and free up the time. Technology is going to free up time so our staff can focus on the right things and have more contact time with patients and less time doing administrative tasks.

“Having the nurse teaching a patient about that medication or teaching a patient about their therapy and using their nursing skillset — that’s top-of-license care, taking administrative tasks away from nurses. There was a time when you had nurses sitting at a desk answering phones. Unless they’re using that phone to make a clinical decision, you’re not leveraging their nursing skillset the way it was intended to be used. We want to take all those tasks off the table.

“Rochester General and Unity, for example, are using transfer robots now. Nurses used to run from the unit down to the pharmacy to get meds or down to the supply room

to get stuff. You want those nurses at bedside performing the clinical functions they were trained to do. Let the robot deliver the goods. They’re called MOXI units. They’re cool little guys.”

Ireland is convinced that hospitals will change from within, driven by the experts who work there.

“At Rochester Regional we developed our first center of innovation lab out at Batavia, rooms designed to bring staff in and have them ideate, come up with ways to make their work more efficient and only they can come up with those ideas. How do we change a routine on their unit? That’s not something I can change in my office or the board room, it’s got to come from them.”

Mark Soell, the former CEO of UMMC before the merger and still a board member, was Ireland’s mentor.

“Dan is very even-keeled, very energetic and ambitious. He is also a person who really cares about patients and our staff. His empathy with people and ability to connect with staff at every level of the organi zation is really excellent,” he said.

Now the direction of three hospitals is in Ireland’s hands.

“One of the most exciting things I do now is to focus on rural healthcare and the special needs we have in our community hospitals. I’m not doing open-heart surgery or brain surgery in our hospitals, but how can I leverage the more routine things that patients can get locally in our communities? How can I advocate for the resources to do that?”

As an example, he said more orthopedic procedures should be done in local, rural hospitals.

The best part of rehab is when it’s over. And ours is over 40% sooner.

At St. Ann’s, our goal is to get you healthy and home as soon as possible following surgery or a cardiac event. In fact, our average length of stay is 40% shorter than the national average. That means you’ll be back doing the things you enjoy before you know it.

“It won’t be acceptable to say those procedures should go to a bigger hospital. You need the bigger hospitals to do the complex procedures,” he said. “How do we prepare ourselves for the coming needs in rural healthcare and how do we manage resources that are finite?”

Getting professionals out to the burbs is another challenge.

Ireland is having none of that. For him — and he’s living proof — the reality is that there is opportunity and excellence in rural medicine.

“We have fantastic healthcare people here,” he said. “I work with some of the best clinicians, the most compassionate people that I have ever met who go to great lengths to make sure our patients are taken care of. I couldn’t be more honored. It’s what gets me up in the morning. I get to come in here and interact with people whom I know care…a lot of people go to jobs and don’t get to say that.”

Dan Ireland at the lobby area of Clifton Springs Hospital.

Addressing the Risks of Mobile Sports Betting

By Jennifer Faringer

When the Supreme Court opened the doors to mobile sports betting (MSB) in 2018, it laid the path for states to follow.

As of 2024, it has been legalized in 38 states. New York state legalized sports gambling in 2013 and went on

to legalize mobile sports betting in 2022, expanding the number of bets and gamblers exponentially. The state focused on the projected revenue that mobile sports betting would bring in, rather than the exponential increase in the numbers of individuals, fam-

ilies and communities impacted by this decision and the devastation of this addiction.

While problem gambling affects individuals of all ages, the greatest increase, according to a recent Siena College poll, was found in men aged 25 to 34. Of the young men who are placing bets online, half of the poll participants acknowledged that they are betting far over their limits. This affects teens and younger adults as well those who are betting on more than a favorite sport. Instead, they are seeking the action of placing bets on various plays, much more than the game itself. Betting on separate plays within a game is known as microbetting, which has increased in frequency with MSB.

Mobile sports betting utilizes artificial intelligence (AI), which is capable of drilling down to the individual gamblers' preferences to determine their betting data points. The industry looks at what offers are more attractive, what the push points are, the inducements that both attract and retain the gambler, and how to ensure a gambler will continue to gamble for longer periods with increasing wagers. Essentially, AI learns when an individual is most vulnerable.

It is important to remember we are dealing with an addiction that can devastate not only the individual gambler but also their families, their communities, and their places of

work.

The industry blames the gambler just as the tobacco companies several decades ago blamed the smoker for refusing to acknowledge the addictive nature of their product.

We are again dealing with an addictive product with few, if any, guardrails when it comes to MSB. A recent 60 Minutes interview described it as a ‘Wild West’ due to lack of controls in place.

Problem gambling help is available!

For more information and to access referral resources, visit the National Council on Alcoholism and Drug Dependence – Rochester Area’s website at www.ncadd-ra.org/ services/finger-lakes-addiction-resource-center/ and view the “Problem Gambling Services Directory” (https://ncadd-ra.org/wp-content/ uploads/2023/12/Problem-Gambling-for-9-Counties-Dec-2023.pdf).

Other resources are available through the Finger Lakes Problem Gambling Resource Center at https://nyproblemgamblinghelp. org/stop-gambling-near-me/.

Jennifer Faringer, MS Ed, CPP-G, is the director of the National Council on Alcoholism and Drug Dependence – Rochester Area (NCADD-RA).

Nonprofit Uses Fitness and Exercise to Fight Addiction

By Deborah Jeanne Sergeant

Recovery from substance abuse relies upon the right support.

That’s what Jonathan Westfall strives to offer at ROCovery Fitness, a community recovery outreach center where he serves as executive director.

The peer-led, largely volunteer-run programming helps people with substance use disorder develop coping mechanisms and prove that they can live a full life in sobriety.

ROCovery uses peers because “people with lived experience help others get through their substance use disorder, whether alcohol or illicit drugs or other addiction,” Westfall said.

All the programs, classes and events are free for anyone with 48 hours of continuous sobriety.

People wishing to participate in the programs must fill out a one-time membership questionnaire. Westfall said that the 48-hour sobriety requirement has proven motivational to participants.

“Our ultimate mission and goal

is to foster a safe, supportive and inclusive environment for recovery,” Westfall said. “We have folks who are pursuing an abstinence-based path and some who are more interested in harm reduction. When doing fitness activities in particular, sobriety is important for safety.”

Participants can use the gym facilities, enjoy the community center, chat with a peer and join in organized trips and events such as sledding, skiing and more.

ROCovery was founded in 2015 and Westfall has served as executive director since 2020.

About 150 new people join the membership monthly. In December 2023, 324 unique individuals participated at ROCovery, accounting for 1,232 experiences. The organization held 85 scheduled events.

“A lot of people experience a return to use or ‘relapse’ after leaving formal services,” Westfall said. “People get out of treatment or incarcerated. They’re forced to focus on sobriety and go back to everyday

life. It’s an abrupt change. We give a softer landing. We want to help rebuild natural social supports in a healthy way.”

Instead of returning to partying, bars and friends who are a bad influence, people in recovery can turn to ROCovery for socializing, building a support network and learning that they can enjoy sober life. Finding ways to get fit, active and learning help people build a new life away from substance use and spend their time in wholesome ways.

“The social aspect is a big point,” Westfall said. “They don’t have to be in shape or use the gym. We do all kinds of things like modern board games, open mic night, dinners and social gatherings. During times that are triggering moments like holidays, we provide a safe social environment for people who don’t have a family or whose family isn’t supportive. We do social things that aren’t fitness-based at all.”

Westfall has found that many people in recovery build good habits

on top of good habits. For example, if they reduce drug use, members find that they want to also take care of their dental health or receive a checkup with the Trillium Health Mobile clinic providers. Or if they cut back on alcohol, they want to work out more. That is part of the reason that ROCovery requires 48 hours of sobriety for participants. As they begin to join in the programs, they reduce use so that they can join the next event or work out at the gym. Westfall said that has led to sustained sobriety among members.

Grants, fundraisers and private donations provide funding for ROCovery Fitness. The biggest annual fundraiser is a 5K run, which attracts 600 participants in September.

The organization employs nine and the rest of the instructors, outreach staff and leaders are volunteers.

“We could not exist without our volunteers,” Westfall said.

LEFT: ROCovery Fitness’ participants. They can use the gym facilities, enjoy the community center, chat with a peer and join in organized trips and events such as sledding, skiing and more.

RIGHT: Jonathan Westfall is the executive director at ROCovery Fitness, a community recovery outreach center.

Is Your Kid Gambling Online? Poll Shows Most Parents Wouldn't Know

"Teens and young adults may have a difficult time going into a casino unnoticed but they have easy access to a variety of betting and gambling options," said Sarah Clark, co-director of C.S. Mott Children's Hospital National Poll on Children's Health. "This expanded accessibility has increased exposure to the risks of underage betting, but there is little regulation or conversation around this problem."

Just one in four parents who took part in the latest poll said they had talked to their teen about virtual betting.

More than half of parents who participated didn't know their state's legal age for online gambling, and one in six said they probably wouldn't know if their kids were betting online.

More than half of states — including New York — have legalized some form of online gambling in the wake of a 2018 U.S. Supreme Court ruling. Most restrict online sport and casino betting to people 21 years or older, but loopholes exist, along with concerns that teens may bypass security steps.

Clark likened online sports bet-

ting to fantasy football leagues and March Madness pools that are popular with sports fans, including kids.

"Many online gambling options will seem familiar to teens," Clark said in a news release. "They feel like games kids have been playing on their phones, including features like bonus points and rewards. That familiarity may make it harder for teens to appreciate the difference between playing for fun and playing for money."

The nationally representative poll is based on responses from 923 parents with at least one 14- to 18-year-old.

In all, 2% of respondents said they thought their teen had used an online betting platform, and more than half said they thought they would definitely know if their teen had been betting online.

Two-thirds said their teen has a bank account or debit or credit card in their own name that could be used to register for online betting — adding to the possibility that they could participate without their parents' knowledge.

"Parents may be underestimating their teen's interest and savviness," Clark said. "Online betting can be difficult to detect because a teen can easily log in on their smartphone or other personal device, delete the search history, hide the app or use it discretely."

Exposure to online gambling is widespread. More than six in 10 parents said they had heard or seen ads for online sports or casino betting.

Young people who engage in fantasy sports or gaming apps intended for adults may also see gambling ads. Clark noted these ads often feature

popular entertainers or athletes and often offer bonuses for continuing use.

"Teens may be especially susceptible to these ads, which are often marketed to convey feelings of excitement, endless possibilities, and social credit," she said.

Many parents are concerned about teen gambling risks.

Two-thirds of respondents said 21 should be the legal age for online betting. Twenty-two percent would prefer 18-20 years, while 11% said it should be illegal at any age.

Respondents expressed concerns about youth going into debt or developing a gambling addiction, and a quarter of those who had talked with their teen about online betting said they had highlighted those risks.

Some said they support strategies to minimize the risks, including restricted betting after a certain amount is lost; offering a "parent view" option to monitor online betting accounts; verifying legal age at sign up with a photo ID; limiting bets within a certain period; and paying treatment costs for young people who develop gambling addictions.

Talk to your teens, Clark urged.

"The ubiquity of gambling ads may offer parents an opportunity to initiate open, productive conversations with their teen about the risks of gambling and its prevalence in their social circles," she said. "Whether or not a child is actually using betting platforms, ongoing discussions may help them navigate the social pressures and media presence of gambling platforms."

Addiction

New Internet Addiction Spectrum: Where Are You on the Scale?

Young people (24 years and younger) spend an average of six hours a day online, primarily using their smartphones, according to research from the University of Surrey. Older people (those 24 years and older) spend 4.6 hours online.

Surrey's study, which involved 796 participants, introduces a new internet addiction spectrum, categorizing internet users into five groups:

•Casual Users (14.86%): This group mainly goes online for specific tasks and logs off without lingering. They show no signs of addiction and are generally older, with an average age of 33.4 years. They are the least interested in exploring new apps.

• Initial Users (22.86%): These individuals often find themselves online longer than they initially planned and are somewhat neglectful of household chores but don't consider themselves addicted. They are moderately interested in apps and have an average age of 26.1 years.

• Experimenters (21.98%): This group feels uneasy or anxious when not connected to the internet. Once they go online, they feel better. Experimenters are more willing to try

out new apps and technology, and their average age is between 22.8 and 24.3 years.

• Addicts-in-Denial (17.96%): These users display addictive behaviours like forming new relationships online and neglecting real-world responsibilities to be online. However, they won't admit to feeling uneasy when they're not connected. They are also quite confident in using mobile technology.

• Addicts (22.36%): This group openly acknowledges their internet addiction and recognizes its negative impact on their lives. They are the most confident in using new apps and technology. Their time online is significantly greater than that of the casual users.

Physician Brigitte Stangl, the lead author of the study at the University of Surrey, said:

"Our main aim was to clarify the difference between using the internet in a problematic way and being addicted to it. We found that the younger you are, the more likely you are to be addicted to the internet, and this tendency decreases with age.

"We also wanted to explore how

the severity of internet addiction affects users' experience with new, high-tech applications like augmented reality."

The researchers found no link between gender and online behaviour.

Additionally, higher levels of addiction correlated with more confidence in using mobile technology, particularly a greater willingness to try out new apps.

The study also discovered that emotional experiences (the emotions felt while using an app) strongly predicted future behaviour for all groups when interacting with aug-

mented reality.

In contrast, action experiences (navigating a website or playing a game) were mostly irrelevant for addicts.

Stangl concluded:

"Our study underscores the need for tailored interventions and support for individuals at various stages of internet addiction. The findings will certainly influence the design and development of digital services and AR applications, ensuring they cater to the diverse needs of users in the current digital environment."

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Overlooked Peanut Packs

Plenty of Nutrients

Pity the poor peanut.

Despite being America’s most popular nut, peanuts rarely get the nutritional shout-out its trendier cousins get. Perhaps it’s their association with ballparks that clouds our perception. Or circuses, state fairs and bars. Whatever the reason, it’s time to unpack the impressive nutrition found in every peanut.

sure normal and the heart rhythm steady.

Let’s begin with a peanut’s most salient nutrient: protein.

Did you know that peanuts have more plant protein than any other nut? One handful (about ¼ cup) has 10 complete grams, meaning it has all eight amino acids in sufficient amounts. While protein is certainly important for growth, tissue repair and recovery from exercise, it is equally important for something else: weight control. Studies show that because protein improves function of weight-regulating hormones, it reduces hunger, helping you eat fewer calories.

Peanuts, like most nuts, are exceptionally good for hearts. For starters, their mix of soluble and insoluble fiber helps prevent heart disease by lowering bad cholesterol levels. A peanut’s healthy fats do the same, while also reducing plaque build-up in arteries and decreasing triglycerides (unhealthy fats) in blood. What’s more, peanuts are a good source of magnesium, a crucial mineral that helps keep blood pres-

Another reason to reach for America’s favorite nut? When it comes to managing or thwarting Type 2 diabetes, peanuts are like a secret weapon: they taste great but don’t cause blood sugar to spike; they’re filling and so help with weight management (excess weight is No. 1 cause of this quiet epidemic); their plant proteins have been proven to reduce the risk of getting diabetes; and, they’re endorsed by the American Diabetes Association.

Although low in carbs, peanuts are high in calories—a handful (¼ cup) has about 200. But because they’re so satisfying, a modest amount may sate your hunger.

Coincidentally, March is National Peanut Month. Woo-hoo! Another reason to go nuts for nuts!

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Ginger Peanut Dressing

1½ tablespoons honey (more if prefer sweeter)

¼ cup olive oil

¼ cup unseasoned rice vinegar

1 tablespoon soy sauce

1 teaspoon Asian sesame oil

2 tablespoons peanut butter

1 teaspoon salt

1 teaspoon Sriracha sauce (optional)

1½ tablespoons minced fresh ginger

2 garlic cloves, minced

In a medium bowl, whisk together all of the ingredients for the dressing. Set aside.

Combine all of the slaw ingredients in a large mixing bowl. Add the dressing and toss well. Let the slaw sit for at least ten minutes so the vegetables have a chance to soak up the dressing. Taste and adjust sea-

Helpful Tips

If buying shelled roasted peanuts, read labels carefully and opt for no-salt or lightly salted versions. Store nuts in an airtight container in a cool place away from sunlight to preserve flavor and texture and prevent rancidity. Roasted peanuts last about a month but should be consumed within two weeks for best quality.

Slaw

10 cups shredded cabbage

2 cups shredded carrots

2 red bell peppers, thinly sliced into bite-sized pieces

1½ cups cooked and shelled edamame (more if preferred)

2 medium scallions, finely sliced (optional)

1 cup roasted peanuts, coarsely chopped

1 cup loosely packed fresh cilantro, chopped

sonings. Serve room temperature or cold. This slaw is best served fresh but leftovers will keep in a covered container in the refrigerator for a few days.

Make-Ahead Instructions:

The dressing can be prepared up to 2 days ahead of time; store in a covered container in the refrigerator.

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The New Teens

How the pandemic has shaped the way young teens think and act

By Deborah Jeanne Sergeant

During the pre-teen years, young people tend to develop much of their sense of self as they begin to identify less with their family and more with peers.

Youth who are young teens now had a stunted transition into their teen years as the pandemic curtailed many typical opportunities to interact with peers or else made them virtual experiences.

It’s unclear exactly how this different development will translate into how they relate to others in the future, but at this point, coming of age during the pandemic appears to mean many teens feel socially awkward at best.

“It’s exacerbated the already bigger levels of anxiety we’ve been seeing in teens and young adolescents,” said Ashley DiMino, licensed mental health counselor practicing in Rochester. “We were seeing higher levels before the pandemic and then two years of isolation gets in the way of their normal development.”

With few chances to practice interpersonal skills in normal settings, these young people feel less sure of themselves and less confident in their ability to navigate social situations. While DiMino feels pleased that

teens are better able to access mental health services, the pandemic’s outcomes also mean that teens need more help. DiMino said that many worry more about death, divorce,

ties by asking open-ended questions about how they feel and how their day has gone. But avoid approaching teens from the perspective of knowing how they feel and what they need.

“It’s helpful to share their own experience about what the transition was like to go back to work and socializing,” DiMino said. “Emotion coaching can be helpful. Talk with other parents and lean on their experience. Do what you can to be stable and healthy. It’s like on a plane: put your own air mask on before you help someone else. Encourage the

The Centers for Disease Control and Prevention reports that in 2021, 30% of teens reported that they’ve ever had sex, a drop of 8% from 2019 and a sizable plunge from 30 years ago, when over half of teens said they’d had sex.

their future and frightening world events.

Teens’ comfort with virtual interactions can help them operate effectively in an increasingly virtual world, where remote work and remote sessions become more mainstream; however, “we also need face-to-face skills,” DiMino said.

She encourages parents to prime the pump of their teens’ social abili-

kids to join something, do something outside of their room.”

Although parents may feel concern about the long-term effects of the pandemic on their children, DiMino remains optimistic and believes that teens’ resilience will carry them through to a healthy adulthood.

“I think it’s too early to see what kind of major effect it will have,” she

Colorectal Cancer: Incidence in Younger People Nearly Doubles

Researchers can’t fully explain the trend but nearly double the number of young adults are being diagnosed with colorectal cancer — and more are dying from the disease every year.

We interview colon and rectal surgeon Kristina Go of Upstate Cancer Center

By Barbara Pierce

Q: Isn’t colorectal cancer just something that older people are diagnosed with?

A: Though the frequency of colorectal cancer is decreasing in people older than 50, the incidence of colorectal cancer is increasing in male and female patients younger than 50. It’s the same kind of cancer, just shifted to a young age. Even as overall cancer deaths continue to fall in the U.S., the American Cancer Society reports for the first time that colon and rectal cancers have become leading causes of cancer death in younger adults. Younger people tend to be diagnosed at later stages of their cancer, when it is more aggressive, says the American Cancer Society online.

Q: Why are so many more young people being diagnosed with colorectal cancer?

A: We don’t fully understand why this is occurring. Several studies have identified that obesity, a sedentary lifestyle and diets that are high in fat, salt, red or processed meats are associated with young-onset colorec-

said. “There’s research on how it will affect their brains with high levels of cortisol. But it’s hard to say if it’s being a teen in 2024 or pandemic. The good news is that we’d use the same interventions whatever the causes.”

Another possible effect of the pandemic on teens is that fewer teens are having sex than before.

The Centers for Disease Control and Prevention reports that in 2021, 30% of teens reported that they’ve ever had sex, a drop of 8% from 2019 and a sizable plunge from 30 years ago, when over half of teens said they’d had sex.

Naturally, during the quarantine hookups among teens weren’t possible. And children remaining home from school curtailed meeting other teens and developing romantic connections. But DiMino isn’t sure if less sex is related to the pandemic or overall shifts in teens’ mindset.

“I’m seeing such maturity out of current-day teenagers,” she said. “There’s less risk-taking behavior. I’m not sure what that means. Social media gets a bad rap, but kids have more access to information, and they see the risks of those behaviors. They are taking long-term thinking into account. Teens’ brains are wired for short-term thinking.”

She encourages any family worried about their teens’ behavior to seek professional help.

“The worst thing is you have a counseling session with your teen, and they say everything is normal,” DiMino said. “We’d rather do that than see someone who could’ve used support.”

narrower than usual. Keep in mind that some patients have no symptoms at all before being diagnosed with colon cancer.

I recommend you see a doctor if you’re experiencing any of the above symptoms or if you’re due for colorectal cancer screening. Colorectal screening is recommended at age 45 if there is no family history of colorectal cancer. Patients with a history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) or a family history of colorectal cancer or polyps may need to have a colonoscopy sooner than age 45.

tal cancer. Additionally, some studies have suggested that our increased use of antibiotics — in comparison to what patients received before the 1950s — may also play a role in this. All of these factors can change the diversity of bacteria in one’s stool in a way that might promote inflammation and make a person more susceptible to developing colorectal cancer.

Physicians and researchers can’t fully explain the trend. And a combination of factors — including that young people don’t get regular screenings, are more likely to ignore symptoms and may not see a doctor regularly — can make diagnoses challenging. Diagnosing patients in this group is difficult.

Sadly, nobody knows for sure why colorectal cancer numbers are rising in young people.

Q: Why aren’t young people diagnosed earlier in the disease process?

A: Early detection saves lives. The earlier that a colorectal cancer is found, the better chance a patient has at surviving five years after being diagnosed.

Several factors stand in the way

of colorectal cancer diagnosis for young people. To start, people are often hesitant to mention bowel problems to family and friends, let alone a health care professional. And nearly half of young adults don’t have a primary health care professional. Many ignore early indicators because of their age; health care providers shrugged off their concerns for the same reason.

Q: What are symptoms that indicate one should consult a health care professional?

A: The most common symptoms are blood in the stool or rectal bleeding, long term abdominal pain, changes in stool habits (intermittent constipation and diarrhea), unexplained weight loss, stools that are

Right now, we recommend screening (doing a test in the absence of symptoms) starting at age 45. If someone younger than 45 is having the above symptoms, I urge them to speak to their health care provider for additional evaluation.

Several screening tests have been developed to find colorectal cancer before symptoms begin, when it may be more treatable. Some tests also allow polyps to be removed before they become cancer. Therefore, the screening is a form of cancer prevention in addition to early detection.

Colonoscopy screening is generally recommended starting at age 45. People with family histories of the illness may need to begin screening earlier. Many people are put off by the preparation for a colonoscopy, which includes taking a strong laxative the day before to clean out the bowels. But colonoscopy is considered the gold standard for diagnosing colorectal cancers, and it saves lives.

‘Epilepsy Diagnosis Hit Me Like a Ton of Bricks’

By Carter I.

Senior year at Victor Senior High School has been exciting so far.

I’m Carter I., a 18-year-old who’s enjoying every moment of it. My mom always says I’ve got big dreams of becoming an entrepreneur. I guess she’s right. I can totally see myself owning a gym someday. Staying fit and healthy is a huge part of who I am.

Life hasn’t exactly been a smooth ride for me and my family, though. Things took a scary turn when I was diagnosed with epilepsy back in third grade.

I remember my mom noticing my eyes fluttering behind my glasses. We thought it was a vision problem until the eye doctor referred us to my pediatrician, who then sent me straight to a neurologist.

That’s when it hit us like a ton of bricks — I had absence seizures, a form of epilepsy.

The journey since then has been a rollercoaster. Medications, countless doctor visits, and even enduring 24 seizures in 24 hours at one point—it’s been tough. But I’m grateful that for the past two and a half years, I’ve been seizure-free.

Back when I was first diagnosed, I didn’t want to talk about it. Seizures were this scary, taboo thing. But I’ve come to realize they’re just a small part of who I am. Camp EAGR played a huge role in boosting my confidence and changing my per-

spective. It was a turning point for me.

Camp EAGR isn’t just any camp; it’s specifically designed for kids aged 8 to 17 with epilepsy and their siblings. It’s part of EPI (Empowering People’s Independence).

One of the best things about it was that I didn’t have to miss out on any activities. With trained staff and a neurologist on site 24/7, we could do things we’d normally have to sit out of due to our epilepsy diagnosis. It felt liberating to swim, go horseback riding, and even try zip-lining—just like any other kid. Having the neurologist there around the clock gave my parents peace of mind. They knew I was safe and well taken care of.

At camp, I discovered I’m not alone. There are others like me, facing their own battles. It’s where I made new friends. And I am proud to say that I even became a counselor-in-training last summer.

I owe a lot to Camp EAGR and the support they’ve given me. And now, I’m eager to pay it forward by helping other families dealing with epilepsy. Who knows, maybe someday I’ll run my own camp, helping kids just like me find their confidence and strength.

Submitted by EPI. For more information visit www.epiny.org.

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Dentists' Group Issues New Pain-Control Guidelines for Teens, Adults

New guidelines from the American Dental Association (ADA) are cracking down on the use of opioids for tooth pain.

The guidelines say that non-steroidal anti-inflammatory drugs (NSAIDs) taken alone or alongside acetaminophen should be the firstline treatment for managing shortterm dental pain in teenagers and adults.

The available medical evidence indicates that those medications can effectively manage pain from a toothache or after a tooth removal, an ADA guideline panel concluded.

“We hope this clinical practice guideline will reduce the risk of opioid addiction, overdose and diversion,” Marta Sokolowska, deputy center director for substance use and behavioral health at the FDA's Center for Drug Evaluation and Research, said in an ADA news release.

A previous set of recommendations for pediatric patients was published in 2023.

Over-the-counter NSAIDs include aspirin, ibuprofen and naproxen sodium. There also are prescription-strength NSAIDs available for more severe pain.

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The guidelines also say that opioid painkillers should be prescribed under limited circumstances, after considering any risk factors for opioid misuse.

Dentists should avoid providing “just in case” opioid prescriptions for patients, and use extreme caution in prescribing opioids to teens and young adults, the guidelines say.

Patients also should be educated on proper storage and disposal of opioid drugs, according to the guidelines.

The guidelines were developed under a $1.5 million grant handed down by the U.S. Food and Drug Administration in 2020 to develop guidelines for handling dental pain in patients.

One

“It's important to take special consideration when prescribing any type of pain reliever, and now dentists have a set of evidence-based recommendations to determine the best care for their patients,” said senior author and panel chair Dr. Paul Moore, a professor emeritus at the University of Pittsburgh's School of Dental Medicine.

“Patients are encouraged to discuss pain management expectations and strategies with their dentist so they can feel confident that they are receiving the safest, most effective treatment for their symptoms,” Moore said.

The new guidelines appear Feb. 5 in the Journal of the American Dental Association.

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Dental Care

Dental Trauma Emergencies

Broken or displaced tooth? What to do before heading out to the dentist’s

By Deborah Jeanne Sergeant

Adental emergency is traumatic, as an acute injury to a tooth can be painful and disfiguring. For the best chances of a good outcome, follow these tips from area experts.

Tips from Linda Rasubala, associate professor and assistant director, Howitt Urgent Dental Care at Eastman Dental:

• “First, you need to save any pieces if the tooth breaks.

• “If you notice any bleeding, apply firm pressure with gauze or cloth to the area for 10-15 minutes or until the bleeding stops.

• “Call your dentist as soon as

possible during that time.

• “If your tooth was knocked out from its socket, try to put it back in place and ensure it faces the right way. If it won’t stay in the socket, you need to hold it in place on your way to the dentist or to an urgent dental care clinic.

• “You also can put the tooth into a small container with milk.

• “Seeing a dentist as soon as possible and placing the tooth back into its socket within one hour post-trauma has the highest chance of saving the tooth. If someone experiences facial trauma, such as a fall or assault, he or she should be evaluated by a dentist as quickly as possible to identify any possible face

bone fractures that may need urgent treatment.”

Tips from Renee Pellegrino, dentist with Rochester General Hospital Dental Center:

• “You need to determine or assess the extent of the injury. Is the injury localized to the tooth? Has the accident been bad enough where you think there could be other trauma, like head injury, concussion or the face is cut? Or you think you broke something. Check if the person is woozy and can’t answer correctly. There may be something higher order than a broken tooth. Then you need to see someone medical in the ED, if there’s trauma beyond the tooth.

• “If you have no other injury, then what I’d tell the parent or patient is to assess the break of the tooth. Not all breaks are created equally. Teeth have different layers. Depending on how severe the break is, the patient will report different symptoms. If it’s contained to the tooth only, call your dentist. They can provide an emergency visit. The tooth has three layers. The enamel is the white outer layer, then there’s dentin. The blush red is the nerve. The treatment modalities will depend on the layer. If the break is to the enamel, there won’t be pain.

• “If you don’t have a comprehensive dental provider, dental urgent care is recommended. Some ERs have limited dental capabilities to address discomfort but they won’t fix a tooth. Dentists have after-hours numbers or use a call center.

• “Evulsion is when the tooth is completely knocked out. It’s a very serious injury. We need to assess if it’s a primary baby tooth or an adult tooth. We don’t put baby teeth back in as it can obstruct the eruption of

the permanent tooth.

• “If you’re an active family and sports are a really big thing to you, you may want to consider Hank’s Balanced Solution, available on Amazon. It’s a storage medium for when teeth come out. You don’t want to leave the tooth out to dry if it’s been evulsed. Hank’s has a lot of the minerals that help that tooth try to survive. If you’re unsure if the tooth is baby or adult, save the tooth. You’d be surprised the number of people who don’t locate and bring the tooth.

• “If the tooth is dirty, don’t scrub it. You’ll scrub the fibers off you need to attach to the bone. If there is debris, use some milk or Hank’s to get the dirt off.

• “Never put the tooth in straight water. It doesn’t have the right mineral content and it can damage those fibers.

• “If you are positive that the tooth is an adult tooth and you feel you can get it back into the socket in the right position, I encourage you to try to do so. The critical time is about an hour. After an hour, the prognosis drops. Use finger pressure and get to the ER.

• “If the patient is old enough and you don’t feel comfortable repositioning the tooth, the best place is in your cheek with your own saliva. But you have to consider the patient’s age, that they won’t swallow it. You don’t want to put a tooth in someone else’s mouth. If someone can spit in the cup, you can store the tooth there.

• “When you bang teeth around, those are forceful injuries. Let your dentist know that you had this. It needs to be monitored. Sometimes the injury won’t show for years. You may notice that tooth becomes more sensitive. Or it becomes darker. Over time, the nerve of the tooth is changing. The extent can’t always be determined at that point.”

By Jim Miller

Easy-to-Use Dental Care Products for Elderly Seniors

Dear Savvy Senior,

I have arthritis and hand tremors that affects my grip strength and makes brushing my teeth difficult. I’ve read that electric toothbrushes can help make the job easier. Can you make any recommendations for seniors?

Arthritic Alice

Dear Alice,

For seniors who suffer from arthritis or have other hand weaknesses or tremors, an electric toothbrush is an often turned to solution for keeping your teeth clean. At the push of a button, an electric toothbrush will do everything but shake, rattle and roll to do the cleaning for you, and most come with a wide, slightly weighted handle and rubberized grip that make them easier and more comfortable to hold on to.

How to Choose

Tuesday,

a smartphone or tablet via Bluetooth to track brushing habits. What extra features do you want?

Best Electric Toothbrushes

According to Consumer Reports

— an independent, nonprofit product testing and research organization –the top electric toothbrushes for 2024 are the Oral-B iO 7 Series ($150); Oral B Genius X 10000 ($200); Bruush Electric Toothbrushes ($95); and the Philips Sonicare ProtectiveClean 6100 ($120). And the top rated low-cost electric toothbrush is the Brightline 86700 ($30).

The New York Times Wirecutter, another popular product reviewing service, rates the Oral-B Pro 1000 ($40) as the best electric toothbrush followed by the Philips Sonicare 4100 ($40).

Easier Flossing Tools

With dozens of different electric toothbrushes on the market today, here are several points to consider to help you choose: smartphone integrations and other features. How much are you willing to spend?

• Brushing action: Brush heads tend to be either “spinning” (they rotate very fast in one direction, then the other, and bristles may pulsate in and out) or “sonic” (they vibrate side to side). Both methods are effective and a matter of personal preference.

• Electric versus battery: Choose a brush with a built-in rechargeable battery and an electric charging station. They’re much more convenient and cost effective than toothbrushes that use replaceable batteries.

• Brushing timer: Since most dentists recommend brushing for two minutes (most adults average about 45 seconds), get an electric toothbrush with a built-in brushing timer — most have them. Some brushes will even split the two minutes onto four 30-second intervals and will notify you when it’s time to switch to a different quadrant of your mouth.

• Extra features: Most higher-priced electric brushes come with extra features like cleaning modes, pressure sensors, a charge-level display and more. There are even “smart” toothbrushes that connect to

If flossing has become challenging too, a good alternative to traditional string floss are floss picks. These are disposable plastic-handle tools that have floss threaded onto them, which makes them easier to hold and use. DenTek, Oral-B and others sell packages for a few dollars or check out the Listerine UltraClean Access Flosser, which comes with a toothbrush-like handle for a better reach.

Some other flossing products to consider that are easy on the hands are the WaterPik Power Flosser ($15), which gently vibrates to dislodge embedded food particles between your teeth. Or consider a water flosser, which use high-pressured pulsating water to remove food particles and plaque and will stimulate your gums in the process. WaterPik offers a variety of water flossing products at prices ranging between $40 and $140, as does Oral Breeze, which offers the Shower Breeze and Quick Breeze water flossers (around $40) that connects directly to your faucet or shower head.

All of these dental care products can also be found at your local pharmacy or retailer that sells personal care items or online.

Social Workers Make a New Environment Feel Like Home

By Danielle Guillemette

Think of the last time you visited someplace you'd never been before. You don't know the lay of the land, you haven't met the locals, you don't know the customs. It can be intimidating-unless you've got a reliable guide to show you the way.

That's similar to the role a social worker plays for people first entering a skilled nursing community. Social workers are uniquely trained in building relationships to know and understand the people they serve. This allows us to ensure an environment that supports each resident's individuality, comfort and dignity.

With March being National Social Worker Month, let's take a look at how social workers help elders make a smooth transition to a new environment.

When your loved one first enters a skilled nursing community, the social worker is one of the first people who will welcome them. For the new resident and their family, it's a whole new world with a lot of uncertainty. Like a trusted guide, the social worker is there to put them at ease. We're there to answer basic questions about the daily routine and who's who on the staff; equally important, we're happy to help you make your space your own, from where to hang your family photos to how best to organize your clothes.

That type of personal attention is what social workers pride themselves on. We know that every resident comes with their own individual background, life experiences and personal preferences. By talking with our residents and their families, we can make sure those things are reflected in the new environment. If you enjoy reading the newspaper each morning or sleeping late, we'll see to it that you can continue that. You don't have to change to fit us; we'll accommodate you and help you

feel at home.

The social worker will be there throughout the settling-in process and will be a frequent visitor, checking in and making sure you've got everything you need. We'll continue to be part of your care team which includes the nursing, dietary, therapeutic and life enrichment professionals who provide round-the-clock care and communicate regularly with you and your family.

The social worker is also your liaison to the in-house experts in areas such as finance, billing and Medicaid as well as our pastoral care team. We can also make arrangements with external resources (companion services, psychiatrists, neurologists, etc.) to be involved in a resident's care plan should that be necessary.

At St. Ann's, we focus on our residents' quality of life as an acknowledged Eden Alternative community. That means our approach to care puts the needs and preferences of each resident first. It also means that social workers and our colleagues work to combat the destructive forces of loneliness, boredom and helplessness that detract from our elders' health and well-being. That's part of the person-centered approach that is the hallmark of our care.

As social workers, it is our honor to be a part of our elders' lives and to make this stage of life meaningful and enjoyable.

Danielle Guillemette, BSW, is a social worker at St. Ann's Care Center at Cherry Ridge. She can be reached at dguillemette@ mystanns.com.

Social Security works with the Office of the Inspector General (OIG) to protect you from scams that use Social Security as bait. Section 1140 of the Social Security Act allows OIG to impose severe penalties against anyone who engages in misleading Social Security-related advertising or imposter communications.

For example, the OIG may impose a penalty against anyone who:

• Mails misleading solicitations that appear to be from or authorized by Social Security.

• Operates an imposter website or social media account designed to look like it belongs to or is authorized by Social Security.

• Sends emails or text messages or makes telephone calls claiming to be from Social Security.

• Sells Social Security’s free forms, applications, and publications without our written approval.

• Charges a fee for a service that Social Security provides free of charge without providing a clearly visible notice that Social Security provides the service for free.

If you receive a suspicious Social Security-related advertisement or imposter communication, please let us know immediately. We encourage you to report potential scams to the

OIG at oig.ssa.gov. You can also send an email to OIG.1140@ssa.gov.

Please try to capture as much information about the communication as you can. Here’s what you can do:

• For suspicious websites or social media accounts, take a screenshot of the webpage. Note the website address or social media link — and how you came across it.

• For emails and text messages, capture the entire message and any message links.

• For U.S. mail, retain the complete communication, including the outside envelope and all inserts.

• For telephone calls, note the caller identification phone number and any company name or callback number that the caller or recorded message provides.

This information will help OIG locate the source of the suspicious communication. You can review Section 1140 at www.ssa.gov/OP_ Home/ssact/title11/1140.htm. You can also check out our publication, “What You Need to Know About Misleading Advertising,” at www. ssa.gov/pubs/EN-05-10005.pdf.

Please share this information with friends and family and help us spread the word on social media!

New Hybrid CNA Class Expedites Training

Elemental Management Group’s program is bringing more workers into long-term care

The shortage of certified nurse assistants has challenged nearly all long-term care facilities since even before the pandemic.

These frontline workers provide essential services such as checking vital signs, helping move residents, assisting with grooming and other personal care and supporting nutrition.

Elemental Management Group, which operates Aaron Manor Rehabilitation and Nursing Center in Fairport and other senior facilities in Upstate New York, has developed a 75-hour hybrid nurse aide training program designed to help expedite CNA training, enabling students to complete the program in less than three weeks instead of 164 hours across four to six weeks.

Elemental’s program has been available for nearly a year and has introduced hundreds of new CNAs into the health care system who otherwise would have been unlikely to have completed a standard CNA program.

“It’s our dream come true that we’re the first to get this up and going,” said Judy Harding-Staelens, registered nurse and licensed nursing home administrator and regional director of operations for Elemental.

Elemental manages long-term care and assisted living facilities in locations throughout New York. Five of Elemental’s facilities operate the program.

“The hybrid program has been exciting as we understand the generation seeking work now wants faster training and are more tech savvy,” Harding-Staelens said.

Students may sign up and complete the classes on a phone or laptop and schedule in-person times for completing the more clinical, handson aspects of the training. Instructors can monitor students’ progress and are always available for questions and feedback via email or in real time via chat. The program’s flexibility makes it accessible to people who are already working and those who have families and other obligations on their time.

“It helps focus on the social economic factors that our students face,” said Peg Reith, registered nurse, regional nurse educator and CNA educator for Elemental. “There are young women joining in the workforce or middle-aged women. They can work at home while juggling their families, whether as caregivers or parents. This program has been very successful for them.”

It’s not that students of typical CNA programs lack the time to complete them. The big problem has been that the standard class times often conflict with when students have available time. Reith said that this timing and the length of the course caused many to drop out. Now Elemental runs a course every two weeks and can more quickly intro-

duce CNAs into the workforce.

The hybrid CNA program can accommodate up to 20 students, providing sufficient instructors are available for clinical time. Some industrious students complete the program in a week, but most take about three if they work at it for four to six hours on weekdays. Students unable to finish in the prescribed three weeks can jump into the next session without having to redo material previously covered.

Training CNAs for other organization

In addition to training its own CNAs, Elemental can offer outsourced training for other organizations, which offers Elemental another revenue stream beyond providing care.

Elemental has two packages. One provides training for educators who want to teach the hybrid CNA classes at their own facility. The other package completely handles the hybrid CNA classes as a third-party entity.

“We have a vested interest in this,” said Ryan Gilbartin, chief operating officer and licensed nursing home administrator at Elemental, which provides administrative support services to five nursing homes and two assisted living facilities.

Harding-Staelens said that the hybrid CNA program has enabled Elemental and other organizations to easily cross-train staff such as housekeeping and laundry personnel so that they can also perform hands-on duties, such as feeding residents.

“It puts more hands on your residents as they can get more oneon-one time,” Harding-Staelens said. “It helps for the CMS star rating for number of people per resident. It goes up as to how many direct staff

you have if they’re functioning as a CNA.”

Developed by the federal government, the CMS Five-Star Quality Rating System helps consumers compare long-term care options more easily. Legally, staff trained only as housekeeping or laundry workers are not permitted to provide any personal care to residents.

Reith said that occasionally, some people who are not familiar with the Moodle platform — or technology in general — don’t readily embrace the program. However, with a little coaching, she has not encountered any insurmountable problems. The program was written on a six-grade reading level to make it more accessible to students.

“I think it’s opened a door for us,” Harding-Staelens said. “Our goal is to get approval with the Department of Education to keep on going. The opportunities are endless.”

The next goal is launching a program to teach more types of skilled programs in a hybrid, accelerated model. In addition to helping alleviate the CNA staffing crisis, Elemental’s program provides an additional revenue stream to the company, which helps in light of stagnant Medicaid reimbursement for the past 15 years in the face of soaring inflation.

The initial start-up cost to train a facility’s educator is $7,500 and for each following month, $1,500. For organizations that want to outsource the entire program, it’s $1,200 per student.

“It’s very exciting,” Harding-Staelens said. “It’s a huge collaboration. I get to see a lot of families affected as they can gain steady employment. There’s joy in the life-changing things we’ve done for them.”

Ryan Gilbartin is chief operating officer and licensed nursing home administrator at Elemental Management Group.

Peg Reith, registered nurse, regional nurse educator and CNA educator for Elemental Management Group.

Health News

The Breast Cancer Coalition appoints new director

The Breast Cancer Coalition

Christina Thompson

recently announced that Christina Thompson, the organization’s current associate director, has been selected as the new executive director of the coalition, effective March 1. She succeeds Holly Anderson, who served as director for 23 years.

Since joining the nonprofit in January 2021, Thompson has exemplified empathic leadership, a capacity for strong community building, and a steadfast determination to advocate for breast and gynecologic cancer survivors, according to a news release.

“Christina’s strategic vision and great desire will help lead the coalition to new heights,” said Melinda Goldberg, chairwoman of the board of directors.

Thompson has contributed significantly to the growth of the coalition over the past three years, particularly in expanding the organization’s supportive and educational programming offered throughout 27 counties in Central and Western New York. Additionally, she has lent her guidance and insights to many

of the group’s initiatives, such as chairing the advocacy committee and providing major assistance with the research initiative.

“I am deeply honored and humbled to be appointed as the executive director of the Breast Cancer Coalition,” said Thompson.

The Breast Cancer Coalition of Rochester’s mission is to cultivate community among those touched by breast or gynecologic cancer; to empower informed decision-making through education, support, and advocacy; and to advance research in our region with the goal of eradicating breast cancer.

HCR Home Care adds therapy clinical manager

HCR Home Care has hired Vicki

Vicki Wilkins

Wilkins as therapy clinical manager for the Finger Lakes region. In this role, she supervises the day-to-day operations of an interdisciplinary team of social workers and physical, occupational and speech therapists to ensure appropriate clinical services.

Wilkins brings eight years of leadership experience and 30 years of clinical knowledge to the position, including 10 years in the home health care industry. Most recently,

Forbes: Excellus Among Best Midsize Employers in America

Excellus BlueCross BlueShield was ranked No. 8 on the Forbes 2024 list of America’s Best Midsize Employers.

This is the second consecutive year that Excellus BCBS has been named to the list.

“We’re thrilled to once again be named a top employer in the United States. It is thanks to our employees that we maintain an inclusive, supportive culture where we work collaboratively to ensure our members have access to high quality, affordable care,” said Excellus BCBS President and CEO Jim Reed.

“We remain committed to cultivating an environment where our employees can thrive by focusing on employee wellbeing, growth and development, diversity, equity and inclusion, comprehensive employee benefits, a flexible work environment and more,” Reed added.

This prestigious award is presented by Forbes and Statista Inc., a global data and business intelligence platform established in Germany in 2007.

America’s best employers are

identified using an independent survey from a vast sample of more than 170,000 U.S. employees working for companies employing at least 1,000 people within the U.S.

The final ranking is based on two types of evaluations:

• Personal Given by employees, also known as direct evaluations.

• Public Given by friends and family members of employees, or members of the public who work in the same industry, also known as indirect evaluations, with a much higher weighting for personal evaluations.

The ranking is divided into two lists of 600: one for the top large companies with more than 5,000 U.S. employees, and another for the top midsize companies with 1,000 to 5,000. Based on the results of the study, Excellus BCBS has been recognized on the Forbes list of America’s Best Midsize Employers 2024.

See Forbes’ full list of America’s best employers on Forbes.com.

she served as a physical therapist at a local hospital system.

Wilkins provides clinical expertise in geriatrics, orthopedics and manual therapy. She is a fellow of the Academy of Orthopedic Manual Physical Therapists and a member of the American Physical Therapy Association.

Wilkins earned a doctorate in physical therapy from Daemen College and a bachelor’s degree in physical therapy from West Virginia University. She also earned certifications as a geriatric clinical specialist and orthopedic clinical specialist from the American Board of Physical Therapy Specialists. She resides in Victor.

Physician joins Thompson’s Lima Family Practice

Physician Jennifer Albrecht

Jennifer Albrecht

recently joined UR Medicine

Thompson Health’s Lima Family Practice. A resident of Canandaigua, Albrecht is a graduate of the Midwestern University Chicago College of Osteopathic Medicine. She completed a residency in family medicine at Riverside Regional Medical Center in Newport News, Virginia, followed by a fellowship in primary care sports medicine at Virginia Tech in Blacksburg, Pennsylvania.

She worked as a family and osteopathic sports medicine physician at a primary care practice in Mooresville, North Carolina, prior to serving as a family and lifestyle medicine

May 5

physician at a Rochester Regional Health practice in Canandaigua from 2019 through 2023.

Board-certified in family and osteopathic sports medicine, Albrecht also holds a certificate of added qualifications in sports medicine. She has several professional memberships, including the American Academy of Family Physicians, the American Board of Family Medicine, the American Medical Society for Sports Medicine, the American Osteopathic Association of Sports Medicine, and the American Osteopathic Board of Family Physicians.

Three receive Thompson’s Service Excellence Award

UR Medicine Thompson Health recently named three of its associates as fourth-quarter 2023 Service Excellence Award winners.

Chosen for the honor by the health system’s service excellence team were:

• Sandy Irving of Canandaigua, a registered nurse from the hospital’s nursing floats department;

• Cheryl James of Naples, a registered nurse from the diagnostic imaging department;

• Cassandra Kling of Phelps, a radiology technologist from the diagnostic imaging department

The award acknowledges Thompson associates who consistently deliver exceptional service. A hospital team selects award recipients quarterly, after reviewing system leaders’ submissions of compliments from patients, families, and coworkers.

Each recipient is given points to be used on Thompson’s online shopping site and is featured in CEO presentations as well as on Thompson’s intranet site and in its internal newsletter.

CALENDAR HEALTH EVENTS of

Embrace Your Sisters holds fashion show to raise funds

Embrace Your Sisters (EYS) is hosting its annual Tea at Two Fashion Show May 5 at Casa Larga in Fairport. Attendees will be entertained with the refreshments, silent auction, music, speakers and models of the latest fashions.

Breast cancer patients living in Monroe County and 13 other surrounding counties can apply for emergency financial assistance

through EYS.

EYS is a nonprofit organization with a 501(c)(3) tax-exempt status. Its mission is to provide to provide support and hope to people in the communities struggling with breast cancer through financial assistance, education and informational resources.

The nonprofit organization fills a unique niche in breast cancer services by providing this support to residents, assisting with their daily living bills.

Tickets are now on sale at https://e.givesmart.com/events/ AaN/.

For more information, please visit: www.embraceyoursisters.org.